ATI RN
ATI Pharmacology Proctored Exam 2019
1. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?
- A. Administer intravenously to prevent injury.
- B. Ensure that the medication is kept refrigerated until just prior to administration.
- C. Do not shake the vial; gently invert it to mix before withdrawing the dose.
- D. Discard the vial after removing one dose of the medication.
Correct answer: D
Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing. It is crucial not to shake the vial but gently invert it to mix the medication before withdrawing the appropriate dose. Refrigeration is not required for Filgrastim; it should be stored at room temperature until just before administration. Choice A is incorrect because Filgrastim is typically administered subcutaneously, not intravenously. Choice B is incorrect as the medication should be stored at room temperature, not refrigerated, until administration. Choice C is incorrect as shaking the vial is not recommended for Filgrastim.
2. A client with breast cancer is receiving cyclophosphamide. What finding should the nurse monitor for?
- A. Hypertension
- B. Hyperglycemia
- C. Ototoxicity
- D. Hemorrhagic cystitis
Correct answer: D
Rationale: When a client is receiving cyclophosphamide, the nurse should monitor for hemorrhagic cystitis, a severe adverse effect caused by bladder irritation. It is essential to watch for signs such as hematuria, dysuria, and urinary frequency, and promptly intervene to prevent further complications. Hypertension (Choice A) is not typically associated with cyclophosphamide use. Hyperglycemia (Choice B) is not a common side effect of cyclophosphamide. Ototoxicity (Choice C) is more commonly associated with medications like aminoglycoside antibiotics or high-dose aspirin.
3. A client has a new prescription for Furosemide. Which of the following adverse effects should the nurse monitor?
- A. Hyperkalemia
- B. Hyponatremia
- C. Hypernatremia
- D. Hypercalcemia
Correct answer: B
Rationale: The correct answer is B: Hyponatremia. Furosemide, a diuretic, commonly causes hyponatremia (low sodium levels) as it increases the excretion of sodium. The nurse needs to monitor the client for signs of hyponatremia, such as confusion, weakness, and muscle cramps, by checking electrolyte levels regularly. Choices A, C, and D are incorrect because hyperkalemia (choice A), hypernatremia (choice C), and hypercalcemia (choice D) are not typically associated with Furosemide use.
4. A client is receiving treatment with etoposide. Which of the following findings should the nurse monitor?
- A. Hypotension
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypertension
Correct answer: A
Rationale: Etoposide is associated with hypotension as a common adverse effect. Therefore, the nurse should closely monitor the client for signs and symptoms of hypotension while receiving this medication, such as dizziness, light-headedness, or low blood pressure readings. Prompt recognition and management of hypotension can help prevent complications and ensure the client's safety during treatment with etoposide.
5. Why has an ACE inhibitor been prescribed following an MI?
- A. “This medication will lower your potassium level.”
- B. “ACE inhibitors have been found to reduce mortality following MI.”
- C. “ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI.”
- D. “This medication will treat your hypotension.”
Correct answer: B
Rationale: Following a myocardial infarction (MI), ACE inhibitors are commonly prescribed due to their proven benefit in reducing mortality and improving outcomes post-MI. These medications help by decreasing the workload of the heart, preventing remodeling of the heart chambers, and improving survival rates. While ACE inhibitors may have effects on potassium levels, the primary reason for their prescription post-MI is their mortality-reducing properties.
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