ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is being taught about a new prescription for Escitalopram to treat generalized anxiety disorder. Which statement by the client indicates understanding of the teaching?
- A. I should take the medication with food.
- B. I will monitor my blood sugar levels while taking this medication.
- C. I need to discontinue this medication slowly.
- D. I can crush this medication before swallowing.
Correct answer: C
Rationale: The correct answer is C. When discontinuing Escitalopram, the client should taper the medication slowly according to a prescribed dosing schedule to reduce the risk of withdrawal syndrome. Abruptly stopping the medication can lead to withdrawal symptoms, so it is important to follow the healthcare provider's instructions for gradual discontinuation. Choices A, B, and D are incorrect because Escitalopram should not necessarily be taken with food, there is no direct correlation with blood sugar levels, and the medication should not be crushed before swallowing.
2. A client is starting therapy with filgrastim. Which of the following adverse effects should the nurse instruct the client to monitor?
- A. Bone pain
- B. Constipation
- C. Tinnitus
- D. Dry mouth
Correct answer: A
Rationale: When a client is starting therapy with filgrastim, monitoring for bone pain is essential. Filgrastim can lead to increased bone marrow activity, resulting in bone pain as a common adverse effect. Instructing the client to monitor and report any bone pain promptly can help in managing this side effect effectively.
3. A client with angina asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with Sildenafil?
- A. Aspirin
- B. Isosorbide
- C. Clopidogrel
- D. Atorvastatin
Correct answer: B
Rationale: Isosorbide is an organic nitrate used to manage angina. Concurrent use of sildenafil with organic nitrates, like isosorbide, is contraindicated due to the risk of fatal hypotension. It is essential for clients to avoid taking nitrate medications within 24 hours of using isosorbide to prevent serious complications.
4. A nurse is providing discharge instructions for a client who has a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take the medication before bed.
- B. Monitor for increased blood pressure.
- C. Take the medication on an empty stomach.
- D. Monitor for leg cramps.
Correct answer: D
Rationale: The correct answer is D: 'Monitor for leg cramps.' Leg cramps may indicate hypokalemia, an adverse effect of hydrochlorothiazide, and should be reported to the provider. Choice A is incorrect because hydrochlorothiazide is usually taken in the morning to avoid nocturia. Choice B is incorrect as hydrochlorothiazide is a diuretic that helps lower blood pressure. Choice C is incorrect as hydrochlorothiazide can be taken with or without food.
5. A client is being taught about a new prescription for Celecoxib. Which of the following information should be included in the teaching?
- A. Increases the risk for a myocardial infarction
- B. Decreases the risk of stroke
- C. Inhibits COX-1
- D. Increases platelet aggregation
Correct answer: A
Rationale: The correct answer is A: 'Increases the risk for a myocardial infarction.' Celecoxib, a COX-2 inhibitor, increases the risk for a myocardial infarction due to its effect on suppressing vasodilation, which can lead to this adverse cardiovascular event. Choices B, C, and D are incorrect. Celecoxib does not decrease the risk of stroke, inhibit COX-1, or increase platelet aggregation. It's crucial for the nurse to educate the client about the increased risk for a myocardial infarction when taking Celecoxib and emphasize monitoring for signs of heart issues and the importance of seeking prompt medical attention if symptoms occur.
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