ATI RN
ATI Pharmacology Proctored Exam 2024
1. When teaching a client who has a prescription for Lisinopril, which of the following instructions should the nurse include?
- A. Take the medication at bedtime.
- B. Monitor for a persistent cough.
- C. Expect to have increased appetite.
- D. Avoid foods high in potassium.
Correct answer: B
Rationale: The correct answer is B: 'Monitor for a persistent cough.' Lisinopril, an ACE inhibitor, can cause a persistent dry cough as a side effect. It is essential for the client to report this symptom to their healthcare provider for further evaluation and management. Choice A is incorrect because Lisinopril is typically taken in the morning. Choice C is incorrect as Lisinopril is not known to cause increased appetite. Choice D is also incorrect as Lisinopril can lead to increased potassium levels in the blood, so avoiding foods high in potassium is not necessary.
2. A client has a new prescription for clonidine to treat hypertension. Which of the following instructions should the nurse include?
- A. Discontinue the medication if a rash develops.
- B. Expect increased salivation during the first few weeks of therapy.
- C. Avoid driving until the client's reaction to the medication is known.
- D. Stop the medication if you experience a dry mouth.
Correct answer: C
Rationale: The correct instruction for a client starting clonidine therapy for hypertension is to avoid driving until their reaction to the medication is known. Clonidine can cause drowsiness, so engaging in activities like driving that require alertness should be avoided until the individual understands how the medication affects them. Choices A, B, and D are incorrect because they do not address the specific side effect of drowsiness associated with clonidine that could impair driving abilities. Discontinuing the medication if a rash develops, expecting increased salivation, or stopping the medication for dry mouth are not primary concerns related to clonidine therapy for hypertension.
3. A client is taking oral Oxycodone and Ibuprofen in recommended doses. The nurse should identify that an interaction between these two medications will cause which of the following findings?
- A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
- B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
- C. An increase in the expected therapeutic effect of both medications.
- D. An increase in expected adverse effects for both medications.
Correct answer: C
Rationale: When Oxycodone, a narcotic analgesic, and Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), are taken together, they work synergistically to enhance the pain-relieving effects of both medications. These drugs act through different mechanisms, leading to a combined analgesic effect that is more effective than when used alone. Therefore, the interaction between Oxycodone and Ibuprofen results in an increase in the expected therapeutic effect of both medications.
4. A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?
- A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
- B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
- C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
- D. Draw a peak level at 0900 and a trough level at 2100.
Correct answer: C
Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.
5. How do ACE inhibitors work?
- A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
- B. Block stimulation of beta 1 and beta 2 at the receptor sites
- C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
- D. None of the above
Correct answer: C
Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.
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