ATI RN
Proctored Pharmacology ATI
1. A client has been prescribed Nitroglycerin patches for angina. Which of the following instructions should the nurse include during discharge teaching?
- A. Apply the patch to a different site each time.
- B. Remove the patch for 12 hours each day.
- C. Apply the patch at the same time every day.
- D. Cut the patch in half if your blood pressure is well controlled.
Correct answer: B
Rationale: The correct answer is B: 'Remove the patch for 12 hours each day.' Nitroglycerin patches should be removed for 12 hours each day to prevent the development of tolerance. This nitrate-free interval ensures the medication remains effective in managing angina. Choice A is incorrect because applying the patch to a different site each time is not necessary; it is more important to ensure a nitrate-free interval. Choice C is incorrect because while consistency in timing is good for medication adherence, the crucial aspect for Nitroglycerin patches is the nitrate-free interval. Choice D is incorrect because cutting the patch in half based on blood pressure control is not a recommended practice and could alter the medication's efficacy.
2. A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism?
- A. Performing hand hygiene before and after IV insertion
- B. Rotating IV sites at least every 72 hours
- C. Minimizing tourniquet time
- D. Avoiding reinserting the needle into an IV catheter
Correct answer: D
Rationale: To minimize the risk of catheter embolism, it is crucial to avoid reinserting the needle into an IV catheter. This practice can potentially sever the end of the catheter, leading to catheter embolism. Proper insertion techniques, securement, and avoiding unnecessary manipulations of the catheter can help prevent this serious complication.
3. A client has a new prescription for hydrochlorothiazide. The client should monitor for which of the following adverse effects?
- A. Hyponatremia
- B. Ototoxicity
- C. Hypoglycemia
- D. Hyperkalemia
Correct answer: A
Rationale: Hyponatremia is a potential adverse effect of hydrochlorothiazide due to its diuretic action. Hydrochlorothiazide is a thiazide diuretic that can cause sodium and water loss, potentially leading to hyponatremia. Monitoring for symptoms such as weakness, confusion, and muscle cramps can help detect hyponatremia early. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) is not typically associated with hydrochlorothiazide use. Hyperkalemia (choice D) is more commonly associated with potassium-sparing diuretics rather than thiazide diuretics like hydrochlorothiazide.
4. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
- A. Perform immediate gastric lavage.
- B. Prepare the client for hemodialysis.
- C. Administer an additional oral dose of lithium.
- D. Request a stat repeat of the laboratory test.
Correct answer: A
Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.
5. A client has a new prescription for Verapamil to treat angina. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Muscle pain
- B. Dry cough
- C. Peripheral edema
- D. Increased urination
Correct answer: C
Rationale: Verapamil, a calcium channel blocker, can cause peripheral edema due to vasodilation. Clients should monitor for this adverse effect characterized by swelling in the extremities. Muscle pain (choice A) is not a common adverse effect of Verapamil. Dry cough (choice B) is more commonly associated with ACE inhibitors. Increased urination (choice D) is not a typical adverse effect of Verapamil. Therefore, the correct answer is monitoring for peripheral edema.
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