ATI RN
ATI Pharmacology Proctored Exam 2023
1. A healthcare professional is educating a client who is starting therapy with topotecan. Which of the following findings should the professional instruct the client to report?
- A. Hair loss
- B. Fatigue
- C. Sore throat
- D. Red urine
Correct answer: C
Rationale: The correct answer is C: 'Sore throat.' Clients starting therapy with topotecan should be instructed to report a sore throat because it can indicate an infection due to the immunosuppressive effects of the medication. Infections can be serious in clients undergoing chemotherapy, so early detection and treatment are crucial to prevent complications. Choices A, B, and D are incorrect because while they are potential side effects of topotecan, they are usually not as immediately concerning as a sore throat, which could signal a serious infection requiring prompt attention.
2. A client is receiving combination chemotherapy. Which of the following findings should the nurse identify as an indication of an oncologic emergency?
- A. Dry oral mucous membranes
- B. Nausea and vomiting
- C. Temperature of 38.1°C (100.6°F)
- D. Anorexia
Correct answer: C
Rationale: A temperature of 38.1°C (100.6°F) can indicate an infection, which is considered an oncologic emergency in clients receiving chemotherapy due to the increased risk of sepsis in immunocompromised individuals. Dry oral mucous membranes (Choice A), nausea and vomiting (Choice B), and anorexia (Choice D) are common side effects of chemotherapy but do not typically indicate an oncologic emergency requiring immediate intervention.
3. A healthcare professional working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the healthcare professional's priority?
- A. Administer flumazenil.
- B. Identify the client's level of orientation.
- C. Infuse IV fluids.
- D. Prepare the client for gastric lavage.
Correct answer: B
Rationale: When managing a client with Benzodiazepine toxicity, the priority action for the healthcare professional is to assess the client. Identifying the client's level of orientation allows the healthcare professional to understand the client's cognitive status, which is crucial for further interventions and decision-making in the care plan. Administering flumazenil (Choice A) may precipitate withdrawal symptoms and should be done cautiously. Infusing IV fluids (Choice C) can be important but is not the priority over assessing the client. Gastric lavage (Choice D) is not typically recommended due to the risk of complications and its limited effectiveness in cases of Benzodiazepine overdose.
4. A healthcare professional is administering a Dopamine infusion at a low dose to a client with severe heart failure. Which of the following findings is an expected effect of this medication?
- A. Lowered heart rate
- B. Increased myocardial contractility
- C. Decreased conduction through the AV node
- D. Vasoconstriction of renal blood vessels
Correct answer: B
Rationale: Dopamine, when administered at a low dose, is expected to increase myocardial contractility by stimulating beta1 receptors. This positive inotropic effect leads to an increase in cardiac output. Therefore, the correct answer is increased myocardial contractility, as it is a desired effect of administering dopamine to a client with severe heart failure.
5. A client has a new prescription for Alteplase. Which of the following actions should the nurse plan to take?
- A. Administer the medication within 4 hours of the onset of symptoms.
- B. Reconstitute the medication with sterile saline.
- C. Administer heparin concurrently with the Alteplase infusion.
- D. Monitor for changes in level of consciousness.
Correct answer: D
Rationale: Alteplase is a thrombolytic agent used to dissolve blood clots. Patients receiving Alteplase are at risk for bleeding complications, including intracranial bleeding. Monitoring for changes in the level of consciousness is crucial as it can indicate early signs of bleeding, such as increased intracranial pressure. This rapid assessment allows for timely intervention and prevention of further complications. Choices A, B, and C are incorrect. Administering Alteplase within 4 hours of symptom onset is related to the time-sensitive nature of thrombolytic therapy for conditions like acute myocardial infarction or ischemic stroke. Reconstituting Alteplase with sterile saline is a correct step in preparing the medication for administration. Administering heparin concurrently with Alteplase is generally avoided due to the increased risk of bleeding.
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