ATI RN
ATI Pharmacology
1. When providing discharge instructions to a client prescribed Prednisone, which of the following dietary instructions should the nurse include?
- A. Increase your intake of potassium-rich foods.
- B. Increase your intake of dairy products.
- C. Avoid foods high in vitamin K.
- D. Decrease your intake of protein.
Correct answer: A
Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods. Prednisone can lead to potassium depletion, making it essential to consume foods high in potassium, such as bananas, oranges, and spinach, to maintain electrolyte balance and prevent complications. Choice B is incorrect because increasing dairy products is not specifically necessary when taking Prednisone. Choice C is wrong as foods high in vitamin K are not contraindicated with Prednisone. Choice D is incorrect as there is no need to decrease protein intake when prescribed Prednisone.
2. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
- A. This medication can safely be taken during pregnancy.
- B. Eliminate grapefruit juice from your diet.
- C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
- D. Notify your provider if you develop a rash.
Correct answer: B
Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.
3. What is the pharmacological action of metformin?
- A. Blocks stimulation of beta1 and beta2.
- B. Blocks vasoconstriction and aldosterone.
- C. Acts at many levels in the CNS to produce an anxiolytic effect.
- D. Decreases hepatic glucose production.
Correct answer: D
Rationale: The correct answer is D: Decreases hepatic glucose production. Metformin's primary pharmacological action is to decrease hepatic glucose production, leading to lower blood sugar levels and improved insulin sensitivity in the liver. Choices A, B, and C are incorrect because metformin does not block stimulation of beta1 and beta2 receptors, vasoconstriction, aldosterone, or act in the CNS to produce an anxiolytic effect. Therefore, these options are not reflective of metformin's mechanism of action.
4. When teaching a client with a new prescription for Furosemide, which instruction should the nurse include?
- A. Take this medication at bedtime.
- B. Avoid eating foods high in potassium.
- C. Change positions slowly.
- D. Take this medication with meals.
Correct answer: C
Rationale: The correct instruction for a client with a new prescription for Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these potential adverse effects. Choices A, B, and D are incorrect. Taking Furosemide at bedtime (Choice A) is not necessary as it can be taken at any time of the day. Avoiding foods high in potassium (Choice B) is more relevant for clients taking potassium-sparing diuretics. Taking Furosemide with meals (Choice D) may lead to increased diuretic effects and frequent urination.
5. A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?
- A. Apply the patch to a different location each day.
- B. Remove the patch every night before bedtime.
- C. Massage the patch area gently after application.
- D. Shave the area before applying the patch.
Correct answer: B
Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.
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