ATI RN
ATI Pharmacology Proctored Exam
1. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?
- A. Administering a supplemental dose of hydrocortisone
- B. Instructing the client about coughing and deep breathing
- C. Collecting additional information from the client about his history of Addison's disease
- D. Inserting an indwelling urinary catheter
Correct answer: A
Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.
2. A client with a prescription for Vasopressin to treat Diabetes Insipidus is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?
- A. I will reduce my sodium intake.
- B. I should increase my water intake.
- C. I will notify my doctor if I develop chest pain.
- D. I should take this medication with food.
Correct answer: C
Rationale: The correct answer is C because Vasopressin can cause vasoconstriction, potentially leading to chest pain. It is crucial for the client to inform their healthcare provider immediately if they experience chest pain while on Vasopressin therapy to address any potential cardiovascular complications promptly. Choices A, B, and D are incorrect. While maintaining adequate hydration is essential with Vasopressin therapy due to its antidiuretic effect, increasing water intake is not the most critical aspect to monitor. Reducing sodium intake may be beneficial in some cases but is not directly related to the potential side effects of Vasopressin. Taking the medication with food is not a specific instruction for Vasopressin administration.
3. A healthcare professional in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?
- A. Calcium 9.2 mg/dL
- B. Calcium 10.3 mg/dL
- C. Potassium 3.4 mEq/L
- D. Potassium 4.8 mEq/L
Correct answer: C
Rationale: The correct answer is C: Potassium 3.4 mEq/L. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, especially in older clients taking Digoxin, as potassium plays a crucial role in the heart's electrical activity. Choices A and B are related to calcium levels, which do not directly increase the risk of Digoxin toxicity. Choice D, Potassium 4.8 mEq/L, is within the expected reference range and would not increase the risk of Digoxin toxicity.
4. When administering an Antiulcer Agent, you should be more cautious when administering it to:
- A. A healthy 27-year-old patient
- B. Patient with renal failure
- C. Elderly patients
- D. Choices B & C
Correct answer: D
Rationale: When administering an antiulcer agent, caution is warranted in patients with renal failure due to the potential impact on drug metabolism and excretion. Additionally, elderly patients may be more susceptible to adverse effects from antiulcer agents due to age-related physiological changes. Therefore, it is important to be more cautious when administering antiulcer agents to patients with renal failure and elderly patients. Choice A, a healthy 27-year-old patient, would typically not require as much caution compared to patients with renal failure or elderly patients when administering antiulcer agents. Therefore, choices B & C are the correct options for increased caution.
5. A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?
- A. BUN
- B. Creatinine
- C. Hemoglobin
- D. White blood cell count
Correct answer: B
Rationale: Corrected Rationale: Creatinine levels should be monitored to evaluate vancomycin's effect on kidney function. Vancomycin can be nephrotoxic, so monitoring creatinine levels helps assess renal function and ensure that the medication is not causing harm to the kidneys. Monitoring BUN (choice A) is important for assessing kidney function but is not as specific as monitoring creatinine levels. Hemoglobin (choice C) and white blood cell count (choice D) are not directly related to evaluating the therapeutic effect of vancomycin.
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