ATI RN
ATI Pharmacology Proctored Exam 2023
1. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include in the discharge teaching?
- A. Take one tablet every 15 minutes until pain is relieved.
- B. Take one tablet every 5 minutes, up to three doses.
- C. Take one tablet at bedtime.
- D. Take one tablet on an empty stomach.
Correct answer: B
Rationale: The correct instruction for Nitroglycerin sublingual tablets is to take one tablet at the onset of chest pain, then repeat every 5 minutes for up to three doses. This regimen helps in relieving angina symptoms effectively. Option A of taking one tablet every 15 minutes is too infrequent and may delay symptom relief. Option C of taking one tablet at bedtime is not appropriate as Nitroglycerin is used for immediate relief of angina. Option D of taking one tablet on an empty stomach is irrelevant since Nitroglycerin is not affected by food intake.
2. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?
- A. Vitamin K
- B. Calcium carbonate
- C. Acetaminophen
- D. Ranitidine
Correct answer: C
Rationale: The correct answer is Acetaminophen. Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking warfarin. Warfarin works by inhibiting the clotting factors dependent on vitamin K, so Vitamin K intake should be consistent but not excessive. Calcium carbonate and ranitidine do not significantly increase the risk of bleeding when used concurrently with Warfarin.
3. A client reports taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?
- A. Sedation
- B. Nasal congestion
- C. Productive cough
- D. Constipation
Correct answer: B
Rationale: The correct answer is B: Nasal congestion. When used for more than 5 days, nasal sympathomimetic medications like phenylephrine can lead to rebound nasal congestion, which is an adverse effect to be assessed in the client. Sedation (choice A) is not a common adverse effect of phenylephrine. Productive cough (choice C) and constipation (choice D) are also not typical adverse effects associated with phenylephrine use.
4. A client has a new diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?
- A. Colchicine
- B. Hydroxychloroquine
- C. Auranofin
- D. Duloxetine
Correct answer: D
Rationale: The correct answer is D, Duloxetine. Duloxetine is a serotonin-norepinephrine reuptake inhibitor commonly used to manage fibromyalgia. It helps in reducing pain and improving mood in individuals with this condition. Colchicine (Choice A) is primarily used to treat gout, while Hydroxychloroquine (Choice B) and Auranofin (Choice C) are medications used to manage conditions like rheumatoid arthritis and lupus, not fibromyalgia.
5. When teaching the parents of a child who has a new prescription for Desipramine, which of the following adverse effects should the nurse instruct the parents is the priority to report to the provider?
- A. Constipation
- B. Suicidal thoughts
- C. Photophobia
- D. Dry mouth
Correct answer: B
Rationale: The priority adverse effect to report when a child is taking Desipramine is suicidal thoughts. Desipramine can lead to an increased risk of suicidal thoughts and behaviors. The nurse should emphasize to the parents the importance of monitoring the child for any signs of worsening depression or suicidal ideation. Prompt reporting of such symptoms can help prevent harm to the child. Choices A, C, and D are not the priority adverse effects associated with Desipramine. While constipation, photophobia, and dry mouth can occur as side effects of Desipramine, they are not as critical as the risk of suicidal thoughts, which requires immediate attention to ensure the safety of the child.
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