ATI RN
ATI Pharmacology Proctored Exam
1. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Hypokalemia
- B. Hypernatremia
- C. Neutropenia
- D. Bradycardia
Correct answer: C
Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. It is characterized by a decreased level of neutrophils, which are important in fighting infections. Monitoring the client's complete blood count (CBC) is crucial to detect neutropenia early. The nurse should also educate the client on recognizing signs of infection and promptly reporting them to the healthcare provider for timely intervention. Hypokalemia is a potential adverse effect of diuretics, not ACE inhibitors. Hypernatremia is an electrolyte imbalance more commonly associated with conditions like dehydration. Bradycardia is not a typical adverse effect of Captopril.
2. A patient is receiving spironolactone for heart failure. Which of the following findings should the nurse report to the provider?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hyponatremia
- D. Hypokalemia
Correct answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone, a potassium-sparing diuretic, can lead to hyperkalemia due to its mechanism of action. Hyperkalemia, or elevated potassium levels, can result in serious cardiac complications and requires immediate medical attention. Therefore, the nurse should promptly report any signs or symptoms of hyperkalemia to prevent potential adverse outcomes in the patient. Choices B, C, and D are incorrect because spironolactone is not associated with hypernatremia, hyponatremia, or hypokalemia. Hyperkalemia is the critical finding that the nurse should report in a patient receiving spironolactone.
3. A client has a new prescription for Warfarin. Which of the following instructions should the nurse include?
- A. Avoid consuming foods high in vitamin K.
- B. Monitor your blood pressure regularly.
- C. Increase your intake of green, leafy vegetables.
- D. Take the medication with a high-fat meal.
Correct answer: A
Rationale: The correct answer is to advise the client to avoid consuming foods high in vitamin K. Warfarin's effectiveness can be affected by vitamin K intake. Clients should maintain a consistent intake of vitamin K and avoid sudden increases in foods high in vitamin K to ensure the medication works properly and consistently. Choices B, C, and D are incorrect. Monitoring blood pressure, increasing intake of green, leafy vegetables, or taking the medication with a high-fat meal are not specific instructions related to Warfarin therapy.
4. When administering subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty, what action should the nurse plan to take?
- A. Expel any air bubbles from the prefilled syringe before injecting.
- B. Insert the needle completely into the client's tissue.
- C. Administer the injection in the client's thigh.
- D. Aspirate carefully after inserting the needle into the client's skin.
Correct answer: B
Rationale: When administering enoxaparin via a prefilled syringe for deep subcutaneous injection, the nurse should insert the needle completely into the client's tissue. This action ensures proper delivery of the medication into the subcutaneous layer, promoting optimal therapeutic effects. Choice A is incorrect because there is no need to expel air bubbles from a prefilled syringe. Choice C is incorrect as enoxaparin is typically administered in the abdomen for subcutaneous injections. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or damage to tissues.
5. A healthcare professional is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. How many mL/hr should the IV pump be set to deliver?
- A. 200 mL/hr
- B. 150 mL/hr
- C. 100 mL/hr
- D. 250 mL/hr
Correct answer: A
Rationale: To calculate the flow rate in mL/hr: (Volume in mL / Time in hours) = Flow rate in mL/hr. In this case, (100 mL / 0.5 hr) = 200 mL/hr. Therefore, the IV pump should be set to deliver 200 mL/hr to administer clindamycin 200 mg over 30 minutes. Choice A is correct because it provides the accurate flow rate needed for the administration of the medication. Choices B, C, and D are incorrect as they do not calculate the flow rate correctly based on the volume and time specified in the question.
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