ATI RN
ATI Pharmacology Proctored Exam
1. When educating a client with early Parkinson's disease about pramipexole, what adverse effect should the nurse advise the client to monitor for?
- A. Hallucinations
- B. Increased salivation
- C. Diarrhea
- D. Discoloration of urine
Correct answer: A
Rationale: The correct answer is A: Hallucinations. Pramipexole can lead to hallucinations, especially within 9 months of starting the medication, and may necessitate discontinuation. Hallucinations are a serious adverse effect that the client should be aware of and report promptly to their healthcare provider for evaluation and management. Increased salivation (choice B), diarrhea (choice C), and discoloration of urine (choice D) are not common adverse effects associated with pramipexole and are not typically emphasized in client education for this medication.
2. A male client recently started taking Haloperidol. Which of the following findings is the highest priority to report to the provider?
- A. Shuffling gait
- B. Neck spasms
- C. Drowsiness
- D. Impotence
Correct answer: B
Rationale: Neck spasms are an indication of acute dystonia, a serious side effect of Haloperidol that can quickly progress to a crisis situation. Immediate medical attention is necessary to prevent complications. Shuffling gait and drowsiness are common side effects of Haloperidol but are not as urgent as neck spasms. Impotence is not typically associated with Haloperidol use. Therefore, identifying neck spasms as the priority finding is crucial for the client's safety.
3. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?
- A. Spironolactone
- B. Furosemide
- C. Hydrochlorothiazide
- D. Bumetanide
Correct answer: A
Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.
4. A client has a new prescription for Losartan. Which of the following laboratory values should the nurse monitor?
- A. Serum potassium
- B. Serum sodium
- C. Serum calcium
- D. Serum magnesium
Correct answer: A
Rationale: Corrected Rationale: Losartan, an angiotensin II receptor blocker (ARB), can cause hyperkalemia. The nurse should monitor the client's serum potassium levels closely because Losartan can increase potassium levels, potentially leading to serious complications such as arrhythmias. Monitoring serum sodium, calcium, or magnesium levels is not typically necessary when a patient is prescribed Losartan, as these values are not directly affected by this medication.
5. When administering Phenytoin, what should you monitor?
- A. Behavior
- B. Therapeutic blood levels
- C. For signs of Stevens-Johnson syndrome
- D. All of the above
Correct answer: D
Rationale: When administering Phenytoin, monitoring the patient's behavior is important to assess for any changes that may indicate adverse effects. Monitoring therapeutic blood levels helps ensure the medication is within the effective range and not causing toxicity. Additionally, being vigilant for signs of Stevens-Johnson syndrome, a severe skin reaction associated with Phenytoin use, is crucial for early detection and intervention. Therefore, monitoring behavior, therapeutic blood levels, and for signs of Stevens-Johnson syndrome are all essential when administering Phenytoin.
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