ATI RN
ATI Pharmacology Proctored Exam
1. A client is receiving long-term aspirin therapy. The healthcare provider should monitor the client for which of the following complications?
- A. Hemorrhagic stroke
- B. Thromboembolic stroke
- C. Iron deficiency anemia
- D. Neutropenia
Correct answer: A
Rationale: The correct answer is A: Hemorrhagic stroke. Long-term aspirin therapy can lead to hemorrhagic stroke due to its antiplatelet effects, which increase the risk of bleeding. Aspirin inhibits platelet aggregation, which can predispose the individual to bleeding complications, including hemorrhagic stroke. Choices B, C, and D are incorrect because aspirin therapy is more likely to cause bleeding complications rather than thromboembolic events, iron deficiency anemia, or neutropenia.
2. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?
- A. The vein for thrombophlebitis during IV administration.
- B. The subcutaneous site for redness following injection.
- C. The oral mucosa for ulceration after oral administration.
- D. The skin for irritation following removal of transdermal patch.
Correct answer: B
Rationale: Adalimumab is administered subcutaneously for Rheumatoid Arthritis. Injection-site reactions such as redness and swelling are common. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for potential adverse effects.
3. Which drug undergoes extensive first-pass hepatic metabolism?
- A. Heparin
- B. Insulin
- C. Propranolol
- D. Nitroglycerin
Correct answer: C
Rationale: Propranolol undergoes extensive first-pass hepatic metabolism in the liver. When administered orally, propranolol is extensively metabolized by the liver before reaching systemic circulation, leading to reduced bioavailability. This process is known as first-pass hepatic metabolism, which significantly affects the drug's effectiveness and necessitates higher oral doses compared to other routes of administration. Heparin (Choice A) is not metabolized by the liver but excreted unchanged by the kidneys. Insulin (Choice B) is a peptide hormone that is not subject to significant first-pass metabolism. Nitroglycerin (Choice D) is primarily metabolized in the blood and tissues, bypassing significant first-pass metabolism in the liver.
4. A client has a new prescription for Valproic Acid. The client should be informed that which of the following laboratory tests need to be completed periodically? (Select all that apply.)
- A. Thrombocyte count.
- B. Hematocrit.
- C. Amylase.
- D. Liver function tests.
Correct answer: A
Rationale: Valproic acid can lead to thrombocytopenia, making it essential to monitor the client's thrombocyte count periodically. Additionally, valproic acid can cause pancreatitis, necessitating the monitoring of amylase levels. Furthermore, valproic acid carries a risk of hepatotoxicity, requiring regular monitoring of liver function tests.
5. A client has a new prescription for Calcitonin-salmon for Osteoporosis. Which of the following tests should the client expect before beginning this medication?
- A. Skin test for allergy to the medication
- B. ECG to rule out cardiac dysrhythmias
- C. Mantoux test to rule out exposure to tuberculosis
- D. Liver function tests to assess risk for medication toxicity
Correct answer: A
Rationale: Before initiating Calcitonin-salmon, a skin test for allergy to the medication may be performed to prevent anaphylactic reactions. Allergic reactions can occur due to sensitivities to the drug, particularly in individuals with fish allergies. Therefore, it is essential for healthcare providers to assess the client's potential allergic response to Calcitonin-salmon through a skin test. The other options are not relevant in this context. An ECG is not typically required before starting Calcitonin-salmon for Osteoporosis, nor is a Mantoux test or liver function tests.
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