ATI Pharmacology Proctor 2019
ATI Pharmacology Proctor 2019
A nurse is assessing a client who is receiving intravenous therapy. The nurse should
... [Show More] identify
which of the following findings as a manifestation of fluid volume excess?
a. Decreased bowel sounds
b. Distended neck veins
c. Bilateral muscle weakness
d. Thread pulse
A nurse is caring for a client who has hyponatremia and is receiving an infusion of a
prescribed hypertonic solution. Which of the following findings should indicate to the nurse
that the treatment is effective?
a. Absent Chvostek's sign
b. Improved cognition
c. Decreased vomiting
d. Cardiac arrhythmias absent
A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal
patch. Which of the following instructions should the nurse include?
a. "Discontinue the patch if you experience a headache."
b. "Apply a new patch if you have chest pain."
c. "Cover the patch with dry gauze when taking a shower."
d. "Remove the patch prior to going to bed."
A nurse is reviewing the laboratory results of a client who has a prescription for sodium
polystyrene sulfonate (Kayexalate) every 6 hr. which of the following should the nurse
report to the provider?
a. Creatinine 0.72 mg/dL
b. Sodium 138 mEq/L
c. Magnesium 2 mEq/L
d. Potassium 5.2 mEq/L
A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin.
Which of the following outcomes indicates that the client is adhering to the medication
regimen?
a. The client has a negative sputum culture
b. The client tests negative for HIV
c. The client has a positive purified protein derivative test
d. The client's liver function test results are within the expected reference range
A client is caring for a client who develops an anaphylactic reaction to IV administration.
After assessing the client's respiratory status and stopping the medication infusion. Which
of the following actions should the nurse take next?
a. Replace the infusion with 0.9% sodium chloride
b. Give diphenhydramine IM
c. Elevate the client's legs and feet
d. Administer epinephrine IM
A nurse is caring for a client who is taking sertraline and reports a desire to begin taking
supplements. Which of the following supplements should the nurse advise the client to
avoid?
a. St. John's Wort
b. Ginger root
c. Black cohosh
d. Coenzyme Q10
A nurse is caring for a client who has heart failure and a new prescription for lisinopril.
For which of the following adverse effects should the nurse monitor when administering
lisinopril?
a. Bradycardia
b. Hypokalemia
c. Tinnitus
d. Hypotension
A nurse is assessing a client who is receiving heparin IV continuous IV. The client has an
PPT of 90 seconds. They should monitor the client for which of the following changes in
their vital signs?
a. Decreased temperature
b. Increased pulse rate
c. Decreased respiratory rate
d. Increased blood pressure
A nurse is preparing to administer medication to a client and discovers a medication error.
The nurse should recognize that which of the following staff members is responsible for
completing an incident report?
a. The quality improvement committee
b. The nurse who identifies the error
c. The nurse who caused the error
d. The charge nurse
A nurse is planning care for a client who is receiving morphine via continuous epidural
infusion. The nurse should monitor the client for which of the following?
a. Pruritus
b. Cough
c. Tachypnea
d. Gastric bleeding
A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps
the nurse should take. (Move the steps into the box on the right placing them in the order
of performance. Use all the steps.)
a. Obtain the client's apical heart rate 1
b. Remove the medication from the dispensing system 2
c. Open the medication package 3
d. Compare the client's wristband to the medication administration record 4
e. Document administration of the medication 5
A nurse is reviewing the medical record of an adult client who has a fever and a
prescription for acetaminophen. Which of the following findings should the nurse identify
as a contraindication for receiving this medication?
a. Alcohol use disorder
b. Chronic kidney disease
c. Hepatitis B vaccine within the last week
d. Diabetes mellitus
A home health nurse is visiting a client who has heart failure and a prescription for
furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2
days ago. Which of the following actions should the nurse take first?
a. Encourage the client to dangle the legs while sitting in a chair
b. Teach the client about foods low in sodium
c. Determine medication adherence by the client
d. Notify the provider of the client's weight gain
A nurse is preparing to administer the initial dose of penicillin G IM to a client. The nurse
should monitor for which of the following as an indication of an allergic reaction following
the injection?
a. Urticaria
b. Bradycardia
c. Pallor
d. Dyspepsia
A nurse is teaching a client who has angina a new prescription for sublingual nitroglycerin
tablets. Which of the following instructions should the nurse include in the teaching?
a. "Discard any tablets you do not use every 6 months."
b. "Take one tablet each morning 30 minutes prior to eating."
c. "Keep the tablets at room temperature in their original glass bottle."
d. "Place the tablet between your cheek and gum to dissolve."
