ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?
- A. Insomnia
- B. Hypertension
- C. Bone marrow suppression
- D. Constipation
Correct answer: C
Rationale: The correct answer is bone marrow suppression (Choice C). Methotrexate can lead to bone marrow suppression, resulting in adverse effects such as anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is essential to prevent complications and adjust treatment as needed. Choices A, B, and D are incorrect. Insomnia, hypertension, and constipation are not typically associated with methotrexate use in the treatment of Rheumatoid Arthritis.
2. A client has a new prescription for Sucralfate. Which of the following instructions should the nurse include?
- A. Take the medication on an empty stomach.
- B. Increase your intake of high-sodium foods.
- C. Take the medication with a full glass of milk.
- D. Expect your stools to be black and tarry.
Correct answer: A
Rationale: The correct instruction that the nurse should include for a client prescribed Sucralfate is to take the medication on an empty stomach. Sucralfate works by forming a protective barrier over ulcers, which is most effective when the stomach is empty. Taking it with food or other medications may decrease its effectiveness. Instructing the client to take Sucralfate on an empty stomach helps ensure optimal therapeutic benefits. Choices B, C, and D are incorrect because increasing high-sodium foods is not related to Sucralfate therapy, taking the medication with a full glass of milk is not recommended as it may decrease its effectiveness, and the presence of black and tarry stools is not an expected outcome of Sucralfate.
3. A client has a new prescription for Warfarin. Which of the following herbal supplements should the client be instructed to avoid?
- A. St. John's wort
- B. Echinacea
- C. Garlic
- D. Ginseng
Correct answer: A
Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by affecting its metabolism. Echinacea, garlic, and ginseng are also known to interact with Warfarin, either by increasing the risk of bleeding or altering its anticoagulant effects. However, St. John's wort is particularly significant due to its potent enzyme-inducing properties that can lead to subtherapeutic levels of Warfarin, potentially increasing the risk of blood clots.
4. A healthcare professional is reviewing the medication list of a client who has a new prescription for Digoxin to treat heart failure. Which of the following medications places the client at risk for Digoxin toxicity?
- A. Spironolactone
- B. Calcium channel blockers
- C. Loop diuretics
- D. ACE inhibitors
Correct answer: C
Rationale: Loop diuretics, such as Furosemide, can increase the risk of Digoxin toxicity by causing hypokalemia. Hypokalemia enhances the toxic effects of Digoxin on the heart, leading to an increased risk of Digoxin toxicity. Spironolactone (Choice A) is less likely to cause hypokalemia and does not significantly increase the risk of Digoxin toxicity. Calcium channel blockers (Choice B) and ACE inhibitors (Choice D) do not directly increase the risk of Digoxin toxicity through hypokalemia; therefore, they are not the medications that place the client at risk for Digoxin toxicity.
5. When educating a client who has a prescription for Propranolol, what instruction should the healthcare provider include?
- A. Take this medication with food.
- B. Discontinue the medication if you feel fatigued.
- C. Expect to have decreased heart rate with this medication.
- D. Do not stop taking this medication abruptly.
Correct answer: D
Rationale: The correct instruction for a client with a prescription for Propranolol is not to stop taking the medication abruptly. Abrupt cessation can result in rebound hypertension or other cardiac complications. It is crucial for the client to taper off the medication gradually under healthcare provider supervision to prevent adverse effects. Choice A is incorrect because Propranolol can be taken with or without food. Choice B is incorrect as discontinuing the medication based on fatigue alone is not advisable without consulting a healthcare provider. Choice C is incorrect because while Propranolol can decrease heart rate, it is not the primary instruction to provide in this scenario.
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