ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?
- A. Digoxin
- B. Metformin
- C. Warfarin
- D. Nitroglycerin
Correct answer: C
Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.
2. A client in the post-anesthesia recovery unit received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications?
- A. Neostigmine
- B. Naloxone
- C. Dantrolene
- D. Vecuronium
Correct answer: A
Rationale: Neostigmine is a cholinesterase inhibitor commonly used to reverse the effects of nondepolarizing neuromuscular blockers, such as the one the client received. It works by inhibiting the breakdown of acetylcholine, thereby enhancing neuromuscular transmission and reversing muscle weakness caused by the neuromuscular blocking agent.
3. A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
- A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
- B. I will call the provider to get a prescription for discontinuing the IV heparin today.
- C. Both heparin and warfarin work together to dissolve the clots.
- D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.
Correct answer: A
Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.
4. A client has a new prescription for Metronidazole. Which of the following instructions should be included in the discharge teaching?
- A. Avoid drinking alcohol while taking this medication.
- B. Take this medication on an empty stomach.
- C. Avoid dairy products while taking this medication.
- D. Take this medication with antacids.
Correct answer: A
Rationale: The correct instruction to include in the discharge teaching for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Drinking alcohol with Metronidazole can result in a disulfiram-like reaction, leading to symptoms such as nausea, vomiting, and flushing. Therefore, it is crucial for the client to abstain from alcohol consumption during the course of treatment with Metronidazole.
5. When educating a client who has a prescription for Levothyroxine, which instruction should the nurse include?
- A. Take this medication on an empty stomach.
- B. Take this medication with food.
- C. Take this medication at bedtime.
- D. Take this medication with antacids.
Correct answer: A
Rationale: The correct instruction for taking Levothyroxine is on an empty stomach. This helps to enhance the absorption and effectiveness of the medication. Consuming it with food or antacids can impede its absorption, leading to decreased efficacy.
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