ATI RN
ATI Pharmacology Proctored Exam 2024
1. What is the pharmacological action of metformin?
- A. Blocks stimulation of beta1 and beta2.
- B. Blocks vasoconstriction and aldosterone.
- C. Acts at many levels in the CNS to produce an anxiolytic effect.
- D. Decreases hepatic glucose production.
Correct answer: D
Rationale: The correct answer is D: Decreases hepatic glucose production. Metformin's primary pharmacological action is to decrease hepatic glucose production, leading to lower blood sugar levels and improved insulin sensitivity in the liver. Choices A, B, and C are incorrect because metformin does not block stimulation of beta1 and beta2 receptors, vasoconstriction, aldosterone, or act in the CNS to produce an anxiolytic effect. Therefore, these options are not reflective of metformin's mechanism of action.
2. A client informs the nurse about taking Gingko Biloba. Which of the following medications is contraindicated for a client taking Gingko Biloba?
- A. Acetaminophen
- B. Warfarin
- C. Digoxin
- D. Lisinopril
Correct answer: B
Rationale: The correct answer is B, Warfarin. Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction. Gingko Biloba can suppress coagulation and increase the risk of bleeding or hemorrhage when taken with anticoagulants like Warfarin. Acetaminophen (choice A), Digoxin (choice C), and Lisinopril (choice D) do not have significant interactions with Gingko Biloba.
3. A client is starting a new prescription for verapamil. Which of the following instructions should be included?
- A. Take the medication with a full glass of water.
- B. Avoid grapefruit juice.
- C. Monitor blood pressure regularly.
- D. Monitor heart rate daily.
Correct answer: B
Rationale: Clients prescribed verapamil should be advised to avoid grapefruit juice as it can potentiate the drug's effects, leading to adverse reactions. Grapefruit juice can inhibit the metabolism of verapamil, resulting in higher blood levels of the medication and an increased risk of side effects. Instructions such as taking the medication with a full glass of water (Choice A) are not specific to verapamil and are generally recommended. While monitoring blood pressure regularly (Choice C) is important for clients on antihypertensive medications, it is not a direct concern related to verapamil. Monitoring heart rate daily (Choice D) is not a primary consideration when starting verapamil, as it is more commonly used for its effects on blood pressure and arrhythmias rather than heart rate.
4. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client be instructed to monitor for and report to the provider?
- A. Dry cough
- B. Pedal edema
- C. Bruising
- D. Yellow-tinged vision
Correct answer: D
Rationale: Yellow-tinged vision is a potential adverse effect of digoxin, which may indicate toxicity. It is crucial for the client to report this symptom promptly to the healthcare provider to prevent any further complications. Dry cough is not typically associated with digoxin use. Pedal edema is a common symptom of heart failure, which digoxin is prescribed to manage. Bruising is not a common adverse effect of digoxin.
5. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?
- A. Epinephrine
- B. Lorazepam
- C. Furosemide
- D. Diphenhydramine
Correct answer: C
Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.
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