ATI RN
ATI Pharmacology Proctored Exam 2024
1. A client who has been taking prednisone to treat asthma is advised to discontinue the medication. The client should be instructed to reduce the dose gradually to prevent which of the following adverse effects?
- A. Hyperglycemia
- B. Adrenocortical insufficiency
- C. Severe dehydration
- D. Rebound pulmonary congestion
Correct answer: B
Rationale: Abruptly stopping prednisone can result in adrenocortical insufficiency due to suppression of the adrenal glands. Gradually tapering the dose helps the body adjust and resume its natural cortisol production, preventing adrenal insufficiency. Choice A, hyperglycemia, is a possible adverse effect of prednisone, but it is not the primary reason for gradual tapering. Severe dehydration (Choice C) and rebound pulmonary congestion (Choice D) are not typically associated with discontinuing prednisone.
2. When assessing a patient with generalized anxiety disorder (GAD), which symptom would a nurse most likely observe?
- A. Flashbacks
- B. Excessive worry
- C. Hallucinations
- D. Compulsive behaviors
Correct answer: B
Rationale: Excessive worry is a primary characteristic of generalized anxiety disorder (GAD). Patients with GAD experience persistent and excessive worry about various aspects of their lives, often anticipating disaster or catastrophic outcomes. This worry is difficult to control and can be accompanied by physical symptoms like restlessness, fatigue, irritability, muscle tension, and difficulty concentrating. Flashbacks are more commonly associated with post-traumatic stress disorder (PTSD), hallucinations are more typical of psychotic disorders, and compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD). Therefore, when assessing a patient with GAD, a nurse would most likely observe excessive worry.
3. What symptom would most likely be associated with late dumping syndrome?
- A. abdominal cramps
- B. nausea
- C. diarrhea
- D. confusion
Correct answer: D
Rationale: Confusion is the most likely symptom associated with late dumping syndrome. Late dumping syndrome occurs when blood sugar levels drop rapidly after eating due to rapid gastric emptying. While abdominal cramps, nausea, and diarrhea can occur with dumping syndrome, confusion is specifically linked to late dumping syndrome due to hypoglycemia.
4. A client with lupus experience Raynaud’s phenomenon. What should the nurse include when providing client education about this?
- A. In order to avoid flare-ups of Raynaud’s, ensure you wear gloves in winter.’
- B. ‘In order to avoid flare-ups of Raynaud’s, ensure you brush your teeth for 2 minutes.’
- C. ‘In order to avoid flare-ups of Raynaud’s, ensure to keep cool.’
- D. ‘In order to avoid flare-ups of Raynaud’s, ensure you wear sunscreen.’
Correct answer: In order to avoid flare-ups of Raynaud’s, ensure you wear gloves in winter.’
Rationale:
5. A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?
- A. Remove the prior dose before applying a new dose.
- B. Rub the ointment directly into the skin until it is no longer visible.
- C. Cover the applied ointment with a clean gauze pad.
- D. Apply the ointment to the same skin area each time.
Correct answer: A
Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.
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