A nurse is providing teaching to a client who has a new prescription for theophylline a
sustained-released capsule. Which of the following statements by the client indicates an
understanding of the teaching?
a. "I can take my medication in the morning with my coffee."
b. "I may sprinkle the medication in applesauce."
c. "I should limit my fluid intake while on this medication."
d. "I will need to have blood levels drawn."
A nurse is mixing regular insulin and NPH insulin in the same syringe prior to
administering it to client who has diabetes mellitus following actions should the nurse take
first?
a. Withdraw the regular insulin from the viral
b. Withdraw the NPH insulin form the vial
c. Inject air into the NPH vial
d. Inject air into the regular insulin vial
A nurse is preparing to administer subcutaneous heparin to a client. Which of the following
should the nurse take?
a. Massage the site after administering the medication
b. Use a 21-gauge needle for the injection
c. Aspirate before injecting the medication
d. Insert the needle at least 5 cm (2 in) from the umbilicus
A nurse is caring for a client who has a prescription for amoxicillin. Which of the following
findings indicates the client is experiencing an allergic reaction?
a. Nausea
b. Cardiac dysrhythmia
c. Laryngeal edema
d. Insomnia
A nurse is teaching a newly licensed nurse about medication reconciliation. The nurse
should instruct the newly licensed nurse to perform medication reconciliation for which of
the following?
a. A client who has a referral for social services
b. A client who is transdermal to radiology
c. A client who is transferal to a step-down unit
d. A client who has a consultation for physical therapy
A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of
the following laboratory values indicates the treatment has been effective?
a. BUN 15 mg/dL
b. Blood glucose 90 mg/dL
c. Urine specific gravity 1.020
d. LDL 120 mg/dL
A nurse is receiving a medication prescription by telephone from a provider. The provider
states "Administer 6 milligrams of morphine IV push every 3 hours as needed for acute
pain." How should the nurse transcribe the prescription in the client's medical record?
a. Morphine 6 mg IV push every 3 hr PRN acute pain
b. MSO 6 mg IV push every 3 hr PRN acute pain
c. MS 6 mg IV push every 3 hr PRN acute pain
d. Morphine 6.0 mg IV push every 3 hr PRN acute pain
A nurse is assessing a client's IV infusion site and notes that the site is cool and edematous.
Which of the following actions should the nurse take?
a. S;ow the IV solution rate
b. Initiate a new IV distal to the initial site
c. Maintain the extremity below the level of the heart
d. Apply a warm moist compress
A nurse is providing teaching to a client who has a new prescription for clozapine. Which of
the following statements should the nurse include in the teaching?
a. "Diarrhea is a common adverse effect of this medication."
b. "Ringing in the ears is an expected adverse effect of this medication."
c. "Notify your provider if you develop a fever while taking this medication."
d. "You might experience weight loss while taking this medication."
A nurse is teaching a client about oral contraceptive. Which of the following information
should the nurse include in the teaching?
a. Abdominal pain is an expected adverse effect of oral contraceptives
b. It can take up to 1 year to become pregnant after stopping an oral contraceptive
c. Some herbal supplements can decrease the effectiveness of an oral contraceptive
d. A pelvic examination is needed prior to starting an oral contraceptive
A nurse is planning to administer medication to an older adult client who has dysphagia.
