ATI RN
ATI Pharmacology Proctored Exam 2023
1. A patient on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?
- A. Reduced cardiac function
- B. First-pass effect
- C. Reduced hepatic function
- D. Increased gastric motility
Correct answer: C
Rationale: In older adults, reduced hepatic function can lead to prolonged effects of medications metabolized by the liver. This prolonged effect may result in drowsiness the next morning. Adjusting the dosage of the hypnotic medication may be necessary for this client. Choices A, B, and D are incorrect. Reduced cardiac function (Choice A) is not typically associated with drowsiness due to medication effects. The first-pass effect (Choice B) relates to the initial metabolism of a drug in the liver before reaching systemic circulation, which is not directly linked to drowsiness the next morning. Increased gastric motility (Choice D) does not commonly cause drowsiness as described in the scenario.
2. A nurse is preparing to administer vancomycin IV to a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following actions should the nurse take?
- A. Administer the medication over 60 minutes
- B. Monitor the client's blood glucose level during administration
- C. Infuse the medication rapidly to reduce the risk of infection
- D. Administer the medication using a filter needle
Correct answer: A
Rationale: The correct action the nurse should take is to administer the medication over 60 minutes. This is important because administering vancomycin over 60 minutes helps prevent red man syndrome, a reaction that can occur with rapid infusion. Monitoring the client's blood glucose level (Choice B) is unrelated to vancomycin administration. Infusing the medication rapidly (Choice C) is incorrect and can lead to adverse reactions. Administering the medication using a filter needle (Choice D) is unnecessary for vancomycin administration.
3. What is the most important nursing action for a patient post-surgery?
- A. Monitor vital signs
- B. Monitor the surgical site
- C. Check blood pressure
- D. Check oxygen saturation
Correct answer: A
Rationale: The most crucial nursing action for a patient post-surgery is to monitor vital signs. Monitoring vital signs helps in detecting early signs of complications such as hemorrhage, shock, or infection. While monitoring the surgical site is important for assessing wound healing and signs of infection, it is secondary to monitoring vital signs. Checking blood pressure and oxygen saturation are also important, but they are components of monitoring vital signs.
4. When teaching a client with a new prescription for Ramelteon, which of the following foods should the nurse instruct the client to avoid?
- A. Baked potato
- B. Fried chicken
- C. Whole-grain bread
- D. Citrus fruits
Correct answer: B
Rationale: The correct answer is B: Fried chicken. High-fat foods, like fried chicken, can delay the absorption of Ramelteon. It is important for the client to avoid such foods to ensure the medication's effectiveness. Baked potato, whole-grain bread, and citrus fruits do not have a significant interaction with Ramelteon and can be consumed safely while taking the medication.
5. A nurse is assessing a client who is at 28 weeks of gestation and has gestational hypertension. Which of the following findings should the nurse report to the provider?
- A. 1+ proteinuria
- B. Blood pressure 144/92 mm Hg
- C. Respiratory rate 22/min
- D. Urine output 20 mL/hr
Correct answer: D
Rationale: The nurse should report a urine output of 20 mL/hr. This finding can indicate decreased renal perfusion and possible development of preeclampsia, which is a severe complication of gestational hypertension. Inadequate urine output can suggest compromised kidney function and impaired maternal and fetal well-being. Options A, B, and C are within normal limits for a client with gestational hypertension and may not require immediate reporting to the provider.
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