ATI RN
ATI Proctored Pharmacology Test
1. A healthcare professional is reviewing the medication list of a client who has a new prescription for Metformin to treat type 2 diabetes. Which of the following medications should the healthcare professional identify as placing the client at risk for lactic acidosis?
- A. Metformin
- B. Metoprolol
- C. Lisinopril
- D. Insulin
Correct answer: A
Rationale: Metformin is known to have a risk of causing lactic acidosis, particularly in clients with renal impairment or predisposing conditions. Lactic acidosis is a rare but serious adverse effect of metformin use that can be life-threatening. Metoprolol, Lisinopril, and Insulin do not have a known association with lactic acidosis. Healthcare professionals should monitor clients prescribed metformin carefully, especially those with risk factors, to detect and manage lactic acidosis promptly.
2. A client is starting therapy with Metformin. Which of the following instructions should be included by the healthcare provider?
- A. Take this medication with your first bite of food.
- B. Take this medication on an empty stomach.
- C. Take this medication before bedtime.
- D. Take this medication every other day.
Correct answer: A
Rationale: The correct answer is A: 'Take this medication with your first bite of food.' Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. By taking the medication with the first bite of food, the client can help minimize potential stomach upset and improve the drug's effectiveness. Choice B is incorrect because taking Metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect as there is no specific recommendation to take Metformin before bedtime. Choice D is incorrect because Metformin is typically taken daily, not every other day, as prescribed by the healthcare provider.
3. A client has a new prescription for Alendronate to treat osteoporosis. Which of the following instructions should the nurse include?
- A. Take the medication with a full glass of water after rising in the morning.
- B. Lie down for at least 30 minutes after taking the medication.
- C. Take the medication before bedtime to reduce the risk of esophageal irritation.
- D. Crush the tablet and mix it with applesauce if having difficulty swallowing.
Correct answer: A
Rationale: The correct instruction is to take Alendronate with a full glass of water after rising in the morning. This helps reduce the risk of esophageal irritation, as the medication can cause irritation if not taken correctly. Taking it before bedtime (choice C) can increase the risk of irritation as the individual lies down. Lying down after taking the medication (choice B) can also lead to esophageal irritation. Crushing the tablet (choice D) is not recommended as Alendronate should be taken whole with a full glass of water.
4. A client is receiving heparin therapy. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?
- A. PT
- B. aPTT
- C. INR
- D. Platelet count
Correct answer: B
Rationale: The corrected answer is B: aPTT. The activated partial thromboplastin time (aPTT) is the laboratory value used to monitor the effectiveness of heparin therapy. The aPTT should be maintained at 1.5 to 2 times the normal level to ensure therapeutic anticoagulation. Monitoring aPTT helps healthcare providers adjust heparin doses to achieve the desired anticoagulant effects and prevent complications such as bleeding or clotting. Choice A, PT (prothrombin time), is used to monitor warfarin therapy, not heparin. Choice C, INR (international normalized ratio), is also used to monitor warfarin therapy. Choice D, platelet count, is important for assessing the risk of bleeding, but it does not directly monitor the effectiveness of heparin therapy.
5. 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: When a client is receiving IV Opioid analgesics during labor, the nurse should offer oral hygiene every 2 hours. Opioid analgesics can cause adverse effects like dry mouth, nausea, and vomiting. Providing oral hygiene care helps alleviate these symptoms and maintains the client's comfort and well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate during labor as mobility may be limited. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's needs and the progress of labor. Monitoring fetal heart rate every 2 hours is important during labor, but it is not specifically related to the client receiving IV Opioid analgesics.
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