ATI RN Proctored Pharmacology (1)Form 2013B
Pharmacology ATI
1. A nurse is assessing a client who is receiving chloramphenicol(Chloromycetin). Which o
... [Show More] f the following findings is an adverse effect of thismedication? (adverse affect is thrombocytopenia)
o EcchymosisoOtotoxicity
o Hypertension o Anxiety
2. A nurse is caring for a client who is to receive 1,500 mL of 0.9% sodiumchloride IV over 8 hours. The nurse plans to use IV tubing with a drop factor of 10gtt/mL.
How many gtt/min of IV fluid should the client receive? (Round your answerto the nearest wholenumber).
31gtt/min
3. A nurse is admitting a client to a long-term care facility. While reconcilingthe medication prescribed at home with those prescribed in the facility, the nursediscovers a discrepancy in the dosages. Which action should the nursetake?
o Clarify the medication dosages with theprovider.
o Change the prescribed medication dosages to reconcile thediscrepancy o Contact the pharmacist regarding the dosagediscrepancies
o Ask a family member to verify the medicationdosages
4. A nurse is caring for a client who is receiving a fentanyl transdermalsystem (Duragesic). What is important to document in the client’srecord?
o Fluidintake o Skinintegrity
o Respiratoryrate o Pulserate
5. A nurse is caring for a client who has acute angina and has a prescription fornitroglycerin. Which of the following is an appropriate intervention for the nurse totake whenadministering thismedication?
o Massage the nitroglycerin ointment completely into theskin. o Replace the nitroglycerin transdermal patch every 4hours.
o Administer a sustained nitroglycerin tabletorally.
o Administer a nitroglycerin tablet sublingually every 5minutes.
6. A nurse is preparing to administer infliximab (Remicade) to a client who hasrheumatoid arthritis. The nurse should watch the patient for which of the following adverse effects?(Select all thatapply.)
o Bradycardiao Jaundice
o Polyuria oUrtipeniaoFever
7. A nurse is providing teaching to a client who was recently diagnosed as HIV positive.The client is beginning medication therapy with zidovudine (Retrovir). Which of thefollowing statements should the nurse include in the teaching. (Select all thatapply.)
o Must be taken with other retroviralmedicines.o Has few adverseeffects
o Cures an HIVinfection
o Prevents you from transmitting the HIVinfection o Increases CD4+ cellcount
8. A nurse is assessing a school age client who is experiencing seizure activity and isprescribed diazepam (Valium) IV. The nurse should should clarify the order if the client is receivinga continuous infusion of which of the followingIV:
o Lactated Ringerssolution
o 0.9% Sodium chloride with 100 units of regularinsulin o 0.9% sodiumchloride
o 0.9% Sodium chloride with 20 mEq of potassiumchloride
9. A nurse is assessing a client who is taking enalapril (Vasotec) for congestive heartfailure. Which of the following indicates an expectedfinding?
o Activitytolerance
o Orthostatichypotension o Loss of strength
o Increase in bloodpressure
10. A child with cerebral palsy is prescribed Baclofen (Lioresol). Which of thefollowing therapeutic effects should the nursemonitor?
o Increased urineoutput o Increasedenergy
o Decreased anxiety o Decreased spacity
11. Clinical findings of a client who has a prescription for lithium carbonate (Lithobid).For which reasons should the nurse withhold the medication and notify theprovider?
o Lithium level 1.0mEq/L o Potassium at 3.7mEq/L o Sodium at 143mEq/L
o Lithium level 2.5mEq/L
12. The nurse is caring for a client who has tuberculosis and is being treated withcombination medication therapy. To test the effectiveness of the treatment, the nurse shouldperiodically monitor which of the following laboratoryresults.
o TT
o ESDrate
o Sputumculture oINR
13. A nurse is caring for a client who is taking amoxicillin (Amoxil) and isexperiencing adverse effects. Which of the following instructions should the nurse give to thisclient? o “Stand up slowly after taking thismedication.”
o“Monitorforincreasedurineoutput.” o “Take this medication with asnack.”
o “Administer the medication atbedtime.”
14. A nurse is reviewing the medication administration record for a client whohas
metastatic cancer and a fentanyl (Duragesic) transdermal patch for pain. The client reports apain level of 10 on a scale of 0 to 10. Which of the following medications should the nurseanticipate administering?
o Hydromorphone(Dilaudid) o Butorphanol(Stadol)
o Alprazolam(Xanax)
o Carbenezepine(Tegretol)
15. A nurse is caring for a client with PCA Morphine Sulfate. Which of thefollowing statements is nottrue?
o "I will not receive any pain medications during the lockoutperiod" o "I should push the button when the pain becomessevere"
o "I will be asked to rate my painoccasionally"
o "I don't have to worry about getting an overdose of themedication"
16.A nurse is caring for a client who is to receive a series of allergy tests. The nurseshould instruct the client to avoid which medications for up to 4 weeks before theprocedure?
o Acetemetaphen(Tylenol)
o Diphenhyramine(Benadryl) o Albuterol(Accuneb)
o Psuedoephedrine hydrochloride(Sudafed)
17. A nurse administered meperidine (Demerol) intramuscularly to a client with anankle fracture. Which of the following actions should the nurse takenext?
