ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client be instructed to monitor for and report to the provider?
- A. Dry cough
- B. Pedal edema
- C. Bruising
- D. Yellow-tinged vision
Correct answer: D
Rationale: Yellow-tinged vision is a potential adverse effect of digoxin, which may indicate toxicity. It is crucial for the client to report this symptom promptly to the healthcare provider to prevent any further complications. Dry cough is not typically associated with digoxin use. Pedal edema is a common symptom of heart failure, which digoxin is prescribed to manage. Bruising is not a common adverse effect of digoxin.
2. A healthcare provider is assessing a client who is taking Digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity?
- A. Bruising
- B. Report of metallic taste
- C. Muscle pain
- D. Report of anorexia
Correct answer: D
Rationale: The correct manifestation of digoxin toxicity is the report of anorexia. Anorexia, blurred vision, stomach pain, and diarrhea are common signs of digoxin toxicity. Bruising, metallic taste, and muscle pain are not typically associated with digoxin toxicity. Patients should promptly report symptoms of toxicity to their healthcare provider for further evaluation and management.
3. When instructing a client with a new prescription for Timolol on how to insert eye drops, which area should the nurse instruct the client to press on to prevent systemic absorption of the medication?
- A. Bony orbit
- B. Nasolacrimal duct
- C. Conjunctival sac
- D. Outer canthus
Correct answer: B
Rationale: Pressing on the nasolacrimal duct, located near the inner corner of the eye, blocks the lacrimal punctum and prevents the medication from entering the systemic circulation. This technique helps to ensure the medication stays localized in the eye, enhancing its therapeutic effect while minimizing systemic side effects. Choices A, C, and D are incorrect. The bony orbit is the eye socket and not a site to press for preventing systemic absorption. The conjunctival sac is where eye drops are instilled, not pressed on. The outer canthus is also not the correct area to press to prevent systemic absorption.
4. A client with a history of preterm labor is reviewing a new prescription for Terbutaline. Which of the following client statements indicates understanding of the teaching?
- A. I will increase my daily fluid intake to 3 quarts.
- B. I can increase my activity now that I've started on this medication.
- C. I will report increasing intensity of contractions to my doctor.
- D. I am glad this will prevent preterm labor.
Correct answer: C
Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider because these are manifestations of preterm labor. This response demonstrates the client's understanding of the importance of monitoring contractions and seeking appropriate medical attention. Choices A, B, and D are incorrect because increasing fluid intake, increasing activity, or assuming the medication will prevent preterm labor are not relevant actions in managing preterm labor or taking Terbutaline.
5. A client is taking metformin for type 2 diabetes. Which of the following findings should indicate to the nurse that the medication is effective?
- A. Increased urine output
- B. Decreased fasting blood glucose
- C. Decreased hemoglobin A1C
- D. Decreased polyuria
Correct answer: C
Rationale: A decrease in hemoglobin A1C is a more specific indicator of metformin's effectiveness in controlling blood glucose levels over a longer period compared to fasting blood glucose levels. Hemoglobin A1C reflects average blood sugar levels over the past 2-3 months, providing a more comprehensive view of glycemic control. Increased urine output (choice A) is not a direct indicator of metformin's effectiveness and can be influenced by various factors. Decreased fasting blood glucose (choice B) can fluctuate due to various reasons and may not provide a reliable long-term assessment of metformin's efficacy. Decreased polyuria (choice D) refers to a symptom rather than a direct measure of metformin's effectiveness in managing diabetes.
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