ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is starting therapy with Metformin. Which of the following instructions should the nurse include?
- A. Take this medication with your first bite of food.
- B. Take this medication on an empty stomach.
- C. Take this medication before bedtime.
- D. Take this medication every other day.
Correct answer: A
Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. Instructing the client to take the medication with the first bite of food helps in achieving optimal effectiveness and minimizes the risk of side effects like nausea or upset stomach. Choice B is incorrect because taking Metformin on an empty stomach can lead to increased gastrointestinal side effects. Choice C is incorrect as there is no specific timing requirement for taking Metformin before bedtime. Choice D is incorrect as Metformin is usually taken daily, not every other day.
2. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?
- A. Weight loss of 1 kg in 24 hours
- B. Blood pressure of 104/60 mm Hg
- C. Potassium level of 3.5 mEq/L
- D. Urine output of 200 mL in 8 hours
Correct answer: D
Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function, potentially due to Furosemide therapy. This finding can suggest inadequate renal perfusion and impaired drug clearance, necessitating immediate reporting to prevent further complications like electrolyte imbalances and worsening heart failure. Choice A: Weight loss may be expected in heart failure patients due to fluid retention, but it is not an immediate concern. Choice B: A blood pressure of 104/60 mm Hg is slightly low but not a priority compared to the indication of kidney dysfunction. Choice C: A potassium level of 3.5 mEq/L is within the normal range, so it does not require immediate reporting.
3. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
- A. Take one tablet at the first sign of chest pain.
- B. If pain is not relieved, take another tablet in 10 minutes.
- C. You can take up to five tablets in 15 minutes.
- D. Swallow the tablet with water.
Correct answer: A
Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.
4. When providing discharge instructions to a client prescribed Warfarin, which herbal supplement should the nurse instruct the client to avoid?
- A. St. John's wort
- B. Echinacea
- C. Garlic
- D. Ginseng
Correct answer: A
Rationale: St. John's wort should be avoided by clients taking Warfarin as it can reduce the medication's effectiveness by interacting with its metabolism. While garlic and ginseng are also known to interact with Warfarin, the specific supplement the nurse should instruct the client to avoid in this scenario is St. John's wort. Echinacea, although an herbal supplement, is not typically associated with significant interactions with Warfarin and is not the primary concern in this case.
5. A client is prescribed Omeprazole for managing heartburn. What information should the nurse include in the teaching?
- A. Take this medication at bedtime.
- B. This medication decreases the production of gastric acid.
- C. Take this medication 2 hours after eating.
- D. This medication can cause hyperkalemia.
Correct answer: B
Rationale: The correct answer is B. The nurse should educate the client that Omeprazole works by reducing the production of gastric acid through inhibiting the enzyme responsible for its production. This action helps in managing heartburn and related symptoms effectively. Choice A is incorrect because Omeprazole is usually taken before eating. Choice C is incorrect as Omeprazole is typically taken before a meal. Choice D is unrelated to Omeprazole, as it is not associated with causing hyperkalemia.
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