ATI RN
ATI Pharmacology Test Bank
1. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?
- A. Uroprotectant agent, such as mesna
- B. Opioid, such as morphine
- C. Loop diuretic, such as furosemide
- D. H1 receptor antagonist, such as diphenhydramine
Correct answer: A
Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.
2. A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
- A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
- B. I will call the provider to get a prescription for discontinuing the IV heparin today.
- C. Both heparin and warfarin work together to dissolve the clots.
- D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.
Correct answer: A
Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.
3. A healthcare professional is caring for a group of clients receiving antimicrobial therapy. Which of the following clients should the professional plan to monitor for manifestations of antibiotic toxicity?
- A. An adolescent client with a sinus infection
- B. An older adult client with prostatitis
- C. A client who is postpartum with mastitis
- D. A middle-aged client with a urinary tract infection
Correct answer: B
Rationale: An older adult client with prostatitis who is receiving antibiotics should be monitored for toxicity due to age-related reductions in medication metabolism and excretion. Older adults are more susceptible to antibiotic toxicity, making them a high-risk group for adverse effects.
4. A healthcare professional is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion. Which of the following results indicates that the heparin infusion should be increased?
- A. aPTT of 90 seconds
- B. Platelet count of 150,000/mm³
- C. INR of 1.0
- D. Hgb of 15 g/dL
Correct answer: A
Rationale: An aPTT of 90 seconds is above the therapeutic range for heparin, which typically falls between 60-80 seconds. This indicates that the current heparin dose is too high, and the infusion rate should be decreased to avoid excessive anticoagulation and the risk of bleeding. Monitoring aPTT is crucial in adjusting heparin therapy to maintain it within the therapeutic range.
5. A client with peptic ulcer disease is prescribed sucralfate. Which of the following instructions should the nurse include?
- A. Take sucralfate with meals.
- B. Take sucralfate 1 hr before meals.
- C. Take sucralfate with antacids.
- D. Take sucralfate 2 hours after meals.
Correct answer: B
Rationale: The correct instruction for taking sucralfate is 1 hour before meals. This timing allows sucralfate to effectively coat the stomach lining and provide a protective barrier against gastric acid, helping to prevent ulcers.
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