ATI RN
ATI Pharmacology Proctored Exam 2019
1. A nurse is teaching a client who has breast cancer about the adverse effects of chemotherapy. Which of the following statements should the nurse include?
- A. You should use a soft-bristled toothbrush to prevent bleeding.'
- B. You should take aspirin for minor aches and pains.'
- C. You should avoid contact with individuals who recently received live virus vaccines.'
- D. You should consume a diet low in protein to reduce the risk of renal damage.'
Correct answer: A
Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia.
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 is taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication?
- A. Increased TSH level
- B. Decreased ALT level
- C. Hypoglycemia
- D. Hyperlipidemia
Correct answer: D
Rationale: The correct answer is D: Hyperlipidemia. Ritonavir, a protease inhibitor used in HIV treatment, can lead to hyperlipidemia, characterized by increased cholesterol and triglyceride levels. Monitoring lipid levels is crucial to identify and manage this potential adverse effect. Choices A, B, and C are incorrect because Ritonavir is not known to cause an increased TSH level, decreased ALT level, or hypoglycemia as adverse effects.
4. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?
- A. A client with a history of deep-vein thrombosis
- B. A client with a history of migraine headaches
- C. A client with a history of hypertension
- D. A client with a history of anemia
Correct answer: A
Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots forming and leading to serious complications like pulmonary embolism. Clients with a history of deep-vein thrombosis are at a higher risk of recurrent thromboembolic events when taking tamoxifen, making it unsafe for such individuals. Choices B, C, and D are not contraindications for tamoxifen therapy, as migraine headaches, hypertension, and anemia do not directly interact with tamoxifen's mechanism of action or pose significant risks when used together.
5. A client with chronic Neutropenia is receiving Filgrastim. What action should the nurse take to assess for an adverse effect of filgrastim?
- A. Assess for bone pain.
- B. Assess for right lower quadrant pain.
- C. Auscultate for crackles in the bases of the lungs.
- D. Auscultate the chest to listen for a heart murmur.
Correct answer: A
Rationale: Bone pain is a known adverse effect of Filgrastim, which is dose-related. By assessing for bone pain, the nurse can monitor for this common side effect. Acetaminophen and, if necessary, an opioid analgesic can be used to manage the bone pain associated with Filgrastim. Assessing for right lower quadrant pain, crackles in the bases of the lungs, or heart murmurs would not directly relate to the adverse effects of Filgrastim in a client with chronic Neutropenia.
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