ATI RN
ATI Pharmacology Proctored Exam 2023
1. A client has a new prescription for transdermal patches. Which statement should the client make to indicate understanding of the instructions?
- A. I will clean the site with an alcohol swab before applying the patch.
- B. I will rotate the application sites weekly.
- C. I will apply the patch to an area of skin with no hair.
- D. I will place the new patch on the site of the old patch.
Correct answer: C
Rationale: The correct answer is C. Applying the patch to a hairless area of skin is essential for optimal medication absorption. Hair can interfere with the patch's adherence and effectiveness. It is important for the client to choose a site without hair to ensure proper delivery of the medication. Choices A, B, and D are incorrect because cleaning the site with an alcohol swab (Choice A) is a good practice but not the most crucial aspect for transdermal patch application. Rotating application sites weekly (Choice B) is more relevant for injections to prevent skin irritation or breakdown. Placing the new patch on the site of the old patch (Choice D) can lead to skin irritation and poor absorption due to a build-up of medication.
2. A client with congestive heart failure taking digoxin refused breakfast and is complaining of nausea and weakness. Which action should the nurse take first?
- A. Check the client's vital signs.
- B. Request a consult with a dietitian.
- C. Suggest that the client rests before eating the meal.
- D. Request an order for an antiemetic.
Correct answer: A
Rationale: The nurse should check the client's vital signs first because nausea and weakness can be signs of digoxin toxicity. Vital signs can provide immediate information on the client's condition and help guide further interventions. Monitoring vital signs will allow the nurse to assess for bradycardia, a common sign of digoxin toxicity. Requesting a dietitian consult (choice B) may be necessary but addressing the immediate concern of toxicity is the priority. Suggesting rest before eating (choice C) may not address the underlying issue of digoxin toxicity. Requesting an antiemetic (choice D) can be considered later but is not the initial action needed in this situation.
3. A client reports taking Aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?
- A. Digoxin
- B. Metformin
- C. Warfarin
- D. Nitroglycerin
Correct answer: C
Rationale: The correct answer is C, Warfarin. Aspirin increases the effect of anticoagulants like warfarin by inhibiting platelet aggregation, leading to an increased risk of bleeding. Therefore, the use of aspirin is generally contraindicated for clients taking warfarin. Choices A, B, and D are not contraindicated with aspirin. Digoxin, Metformin, and Nitroglycerin do not have significant interactions with Aspirin, unlike Warfarin, making them safe to use concomitantly.
4. A client informs the nurse that she has difficulty swallowing tablets and struggles with liquid or chewable medications due to taste. What medication should the nurse request a prescription for when preparing to administer Penicillin V to treat the client's streptococcal infection?
- A. Fosfomycin
- B. Amoxicillin
- C. Nafcillin
- D. Cefaclor
Correct answer: C
Rationale: Nafcillin is an appropriate alternative within the penicillin class for clients who have difficulty swallowing tablets or struggle with liquid or chewable medications. It is available for intramuscular (IM) or intravenous (IV) administration, offering options beyond oral formulations. Fosfomycin, Amoxicillin, and Cefaclor are not suitable alternatives for Penicillin V in this scenario as they belong to different classes of antibiotics and may not be as effective in treating streptococcal infections.
5. A healthcare provider is providing discharge instructions to a client who has a new prescription for Warfarin. Which of the following over-the-counter medications should the provider instruct the client to avoid?
- A. Acetaminophen
- B. Ibuprofen
- C. Diphenhydramine
- D. Loratadine
Correct answer: B
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. The combination of Warfarin, an anticoagulant, and NSAIDs can potentiate the risk of bleeding complications. Clients on Warfarin should avoid NSAIDs like ibuprofen and opt for alternative pain relief options such as acetaminophen. Diphenhydramine and loratadine are antihistamines and are generally safe to use with Warfarin as they do not significantly increase the risk of bleeding when compared to NSAIDs like ibuprofen.
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