ATI RN
ATI Proctored Pharmacology Test
1. 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.
2. A client has a new prescription for Trimethoprim-sulfamethoxazole. Which of the following information should the nurse include?
- A. Take the medication on an empty stomach.
- B. Maintain a fluid restriction while taking it.
- C. Take it with food.
- D. Stop taking it when manifestations subside.
Correct answer: C
Rationale: The correct answer is C: 'Take it with food.' Trimethoprim-sulfamethoxazole can cause gastrointestinal upset, and taking it with food helps reduce the risk of stomach irritation. It should not be taken on an empty stomach. Maintaining good hydration is important to prevent kidney-related side effects, so maintaining a fluid restriction, as in choice B, is not appropriate. Additionally, stopping the medication when manifestations subside, as in choice D, is incorrect as antibiotics should be taken for the full prescribed course to ensure eradication of the infection and to prevent antibiotic resistance.
3. A healthcare professional is educating a client about the adverse effects of Metformin. Which of the following adverse effects should the healthcare professional include?
- A. Lactic acidosis.
- B. Hypoglycemia.
- C. Hyperlipidemia.
- D. Weight gain.
Correct answer: A
Rationale: The correct answer is A: Lactic acidosis. Lactic acidosis is a rare but severe side effect of Metformin, particularly in individuals with renal or liver issues. It is crucial for clients taking Metformin to be aware of the symptoms of lactic acidosis, such as muscle pain, weakness, trouble breathing, stomach discomfort, and feeling cold. Choice B, hypoglycemia, is not a common adverse effect of Metformin but can occur when combined with other antidiabetic medications. Choice C, hyperlipidemia, is not a typical adverse effect of Metformin. Choice D, weight gain, is not associated with Metformin use; in fact, Metformin is often associated with weight loss or weight neutrality.
4. A client has a prescription for Timolol eye drops for the treatment of glaucoma. Which of the following instructions should the nurse include?
- A. Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application.
- B. Avoid blinking immediately after instilling the drops.
- C. Keep your eyes closed for 5 minutes after application.
- D. Administer the drops directly onto the cornea.
Correct answer: A
Rationale: The correct instruction for the nurse to include is to apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application. This technique helps prevent systemic absorption of the medication, reducing the risk of systemic side effects. By applying pressure, the drainage of the medication into the bloodstream through the nasolacrimal duct is minimized, enhancing the drug's local ocular effects. Choices B, C, and D are incorrect because blinking immediately after instilling the drops, keeping eyes closed for 5 minutes, and administering the drops directly onto the cornea are not recommended practices for administering Timolol eye drops.
5. A client has a new prescription for Beclomethasone. Which of the following instructions should the nurse include in the teaching?
- A. Take the medication with meals.
- B. Increase your intake of calcium-rich foods.
- C. Rinse your mouth after each use.
- D. Limit fluid intake while taking this medication.
Correct answer: C
Rationale: The correct answer is C: 'Rinse your mouth after each use.' Beclomethasone can cause oral candidiasis (thrush) as an adverse effect. Rinsing the mouth after each use helps reduce the risk of developing thrush by removing any residue of the medication from the mouth, which can promote fungal growth. Choices A, B, and D are incorrect. Taking the medication with meals, increasing calcium-rich foods intake, or limiting fluid intake are not specific instructions related to minimizing the side effect of oral candidiasis associated with Beclomethasone.
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