ATI RN
ATI Pharmacology Proctored Exam
1. A nurse is caring for a client who is receiving treatment with vincristine. Which of the following findings should the nurse monitor?
- A. Hyperkalemia
- B. Neurotoxicity
- C. Neutropenia
- D. Bradycardia
Correct answer: B
Rationale: The correct answer is B: Neurotoxicity. Vincristine is known to cause neurotoxicity as an adverse effect due to its impact on the nervous system. Monitoring for symptoms such as peripheral neuropathy, muscle weakness, and tingling sensations is crucial. Choices A, C, and D are incorrect because hyperkalemia, neutropenia, and bradycardia are not typically associated with vincristine therapy.
2. 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.
3. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?
- A. Sodium level of 138 mEq/L
- B. Potassium level of 5.2 mEq/L
- C. Chloride level of 100 mEq/L
- D. Calcium level of 9.5 mg/dL
Correct answer: B
Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.
4. A client is receiving Morphine IV for pain management. Which of the following actions should the nurse take to monitor for adverse effects?
- A. Monitor the client's respiratory rate every 15 minutes.
- B. Monitor the client's blood pressure every 30 minutes.
- C. Monitor the client's oxygen saturation every hour.
- D. Monitor the client's heart rate every 5 minutes.
Correct answer: A
Rationale: The correct action for the nurse to monitor for adverse effects of Morphine IV is to check the client's respiratory rate every 15 minutes. Respiratory depression is a potentially life-threatening adverse effect of Morphine. Monitoring the respiratory rate frequently allows for early detection and intervention if needed. Monitoring blood pressure, oxygen saturation, or heart rate alone may not provide early signs of respiratory depression, which is a critical adverse effect of Morphine IV.
5. A client is being taught about a new prescription for Celecoxib. Which of the following information should be included in the teaching?
- A. Increases the risk for a myocardial infarction
- B. Decreases the risk of stroke
- C. Inhibits COX-1
- D. Increases platelet aggregation
Correct answer: A
Rationale: The correct answer is A: 'Increases the risk for a myocardial infarction.' Celecoxib, a COX-2 inhibitor, increases the risk for a myocardial infarction due to its effect on suppressing vasodilation, which can lead to this adverse cardiovascular event. Choices B, C, and D are incorrect. Celecoxib does not decrease the risk of stroke, inhibit COX-1, or increase platelet aggregation. It's crucial for the nurse to educate the client about the increased risk for a myocardial infarction when taking Celecoxib and emphasize monitoring for signs of heart issues and the importance of seeking prompt medical attention if symptoms occur.
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