Which of the following actions should the nurse plan to take?
a. Tilt the client's head back when administering the medications
b. Mix the medications with a semisolid food for the client
c. Administer more than one pill to the client at a time
d. Place the medications on the back of the client's tongue
A nurse is providing teaching to a client about the administration of omeprazole. Which of
the following should the nurse include?
a. "You cannot take this medication with an antacid."
b. "You should reduce your intake of calcium while taking this medication."
c. "You should take this medication before meals."
d. "You can take a second dose if symptoms persist up to 2 hours after the first dose."
A nurse is assessing for allergies with a client who is scheduled to receive the influenza
vaccine. Which of the following allergies should the nurse report to the provider as a
possible contraindication to receiving the vaccine?
a. Eggs
b. Shellfish
c. Peanuts
d. Milk
A nurse is caring for a client who has a new diagnosis of benign prostate hypertrophy and a
prescription for doxazosin. The client tells the nurse. "I do not take this medication. I
would prefer a natural therapy." Which of the following supplements should the nurse
suggest the client discuss with the provider?
a. Black cohosh
b. Garlic
c. Feverfew
d. Saw palmetto
A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the
following predisposes this client to developing digoxin toxicity?
a. Taking a high ceiling diuretic
b. Having a 10-year history of COPD
c. Having a prolapsed mitral valve
d. Taking an HMG CoA reductase inhibitor
A nurse is administering naloxone to a client who has developed an adverse reaction to
morphine. The nurse should identify which of the following findings as a therapeutic effect
of naloxone?
a. Decreased nausea
b. Increased pain relief
c. Decreased blood pressure
d. Increased respiratory rate
A nurse is reviewing the medical record of a client who has sinusitis and a new prescription
for cefuroxime. Which of the following client information is the priority for the nurse to
report to the provider?
a. The client has a BUN of 18 mg/dL
b. The client takes an aspirin daily
c. The client has a history of a severe penicillin allergy
d. The client reports a history of nausea with cefuroxime
A nurse is assessing a client who has hypermagnesemia. Which of the following medications
should the nurse prepare to administer?
a. Protamine sulfate
b. Acetylcysteine
c. Calcium gluconate
d. Flumazenil
A nurse is assessing a client following the administration of ondansetron (Zofran). Which of
the following findings should indicate to the nurse that the ondansetron has been effective?
a. Client reports a decrease in pain
b. Client reports a decrease in nausea
c. Client reports a decrease in coughing
d. Client reports a decrease in diarrhea
A nurse manager is planning an in-service about pain management with opioids for client
who has cancer. Which of the following information should the nurse manager include?
a. IM administration is recommended if PO opioids are ineffective
b. Respiratory depression decreases as opioid tolerance develops
c. Meperidine is the opioid of choice for treating chronic pain
d. Withhold PRN pain medication for the client who is receiving opioids every 6 hr
A nurse is reviewing the list of current medication for a client who is to start prescription
for carbamazepine. The nurse should identify that which of the following medications
interacts with carbamazepine?
a. Nicotine transdermal system
b. Diphenhydramine
c. Estrogen-progestin combination
d. Beclomethasone
A nurse is caring for a client who has a respiratory infection and is receiving an antibiotic.
Which of the following medications puts the client at risk for developing hearing loss?
a. Rifampin
b. Ciprofloxacin
c. Penicillin G
d. Gentamicin
A nurse is teaching a guardian of a school-age child who has a new prescription for a
fluticasone metered-dose inhaler. Which of the following information should the nurse
include in the teaching? (SATA)
a. "Soak the inhaler in water after use."
b. "Have your child take one inhalation as needed for shortness of breath."
c. "Shake the device prior to administration."
d. "A spacer will make it easier to use the device."
e. "Rinse your child's mouth following administration."
A nurse is preparing to administer potassium chloride elixir 20 mEq/day PO to divide
equally 12 hr. available is 6.7 mEq/5 mL. How many mL should the nurse administer per
dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a
trialing zero.) 7.5
A nurse is instructing a client who has a new prescription for a daily dose of lovastatin
extended release. Which of the following information should the nurse include in the
teaching?
a. "You will need liver function tests before beginning therapy."
b. "Avoid consuming dairy products while taking this medication."
c. "You may crush the medication and mix it with applesauce."
d. "You should take the medication in the morning."
