ATI RN
ATI Pharmacology Proctored Exam 2024
1. A client with chronic kidney disease has a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?
- A. Iron
- B. Protein
- C. Potassium
- D. Sodium
Correct answer: A
Rationale: Patients with chronic kidney disease are often prescribed epoetin alfa to treat anemia. Epoetin alfa stimulates red blood cell production, increasing the body's demand for iron to support this process. Therefore, clients taking epoetin alfa should be advised to increase their dietary intake of iron-rich foods to meet the increased demand and prevent iron deficiency anemia. Choices B, C, and D are incorrect because while protein is essential for overall health, potassium and sodium intake may need to be restricted in clients with chronic kidney disease to manage electrolyte balance and blood pressure.
2. During a home care visit for an infant diagnosed with gastroesophageal reflux, which parental action observed requires intervention by the nurse?
- A. The infant's formula is mixed with rice cereal.
- B. The mother positions the infant in a high Fowler position while feeding.
- C. After feeding, the infant is placed in a car seat.
- D. The mother administers ranitidine (Zantac) to the infant using a syringe.
Correct answer: C
Rationale: Placing an infant diagnosed with gastroesophageal reflux in a car seat after feeding can increase the risk of reflux and aspiration. The semi-upright or high Fowler position is recommended to help reduce reflux symptoms during feeding. Adding rice cereal to formula can help thicken it and reduce reflux episodes. Administering ranitidine using a syringe is a common method of oral medication administration. Therefore, the action of placing the infant in a car seat after feeding is the one that requires intervention due to the increased risk it poses.
3. The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching?
- A. Lack of congruence among family members
- B. Clear set of family values, rules, and beliefs
- C. Adoption of one coping strategy that always promotes positive functioning in dealing with life events
- D. Sense of commitment toward growth of individual family members as opposed to that of the family unit
Correct answer: B
Rationale: Strong families have a clear set of values, rules, and beliefs that guide their interactions and help them function effectively as a unit.
4. A nurse is assessing clients for fluid and electrolyte imbalances. Which client should the nurse assess first for potential hyponatremia?
- A. A 34-year-old on NPO status who is receiving intravenous D5W
- B. A 50-year-old with an infection who is prescribed a sulfonamide antibiotic
- C. A 67-year-old who is experiencing pain and is prescribed ibuprofen (Motrin)
- D. A 73-year-old with tachycardia who is receiving digoxin (Lanoxin)
Correct answer: A 34-year-old on NPO status who is receiving intravenous D5W
Rationale: The correct answer is the 34-year-old on NPO status receiving intravenous D5W because D5W is a hypotonic solution that can dilute the blood's sodium levels, leading to hyponatremia. Patients on NPO status rely solely on intravenous fluids for hydration, making them more susceptible to electrolyte imbalances. Choices B, C, and D are less likely to cause hyponatremia. Choice B, the 50-year-old with an infection on a sulfonamide antibiotic, is at risk for allergic reactions or renal issues. Choice C, the 67-year-old taking ibuprofen, is at risk for gastrointestinal bleeding or kidney problems. Choice D, the 73-year-old on digoxin with tachycardia, is more likely to experience digoxin toxicity, affecting the heart's rhythm.
5. A nurse is caring for a client who has cirrhosis. Which of the following laboratory values should the nurse expect to be elevated?
- A. Serum albumin.
- B. Ammonia.
- C. Bilirubin.
- D. Prothrombin time.
Correct answer: B
Rationale: The correct answer is B: Ammonia. In clients with cirrhosis, impaired liver function can lead to elevated levels of ammonia in the blood. Elevated ammonia levels can result in hepatic encephalopathy, a condition characterized by altered mental status. Serum albumin (Choice A) is typically decreased in cirrhosis due to the liver's reduced synthetic function. Bilirubin (Choice C) levels can be elevated in liver disease but may not always be the most specific marker for cirrhosis. Prothrombin time (Choice D) is prolonged in cirrhosis due to impaired liver synthesis of clotting factors.
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