ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is starting to take amitriptyline. The healthcare provider should instruct the client to monitor for which of the following adverse effects?
- A. Diarrhea
- B. Urinary retention
- C. Bradycardia
- D. Dry cough
Correct answer: B
Rationale: The correct answer is B: Urinary retention. Amitriptyline, a tricyclic antidepressant, can cause relaxation of the bladder sphincter muscles, leading to urinary retention. Monitoring for urinary retention is crucial as it is a common anticholinergic effect associated with this medication. Diarrhea (choice A) is not a common adverse effect of amitriptyline. Bradycardia (choice C) is more commonly associated with beta-blockers rather than tricyclic antidepressants like amitriptyline. Dry cough (choice D) is not a typical adverse effect of amitriptyline.
2. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?
- A. Take the medication at bedtime.
- B. Take the medication with food.
- C. Take the medication first thing in the morning on an empty stomach.
- D. Take the medication with a full glass of milk.
Correct answer: C
Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.
3. A client informs the nurse that she has difficulty swallowing tablets and struggles with liquid or chewable medications due to taste. What medication should the nurse request a prescription for when preparing to administer Penicillin V to treat the client's streptococcal infection?
- A. Fosfomycin
- B. Amoxicillin
- C. Nafcillin
- D. Cefaclor
Correct answer: C
Rationale: Nafcillin is an appropriate alternative within the penicillin class for clients who have difficulty swallowing tablets or struggle with liquid or chewable medications. It is available for intramuscular (IM) or intravenous (IV) administration, offering options beyond oral formulations. Fosfomycin, Amoxicillin, and Cefaclor are not suitable alternatives for Penicillin V in this scenario as they belong to different classes of antibiotics and may not be as effective in treating streptococcal infections.
4. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?
- A. Instruct the client to self-ambulate every 2 hours.
- B. Offer oral hygiene every 2 hours.
- C. Anticipate medication administration 2 hours prior to delivery.
- D. Monitor fetal heart rate every 2 hours.
Correct answer: B
Rationale: Offering oral hygiene every 2 hours is essential for a client receiving opioid analgesics to prevent dry mouth, nausea, and vomiting, which are common adverse effects associated with opioid use. This intervention promotes comfort and enhances the client's well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate for a client in labor receiving opioid analgesics, as it may be challenging and unnecessary during this time. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's pain level and the duration of action of the opioid. Monitoring fetal heart rate every 2 hours is important during labor, but the priority in this case is to address the client's comfort and well-being by offering oral hygiene.
5. A client is being discharged with a new prescription for Atenolol. Which of the following instructions should the nurse include?
- A. Take this medication in the morning.
- B. Monitor your heart rate regularly.
- C. Avoid consuming foods high in potassium.
- D. Increase your fluid intake.
Correct answer: B
Rationale: The correct answer is B: 'Monitor your heart rate regularly.' Atenolol is a beta-blocker that can cause bradycardia (slow heart rate). Monitoring the heart rate regularly is crucial to promptly detect any significant decreases. This allows for timely intervention and adjustment of the medication regimen if needed, helping to prevent adverse effects associated with bradycardia. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning does not address the need for heart rate monitoring. Avoiding foods high in potassium is more relevant for medications like ACE inhibitors or potassium-sparing diuretics. Increasing fluid intake is not directly related to the use of Atenolol.
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