ATI RN
ATI Proctored Pharmacology 2023
1. A nurse is providing discharge teaching to a client who has a new prescription for Warfarin. Which of the following statements should the nurse include?
- A. You should avoid taking aspirin for headaches while on this medication.
- B. You should use a soft toothbrush to brush your teeth.
- C. You should avoid foods that are rich in vitamin K.
- D. You should avoid prolonged exposure to sunlight.
Correct answer: B
Rationale: The correct statement to include in discharge teaching for a client prescribed Warfarin is to use a soft toothbrush to prevent gum bleeding. Warfarin is an anticoagulant that increases the risk of bleeding, so using a soft toothbrush can help prevent gum injury and bleeding. Choice A is incorrect because aspirin, another blood-thinning medication, should generally be avoided while on Warfarin to reduce the risk of bleeding. Choice C is incorrect because clients on Warfarin should maintain a consistent intake of vitamin K-rich foods rather than avoid them completely. Choice D is unrelated to the medication and not a priority teaching point for a client prescribed Warfarin.
2. A client with cirrhosis is about to receive a dose of lactulose. The client questions the need for the medication, stating they are not constipated. The nurse should explain that lactulose is used in cirrhosis to reduce levels of which component in the bloodstream?
- A. Glucose
- B. Ammonia
- C. Potassium
- D. Bicarbonate
Correct answer: B
Rationale: Lactulose is administered to clients with cirrhosis to lower blood ammonia levels, thus aiding in the prevention of hepatic encephalopathy. Elevated ammonia levels in cirrhosis can lead to cognitive impairment and hepatic encephalopathy. Therefore, the correct answer is B (Ammonia). Glucose (Choice A) is not the component targeted by lactulose in cirrhosis. Potassium (Choice C) and Bicarbonate (Choice D) are not directly affected by lactulose administration in cirrhosis.
3. A healthcare professional is about to administer Propranolol to a patient. The healthcare professional takes the patient's apical pulse and documents it as 58 bpm. How should the healthcare professional proceed?
- A. Administer the medication as prescribed
- B. Administer half of the normal dose
- C. Consider the extended-release form of the medication
- D. Withhold administration of the medication and notify the healthcare provider
Correct answer: D
Rationale: When a patient's apical pulse is 58 bpm, it is below the normal range. Propranolol is a beta-blocker that can further lower the heart rate. Therefore, it is crucial to withhold the medication and notify the healthcare provider to evaluate the patient's condition. Administering Propranolol in this situation can exacerbate bradycardia, leading to serious complications. Choosing to administer the medication as prescribed (Choice A) can put the patient at risk. Administering half of the normal dose (Choice B) without healthcare provider guidance is not appropriate in this case. Considering the extended-release form of the medication (Choice C) does not address the immediate concern of bradycardia and is not the best course of action.
4. When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?
- A. Expect the development of a mild rash.
- B. Take the medication on an empty stomach.
- C. Monitor for signs of gingival hyperplasia.
- D. Increase your intake of calcium.
Correct answer: C
Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.
5. A client has a new prescription for colchicine to treat gout. Which of the following instructions should be included?
- A. Take this medication with food if nausea develops.
- B. Monitor for muscle pain.
- C. Expect to have increased bruising.
- D. Increase your intake of grapefruit juice.
Correct answer: B
Rationale: Monitoring for muscle pain is crucial when taking colchicine because it can lead to rhabdomyolysis, a serious condition characterized by muscle breakdown. This adverse effect needs prompt identification to prevent complications. Choices A, C, and D are incorrect because taking colchicine with food, experiencing increased bruising, or increasing grapefruit juice intake are not relevant instructions for a client prescribed colchicine for gout.
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