ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client reports taking Aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?
- A. Digoxin
- B. Metformin
- C. Warfarin
- D. Nitroglycerin
Correct answer: C
Rationale: The correct answer is C, Warfarin. Aspirin increases the effect of anticoagulants like warfarin by inhibiting platelet aggregation, leading to an increased risk of bleeding. Therefore, the use of aspirin is generally contraindicated for clients taking warfarin. Choices A, B, and D are not contraindicated with aspirin. Digoxin, Metformin, and Nitroglycerin do not have significant interactions with Aspirin, unlike Warfarin, making them safe to use concomitantly.
2. A client is receiving Cefotaxime IV for a severe infection. Which finding indicates a potentially serious adverse reaction to this medication that the nurse should report to the provider?
- A. Diaphoresis
- B. Epistaxis
- C. Diarrhea
- D. Alopecia
Correct answer: C
Rationale: Diarrhea is an adverse effect of cefotaxime and other cephalosporins that requires reporting to the provider. Severe diarrhea might indicate the client has developed antibiotic-associated pseudomembranous colitis, which could be life-threatening. Diaphoresis, epistaxis, and alopecia are not typically associated with cefotaxime use and are less likely to indicate a serious adverse reaction necessitating immediate reporting.
3. A healthcare provider is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare provider should recognize that the medication affected which of the following systems in the client?
- A. Cardiovascular
- B. Immune
- C. Central nervous
- D. Gastrointestinal
Correct answer: C
Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders that can be caused by certain medications affecting the central nervous system, such as typical antipsychotic medications. These effects can lead to symptoms like tremors, muscle rigidity, and involuntary movements, which are all related to disruptions in the central nervous system. Choices A, B, and D are incorrect because extrapyramidal effects are specifically associated with the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.
4. A healthcare professional is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare professional should recognize that the medication affected which of the following systems in the client?
- A. Cardiovascular
- B. Immune
- C. Central nervous
- D. Gastrointestinal
Correct answer: C
Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders caused by certain medications affecting the central nervous system. These effects can include symptoms like tremors, rigidity, and bradykinesia. Medications like typical antipsychotics induce extrapyramidal effects by interfering with dopamine transmission in the central nervous system. Choices A, B, and D are incorrect as extrapyramidal effects are specifically related to the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.
5. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?
- A. Reduced cardiac function
- B. First-pass effect
- C. Reduced hepatic function
- D. Increased gastric motility
Correct answer: C
Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.
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