ATI RN
ATI Pharmacology Proctored Exam 2019
1. 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.
2. A client has a new prescription for Lovastatin. Which of the following instructions should be included?
- A. Take this medication on an empty stomach.
- B. Take this medication in the morning.
- C. Take this medication at bedtime.
- D. Increase your intake of potassium-rich foods.
Correct answer: C
Rationale: Lovastatin should be taken at bedtime because cholesterol production in the liver is highest at night, making the medication more effective in reducing cholesterol levels. By taking it at bedtime, the medication aligns with the body's natural rhythm of cholesterol synthesis, optimizing its therapeutic effects.
3. A healthcare provider is caring for a client who is prescribed Digoxin. Which of the following laboratory values should the provider monitor to assess for potential toxicity?
- A. Sodium
- B. Potassium
- C. Magnesium
- D. Calcium
Correct answer: B
Rationale: The correct answer is to monitor the client's potassium levels. Hypokalemia can increase the risk of Digoxin toxicity. Potassium levels should be closely monitored to prevent adverse effects. Monitoring sodium levels is not directly related to Digoxin toxicity. While magnesium and calcium are important electrolytes, potassium levels are more critical for Digoxin toxicity assessment.
4. A healthcare professional is reviewing the medication list of a client who has a new prescription for Digoxin to treat heart failure. Which of the following medications places the client at risk for Digoxin toxicity?
- A. Spironolactone
- B. Calcium channel blockers
- C. Loop diuretics
- D. ACE inhibitors
Correct answer: C
Rationale: Loop diuretics, such as Furosemide, can increase the risk of Digoxin toxicity by causing hypokalemia. Hypokalemia enhances the toxic effects of Digoxin on the heart, leading to an increased risk of Digoxin toxicity. Spironolactone (Choice A) is less likely to cause hypokalemia and does not significantly increase the risk of Digoxin toxicity. Calcium channel blockers (Choice B) and ACE inhibitors (Choice D) do not directly increase the risk of Digoxin toxicity through hypokalemia; therefore, they are not the medications that place the client at risk for Digoxin toxicity.
5. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?
- A. I'll take this medicine with my meals.
- B. I'll take this medicine 30 minutes before I eat.
- C. I'll take this medicine just before I go to bed.
- D. I'll take this medicine as soon as I wake up in the morning.
Correct answer: B
Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. It is crucial for the client to take this medication 15-30 minutes before each meal to synchronize the peak insulin availability with mealtime glucose elevation, maximizing its effectiveness in controlling blood sugar levels. Choice A is incorrect because taking the medicine with meals may not optimize its action. Choice C is incorrect as taking the medicine before going to bed is not in line with its mechanism of action. Choice D is incorrect as taking the medicine upon waking up does not coincide with mealtime glucose elevation.
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