A nurse is assessing a client who is receiving a peripheral IV infusion and notes infiltration
of fluid into the tissue surrounding the insertion site. Which of the following actions should
the nurse take?
a. Flush the IV catheter
b. Apply pressure to the IV site
c. Elevate the extremity
d. Slow the infusion rate
A nurse is preparing to administer 4000 units of heparin subcutaneously to a client who has
deep-vein thrombosis. Available is heparin 10,000 units. How many mL of heparin should
the nurse administer? (Round to the nearest tenth. Use a leading zero if it applies. Do not
use a trailing zero.) 0.4
A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which
of the following findings should the nurse expect?
a. Oxygen saturation 96%
b. PaCO2 30 mm Hg
c. Increase in BP
d. Decrease in protein
A nurse is discussing adverse reactions to pain medications in older adult clients with a
newly licensed nurse. Which of the following findings should the nurse include as risk
factors for an adverse drug reaction? (SATA)
a. Polypharmacy
b. Increased rate of absorption
c. Decreased percentage of body fat
d. Multiple health problems
e. Decreased renal function
A nurse is reviewing the laboratory data of a client prior to administering IV tobramycin.
Which of the following laboratory values should the nurse report to the provider?
a. Sodium 137 mEq/L
b. Hct 4.3%
c. Hgb 15 g/dL
d. Creatinine 2.5 mg/dL
A nurse is preparing to administer enoxaparin to a client. Which of the following actions
should the nurse take?
a. Apply firm pressure to the injection site following administration
b. Administer the medication into the client's muscle
c. Expel the air bubble from the syringe prior to injection
d. Insert the syringe needle halfway into the client's skin
A nurse is reviewing a client's 0800 laboratory values at 1100. The nurse notes that the
client received heparin at 1000. Which of the following laboratory values warrants an
incident report?
a. ePTT 90 seconds
b. Hgb 16 g/dL
c. INR 1.6
d. WBC 6000/mm3
A nurse is caring for a client who has breast cancer and reports pain. 1 hr after
administration of prescribed morphine 10 mg IV. Which of the following medications
should the nurse expect to administer?
a. Naloxone IV
b. Morphine tablet
c. Lidocaine patch
d. Fentanyl transmucosal
A nurse is assessing a client who reports taking over-the-counter antacids. Which of the
following findings should the nurse identify as a manifestation of hypercalcemia?
a. Constipation
b. Decreased urine output
c. Positive Trousseau's sign
d. Headache
A nurse is caring for a client who is to receive potassium replacement. The provider's
prescription reads. "Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over
30 min." which of the following reasons should the nurse clarify this prescription with the
provider.
a. Potassium chloride should be diluted in dextrose 5% in water.
b. The potassium infusion rate is too rapid
c. Another formulation of potassium should be given IV
d. The client should be treated by giving potassium by IV bolus
A nurse is monitoring laboratory values for a client who has chronic heart failure and is
receiving digoxin. Which of the following values should the nurse report to the provider?
a. Sodium 1.38 mEq/dL
b. Magnesium 1.5 mEq/L
c. BUN level 10 mg/dL
d. Potassium 2.9 mEq/L
A client who has active tuberculosis and is taking rifampin reports that his urine and sweat
have developed a red tinge. Which of the following actions should the nurse take?
a. Check the client's liver function test results
b. Instruct the client to increase his fluid intake
c. Document this as an expected finding
d. Prepare the client for dialysis
A nurse accidently administers the medication metformin instead of metoprolol to a client.
