ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?
- A. Sodium level of 138 mEq/L
- B. Potassium level of 5.2 mEq/L
- C. Chloride level of 100 mEq/L
- D. Calcium level of 9.5 mg/dL
Correct answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.
2. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client monitor for and report to the provider?
- A. Dry cough
- B. Pedal edema
- C. Bruising
- D. Yellow-tinged vision
Correct answer: D
Rationale: The correct answer is D: Yellow-tinged vision. Yellow-tinged vision is a potential adverse effect of Digoxin and may indicate toxicity. Clients should be instructed to report this symptom promptly to the healthcare provider to prevent complications. Dry cough (choice A) is not typically associated with Digoxin. Pedal edema (choice B) is more commonly seen with heart failure but is not a direct adverse effect of Digoxin. Bruising (choice C) is not a common adverse effect of Digoxin.
3. A client has a prescription for furosemide. Which of the following instructions should the nurse include?
- A. Take furosemide in the morning.
- B. Eat a diet high in potassium.
- C. Avoid foods that are high in magnesium.
- D. Limit your fluid intake to 1 liter per day.
Correct answer: B
Rationale: The correct answer is to 'Eat a diet high in potassium.' Furosemide is a loop diuretic that can cause hypokalemia (low potassium levels). Instructing the client to eat a diet high in potassium can help counteract the potassium-wasting effect of furosemide and prevent hypokalemia. Choice A is incorrect because furosemide can be taken at different times of the day based on individual needs. Choice C is incorrect as furosemide does not directly interact with magnesium levels. Choice D is incorrect because while fluid intake may need to be monitored, a specific limit of 1 liter per day is not a general instruction for all clients taking furosemide.
4. When starting therapy with Lisinopril, a client should be instructed to monitor for which of the following adverse effects?
- A. Tinnitus
- B. Diarrhea
- C. Cough
- D. Weight gain
Correct answer: C
Rationale: The correct answer is C: Cough. Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. Clients should be informed to monitor for this side effect and report it to their healthcare provider if it occurs. Choices A, B, and D are incorrect because tinnitus, diarrhea, and weight gain are not commonly associated with Lisinopril therapy.
5. A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?
- A. BUN
- B. Creatinine
- C. Hemoglobin
- D. White blood cell count
Correct answer: B
Rationale: Corrected Rationale: Creatinine levels should be monitored to evaluate vancomycin's effect on kidney function. Vancomycin can be nephrotoxic, so monitoring creatinine levels helps assess renal function and ensure that the medication is not causing harm to the kidneys. Monitoring BUN (choice A) is important for assessing kidney function but is not as specific as monitoring creatinine levels. Hemoglobin (choice C) and white blood cell count (choice D) are not directly related to evaluating the therapeutic effect of vancomycin.
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