ATI RN
Proctored Pharmacology ATI
1. A client has a new prescription for Ondansetron for nausea and vomiting associated with chemotherapy. Which of the following statements should the nurse include?
- A. Take this medication one hour before chemotherapy.
- B. You may experience a headache while taking this medication.
- C. Increase your intake of potassium while taking this medication.
- D. This medication may cause temporary hearing loss.
Correct answer: B
Rationale: The correct statement the nurse should include is that the client may experience a headache while taking Ondansetron. Headache is a common side effect of this medication, and clients need to be informed about this potential adverse reaction to enhance their understanding and management of side effects. The other statements are incorrect because Ondansetron is usually taken 30 minutes before chemotherapy, not one hour before (choice A). There is no specific need to increase potassium intake while taking Ondansetron (choice C), and temporary hearing loss is not a common side effect associated with this medication (choice D).
2. A client is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion?
- A. I signed up for a swimming class.
- B. I've been taking an antacid to help with indigestion.
- C. I've lost 2 pounds since my appointment 2 weeks ago.
- D. The naproxen is easier to take when I crush it and put it in applesauce.
Correct answer: B
Rationale: The client stating that they have been taking an antacid to help with indigestion while on naproxen requires further discussion. This statement suggests potential gastrointestinal distress or interactions between the medications. Antacids can affect the absorption of naproxen or lead to other complications. Therefore, the nurse should address this statement with the client to ensure safe and effective medication management. Choices A, C, and D do not raise immediate concerns related to the client's medication regimen and can be considered positive health behaviors or side effects of treatment that do not require immediate intervention.
3. A client is taking Warfarin for atrial fibrillation. Which of the following client statements indicates a need for further teaching?
- A. I will avoid eating broccoli.
- B. I will use an electric razor to shave.
- C. I will take aspirin for headaches.
- D. I will have my blood tested regularly.
Correct answer: C
Rationale: The correct answer is C. Taking aspirin along with Warfarin can increase the risk of bleeding. Clients should be advised to avoid medications that increase the risk of bleeding when taking Warfarin to prevent complications. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding foods high in Vitamin K, using an electric razor to prevent cuts that can lead to bleeding, and regular blood testing to monitor Warfarin levels are all important aspects of managing Warfarin therapy.
4. Which drug undergoes extensive first-pass hepatic metabolism?
- A. Heparin
- B. Insulin
- C. Propranolol
- D. Nitroglycerin
Correct answer: C
Rationale: Propranolol undergoes extensive first-pass hepatic metabolism in the liver. When administered orally, propranolol is extensively metabolized by the liver before reaching systemic circulation, leading to reduced bioavailability. This process is known as first-pass hepatic metabolism, which significantly affects the drug's effectiveness and necessitates higher oral doses compared to other routes of administration. Heparin (Choice A) is not metabolized by the liver but excreted unchanged by the kidneys. Insulin (Choice B) is a peptide hormone that is not subject to significant first-pass metabolism. Nitroglycerin (Choice D) is primarily metabolized in the blood and tissues, bypassing significant first-pass metabolism in the liver.
5. A client with a urinary tract infection (UTI) is prescribed ciprofloxacin. Which instruction should the nurse provide to the client?
- A. If the medication causes an upset stomach, take an antacid at the same time.
- B. Increase your daily fluid intake while taking this medication.
- C. This medication can cause photophobia, so avoid direct sunlight exposure.
- D. You should report any tendon discomfort you experience while taking this medication.
Correct answer: D
Rationale: The correct answer is D. Tendon discomfort is a potential side effect of ciprofloxacin that can lead to tendon rupture and should be reported immediately to prevent serious complications. Monitoring for this adverse effect is crucial for patient safety. Choices A, B, and C are incorrect because: A) Taking an antacid with ciprofloxacin can interfere with its absorption. B) Increasing fluid intake is generally a good recommendation but not specifically related to the side effects of ciprofloxacin. C) Photophobia is not a common side effect of ciprofloxacin; therefore, avoiding direct sunlight exposure is not necessary.
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