Which of the following actions should the nurse take?
a. Monitor the client's thyroid function levels
b. Collect the client's uric acid level
c. Obtain the client's HDL level
d. Check the client's glucose level
A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. the
medication is provided as hydromorphone 8 mg per tablets. Which of the following actions
is appropriate for the nurse to take?
a. Return the remaining medication to the facility's pharmacy
b. Store the remaining half of the pill in the automated medication dispensing system
c. Place the remaining half of the pill in the unit dose package
d. Dispose of the remaining medication while another nurse observes
A nurse is caring for 4-year-old child following an orthopedic procedure. When assessing
the child for pain. Which of the following pain scales should the nurse use?
a. FACES
b. Numeric
c. CRIES
d. Word graphic
A nurse is planning care for a client who requires treatment for high cholesterol. Which of
the following prescriptions should the nurse expect to administer?
a. Colchicine
b. Cimetidine
c. Colerain
d. Chlorpromazine
A nurse is caring for a client who has heart failure. The nurse administered furosemide 60
mg IV bolus 30 min earlier. For which of the following findings should the nurse notify the
provider?
a. Potassium 3.8 mEq/L
b. The client reports dizziness upon standing
c. The client reports difficulty hearing
d. BUN 15 mg/dL
A nurse is planning teaching for a client who is trying to quit smoking. Which of the
following instructions about nicotine replacement options should the nurse include?
a. Change the nicotine patch every other day
b. Do not drink beverages while sucking on a nicotine lozenge
c. Chew nicotine gum for 10 min before spitting it out
d. Administer 2 sprays of nicotine nasal spray in each nostril with each dose
A nurse is caring for a client who has a prescription for total parental nutrition (TPN).
Which of the following routes of administration should the nurse use?
a. Subcutaneous
b. Intraosseous/intravenous
c. Central venous access device
d. Midline catheter
A nurse is preparing to administer filgrastim 5mcg/kg/day subcutaneous to a client who
weighs 143 lb. How many mcg should the nurse administer per day? (Round the answer to
the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 325
A nurse is preparing to initiate IV therapy for a client. Which of the following sites should
the nurse use to place the peripheral IV catheter?
a. Nondominant dorsal venous arch
b. Dominant distal dorsal vein
c. Nondominant forearm basilic vein
d. Dominant antecubital vein
A nurse is assessing a client who is taking an osmotic laxative which of the following
findings should the nurse identify as an indication of fluid volume deficit?
a. Nausea
b. Weight gain
c. Headache
d. Oliguria
A nurse is reviewing the laboratory results of a client who is taking amitriptyline which of
the following laboratory values should the nurse report to the provider?
a. Total bilirubin 1.5 mg/dL
b. Potassium 4.2 mEq/L
c. Hct 0.44%
d. WBC count 5000/mm3
A nurse is caring for a client who is taking lithium and reports starting a new exercise
program. The nurse should assess the client for which of the following electrolyte
imbalances?
a. Hypocalcemia
b. Hypokalemia
c. Hyponatremia
d. Hypomagnesemia
A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of
the following should the nurse identify as an adverse effect of this medication?
a. Hypoglycemia
b. Bradycardia
c. Red man syndrome
d. Hypotension
A nurse is consulting a formulary about a client's new prescription for raloxifene. The
nurse should identify that this medication is used to treat which of the following
conditions?
a. Osteoporosis
b. Hypothyroidism
c. Urinary tract infection
d. Deep vein thrombosis
A nurse is providing discharge dietary teaching to a client who has a something and is
taking medication theophylline and to provide general instructions the nurse should
include?
a. Avoid caffeinated beverages
b. Take the medication with meals
c. Restrict milk products
d. Limit sodium intake
The nurse is mixing regular insulin and NPH into a syringe for a client who has diabetes
mellitus. Which of the following actions should the nurse take first?
a. Withdrawal NPH from the vial
b. Inject air into the NPH vial
c. Inject air into the regular vial
d. Withdrawal regular insulin from the vial
A nurse is teaching a client who has a new prescription of Alendronate for osteoporosis.
What instructions should the nurse include?
a. Take the medication immediately after breakfast
b. Take the medication with an antacid
c. Sit upright for at least 30 mins after taking the medication
d. Drink orange juice with the medication
A nurse is caring for a client who is postoperative following a thyroidectomy and is
receiving morphine for pain. Which of the following findings should the nurse recognize as
an adverse effect of morphine?
a. Bladder distention
b. Productive cough
c. Gastrointestinal bleeding
d. Decrease deep tending reflexes
A nurse is teaching a client who has pernicious anemia to self-administer cyanocobalamin.
