ATI RN
ATI Pharmacology Proctored Exam 2019
1. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?
- A. Epinephrine
- B. Lorazepam
- C. Furosemide
- D. Diphenhydramine
Correct answer: C
Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.
2. A healthcare provider gives a verbal order for a medication. The nurse is uncomfortable with the order and questions its appropriateness. What should the nurse do?
- A. Refuse to administer the medication and document the refusal.
- B. Clarify the order with the provider before proceeding.
- C. Administer the medication and monitor the patient.
- D. Call a pharmacy consult to discuss the medication.
Correct answer: B
Rationale: The correct action for the nurse to take when uncomfortable with a verbal order for medication is to clarify the order with the provider before proceeding. This ensures patient safety by confirming the appropriateness of the order and prevents any potential harm. Choice A is incorrect because refusing to administer the medication without clarification may delay necessary treatment for the patient. Choice C is incorrect as administering the medication without clarification could pose risks if the order is indeed inappropriate. Choice D is also incorrect as the first step should be direct clarification with the provider before involving others.
3. The client is on a calcium channel blocker. What is the expected effect on the heart?
- A. Increased heart rate
- B. Decreased heart rate
- C. Increased blood pressure
- D. Decreased blood pressure
Correct answer: D
Rationale: When a client is on a calcium channel blocker, the expected effect on the heart is a decreased heart rate and decreased blood pressure. Calcium channel blockers work by dilating blood vessels and reducing the heart's workload, resulting in decreased blood pressure. Choice A, increased heart rate, is incorrect as calcium channel blockers actually have a negative chronotropic effect, reducing the heart rate. Choice C, increased blood pressure, is also incorrect because these medications are used to lower blood pressure.
4. What is a condition where the heart muscle becomes thickened without an obvious cause, leading to a reduction in the heart's ability to pump blood?
- A. Hypertrophic cardiomyopathy
- B. Dilated cardiomyopathy
- C. Restrictive cardiomyopathy
- D. Myocarditis
Correct answer: A
Rationale: Hypertrophic cardiomyopathy is the correct answer. It is a condition characterized by the abnormal thickening of the heart muscle without an obvious cause, which impairs the heart's ability to effectively pump blood. Dilated cardiomyopathy (choice B) involves the enlargement and weakening of the heart chambers, not thickening. Restrictive cardiomyopathy (choice C) refers to the stiffening of the heart muscle, limiting its ability to fill properly. Myocarditis (choice D) is inflammation of the heart muscle usually caused by a viral infection, not thickening.
5. A nurse is providing teaching to the parent of an infant about introducing solid foods. The nurse should recommend that which of the following foods be introduced first?
- A. Strained fruits
- B. Pureed meats
- C. Cooked egg whites
- D. Iron-fortified cereal
Correct answer: Iron-fortified cereal
Rationale: When introducing solid foods to infants, it is recommended to start with iron-fortified cereal as it is easily digestible and a good source of iron, an important nutrient for infants around 6 months of age. Strained fruits are usually introduced later due to their natural sugars. Pureed meats can be introduced after iron-fortified cereals to provide additional protein and iron. Cooked egg whites should be avoided until the infant is at least one year old to reduce the risk of allergies.
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