ATI RN
Proctored Pharmacology ATI
1. A client has a prescription for Acyclovir. Which of the following instructions should the nurse include?
- A. Expect to take this medication long-term.
- B. Increase fluid intake during therapy.
- C. Avoid sexual contact while on this medication.
- D. Consult your healthcare provider if you experience nausea.
Correct answer: B
Rationale: The correct instruction for a client taking Acyclovir is to increase fluid intake during therapy. Acyclovir can cause nephrotoxicity, potentially leading to kidney damage. Increasing fluid intake helps prevent this adverse effect by promoting adequate renal function and drug elimination. Choices A, C, and D are incorrect. Acyclovir is usually prescribed for short-term use, there is no need to avoid sexual contact while on the medication, and nausea is not a common side effect that necessitates immediate consultation with a healthcare provider.
2. A nurse is assessing a client who has a new prescription for enoxaparin. Which of the following findings is a priority for the nurse to report?
- A. Platelet count of 200,000/mm³
- B. Hemoglobin level of 15 g/dL
- C. Respiratory rate of 22/min
- D. Dark, tarry stools
Correct answer: D
Rationale: The correct answer is D. Dark, tarry stools indicate gastrointestinal bleeding, which is a serious side effect of enoxaparin that requires immediate medical attention. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and C are within normal ranges and are not directly related to the adverse effects of enoxaparin, so they do not take precedence over the urgent concern of gastrointestinal bleeding.
3. An oncology patient has just returned from the post-anesthesia care unit after an open hemicolectomy. This patient’s plan of nursing care should prioritize which of the following?
- A. Assess the patient hourly for signs of compartment syndrome.
- B. Assess the patient’s fine motor skills once per shift.
- C. Assess the patient’s wound for dehiscence every 4 hours.
- D. Maintain the patient’s head of bed at 45 degrees or more at all times.
Correct answer: C
Rationale: After an open hemicolectomy (surgical removal of part of the colon), monitoring the surgical wound for signs of dehiscence (wound reopening) is a critical nursing priority. Dehiscence is a serious postoperative complication that can occur if the surgical site does not heal properly. Regular wound assessments every 4 hours allow the nurse to identify early signs of complications, such as redness, swelling, increased drainage, or separation of the wound edges. Early detection is key to preventing further complications, such as infection or evisceration (protrusion of abdominal organs through the wound).
4. Which statement made by the nurse demonstrates the best understanding of nonverbal communication?
- A. The patient's verbal and nonverbal communication is often different.
- B. When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.
- C. If a patient is slumped in the chair, I can be sure he's angry or depressed.
- D. It's easier to understand verbal communication than nonverbal communication.
Correct answer: B
Rationale: Checking for congruence between verbal and nonverbal communication helps validate the patient's response.
5. A healthcare professional is reviewing the laboratory values of a client who has cirrhosis. Which of the following findings should the healthcare professional report to the provider?
- A. Ammonia 75 mcg/dL
- B. Sodium 142 mEq/L
- C. Calcium 9.5 mg/dL
- D. Bilirubin 2.5 mg/dL
Correct answer: D
Rationale: An elevated bilirubin level in clients with cirrhosis indicates worsening liver function and potential complications. It is crucial to report this finding promptly as it may require immediate medical intervention. Elevated ammonia levels (choice A) are also concerning in cirrhosis, indicating hepatic encephalopathy, but bilirubin levels are more specific to liver function in this context. Choices B and C are within normal ranges and are not typically of immediate concern in cirrhosis.
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