ATI RN
Proctored Pharmacology ATI
1. A client has a new prescription for Warfarin for atrial fibrillation. Which of the following findings should the nurse report to the provider immediately?
- A. INR of 4.0
- B. Potassium level of 4.5 mEq/L
- C. Sodium level of 140 mEq/L
- D. Creatinine level of 1.0 mg/dL
Correct answer: A
Rationale: An INR of 4.0 is above the therapeutic range for a client on Warfarin, indicating an increased risk of bleeding. This finding requires immediate reporting to the provider for appropriate intervention to prevent complications associated with excessive anticoagulation. Potassium, sodium, and creatinine levels are within normal ranges and are not directly related to the risk of bleeding in a client on Warfarin therapy.
2. A client is taking atorvastatin for hyperlipidemia. Which of the following findings should the nurse report to the provider immediately?
- A. Headache
- B. Nausea
- C. Muscle pain
- D. Diarrhea
Correct answer: C
Rationale: Muscle pain should be reported immediately as it can indicate rhabdomyolysis, a severe adverse effect of atorvastatin. Rhabdomyolysis is characterized by muscle pain, weakness, and can lead to serious complications such as kidney damage, making it crucial for the nurse to notify the provider promptly. Headache, nausea, and diarrhea are common side effects of atorvastatin and do not require immediate reporting unless severe or persistent.
3. When teaching a client with a new prescription for Lithium, which instruction should the nurse include?
- A. Restrict fluid intake to 1,000 mL per day.
- B. Maintain a consistent sodium intake.
- C. Take the medication at bedtime.
- D. Expect to have frequent headaches.
Correct answer: B
Rationale: Maintaining a consistent sodium intake is crucial when taking Lithium to help regulate lithium levels in the body and prevent toxicity. Sodium levels can impact the effectiveness and safety of Lithium therapy. Restricting fluid intake to 1,000 mL per day (Choice A) is not appropriate and could lead to dehydration. Taking the medication at bedtime (Choice C) may vary depending on the individual's schedule but is not a critical instruction. Expecting to have frequent headaches (Choice D) is not a common side effect of Lithium.
4. 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.
5. A client with Subacute Bacterial Endocarditis is receiving Streptomycin IM among other antibiotics. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?
- A. Extremity paresthesias
- B. Urinary retention
- C. Severe constipation
- D. Complex partial seizures
Correct answer: A
Rationale: The correct answer is extremity paresthesias. Streptomycin, used to treat infections like Subacute Bacterial Endocarditis, can cause paresthesias in the hands and feet as an adverse effect. Monitoring for this symptom is vital to detect and manage it promptly. Choices B, C, and D are incorrect because urinary retention, severe constipation, and complex partial seizures are not commonly associated adverse effects of Streptomycin.
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