ATI RN
ATI Pharmacology Proctored Exam
1. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?
- A. It can take several weeks before you feel like the medication is helping.
- B. Take the medication just before bedtime to promote sleep.
- C. You should take the medication when needed for obsessive urges.
- D. Monitor for weight gain while taking this medication.
Correct answer: A
Rationale: The correct answer is A. Paroxetine, an antidepressant commonly used for OCD, typically takes 1 to 4 weeks before the client experiences the full therapeutic benefit. Therefore, informing the client that it may take several weeks before feeling the medication's effects is crucial to manage expectations and ensure compliance with the treatment plan. Choice B is incorrect because Paroxetine is usually taken in the morning due to its activating effects and may cause insomnia if taken before bedtime. Choice C is incorrect because Paroxetine should be taken regularly as prescribed, not just when experiencing obsessive urges. Choice D is incorrect because although weight gain can be a side effect of Paroxetine, it is not a priority instruction compared to the delayed onset of therapeutic effects.
2. A nurse is preparing to administer a dose of vancomycin IV to a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the following actions should the nurse take?
- A. Administer the medication over 15 minutes.
- B. Monitor the client's urine output every 8 hours.
- C. Check the client's creatinine level before administering the medication.
- D. Assess the client for a history of allergies to antibiotics.
Correct answer: C
Rationale: The correct action for the nurse to take is to check the client's creatinine level before administering vancomycin. Vancomycin is known to be nephrotoxic, so assessing the client's renal function before administering the medication is crucial to prevent further kidney damage. Administering the medication over 15 minutes (Choice A) is not the priority in this scenario as renal function assessment takes precedence. Monitoring urine output (Choice B) is important for assessing renal function but checking creatinine level directly provides more accurate information. Assessing for allergies to antibiotics (Choice D) is also important but not as essential as checking the creatinine level due to the nephrotoxic nature of vancomycin.
3. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?
- A. INR of 4.0
- B. Potassium level of 4.5 mEq/L
- C. Creatinine level of 1.0 mg/dL
- D. BUN of 18 mg/dL
Correct answer: A
Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.
4. A client is being discharged with a new prescription for furosemide 40 mg PO daily. Which of the following instructions should be included?
- A. Avoid foods rich in potassium.
- B. Take the medication with food.
- C. Weigh yourself daily.
- D. Stand up slowly to minimize orthostatic hypotension.
Correct answer: D
Rationale: The correct answer is D: 'Stand up slowly to minimize orthostatic hypotension.' Clients prescribed furosemide are at risk for orthostatic hypotension, a sudden drop in blood pressure when changing positions. Advising the client to stand up slowly can help prevent this complication. Instructing the client to avoid rapid position changes decreases the likelihood of dizziness or fainting episodes. Choices A, B, and C are incorrect because furosemide does not require avoiding potassium-rich foods, taking the medication with food, or daily weighing as specific instructions.
5. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?
- A. Obtain a blood specimen immediately prior to administering the next dose of medication.
- B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
- C. Ask the client to provide a urine specimen after the next dose of medication.
- D. Administer the medication and obtain a blood specimen 30 minutes later.
Correct answer: A
Rationale: To verify the trough levels of a medication accurately, the nurse should obtain a blood specimen immediately before administering the next dose of the medication. The trough level represents the lowest concentration of the medication in the bloodstream, typically right before the next dose is due. This timing ensures an accurate assessment of the drug's concentration in the body at its lowest point, aiding in determining the drug's effectiveness and potential toxicity levels. Choice B is incorrect because waiting for 24 hours would not provide the trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect as obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level.
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