ATI RN
ATI Pharmacology Proctored Exam
1. A client is admitted for a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?
- A. Peptic ulcer disease
- B. Breast cancer
- C. Diabetes mellitus
- D. Schizophrenia
Correct answer: D
Rationale: Ketamine is known to produce psychological effects, such as hallucinations. Therefore, individuals with schizophrenia are at increased risk of experiencing exacerbation of their symptoms if given Ketamine, making it a contraindication for its use as an intravenous anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for Ketamine use as an intravenous anesthetic.
2. A client with chronic myeloid leukemia is receiving hydroxyurea. Which of the following findings should the nurse monitor?
- A. Hyperkalemia
- B. Hypertension
- C. Neutropenia
- D. Tinnitus
Correct answer: C
Rationale: The nurse should monitor the client for neutropenia when receiving hydroxyurea. Neutropenia is a common adverse effect caused by bone marrow suppression. It is essential to assess the client's white blood cell count regularly to detect neutropenia early and prevent complications such as infections.
3. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following herbal supplements should the nurse instruct the client to avoid?
- A. St. John's wort
- B. Echinacea
- C. Garlic
- D. Ginseng
Correct answer: A
Rationale: St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism pathways, potentially leading to decreased anticoagulant effects. Therefore, clients on Warfarin therapy should avoid St. John's wort. While echinacea, garlic, and ginseng are also herbal supplements that can interact with Warfarin, St. John's wort is particularly known for its significant impact on Warfarin metabolism. Echinacea may increase the risk of bleeding when taken with Warfarin, garlic may potentiate the anticoagulant effects of Warfarin, and ginseng may also increase the risk of bleeding. However, St. John's wort is the most crucial to avoid due to its significant impact on Warfarin metabolism.
4. A client has a new prescription for Filgrastim to treat neutropenia. Which of the following statements should the nurse include?
- A. This medication will help increase your white blood cell count.
- B. This medication will help reduce your risk of infection.
- C. This medication will help improve your red blood cell count.
- D. This medication will help increase your platelet count.
Correct answer: A
Rationale: The correct statement the nurse should include is that 'This medication will help increase your white blood cell count.' Filgrastim is a medication used to stimulate the production of white blood cells, specifically neutrophils, to increase the white blood cell count. This increase in white blood cells helps reduce the risk of infections in clients with neutropenia. Choices B, C, and D are incorrect because Filgrastim specifically targets white blood cells, not red blood cells or platelets.
5. A client is being taught about a new prescription for Escitalopram to treat generalized anxiety disorder. Which statement by the client indicates understanding of the teaching?
- A. I should take the medication with food.
- B. I will monitor my blood sugar levels while taking this medication.
- C. I need to discontinue this medication slowly.
- D. I can crush this medication before swallowing.
Correct answer: C
Rationale: The correct answer is C. When discontinuing Escitalopram, the client should taper the medication slowly according to a prescribed dosing schedule to reduce the risk of withdrawal syndrome. Abruptly stopping the medication can lead to withdrawal symptoms, so it is important to follow the healthcare provider's instructions for gradual discontinuation. Choices A, B, and D are incorrect because Escitalopram should not necessarily be taken with food, there is no direct correlation with blood sugar levels, and the medication should not be crushed before swallowing.
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