ATI RN
ATI Pharmacology Proctored Exam
1. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?
- A. Swallow tablets on an empty stomach with plenty of water.
- B. Watch for skin rash and redness when applying calcitonin-salmon topically.
- C. Mix the liquid medication with juice and take it after meals.
- D. Alternate nostrils each time calcitonin-salmon is inhaled.
Correct answer: D
Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. To ensure optimal absorption, the client should alternate nostrils daily when inhaling the medication. This practice helps prevent irritation and promotes consistent drug delivery through both nostrils. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed as a tablet, applied topically, or mixed with juice; it is usually administered intranasally.
2. A nurse is teaching a client who has a new prescription for Prednisone. Which of the following instructions should the nurse include?
- A. Increase your intake of vitamin
- B. Take this medication on an empty stomach.
- C. Avoid drinking grapefruit juice.
- D. Take this medication every other day.
Correct answer: A
Rationale: Prednisone can lead to bone loss, so clients should increase their intake of vitamin D and calcium to help maintain bone health.
3. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?
- A. The medication will increase your mother's respirations.
- B. The medication will prevent dependence on the Morphine.
- C. The medication will relieve your mother's constipation.
- D. The medication works with the Morphine to increase pain relief.
Correct answer: C
Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.
4. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?
- A. 22 gtt/min
- B. 24 gtt/min
- C. 20 gtt/min
- D. 18 gtt/min
Correct answer: A
Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.
5. 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.
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