ATI RN
Proctored Pharmacology ATI
1. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?
- A. Spironolactone
- B. Furosemide
- C. Hydrochlorothiazide
- D. Bumetanide
Correct answer: A
Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.
2. A client is prescribed Amlodipine. Which of the following adverse effects should the nurse monitor?
- A. Tachycardia
- B. Peripheral edema
- C. Hyperglycemia
- D. Hypertension
Correct answer: B
Rationale: Corrected Rationale: Amlodipine, a calcium channel blocker, can lead to peripheral edema as an adverse effect. The nurse should assess the client for swelling in the lower extremities, a common manifestation of this side effect. Monitoring for peripheral edema is crucial to ensure early detection and appropriate management. Tachycardia (Choice A) is not a common adverse effect of Amlodipine. Hyperglycemia (Choice C) is not typically associated with Amlodipine use. Hypertension (Choice D) is the condition for which Amlodipine is prescribed to treat, not an adverse effect of the medication.
3. A client has a new prescription for clonidine to treat hypertension. Which of the following instructions should the nurse include?
- A. Discontinue the medication if a rash develops.
- B. Expect increased salivation during the first few weeks of therapy.
- C. Avoid driving until the client's reaction to the medication is known.
- D. Stop the medication if you experience a dry mouth.
Correct answer: C
Rationale: The correct instruction for a client starting clonidine therapy for hypertension is to avoid driving until their reaction to the medication is known. Clonidine can cause drowsiness, so engaging in activities like driving that require alertness should be avoided until the individual understands how the medication affects them. Choices A, B, and D are incorrect because they do not address the specific side effect of drowsiness associated with clonidine that could impair driving abilities. Discontinuing the medication if a rash develops, expecting increased salivation, or stopping the medication for dry mouth are not primary concerns related to clonidine therapy for hypertension.
4. A client has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication?
- A. Sodium 140 mEq/L
- B. Potassium 4.5 mEq/L
- C. BUN 55 mg/dL
- D. Glucose 120 mg/dL
Correct answer: C
Rationale: An elevated BUN level of 55 mg/dL should be reported before starting amphotericin B due to its nephrotoxic effects. Amphotericin B can cause kidney damage, and an elevated BUN indicates impaired kidney function, increasing the risk of further renal damage with this medication. Sodium, potassium, and glucose levels are not directly associated with the nephrotoxic effects of amphotericin B, making choices A, B, and D incorrect.
5. A client has a new prescription for Warfarin for atrial fibrillation. Which of the following findings should the nurse report to the provider immediately?
- A. INR of 4.0
- B. Potassium level of 4.5 mEq/L
- C. Sodium level of 140 mEq/L
- D. Creatinine level of 1.0 mg/dL
Correct answer: A
Rationale: An INR of 4.0 is above the therapeutic range for a client on Warfarin, indicating an increased risk of bleeding. This finding requires immediate reporting to the provider for appropriate intervention to prevent complications associated with excessive anticoagulation. Potassium, sodium, and creatinine levels are within normal ranges and are not directly related to the risk of bleeding in a client on Warfarin therapy.
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