ATI RN
ATI Pharmacology Proctored Exam 2019
1. When administering subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty, what action should the nurse plan to take?
- A. Expel any air bubbles from the prefilled syringe before injecting.
- B. Insert the needle completely into the client's tissue.
- C. Administer the injection in the client's thigh.
- D. Aspirate carefully after inserting the needle into the client's skin.
Correct answer: B
Rationale: When administering enoxaparin via a prefilled syringe for deep subcutaneous injection, the nurse should insert the needle completely into the client's tissue. This action ensures proper delivery of the medication into the subcutaneous layer, promoting optimal therapeutic effects. Choice A is incorrect because there is no need to expel air bubbles from a prefilled syringe. Choice C is incorrect as enoxaparin is typically administered in the abdomen for subcutaneous injections. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or damage to tissues.
2. A client has a new prescription for Digoxin. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Monitor your pulse before taking the medication.
- C. Expect to have an increased appetite.
- D. Discontinue the medication if you feel nauseated.
Correct answer: B
Rationale: When educating a client about Digoxin, it is crucial to instruct them to monitor their pulse before taking the medication. Digoxin can lead to bradycardia, so monitoring the pulse is essential to ensure it is not below 60 beats per minute before taking each dose. If the pulse is low, the client should hold the dose and seek guidance from their healthcare provider. Choices A, C, and D are incorrect. Taking Digoxin with food may affect its absorption, Digoxin is not known to increase appetite, and feeling nauseated does not necessarily indicate the need to discontinue the medication.
3. When assessing a client with chronic Neutropenia receiving Filgrastim, what action should the nurse take to evaluate for an adverse effect of the medication?
- A. Assess for bone pain.
- B. Assess for right lower quadrant pain.
- C. Auscultate for crackles in the bases of the lungs.
- D. Auscultate the chest to listen for a heart murmur.
Correct answer: A
Rationale: The correct action when assessing a client receiving Filgrastim for chronic Neutropenia is to assess for bone pain. Bone pain is a known dose-related adverse effect of Filgrastim. Acetaminophen or opioid analgesics can be used to manage bone pain if necessary. Assessing for other types of pain, lung crackles, or heart murmurs would not be specific to the adverse effects of Filgrastim.
4. How do ACE inhibitors work?
- A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
- B. Block stimulation of beta 1 and beta 2 at the receptor sites
- C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
- D. None of the above
Correct answer: C
Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.
5. A client is withdrawing from alcohol and has a new prescription for Propranolol. Which of the following information should be included in the teaching?
- A. Increases the risk for seizure activity.
- B. Provides a form of aversion therapy.
- C. Decreases cravings.
- D. Results in mild hypertension.
Correct answer: C
Rationale: The correct answer is C: 'Decreases cravings.' Propranolol is commonly used as an adjunct medication during alcohol withdrawal to help reduce cravings for alcohol. It does not increase the risk for seizure activity, provide aversion therapy, or result in mild hypertension. By decreasing cravings, Propranolol can support the client in managing alcohol withdrawal symptoms and promoting abstinence. Therefore, it is important to educate the client on how Propranolol can help them cope with alcohol cravings effectively.
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