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 Metronidazole to treat an infection. Which of the following instructions should the nurse include?
- A. Avoid alcohol while taking this medication.
- B. Take this medication on an empty stomach.
- C. Increase your intake of dairy products while taking this medication.
- D. Avoid direct sunlight while taking this medication.
Correct answer: A
Rationale: The correct instruction is to avoid alcohol while taking Metronidazole. This is crucial to prevent a disulfiram-like reaction, which can result in severe nausea and vomiting. Alcohol should be avoided for at least 48 hours after completing the medication course as well. Choice B is incorrect because Metronidazole can be taken with food to reduce gastrointestinal side effects. Choice C is incorrect because there is no need to increase dairy product intake while on Metronidazole. Choice D is incorrect because there is no specific instruction to avoid direct sunlight while taking this medication.
3. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?
- A. 2+ deep tendon reflexes
- B. 2+ pedal edema
- C. 24 mL/hr urinary output
- D. Respirations 12/min
Correct answer: C
Rationale: In a client receiving Magnesium Sulfate IV for Preeclampsia, a urinary output less than 25 to 30 mL/hr indicates magnesium sulfate toxicity and should be reported to the provider for further evaluation and management. Choice A, 2+ deep tendon reflexes, is a normal finding with magnesium sulfate therapy. Choice B, 2+ pedal edema, is expected in clients with preeclampsia but does not indicate magnesium sulfate toxicity. Choice D, respirations 12/min, is within the normal range and not a concerning finding related to magnesium sulfate administration.
4. A client with Angina Pectoris asks the nurse about the next step if they take one tablet, wait 5 minutes, but still have Anginal pain. Which response should the nurse provide?
- A. Take two more sublingual tablets at the same time.
- B. Call emergency services.
- C. Take a sustained-release nitroglycerin capsule.
- D. Wait another 5 minutes then take a second sublingual tablet.
Correct answer: B
Rationale: If anginal pain persists after taking the first tablet and waiting 5 minutes, the priority step is to call emergency services (911) and then take a second sublingual tablet. Persistent pain could indicate a myocardial infarction, and immediate medical attention is crucial. Taking two more tablets at the same time (Choice A) can lead to excessive vasodilation and hypotension. Taking a sustained-release nitroglycerin capsule (Choice C) is not appropriate for immediate relief during an acute episode. Waiting another 5 minutes and then taking a second tablet (Choice D) is not advisable in this emergency situation where prompt action is necessary.
5. A client with thrombophlebitis receiving heparin by continuous IV infusion asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?
- A. It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.
- B. A pharmacist is the person to answer that question.
- C. Heparin does not dissolve clots. It stops new clots from forming.
- D. The oral medication you will take after this IV will dissolve the clot.
Correct answer: C
Rationale: The correct response is C. Heparin does not dissolve clots; it prevents new clots from forming. Heparin works by inhibiting the formation of new clots and the extension of existing clots, rather than directly dissolving them. The client should be informed that the purpose of heparin therapy is to prevent the clot from getting larger and to reduce the risk of new clots forming. Choices A, B, and D are incorrect. Choice A talks about reaching a therapeutic blood level of heparin, which is not related to clot dissolution. Choice B deflects the question to a pharmacist without providing relevant information. Choice D inaccurately suggests that an oral medication will dissolve the clot, which is not the mechanism of action for heparin.
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