ATI RN
ATI Pharmacology Proctored Exam
1. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Hypokalemia
- B. Hypernatremia
- C. Neutropenia
- D. Bradycardia
Correct answer: C
Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.
2. During discharge instructions, a client with a new prescription for Phenytoin should be advised to take which of the following actions?
- A. Brush and floss your teeth regularly.
- B. Avoid drinking grapefruit juice.
- C. Take this medication on an empty stomach.
- D. Increase your intake of calcium-rich foods.
Correct answer: A
Rationale: The correct instruction for a client with a new prescription for Phenytoin is to brush and floss their teeth regularly. Phenytoin is known to cause gingival hyperplasia, a condition that affects the gums. By maintaining good oral hygiene practices such as regular brushing and flossing, the client can help minimize the risk of developing this side effect. Choices B, C, and D are incorrect. Avoiding grapefruit juice is more relevant for medications affected by grapefruit juice metabolism, taking medication on an empty stomach is not specifically indicated for Phenytoin, and increasing calcium-rich foods is not directly related to the side effects or administration of Phenytoin.
3. A client is prescribed Ranitidine. Which of the following laboratory results should be monitored by the nurse?
- A. Complete blood count (CBC).
- B. Serum creatinine.
- C. Serum potassium.
- D. Serum glucose.
Correct answer: A
Rationale: Ranitidine can potentially lead to blood dyscrasias, necessitating the monitoring of the client's CBC. Checking the CBC can help detect any abnormalities in blood cell counts and assess the client's overall hematologic status during Ranitidine therapy.
4. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The provider should inform the client this medication is contraindicated in which of the following conditions?
- A. Atrophic vaginitis
- B. Dysfunctional uterine bleeding
- C. Osteoporosis
- D. Thrombophlebitis
Correct answer: D
Rationale: Conjugated equine estrogens are contraindicated in clients with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is characterized by inflammation of a vein with the formation of a clot, and estrogen can further exacerbate this condition, leading to serious complications. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and osteoporosis are conditions where estrogen therapy may actually be indicated. Dysfunctional uterine bleeding is another condition where estrogen therapy can be used to help regulate menstrual bleeding.
5. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?
- A. Apply the patch to the same site each day.
- B. Remove the patch at night.
- C. Cover the patch with a heating pad.
- D. Apply the patch to a hairless area of skin.
Correct answer: D
Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This ensures proper absorption of the medication. It is important to rotate the application site daily to prevent skin irritation and tolerance development. Applying the patch to the same site each day can lead to decreased efficacy and potential skin reactions. Removing the patch at night is not necessary as the patches are usually worn continuously to provide constant medication delivery. Covering the patch with a heating pad can increase the absorption of the medication and lead to an overdose, which is not recommended.
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