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. When a client reports urticaria and dyspnea after receiving amoxicillin/clavulanic acid, which medication should be administered first?
- A. Administer epinephrine
- B. Administer albuterol
- C. Administer diphenhydramine
- D. Administer prednisone
Correct answer: A
Rationale: In the scenario described, the client is experiencing symptoms of a severe allergic reaction. The priority intervention is to administer epinephrine. Epinephrine acts quickly to reverse the effects of the allergic reaction and can be life-saving in cases of anaphylaxis. Albuterol is used for bronchodilation and may help with respiratory symptoms but is not the first-line treatment for anaphylaxis. Diphenhydramine and prednisone are used for allergic reactions but are not as rapid-acting as epinephrine and should be considered after administering epinephrine in this situation.
3. When providing teaching to a client with a prescription for Hydrochlorothiazide, which instruction should the nurse include?
- A. Take this medication at bedtime.
- B. Avoid foods high in potassium.
- C. Take this medication on an empty stomach.
- D. Monitor for signs of dehydration.
Correct answer: D
Rationale: The correct instruction for a client prescribed Hydrochlorothiazide is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and electrolyte imbalance, potentially causing dehydration. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. Therefore, it is essential for the client to be vigilant in recognizing these symptoms and seek medical attention if they occur. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide at bedtime is not a specific instruction related to its effects or side effects. Avoiding foods high in potassium may be necessary for some medications, but it is not the primary concern with Hydrochlorothiazide. Taking this medication on an empty stomach is not a requirement and may vary depending on individual preferences or healthcare provider instructions.
4. While providing an Angiotensin-converting enzyme (ACE) inhibitor, the patient asks what the action of the drug is. As a healthcare provider, you explain that the action of an ACE inhibitor is:
- A. To lower blood pressure by blocking the conversion of angiotensin I to vasoconstrictor angiotensin II
- B. To inhibit reabsorption of sodium back into the body, ultimately increasing urine output and lowering blood pressure
- C. To decrease heart rate and blood pressure by competing with Beta1 and Beta2 receptors in the heart and lungs
- D. To lower blood glucose by stimulating the release of insulin
Correct answer: A
Rationale: ACE inhibitors lower blood pressure by blocking the conversion of angiotensin I to vasoconstrictor angiotensin II. Angiotensin II is a potent vasoconstrictor, and by inhibiting its formation, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload on the heart. Choice B is incorrect as it describes the mechanism of action of diuretics, not ACE inhibitors. Choice C is incorrect as it refers to the action of beta-blockers, not ACE inhibitors. Choice D is incorrect as it describes the mechanism of action of antidiabetic medications, not ACE inhibitors.
5. A client is starting therapy with filgrastim. Which of the following adverse effects should the nurse instruct the client to monitor?
- A. Bone pain
- B. Constipation
- C. Tinnitus
- D. Dry mouth
Correct answer: A
Rationale: When a client is starting therapy with filgrastim, monitoring for bone pain is essential. Filgrastim can lead to increased bone marrow activity, resulting in bone pain as a common adverse effect. Instructing the client to monitor and report any bone pain promptly can help in managing this side effect effectively.
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