ATI RN
ATI Proctored Pharmacology Test
1. A client has a new prescription for Diltiazem. Which of the following statements should the nurse include in the teaching?
- A. This medication may cause dry mouth.
- B. You should avoid drinking grapefruit juice.
- C. You may experience a rapid heart rate.
- D. Increase your intake of fiber-rich foods.
Correct answer: B
Rationale: The correct statement to include when teaching a client about Diltiazem is to avoid drinking grapefruit juice. Grapefruit juice can increase the levels of diltiazem in the blood, leading to potential toxicity and increased side effects. It is important for the client to be aware of this interaction to ensure the safe and effective use of the medication. Option A is incorrect because dry mouth is not a common side effect of Diltiazem. Option C is incorrect because Diltiazem is actually used to treat rapid heart rates. Option D is unrelated to the medication and not relevant to the teaching.
2. A client with active pulmonary tuberculosis (TB) is to be started on intravenous rifampin therapy. The client should be informed by the nurse that this medication can cause which of the following adverse effects?
- A. Constipation
- B. Black-colored stools
- C. Staining of teeth
- D. Body secretions turning a red-orange color
Correct answer: D
Rationale: The correct answer is D: Body secretions turning a red-orange color. Rifampin is known to cause body secretions, such as urine, sweat, tears, and sputum, to turn a harmless red-orange color. This is a common and expected side effect of rifampin therapy. Choices A, B, and C are incorrect. Constipation is not a common adverse effect of rifampin. Black-colored stools and staining of teeth are not associated with rifampin therapy. It is important for the nurse to educate the client about the harmless red-orange discoloration that may occur with this medication.
3. Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:
- A. Headaches
- B. Cold remedy
- C. Neuropathic pain
- D. Antianxiety
Correct answer: C
Rationale: Phenytoin, an antiarrhythmic and anticonvulsant medication, is also used off-label for treating neuropathic pain. While its primary indications are for managing heart rhythm disorders and seizures, it has shown efficacy in managing neuropathic pain, expanding its clinical utility. Choices A, B, and D are incorrect as phenytoin is not commonly used for headaches, cold remedies, or antianxiety purposes.
4. A client has a new prescription for Efavirenz, an NNRTI. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime to prevent drowsiness.
- B. Take this medication with a glass of milk.
- C. Take this medication with a glass of juice.
- D. Take this medication at the same time every day.
Correct answer: A
Rationale: The correct instruction is to take Efavirenz at bedtime to prevent drowsiness and manage central nervous system side effects like dizziness and vivid dreams. While it is important to take the medication at the same time daily for consistent blood levels, the emphasis should be on bedtime to minimize the impact of these side effects. Choices B and C suggesting taking the medication with milk or juice are incorrect and not relevant to optimizing Efavirenz therapy.
5. A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?
- A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
- B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
- C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
- D. Draw a peak level at 0900 and a trough level at 2100.
Correct answer: C
Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.
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