ATI RN
Proctored Pharmacology ATI
1. A client has a new prescription for Warfarin for atrial fibrillation. Which of the following findings should the nurse report to the provider immediately?
- A. INR of 4.0
- B. Potassium level of 4.5 mEq/L
- C. Sodium level of 140 mEq/L
- D. Creatinine level of 1.0 mg/dL
Correct answer: A
Rationale: An INR of 4.0 is above the therapeutic range for a client on Warfarin, indicating an increased risk of bleeding. This finding requires immediate reporting to the provider for appropriate intervention to prevent complications associated with excessive anticoagulation. Potassium, sodium, and creatinine levels are within normal ranges and are not directly related to the risk of bleeding in a client on Warfarin therapy.
2. A client is prescribed gentamicin for an infection. Which finding indicates a potential adverse reaction to the medication?
- A. Blood pressure 160/90 mm Hg
- B. Presence of red blood cells in the urine
- C. Urine output of 35 mL/hr
- D. Respiratory rate of 22/min
Correct answer: B
Rationale: The presence of red blood cells in the urine is a significant finding that can indicate nephrotoxicity, a potential adverse effect of gentamicin. Nephrotoxicity can lead to kidney damage, and monitoring for this adverse reaction is crucial during gentamicin therapy. Elevated blood pressure (Choice A) is not typically associated with gentamicin adverse reactions. Decreased urine output (Choice C) may suggest kidney impairment but is not as specific as the presence of red blood cells in the urine. Respiratory rate (Choice D) is not directly related to potential adverse reactions to gentamicin.
3. When teaching the family of a child with Cystic Fibrosis about a new prescription for Acetylcysteine, which information should the nurse include?
- A. Expect this medication to suppress your cough.
- B. Expect this medication to smell like rotten eggs.
- C. Expect this medication to cause euphoria.
- D. Expect this medication to turn your urine orange.
Correct answer: B
Rationale: The correct answer is B: 'Expect this medication to smell like rotten eggs.' Acetylcysteine contains sulfur, which gives it a characteristic rotten-egg odor. This odor is normal and expected when using this medication. Choices A, C, and D are incorrect because Acetylcysteine is not used to suppress cough, cause euphoria, or change urine color. Educating the family on the distinct smell of Acetylcysteine will help them understand its characteristics and alleviate concerns about the odor.
4. A client with migraine headaches is starting prophylaxis therapy with Propranolol. Which finding in the client's history should the nurse report to the provider?
- A. The client had a prior myocardial infarction.
- B. The client takes warfarin for atrial fibrillation.
- C. The client takes an SSRI for depression.
- D. An ECG indicates a first-degree heart block.
Correct answer: D
Rationale: Propranolol is contraindicated in clients with first-degree heart block due to its negative inotropic and chronotropic effects. The nurse should report this finding to the provider to consider an alternative therapy to prevent potential worsening of cardiac conduction abnormalities. Choices A, B, and C are not directly contraindications to Propranolol therapy for migraine headaches and do not pose immediate risks that would require reporting to the provider.
5. When reviewing facility policies for IV therapy with the team, a nurse manager should remind the team that which technique helps minimize the risk of catheter embolism?
- A. Performing hand hygiene before and after IV insertion
- B. Rotating IV sites at least every 72 hours
- C. Minimizing tourniquet time
- D. Avoiding reinserting the needle into an IV catheter
Correct answer: D
Rationale: Avoiding reinserting the needle into an IV catheter is crucial to minimizing the risk of catheter embolism. Reinserting the needle can lead to the severing of the catheter's end, potentially causing a catheter embolism, a serious complication. The other options, while important for IV therapy safety, are not directly related to preventing catheter embolism.
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