ATI RN
ATI Pharmacology Proctored Exam
1. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?
- A. Contact the provider if the heart rate is less than 60/min.
- B. Check the pulse rate for 30 seconds and multiply the result by 2.
- C. Increase the intake of sodium.
- D. Take with food if nausea occurs.
Correct answer: A
Rationale: The correct answer is A. It is crucial for clients on Digoxin to monitor their heart rate. A heart rate less than 60/min can indicate bradycardia, a potential side effect of Digoxin. Therefore, the client should be instructed to contact the provider if their heart rate is less than 60/min to prevent complications and receive appropriate management. Choices B, C, and D are incorrect. Checking the pulse rate for 30 seconds and multiplying by 2 is not specific to Digoxin administration. Increasing sodium intake is contraindicated as Digoxin can lead to sodium retention. Taking Digoxin with food if nausea occurs is not recommended as it may affect the drug's absorption.
2. A client has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?
- A. Orthostatic hypotension
- B. Hearing loss
- C. Gastrointestinal bleeding
- D. Weight loss
Correct answer: A
Rationale: Orthostatic hypotension is a known adverse effect of MAOIs, such as Phenelzine. It is characterized by a drop in blood pressure upon standing, which can lead to dizziness or fainting. Monitoring for orthostatic hypotension is crucial when administering MAOIs to prevent potential complications. Hearing loss (Choice B) is not a typical adverse effect associated with Phenelzine. Gastrointestinal bleeding (Choice C) is more commonly linked to NSAIDs or anticoagulants. Weight loss (Choice D) is not a typical adverse effect of Phenelzine and is more likely related to other factors such as appetite changes or metabolic issues.
3. A client has been prescribed Nitroglycerin patches for angina. Which of the following instructions should the nurse include during discharge teaching?
- A. Apply the patch to a different site each time.
- B. Remove the patch for 12 hours each day.
- C. Apply the patch at the same time every day.
- D. Cut the patch in half if your blood pressure is well controlled.
Correct answer: B
Rationale: The correct answer is B: 'Remove the patch for 12 hours each day.' Nitroglycerin patches should be removed for 12 hours each day to prevent the development of tolerance. This nitrate-free interval ensures the medication remains effective in managing angina. Choice A is incorrect because applying the patch to a different site each time is not necessary; it is more important to ensure a nitrate-free interval. Choice C is incorrect because while consistency in timing is good for medication adherence, the crucial aspect for Nitroglycerin patches is the nitrate-free interval. Choice D is incorrect because cutting the patch in half based on blood pressure control is not a recommended practice and could alter the medication's efficacy.
4. A client has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the client should be advised to do which of the following?
- A. Avoid using acetaminophen for headaches.
- B. Restrict intake of foods rich in sodium.
- C. Decrease fluid intake to less than 1,500 mL daily.
- D. Limit aerobic activity in hot weather.
Correct answer: D
Rationale: The correct answer is to advise the client to limit aerobic activity in hot weather. Aerobic activity in hot weather can lead to excessive sweating, potentially causing sodium and water depletion, which can increase the risk of Lithium toxicity. It is important for clients taking Lithium to maintain adequate hydration and sodium levels to prevent toxicity. Choices A, B, and C are incorrect. Avoiding acetaminophen for headaches is not directly related to Lithium toxicity. Restricting intake of foods rich in sodium is not recommended because adequate sodium levels are necessary to prevent Lithium toxicity. Decreasing fluid intake to less than 1,500 mL daily is also not advisable as adequate hydration is important to prevent Lithium toxicity.
5. A client is receiving treatment with methotrexate. Which of the following supplements should the nurse instruct the client to take?
- A. Folic acid
- B. Vitamin D
- C. Calcium
- D. Iron
Correct answer: A
Rationale: The nurse should instruct the client to take folic acid when receiving treatment with methotrexate to reduce the risk of methotrexate toxicity. Methotrexate acts as a folic acid antagonist, leading to folic acid deficiency, which can be counteracted by supplementing with folic acid. Vitamin D, calcium, and iron are not specifically recommended to counteract methotrexate effects and do not play a significant role in mitigating methotrexate toxicity.
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