ATI RN
ATI Pharmacology
1. A healthcare professional is preparing to administer Butorphanol to a client who has a history of substance use disorder. The healthcare professional should identify which of the following information as true regarding Butorphanol?
- A. Butorphanol has a greater risk of abuse than morphine.
- B. Butorphanol causes a higher incidence of respiratory depression than morphine.
- C. Butorphanol cannot be reversed with an opioid antagonist.
- D. Butorphanol can cause abstinence syndrome in opioid-dependent clients.
Correct answer: D
Rationale: Corrected Rationale: Butorphanol, an opioid agonist/antagonist, can lead to abstinence syndrome in clients who are opioid-dependent. This syndrome may present with symptoms like abdominal pain, fever, and anxiety. It is crucial for healthcare professionals to consider this risk when administering Butorphanol to clients with a history of substance use disorder. Choices A, B, and C are incorrect. Butorphanol is less likely to be abused than morphine, causes less respiratory depression than morphine, and can be reversed with an opioid antagonist.
2. A client is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?
- A. Hold Propranolol if the client's apical pulse is greater than 100/min.
- B. Administer Propranolol to decrease the client's blood pressure.
- C. Assist the client with sitting up or standing after taking this medication.
- D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.
Correct answer: C
Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.
3. A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)
- A. Expect therapeutic effects in 1-3 weeks.
- B. Discontinue the medication gradually under healthcare provider supervision.
- C. Change positions slowly to minimize dizziness.
- D. Increase dietary fiber intake to prevent constipation.
Correct answer: C
Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. The therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so increasing dietary fiber intake would be recommended to prevent constipation, making choice D incorrect.
4. When teaching a client with a prescription for Phenytoin, which of the following instructions should the nurse include?
- A. Expect the development of a mild rash.
- B. Take the medication on an empty stomach.
- C. Monitor for signs of gingival hyperplasia.
- D. Increase your intake of calcium.
Correct answer: C
Rationale: Phenytoin is known to cause gingival hyperplasia, a condition characterized by overgrowth of gum tissue. The nurse should instruct the client to monitor for signs of gingival hyperplasia, such as swollen or bleeding gums. Good oral hygiene practices are essential to prevent or manage this side effect. Choices A, B, and D are incorrect. Phenytoin does not typically cause a mild rash, should be taken with food to reduce gastrointestinal upset, and does not warrant an increase in calcium intake.
5. 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.
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