CMS ATI PHARMACOLOGY EXAM
1. A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements
... [Show More] by the client indicates an understanding of the teaching?
A. "I should apply a patch every 5 minutes if I develop chest pain."
B. "I will take the patch off right after my evening meal."
C. "I will leave the patch off at least 1 day each week."
D. "I should discard the used patch by flushing it down the toilet."
A. Nitroglycerin sublingual tablets are used to treat new onset of angina pain. A client who uses sublingual tablets should place one tablet under their tongue at the onset of angina pain and continue taking a tablet every 5 min for a total of three doses of nitroglycerin. The effects of a nitroglycerin patch will take 30 to 60 min to occur and are not useful to prevent an ongoing angina attack.
B. Clients should remove the patch each evening for a medication free time of 12 to 14 hr before applying a new patch to avoid developing a tolerance to the medication's effects.
C. Nitroglycerin is an antianginal medication that results in dilation of the coronary vessels. Clients should apply the patch daily to sustain prophylaxis.
D. Medication remains in the transdermal patch after removing it from the body and must be discarded safely. The nurse should instruct the client to fold the patch ends together with the medication on the inside and place the discarded patch in a closed container so that children and pets cannot gain access to the medication.
2. A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)?
A. MSO4 5 mg subcut every 4 hr PRN severe pain
B. Morphine 5 mg subcut every 4 hr PRN severe pain
C. MSO4 5 mg SQ every 4 hr PRN severe pain
D. Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain
A. The use of the abbreviation MSO4 is prohibited by The Joint Commission. The medication name of morphine must be spelled out to reduce the risk for error.
B. The nurse should identify this entry as the correct format for the MAR. The medication name is spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use" list included in the transcription.
C. The use of the abbreviations MSO4 and SQ are prohibited by The Joint Commission. The abbreviation SQ can be mistaken for SL and, therefore, this route should be written as subcut, subq, or subcutaneously.
D. The trailing zero on 5.0 can be mistaken for 50 if the decimal point is missed. Therefore, the dosage should be written as 5 mg without a trailing zero.
3. A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report?
A. Tingling of fingers
B. Constipation
C. Weight gain
D. Oliguria
A. The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremities, when taking acetazolamide.
B. Diarrhea is an adverse effect of acetazolamide due to gastrointestinal disturbances.
C. Weight loss is an adverse effect of acetazolamide due to gastrointestinal disturbances causing reduced appetite.
D. Polyuria, rather than oliguria, is an adverse effect of acetazolamide.
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4. A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first?
A. Report the incident to the charge nurse.
B. Notify the provider.
C. Check the client's blood glucose.
D. Fill out an incident report.
A. The nurse should report the incident to the charge nurse to protect the client from injury. However, there is another action the nurse should take first.
B. The nurse should notify the provider to protect the client from injury. However, there is another action the nurse should take first.
C. The first action the nurse should take using the nursing process is to assess the client. The client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and provide the client with a snack to reduce the risk for hypoglycemia.
D. The nurse should fill out an incident report to document the incident. However, there is another action the nurse should take first. The incident report alerts the risk manager to the incident, who then determines the cause and a plan of action to reduce the risk of reoccurrence.
5. A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects of morphine?
A. Constipation
B. Drowsiness
C. Facial flushing
D. Itching
A. Constipation is a common adverse effect of morphine that can be minimized by taking docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine.
B. Drowsiness is not an adverse effect of morphine that can be minimized by taking docusate sodium.
C. Facial flushing is not an adverse effect of morphine that can be minimized by taking docusate sodium.
D. Itching is not an adverse effect of morphine that can be minimized by taking docusate sodium.
6. A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings?
A. Diastolic BP
B. Systolic BP
C. Heart rate
D. Respiratory rate
A. Digoxin increases cardiac output and reduces the heart rate. A diastolic BP of 86 mm Hg is not a cause for withholding the medication and contacting the provider.
B. Digoxin increases cardiac output and reduces the heart rate. A systolic BP of 140 mm Hg is not a cause for withholding the medication and contacting the provider.
C. Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate. The nurse should withhold the medication and notify the provider for a heart rate of 55/min because this is an early indication of digoxin toxicity.
D. Digoxin increases cardiac output and reduces heart rate. A respiratory rate of 20/min is not a cause for withholding the medication and contacting the provider.
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7. A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident?
A. IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified.
B. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified.
C. 1 L of 0.9% sodium chloride completed at 0900. Client denies shortness of breath.
D. IV fluid initiated at 0500. Lungs clear to auscultation.
A. The RN should only chart factual information in pt's medical record without indicating the error that occurred.
B. The nurse should document the type and amount of fluid, how long it took to infuse, provider notification, and the client's physical status.
C. This documentation is not complete because it does not include the amount of fluid that was infused over the amount of time.
D. This documentation is not complete because it does not include the amount of fluid that was infused over the amount of time.
8. A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching?
A. Decreases stomach acid secretion
B. Neutralizes acids in the stomach
C. Forms a protective barrier over ulcers
D. Treats ulcers by eradicating H. pylori [Show Less]