ATI RN
ATI Capstone Pharmacology Assessment 1
1. A 45-year-old client is taking methylprednisolone. What pharmacologic action should the nurse expect with this therapy?
- A. Suppression of beta2 receptors
- B. Suppression of airway mucus production
- C. Fortification of bones
- D. Suppression of candidiasis
Correct answer: B
Rationale: The correct answer is B: Suppression of airway mucus production. Corticosteroids like methylprednisolone are known to suppress airway mucus production. This action helps in reducing inflammation and swelling in the airways, making breathing easier for individuals with conditions like asthma or COPD. Choices A, C, and D are incorrect. Suppression of beta2 receptors is more related to beta-blockers, fortification of bones is associated with medications like bisphosphonates, and suppression of candidiasis is not a typical pharmacologic action of methylprednisolone.
2. A client with an artificial heart valve is prescribed warfarin therapy. Which of the following laboratory values should the nurse monitor to assess the therapeutic effect of warfarin?
- A. Hemoglobin (Hgb)
- B. Prothrombin time (PT)
- C. Bleeding time
- D. Activated partial thromboplastin time (aPTT)
Correct answer: B
Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the clotting factors dependent on vitamin K, such as factors II, VII, IX, and X. The prothrombin time (PT) measures the extrinsic pathway and is used to monitor the therapeutic effects of warfarin therapy. Monitoring PT helps assess the time it takes for the blood to clot, ensuring that the anticoagulant effect is within the desired range. Choices A, C, and D are incorrect because hemoglobin (Hgb) measures the amount of hemoglobin in the blood, bleeding time assesses the time it takes for bleeding to stop, and activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin therapy.
3. A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?
- A. Osteoporosis
- B. Hypertension
- C. Peptic ulcer disease
- D. Immunosuppression
Correct answer: C
Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.
4. A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in the client education related to this medication?
- A. This medication is prescribed for long-term therapy prophylaxis against anginal attacks
- B. Do not crush this medication
- C. Take the medication in the evening after dinner
- D. Do not take an additional tablet if you experience chest pain
Correct answer: A
Rationale: The correct answer is A because isosorbide mononitrate is used for long-term prophylaxis against anginal attacks. Choice B is incorrect because isosorbide mononitrate should not be crushed. Choice C does not specify a particular time for medication administration. Choice D is incorrect because isosorbide mononitrate is not meant to be taken as needed for chest pain; it is part of a long-term therapy plan.
5. Disulfiram is taken by a client daily for abstinence maintenance. What is an adverse effect of this therapy?
- A. Hepatotoxicity
- B. Wernicke's aphasia
- C. Suicidal ideations
- D. Diarrhea
Correct answer: A
Rationale: The correct answer is A: Hepatotoxicity. Disulfiram is known to cause hepatotoxicity as a severe adverse effect. This occurs due to the inhibition of aldehyde dehydrogenase, leading to the accumulation of acetaldehyde when alcohol is consumed. Wernicke's aphasia (Choice B) is a language disorder unrelated to disulfiram therapy. Suicidal ideations (Choice C) may be associated with certain medications, but it is not a common adverse effect of disulfiram. Diarrhea (Choice D) is not a typical adverse effect of disulfiram.
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