ATI RN
ATI Pharmacology Proctored Exam 2023
1. When teaching a client with a new prescription for Amiodarone, which instruction should the nurse include?
- A. Take this medication with meals.
- B. Avoid drinking grapefruit juice.
- C. Take this medication at bedtime.
- D. Increase your intake of sodium-rich foods.
Correct answer: B
Rationale: The correct instruction is to avoid drinking grapefruit juice when taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the drug and potentially causing adverse effects like cardiac toxicity. Choices A, C, and D are incorrect because taking Amiodarone with meals, at bedtime, or increasing sodium-rich foods intake are not relevant instructions for this medication.
2. A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?
- A. The client had a prior myocardial infarction.
- B. The client takes warfarin for atrial fibrillation.
- C. The client takes an SSRI for depression.
- D. An ECG indicates a first-degree heart block.
Correct answer: D
Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.
3. Which of the following is not an effect of the drug isoflurane?
- A. Elevated lipid levels
- B. Nausea
- C. Increased blood flow to the brain
- D. Decreased respiratory function
Correct answer: A
Rationale: Isoflurane is not known to cause elevated lipid levels. Common effects of isoflurane include nausea, increased blood flow to the brain, and decreased respiratory function. Elevated lipid levels are not typically associated with the administration of isoflurane, making choice A the correct answer.
4. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?
- A. Administering a supplemental dose of hydrocortisone
- B. Instructing the client about coughing and deep breathing
- C. Collecting additional information from the client about his history of Addison's disease
- D. Inserting an indwelling urinary catheter
Correct answer: A
Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.
5. A client is taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects?
- A. Increased TSH level
- B. Decreased ALT level
- C. Hypoglycemia
- D. Hyperlipidemia
Correct answer: D
Rationale: Hyperlipidemia, characterized by increased cholesterol and triglyceride levels, can occur as an adverse effect of Ritonavir. Monitoring lipid levels is essential to detect and manage this potential side effect in clients taking this medication for HIV infection.
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