Which of the following information should the nurse include in the teaching?
a. Use nasal decongestion 15 mins before the medication if you have a stuffy nose
b. Lie down for 1 hour after administering the medication
c. Administer the medication into one nostril once per week
d. Plan to self-administer this medication for the next 6 months
A nurse is teaching a newly license nurse about medication reconciliation. The nurse should
instruct the newly license nurse for medication reconciliation for which of the following
clients?
a. Client who is transported to radiology
b. A client who has a consultation for ....
c. A client who has a referral for social services
d. A client who has been transferred to a step-down unit
A nurse is assessing a client who received a dinoprostone gel to stimulate the cervical
ripening. Which of the following is the nurse's priority?
a. Back pain
b. Flushing
c. nausea
d. Uterine tachysystole
A nurse is performing a return demonstration of an enoxaparin administration. Which of
the following client actions indicates an understanding of the teaching?
a. Messages the site to enhance absorption
b. Injections the medication into a muscle
c. Administers the medication into the abdomen
d. Aspirates the medication after injection
A nurse is assessing a client how has been taking digoxin and ...... which of the following
findings to the nurse indicates this client has developed digoxin toxicity?
a. Ringing in the ears
b. Hyperkalemia
c. Blurred vision
d. hypertension
A nurse is caring for a client who received neostigmine 1 hour ago and is experiencing
muscarinic response. Which if the following manifestations should the nurse expect?
a. Headache
b. Excessive salivation
c. Fever
d. Myoclonic seizure
A nurse in the emergency department is reviewing a medication record for client who
reports vomiting blood. The nurse should anticipate the provider will discontinue which of
the following medications?
a. NPH insulin
b. Clopidogrel
c. Furosemide
d. Pantoprazole
A nurse is assessing a who is receiving clindamycin. Which of the following findings should
the nurse identify as an adverse effect of this medication?
a. Agitation
b. Report of blurred vision
c. Hypertension
d. Watery diarrhea
A nurse is teaching a client who is to start taking Cromolyn. Which of the following
information should the nurse include in the teaching?
a. Cromolyn should take effect within 5 mins
b. Cromolyn should dilate the bronchioles
c. Cromolyn can be used after exercise
d. Cromolyn is a long-term management medication
A nurse is reviewing the medications of a client is experiencing orthostatic hypotension.
The nurse should identify this finding as an adverse effect of which of the following
medications?
a. Imipramine
b. Levothyroxine
c. Montelukast
d. Omeprazole
A nurse is reviewing a client's medical history before administering a new prescription of
atropine. Which of the following client conditions is contraindicated?
Glaucoma
A nurse is providing teaching to a client who has a new prescription for carbamazepine for
the treatment of seizures. The nurse should instruct the client to monitor for which of the
following adverse effects?
a. insomnia
b. Blurred vision
c. Tachypnea
d. Metallic taste
Math problem: a nurse is preparing to administer 4000 units of heparin available is 10,000
units 0.4
A nurse is caring for a client who reports that his current pain medication is no longer
relieving her pain. Which of the following medications requires the nurse to obtain a
written rather than a verbal prescription from the provider?
Fentanyl
Charge nurse is observing a newly licensed nurse provide care to a group of clients. Which
of the following action by the newly licensed nurse requires the charge nurse to complete an
incident report?
A client who has a lithium level of 1.8 receives her morning dose
A nurse is caring for a client who has an alcohol use disorder and is experiencing
withdrawals. Which of the following interventions is a priority at this time?
Implement seizure precautions
A nurse is planning care for a group of clients. which of the following client's medications
should be monitored by the nurse for hearing loss related to a medication interaction?
Furosemide and Amikacin
A nurse is caring for a client who has major depression and a new prescription for
citalopram. which of the following adverse effects is the priority for the nurse to report to
the provider?
a. Insomnia
b. Bruxism
c. confusion
d. weight loss [Show Less]