ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?
- A. I'll take this medicine with my meals.
- B. I'll take this medicine 30 minutes before I eat.
- C. I'll take this medicine just before I go to bed.
- D. I'll take this medicine as soon as I wake up in the morning.
Correct answer: B
Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. To ensure the insulin is available when food is digested, the client should take this medication 30 minutes before each meal. This timing aligns the medication with the expected postprandial rise in blood glucose levels, optimizing its effectiveness in controlling blood sugar levels. Choices A, C, and D are incorrect because taking Repaglinide with meals, just before bed, or as soon as waking up does not align with the medication's mechanism of action and timing needed for optimal effectiveness.
2. A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Diarrhea
- B. Dry mouth
- C. Insomnia
- D. Hypertension
Correct answer: B
Rationale: Dry mouth is a common adverse effect associated with Clonidine use. Clonidine is known to cause a reduction in saliva production, leading to dry mouth. Monitoring for this adverse effect is essential to ensure client comfort and compliance with the medication. Diarrhea is not a common adverse effect of Clonidine. Insomnia is more commonly associated with opioid withdrawal rather than Clonidine use. While Clonidine is used to treat hypertension, it is not typically an adverse effect of the medication.
3. A healthcare professional in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings is indicative of this condition?
- A. Insidious onset of painless loss of vision
- B. Gradual reduction in peripheral vision
- C. Severe pain around the eyes
- D. Intraocular pressure 12 mm Hg
Correct answer: C
Rationale: Severe pain around the eyes that radiates over the face is a classic symptom of acute angle-closure glaucoma. This intense pain is often associated with other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. Immediate medical attention is required to prevent permanent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more indicative of conditions like macular degeneration. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12 mm Hg is within the normal range and is not typical of angle-closure glaucoma.
4. A client is taking metformin for type 2 diabetes. Which of the following findings should indicate to the nurse that the medication is effective?
- A. Increased urine output
- B. Decreased fasting blood glucose
- C. Decreased hemoglobin A1C
- D. Decreased polyuria
Correct answer: C
Rationale: A decrease in hemoglobin A1C is a more specific indicator of metformin's effectiveness in controlling blood glucose levels over a longer period compared to fasting blood glucose levels. Hemoglobin A1C reflects average blood sugar levels over the past 2-3 months, providing a more comprehensive view of glycemic control. Increased urine output (choice A) is not a direct indicator of metformin's effectiveness and can be influenced by various factors. Decreased fasting blood glucose (choice B) can fluctuate due to various reasons and may not provide a reliable long-term assessment of metformin's efficacy. Decreased polyuria (choice D) refers to a symptom rather than a direct measure of metformin's effectiveness in managing diabetes.
5. A client is starting therapy with raloxifene. Which adverse effect should the client monitor for as instructed by the nurse?
- A. Leg cramps
- B. Hot flashes
- C. Urinary frequency
- D. Hair loss
Correct answer: B
Rationale: Hot flashes are a common adverse effect associated with raloxifene therapy. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent and treat osteoporosis in postmenopausal women. Hot flashes are a well-known side effect of SERMs due to their estrogen-like effects on the body. Leg cramps, urinary frequency, and hair loss are not typically associated with raloxifene therapy. Therefore, the nurse should instruct the client to monitor for hot flashes as part of the medication education.
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