ATI RN
ATI Pharmacology Proctored Exam 2024
1. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)
- A. Increased renal secretion
- B. Increased medication-metabolizing enzymes
- C. Liver failure
- D. Peripheral vascular disease
Correct answer: C
Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.
2. A patient is receiving spironolactone for heart failure. Which of the following findings should the nurse report to the provider?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hyponatremia
- D. Hypokalemia
Correct answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia due to its mechanism of action. Hyperkalemia, or elevated potassium levels, can result in serious cardiac complications and requires immediate medical attention. Therefore, the nurse should promptly report any signs or symptoms of hyperkalemia to prevent potential adverse outcomes in the patient. Choices B, C, and D are incorrect because spironolactone is not associated with hypernatremia, hyponatremia, or hypokalemia. Hyperkalemia is the critical finding that the nurse should report in a patient receiving spironolactone.
3. A client has a new prescription for Digoxin to treat heart failure. Which of the following findings should the nurse monitor as an adverse effect?
- A. Visual disturbances
- B. Dry cough
- C. Confusion
- D. Urinary retention
Correct answer: A
Rationale: Visual disturbances, such as blurred or yellow vision, can be an early sign of digoxin toxicity. Monitoring for visual changes is crucial to detect and prevent potential adverse effects of digoxin. Dry cough, confusion, and urinary retention are not commonly associated adverse effects of digoxin and are not typically monitored in relation to this medication.
4. When teaching a client with a new prescription for Lisinopril, which instruction should the nurse include?
- A. Take the medication with food.
- B. Expect a persistent, dry cough.
- C. Increase your intake of potassium-rich foods.
- D. Take the medication at bedtime.
Correct answer: B
Rationale: The correct answer is B: 'Expect a persistent, dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent, dry cough as a side effect. This should be reported to the healthcare provider if it becomes bothersome. It is essential for the nurse to educate the client about this potential side effect so the client is aware and can seek appropriate guidance if needed. Choices A, C, and D are incorrect. Taking Lisinopril with food is not required. Increasing potassium-rich foods is not a specific instruction for Lisinopril, and taking the medication at bedtime is not a typical recommendation associated with this medication.
5. A client has a prescription for Prednisone for the treatment of Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will increase my intake of potassium-rich foods.
- B. I should take my medication with food.
- C. I will decrease my intake of calcium-rich foods.
- D. I should avoid eating grapefruit while taking this medication.
Correct answer: A
Rationale: The correct answer is A. Prednisone can cause hypokalemia, leading to low potassium levels. Increasing the intake of potassium-rich foods helps prevent this imbalance. Choices B, C, and D are incorrect because taking Prednisone with food, decreasing calcium-rich foods, or avoiding grapefruit are not specifically related to addressing the side effect of hypokalemia associated with Prednisone.
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