ATI RN
ATI Pharmacology Test Bank
1. A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?
- A. Stop the infusion.
- B. Call the provider.
- C. Elevate the head of the bed.
- D. Auscultate breath sounds.
Correct answer: A
Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.
2. A client is taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects?
- A. Increased TSH level
- B. Decreased ALT level
- C. Hypoglycemia
- D. Hyperlipidemia
Correct answer: D
Rationale: Hyperlipidemia, characterized by increased cholesterol and triglyceride levels, can occur as an adverse effect of Ritonavir. Monitoring lipid levels is essential to detect and manage this potential side effect in clients taking this medication for HIV infection.
3. A nurse is providing teaching to a client who has asthma and is beginning to take montelukast. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will use this medication as a rescue inhaler during asthma attacks.
- B. I should take this medication once daily in the evening.
- C. I need to have my blood levels checked regularly while taking this medication.
- D. I should take this medication before exercising to prevent bronchospasm.
Correct answer: B
Rationale: Montelukast is typically taken once daily in the evening for long-term control of asthma symptoms. It helps prevent asthma attacks by reducing inflammation in the airways. While montelukast can also be used for exercise-induced bronchospasm in some cases, it is generally not a rescue medication and should be taken regularly, not on an as-needed basis.
4. 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.
5. When teaching a client with a prescription for Loperamide for diarrhea, which instruction should the nurse include?
- A. Take the medication with a full glass of water.
- B. Avoid activities that require alertness.
- C. Expect abdominal pain and bloating.
- D. Take an additional dose after each loose stool.
Correct answer: B
Rationale: The correct instruction the nurse should include when teaching a client with a prescription for Loperamide is to 'Avoid activities that require alertness.' Loperamide can cause drowsiness, so clients should avoid such activities until they know how the medication affects them.
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