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 has a new prescription for Lisinopril. Which of the following adverse effects should the nurse monitor?
- A. Dry cough
- B. Weight gain
- C. Diarrhea
- D. Nausea
Correct answer: A
Rationale: The correct answer is 'Dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent dry cough as an adverse effect. If the client experiences this, it is important to notify the healthcare provider for further evaluation and management.
3. A healthcare provider plans to administer Morphine IV to a postoperative client. Which of the following actions should the provider take?
- A. Monitor for seizures and confusion with repeated doses.
- B. Protect the client's skin from severe diarrhea associated with morphine.
- C. Withhold this medication if the respiratory rate is less than 12/min.
- D. Administer Morphine intermittently via IV bolus over 30 seconds or less.
Correct answer: C
Rationale: The correct action for the provider is to withhold morphine if the client's respiratory rate is 12/min or less. Respiratory depression is a serious side effect of morphine and other opioids. Withholding the medication and informing the healthcare provider is essential to prevent further respiratory compromise in the client. Choices A, B, and D are incorrect because monitoring for seizures and confusion, protecting the client's skin from severe diarrhea, and administering morphine via IV bolus over 30 seconds or less are not the primary actions to ensure client safety when administering morphine IV. Respiratory status is crucial due to the risk of respiratory depression associated with opioid administration.
4. When assessing a client taking Gemfibrozil, which of the following findings should the nurse identify as an adverse reaction to the medication?
- A. Mental status changes
- B. Tremor
- C. Jaundice
- D. Pneumonia
Correct answer: C
Rationale: Jaundice is an adverse reaction that can occur in clients taking Gemfibrozil due to the potential development of liver impairment. Other symptoms of liver impairment may include anorexia and upper abdominal discomfort. Monitoring for signs of jaundice is crucial to detect and manage adverse effects of the medication promptly. Mental status changes (choice A) are not commonly associated with Gemfibrozil use. Tremor (choice B) is not a typical adverse reaction of Gemfibrozil. Pneumonia (choice D) is not directly linked to Gemfibrozil use but can be a complication in some cases.
5. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?
- A. Apply the patch to the same site each day.
- B. Remove the patch at night.
- C. Cover the patch with a heating pad.
- D. Apply the patch to a hairless area of skin.
Correct answer: D
Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This ensures proper absorption of the medication. It is important to rotate the application site daily to prevent skin irritation and tolerance development. Applying the patch to the same site each day can lead to decreased efficacy and potential skin reactions. Removing the patch at night is not necessary as the patches are usually worn continuously to provide constant medication delivery. Covering the patch with a heating pad can increase the absorption of the medication and lead to an overdose, which is not recommended.
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