ATI RN
ATI Pharmacology Proctored Exam 2023
1. How should a client prevent systemic absorption of Timolol eye drops according to the nurse's instructions?
- A. Bony orbit
- B. Nasolacrimal duct
- C. Conjunctival sac
- D. Outer canthus
Correct answer: B
Rationale: The correct technique to prevent systemic absorption of eye drops is to press on the nasolacrimal duct while instilling them. By doing so, the lacrimal punctum gets temporarily blocked, reducing drainage into the nasolacrimal duct and systemic circulation. This method helps enhance the localized effect of the medication and decreases the risk of systemic side effects. Choices A, C, and D are incorrect as they do not play a direct role in preventing systemic absorption of the eye drops.
2. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?
- A. Bursitis
- B. Sinusitis
- C. Depression
- D. Glaucoma
Correct answer: D
Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma, as it can worsen the condition. Glaucoma is a condition characterized by increased intraocular pressure, and using Oxybutynin can further elevate this pressure, potentially leading to serious complications such as vision impairment or damage to the optic nerve. Choices A, B, and C are incorrect as bursitis, sinusitis, and depression are not contraindications for Oxybutynin use. Therefore, the correct answer is D, Glaucoma.
3. A client has a new prescription for Zolpidem. Which of the following instructions should the nurse include?
- A. Notify the provider if you plan to become pregnant.
- B. Take the medication 1 hour before planning to go to sleep.
- C. Allow at least 6 hours for sleep when taking zolpidem.
- D. Do not take zolpidem with a bedtime snack.
Correct answer: A
Rationale: Zolpidem is classified as Pregnancy Risk Category C. It is important for the client to inform the provider if they plan to become pregnant because the medication may need to be adjusted or changed to ensure the safety of the fetus. This communication allows for appropriate monitoring and adjustments to be made to the treatment plan. Choice B is incorrect because zolpidem should be taken just before going to bed, not specifically 1 hour before. Choice C is incorrect as zolpidem is a short-acting medication, and it does not require a full 6 hours for sleep. Choice D is incorrect because zolpidem can be taken with or without food, so taking it with a bedtime snack is not contraindicated.
4. A client has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?
- A. Sedation
- B. Nasal congestion
- C. Productive cough
- D. Constipation
Correct answer: B
Rationale: The correct answer is B: Nasal congestion. After more than 5 days of use, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion. This occurs due to prolonged vasoconstriction of nasal blood vessels, causing worsening nasal congestion. Sedation (choice A) is not a common adverse effect of phenylephrine nasal drops. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with this medication.
5. A client is receiving spironolactone. Which of the following findings should the nurse report to the provider?
- A. Serum Sodium 144 mEq/L
- B. Urine output 120 mL in 4 hrs
- C. Serum Potassium 5.2 mEq/L
- D. Blood Pressure 140/90 mmHg
Correct answer: C
Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to potassium retention. The nurse should notify the provider and withhold the medication to prevent further elevation of potassium levels, which can result in serious cardiac complications. The other findings (Serum Sodium 144 mEq/L, Urine output 120 mL in 4 hrs, and Blood Pressure 140/90 mmHg) are within normal ranges and not directly related to spironolactone therapy.
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