ATI RN
ATI Pharmacology Proctored Exam
1. A client in the operating room received a dose of Succinylcholine, leading to muscle rigidity and a sudden rise in body temperature. The nurse should anticipate a prescription for which of the following medications?
- A. Neostigmine
- B. Naloxone
- C. Dantrolene
- D. Vecuronium
Correct answer: C
Rationale: Muscle rigidity and a sudden rise in temperature are indicative of malignant hyperthermia, a potential complication of succinylcholine. Dantrolene is the drug of choice to treat malignant hyperthermia as it acts on skeletal muscles to reduce metabolic activity and counteract the symptoms. Neostigmine (Choice A) is used to reverse the effects of non-depolarizing neuromuscular blocking agents, not for malignant hyperthermia. Naloxone (Choice B) is an opioid antagonist used for opioid overdose. Vecuronium (Choice D) is a non-depolarizing neuromuscular blocking agent and is not the appropriate medication for malignant hyperthermia.
2. A client has a new prescription for Diltiazem. Which of the following statements should the nurse include in the teaching?
- A. This medication may cause dry mouth.
- B. You should avoid drinking grapefruit juice.
- C. You may experience a rapid heart rate.
- D. Increase your intake of fiber-rich foods.
Correct answer: B
Rationale: The correct statement to include when teaching a client about Diltiazem is to avoid drinking grapefruit juice. Grapefruit juice can increase the levels of diltiazem in the blood, leading to potential toxicity and increased side effects. It is important for the client to be aware of this interaction to ensure the safe and effective use of the medication. Option A is incorrect because dry mouth is not a common side effect of Diltiazem. Option C is incorrect because Diltiazem is actually used to treat rapid heart rates. Option D is unrelated to the medication and not relevant to the teaching.
3. A client with tobacco use disorder is being educated about Nicotine replacement therapy. Which statement by the client indicates an understanding of the teaching?
- A. I should avoid eating right before chewing a piece of nicotine gum.
- B. I will need to stop using the nicotine gum after 1 year.
- C. I know that nicotine gum is a safe alternative to smoking during pregnancy.
- D. I must chew the nicotine gum quickly for about 15 minutes.
Correct answer: A
Rationale: The correct answer is A. To maximize the effectiveness of nicotine gum, the client should avoid eating or drinking 15 minutes before and while using it. This helps ensure proper absorption of nicotine through the oral mucosa. Choice B is incorrect because the duration of nicotine gum use can vary depending on the individual's needs and progress. Choice C is incorrect as nicotine gum should be used during pregnancy only under healthcare provider guidance. Choice D is incorrect because nicotine gum should be chewed slowly until a tingling sensation is felt, then parked between the cheek and gum until the tingling stops.
4. A healthcare provider is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?
- A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
- B. Obtain help from another healthcare provider to confirm the correct client and blood product.
- C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
- D. Stay with the client for the first 15 to 30 minutes of the transfusion.
Correct answer: B
Rationale: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction. Choices A, C, and D are important aspects of transfusion safety but are not directly related to preventing acute hemolytic reactions. Ensuring a patent IV line, monitoring vital signs, and staying with the client are all essential during transfusion but do not specifically address the risk of ABO or Rh incompatibility reactions.
5. A client has a new prescription for combination oral NRTIs for the treatment of HIV. Which of the following statements should the nurse include in discharge teaching?
- A. These medications work by inhibiting enzymes to prevent HIV replication.
- B. These medications work by preventing protein synthesis within the HIV cell.
- C. These medications work by weakening the cell wall of the HIV virus.
- D. These medications work by blocking HIV entry into cells.
Correct answer: A
Rationale: The correct answer is A. NRTI antiretroviral medications inhibit the enzyme reverse transcriptase, which is essential for HIV replication. By blocking this enzyme, the medications prevent the virus from replicating and spreading. This mechanism of action helps to control the progression of HIV infection in the body. Choices B, C, and D are incorrect because NRTIs do not work by preventing protein synthesis, weakening the cell wall of the virus, or blocking HIV entry into cells. These mechanisms are associated with different classes of antiretroviral medications used in HIV treatment.
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