ATI RN
ATI Pharmacology Proctored Exam
1. A client is admitted for a surgical procedure. Which preexisting condition can be a contraindication for the use of Ketamine as an intravenous anesthetic?
- A. Peptic ulcer disease
- B. Breast cancer
- C. Diabetes mellitus
- D. Schizophrenia
Correct answer: D
Rationale: Ketamine can produce psychological effects like hallucinations. Patients with schizophrenia may be more prone to experiencing exacerbation of their symptoms when exposed to Ketamine due to its potential to worsen psychotic symptoms. Therefore, schizophrenia can be a contraindication for the use of Ketamine as an anesthetic. Peptic ulcer disease, breast cancer, and diabetes mellitus are not contraindications for the use of Ketamine.
2. A client is receiving warfarin therapy. Which of the following findings should the nurse identify as an adverse effect of warfarin?
- A. Nausea
- B. Epistaxis
- C. Diarrhea
- D. Dyspepsia
Correct answer: B
Rationale: Epistaxis, or nosebleeds, can be an indication of excessive anticoagulation while on warfarin therapy. Warfarin is a blood thinner that helps prevent blood clots. Epistaxis can occur as a result of the blood-thinning effects of warfarin, leading to increased bleeding tendencies, including nosebleeds. Nausea, diarrhea, and dyspepsia are not typically associated with warfarin therapy; therefore, they are not the adverse effects the nurse should identify in a client receiving warfarin.
3. A nurse is providing teaching to a client who has asthma and is beginning to take montelukast. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will use this medication as a rescue inhaler during asthma attacks.
- B. I should take this medication once daily in the evening.
- C. I need to have my blood levels checked regularly while taking this medication.
- D. I should take this medication before exercising to prevent bronchospasm.
Correct answer: B
Rationale: Montelukast is typically taken once daily in the evening for long-term control of asthma symptoms. It helps prevent asthma attacks by reducing inflammation in the airways. While montelukast can also be used for exercise-induced bronchospasm in some cases, it is generally not a rescue medication and should be taken regularly, not on an as-needed basis.
4. A client with cancer is prescribed methotrexate. Which supplement should the healthcare provider recommend to reduce the risk of methotrexate toxicity?
- A. Folic acid
- B. Magnesium
- C. Vitamin D
- D. Iron
Correct answer: A
Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, and supplementing with folic acid can help reduce the risk of methotrexate toxicity. Folic acid supplementation is commonly recommended to counteract the effects of methotrexate on folate metabolism. Magnesium, Vitamin D, and Iron are not specifically indicated to reduce the risk of methotrexate toxicity and therefore are incorrect choices in this scenario.
5. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?
- A. Administer the medication over 5 minutes.
- B. Administer a dose of Naloxone prior to giving the Hydromorphone.
- C. Assess the client's blood pressure prior to administration.
- D. Inject the medication into the client's subcutaneous tissue.
Correct answer: A
Rationale: The correct action for the healthcare professional preparing to administer IV Hydromorphone to a client is to administer the medication over 5 minutes. This slow administration is crucial to reduce the risk of hypotension and respiratory depression. Administering the medication rapidly can lead to adverse effects. Option B, administering Naloxone prior to Hydromorphone, is incorrect because Naloxone is used as an antidote for opioid overdose, not as a routine pre-medication. Option C, assessing the client's blood pressure before administration, is important but not the immediate action to take to reduce adverse effects of Hydromorphone. Option D, injecting the medication into the client's subcutaneous tissue, is incorrect as Hydromorphone is meant for intravenous administration for rapid onset of action.
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