ATI RN
ATI Pharmacology
1. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?
- A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
- B. I will take this medication on an empty stomach.
- C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
- D. I should stop taking oral contraceptives while I'm taking methotrexate.
Correct answer: C
Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.
2. While caring for a client receiving positive-pressure mechanical ventilation, which intervention should the nurse NOT implement to prevent complications?
- A. Elevate the head of the bed to at least 30°.
- B. Verify the prescribed ventilator settings daily.
- C. Administer pantoprazole as prescribed.
- D. Reposition the endotracheal tube to the opposite side of the mouth daily.
Correct answer: Reposition the endotracheal tube to the opposite side of the mouth daily.
Rationale: Repositioning the endotracheal tube to the opposite side of the mouth daily is not a standard practice and can increase the risk of complications, such as accidental extubation or damage to the airway. The endotracheal tube should remain in the initial correct position to ensure proper ventilation and prevent harm to the client. Elevating the head of the bed, verifying ventilator settings, and administering pantoprazole as prescribed are all appropriate interventions to prevent complications in a client receiving positive-pressure mechanical ventilation.
3. A client is receiving heparin therapy. Which laboratory value should be monitored by the nurse to evaluate the effectiveness of the therapy?
- A. PT
- B. aPTT
- C. INR
- D. Platelet count
Correct answer: B
Rationale: The activated partial thromboplastin time (aPTT) is specifically used to monitor the effectiveness of heparin therapy. It should be maintained at 1.5 to 2 times the normal level. Monitoring aPTT helps ensure that the therapeutic range of heparin is achieved to prevent clot formation while minimizing the risk of bleeding complications. Choice A (PT) is incorrect as it is used to monitor warfarin therapy, not heparin. Choice C (INR) is also incorrect as it is primarily used to monitor warfarin therapy. Choice D (Platelet count) is not directly related to monitoring the effectiveness of heparin therapy.
4. Which physiologic response is most likely to accompany activation of the parasympathetic nervous system?
- A. Increased heart rate
- B. Increased gastric motility
- C. Pupil dilation
- D. Sweating
Correct answer: B
Rationale: The correct answer is B: Increased gastric motility. The parasympathetic nervous system is known to promote rest and digest functions, which includes increasing gastric motility to aid in digestion. Choices A, C, and D are incorrect as they are more characteristic of the sympathetic nervous system. The sympathetic nervous system is responsible for the fight or flight response, leading to increased heart rate (Choice A), pupil dilation (Choice C), and sweating (Choice D) among other responses.
5. Dietary fiber has been recommended for its possible benefits in reducing heart disease by lowering blood cholesterol. How is fiber thought to play its role in lowering blood cholesterol?
- A. Insoluble fiber binds with cholesterol in the large intestine and is excreted in feces
- B. Viscous fiber binds with bile in the intestine and is excreted in feces
- C. Soluble fiber binds with cholesterol in the blood and is excreted by the liver
- D. Insoluble fiber converts to bile in the large intestine and binds with cholesterol
Correct answer: B
Rationale: The correct answer is B. Viscous (soluble) fiber binds with bile acids in the intestine, which are then excreted. The liver must use cholesterol to make more bile acids, thereby lowering blood cholesterol levels. Choice A is incorrect as insoluble fiber does not bind with cholesterol in the large intestine. Choice C is incorrect as soluble fiber does not directly bind with cholesterol in the blood. Choice D is incorrect as insoluble fiber does not convert to bile in the large intestine to bind with cholesterol.
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