ATI RN
ATI Proctored Pharmacology Test
1. A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?
- A. Sodium 140 mEq/L
- B. Potassium 4.5 mEq/L
- C. BUN 55 mg/dL
- D. Glucose 120 mg/dL
Correct answer: C
Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.
2. What symptom would alert the healthcare professional to hold Albuterol and notify a healthcare professional immediately?
- A. Insomnia
- B. Paradoxical bronchospasm
- C. Nausea
- D. Headache
Correct answer: B
Rationale: If a patient experiences paradoxical bronchospasm after taking Albuterol, the medication should be withheld, and a healthcare professional should be notified immediately. Paradoxical bronchospasm is a serious adverse reaction where the airways constrict instead of dilating, leading to breathing difficulties. This condition requires prompt medical attention to assess and manage the patient's respiratory status. The other options, insomnia, nausea, and headache, are not typically associated with the need to hold Albuterol and notify a healthcare professional immediately.
3. A patient is being discharged with a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take the medication before bedtime.
- B. Monitor for increased blood pressure.
- C. Take the medication with food.
- D. Monitor for leg cramps.
Correct answer: D
Rationale: The correct instruction the nurse should include is to monitor for leg cramps. Leg cramps can be a sign of hypokalemia, which is a potential adverse effect of Hydrochlorothiazide. By monitoring for leg cramps, the patient can detect signs of low potassium levels and report them to the healthcare provider promptly. This proactive approach helps prevent complications associated with hypokalemia. The other options are incorrect because taking Hydrochlorothiazide before bedtime or with food is not specific to the medication's adverse effects. Monitoring for increased blood pressure is not typically a common adverse effect of this medication.
4. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?
- A. 22 gtt/min
- B. 24 gtt/min
- C. 20 gtt/min
- D. 18 gtt/min
Correct answer: A
Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect as it results from a miscalculation. Choices C and D, 20 gtt/min and 18 gtt/min respectively, are also incorrect calculations based on the given parameters.
5. A client has a new prescription for Maraviroc to treat HIV infection. The healthcare provider should monitor the client for which of the following adverse reactions?
- A. Liver failure
- B. Kidney failure
- C. Pancreatitis
- D. Severe allergic reactions
Correct answer: D
Rationale: The correct answer is D: Severe allergic reactions. Maraviroc, used to treat HIV infection, can lead to severe allergic reactions, including hepatotoxicity. While liver failure is a potential adverse effect, it is often preceded by hepatotoxicity manifestations like jaundice or right upper quadrant pain. Kidney failure and pancreatitis are not typically associated with Maraviroc use. Therefore, monitoring for signs of severe allergic reactions and hepatotoxicity is crucial for early detection and intervention.
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