ATI RN
ATI Pharmacology Proctored Exam
1. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
- A. Take one tablet at the first sign of chest pain.
- B. If pain is not relieved, take another tablet in 10 minutes.
- C. You can take up to five tablets in 15 minutes.
- D. Swallow the tablet with water.
Correct answer: A
Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain persists after 5 minutes, the client should call 911 and take a second tablet. Choice A is correct because taking one tablet at the onset of chest pain helps to relieve symptoms by dilating blood vessels and improving blood flow to the heart. Choices B and C are incorrect as they suggest taking multiple tablets without waiting for the initial dose to take effect, which can lead to hypotension and other adverse effects. Choice D is incorrect as nitroglycerin sublingual tablets should not be swallowed but instead placed under the tongue for rapid absorption.
2. The nurse aspirates 40 mL of undigested formula from the client’s nasogastric tube. Before administering an intermittent tube feeding, the nurse understands that the 40 mL of gastric aspirate should be
- A. Discarded properly and recorded as output on the client’s intake and output record.
- B. Poured into the nasogastric tube through a syringe with the plunger removed.
- C. Mixed with the formula and poured into the nasogastric tube through a syringe with the plunger removed.
- D. Diluted with water and injected into the nasogastric tube by putting pressure on the plunger.
Correct answer: B
Rationale: After checking the residual feeding contents, the gastric contents are reinstalled into the stomach by removing the syringe bulb or plunger and pouring the gastric contents into the syringe and through the nasogastric tube. Gastric contents should be reinstalled to maintain the client’s electrolyte balance. The gastric contents should be poured into the nasogastric tube through a syringe without a plunger and not injected by putting pressure on the plunger. Gastric contents do not need to be mixed with water or should the contents be discarded.
3. A client is hospitalized with a second episode of pulmonary embolism (PE). Recent genetic testing reveals the client has an alteration in the gene CYP2C19. What action by the nurse is best?
- A. Instruct the client to eliminate all vitamin K from the diet.
- B. Prepare preoperative teaching for an inferior vena cava (IVC) filter.
- C. Refer the client to a chronic illness support group.
- D. Teach the client to use a soft-bristled toothbrush.
Correct answer: B
Rationale: Clients with an alteration in the CYP2C19 gene do not metabolize warfarin (Coumadin) well, leading to higher blood levels and more side effects. As this client is a poor candidate for warfarin therapy, the prescriber will most likely recommend the implantation of an inferior vena cava (IVC) filter. This device helps prevent blood clots from reaching the lungs, reducing the risk of pulmonary embolism.
4. A client is experiencing a moderate level of anxiety. Which is an example of an appropriate nursing intervention?
- A. Allow the client to pace in a safe environment.
- B. Encourage the client to discuss feelings.
- C. Help the client identify the cause of anxiety.
- D. Provide a distraction for the client.
Correct answer: A
Rationale: Allowing the client to pace in a safe environment is an appropriate nursing intervention for managing moderate anxiety levels. Allowing pacing provides the client with a physical outlet for their anxiety and can help them release nervous energy without increasing distress. It promotes movement and can aid in reducing feelings of restlessness or agitation. Encouraging the client to discuss feelings (Choice B) is more suitable for addressing emotional aspects of anxiety rather than providing an immediate physical outlet. Helping the client identify the cause of anxiety (Choice C) may be more appropriate for long-term management but may not address the immediate need for physical release. Providing a distraction (Choice D) may not directly address the physical needs associated with moderate anxiety levels.
5. When teaching parents of a school-age child about transdermal Methylphenidate, which instruction should the nurse include?
- A. Apply one patch once per day.
- B. Leave the patch on for 9 hours.
- C. Apply the patch to the child's waistline.
- D. Use the opened tray within 6 months.
Correct answer: B
Rationale: When administering transdermal Methylphenidate, the patch should be left on for 9 hours per day to ensure optimal absorption and effectiveness of the medication. This duration helps maintain a consistent level of the drug in the child's system. Incorrect options: A) Applying one patch once per day is not the correct dosing regimen for transdermal Methylphenidate. C) The patch should not be applied to the child's waistline as it is recommended to apply it to a clean, dry area. D) Using the opened tray within 6 months is not directly related to the administration of transdermal Methylphenidate.
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