ATI RN
Proctored Pharmacology ATI
1. A client has been prescribed Prednisone for asthma. Which of the following instructions should the nurse include in the teaching?
- A. Take this medication with food to prevent nausea.
- B. Take this medication at bedtime to reduce drowsiness.
- C. Take this medication in the morning to reduce insomnia.
- D. Avoid sudden changes in position.
Correct answer: C
Rationale: Prednisone is best taken in the morning to reduce the risk of insomnia, a common side effect of corticosteroids. Instructing the client to take the medication in the morning aligns with the goal of minimizing the impact of insomnia, which can disrupt sleep patterns and affect overall well-being. Choices A, B, and D are incorrect. Taking Prednisone with food does not primarily focus on preventing nausea; taking it at bedtime does not primarily reduce drowsiness, and avoiding sudden changes in position is not a specific instruction related to Prednisone use for asthma.
2. A client has a prescription for Acyclovir. Which of the following instructions should the nurse include?
- A. Expect to take this medication long-term.
- B. Increase fluid intake during therapy.
- C. Avoid sexual contact while on this medication.
- D. Consult your healthcare provider if you experience nausea.
Correct answer: B
Rationale: The correct instruction for a client taking Acyclovir is to increase fluid intake during therapy. Acyclovir can cause nephrotoxicity, potentially leading to kidney damage. Increasing fluid intake helps prevent this adverse effect by promoting adequate renal function and drug elimination. Choices A, C, and D are incorrect. Acyclovir is usually prescribed for short-term use, there is no need to avoid sexual contact while on the medication, and nausea is not a common side effect that necessitates immediate consultation with a healthcare provider.
3. A client is being taught by a nurse about long-term use of oral prednisone for chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Weight Gain
- B. Nervousness
- C. Bradycardia
- D. Constipation
Correct answer: A
Rationale: Weight gain is a common adverse effect of long-term prednisone use. Prednisone, a corticosteroid medication, can cause fluid retention and increased appetite, leading to weight gain. Nervousness (choice B) is more commonly associated with stimulant medications or excessive caffeine intake. Bradycardia (choice C) refers to a slow heart rate and is not a typical adverse effect of prednisone. Constipation (choice D) is not a common side effect of prednisone; in fact, prednisone is more likely to cause gastrointestinal issues such as increased appetite and weight gain.
4. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?
- A. Spironolactone
- B. Furosemide
- C. Hydrochlorothiazide
- D. Bumetanide
Correct answer: A
Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.
5. 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.
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