o Assesstheclient’srespiratorystatus
o Document on the clients medicationrecord o Reassess the client's painlevel
o Check the client's bloodpressure
18. A nurse is caring for a client who has an order for clozapine (Clozaril) 350 mg PO daily.The nurse should recognize that which of the following findings is a side effect of thismedication?
o WBC 8,000mm3
o Serum sodium 136mg/dL
o Fasting blood glucose of 220mg/dL
o Weight loss of 2.26 kg (5 lb) in 2weeks
19. A client with diabetes mellitus is admitted to the medical unit. The client has routinebefore- breakfast prescription for 8 units of regular insulin and 18 units ofNPH. The primarycare provider adds an additional dose of Regular insulin based on thefollowing:
Blood Glucose Regular InsulinDose 121 to 150 2 units
151 to 180 4 units
201. 200 6 units 201 to 250 8 units
> 250 Callprovider
The client’s pre-breakfast glucose is 192 mg/dl. Which dosage of insulinshould the nurseadminister?
o 8 units of Regular, 18 units ofNPH o 8 units of Regular, 24 units ofNPH o 14 units of Regular, 18 units ofNPH o 14 units of Regular, 24 units ofNPH
20. A nurse is caring for a client who has a new prescription of zolpidem (Ambien) 10 mgby mouth. Which comments by the client indicates understanding regarding thismedication?
o“Iwilltakemymedicationatbedtime.” o “I will take this medication withfood.”
o “I will stop taking this medication in 1 week, so I don’t getaddicted.” o “I will take vitamin C to increase the effectiveness of thismedication.”
21. A nurse is monitoring a client who is taking fosinopril (Monopril). The nurseshould understand that this has a beneficial effect on which of the bodysystems?
o GastrointestinaloCardiovascular o Pulmonary
o Reproductive
22. A nurse is assessing a client who is taking naproxen (Naprosyn). Which of the followingis an expected outcome for this client?
o Increasedappetite o Reducedbleeding o Improvedbreathing o Reducedpain
23. A nurse is providing teaching to a client who just started taking lithium (Eskalith). Whichof the following statements indicates that the client understands theteaching?
o ‘I should inject this medicationsubcutaneously.’ o “I should expect to feel better in just a fewdays.”
o“IshouldcallmydoctorifIdevelophandtremors.” o “I should take this medication on an emptystomach.”
24.A nurse is administering verapamil (Calan) to a client via IV bolus. The nurse shouldmonitor for whichoutcome?
o A rapid increase inaPTT.
o A sudden increase in heartrate. o A sudden decrease in heartrate. o A rapid decrease ofaPTT.
25.A nurse is caring for a client who has rheumatoid arthritits. The client isprescribed methotrexate (Rheumatrex). Which of the following should the nurse instruct the clientto monitor and report to theprovider?
o Sorethroat
o Urinaryretention o Constipation
o Insomnia
26.A nurse is caring for a client who has been prescribed Ceftriaxone (Rocephin). Thenurse notes that the client’s chart lists a penicillin allergy. Which of the following actions shouldthe nurse takefirst?
o Notify the provider that the client is allergic to themedication. o Teach the client about signs of allergic response.
o Question the client about previous allergicreactions.
o Administer the medication and monitor the client for allergicresponse.
27.A nurse is teaching a client who has decided to quit smoking about using anicotine transdermal system (Nicotrol). Which of the following instructions should the nurseinclude? o Cleanse the skin with alcohol before applying thepatch.
o Moisten the patch and hold it against the skin until itadheres.
o Apply the patch first thing in the morning and remove it atbedtime.
o Place the patch in the same skin area for the duration of thetreatment.
28. A nurse is caring for a client who has been taking furosemide (Lasix) for 3 days to treatheart failure. Which of the following findings indicate that the medication iseffective?
o Reduced levels ofHDL
o Potassium within the expected referencerange o Clear lungsounds
o Increased level ofconsciousness
29. A client is questioning the nurse about why she is receiving frequent doses of IVantibiotics. Which of the following responses by the nurse isappropriate?
o It helps to maintain a steady druglevel
o It helps to prevent the emergence of drug-resistantbacteria o It decreases the risk of an allergicreaction
o It decreases the length of necessarytreatment
30. A female adult client is scheduled to start a prescription for azathioprine (Imuran) foractive Rheumatoid Arthritis. The nurse should inform the client about the need for which ofthe following diagnostic tests priormedication?
o Erythrosedimentationrateo Bone densityscan
o Electrocardiogram o PregnancyTest
31. A nurse is caring for a client who has been taking ferrous sulfate for the past 2 months.Which of the following findings isexpected?
o Increasedenergy
o Reduced frequency ofcoughing o Increasedvision
o Decreasedinflammation
32. A nurse is caring for a client who has a prescription for Metformin (Glucophage) twicedaily. Which of the following lab results projects the expectedoutcome?
o Hemoglobin A1C6.4%
o Pre-meal plasma glucose135mg/dl o Bedtime blood glucose 150mg/dl
o Systolic blood pressure 146 mmHg
33. A nurse is teaching about IV betamethasone (CelestoneSoluspan) with a client who is at31 weeks of gestation and is in premature labor. Which of the following information shouldthe nurse include in theteaching?
o Prevents contractions of the uterus to avoid prematurebirth o Promotes the production of surfactant in the fetallung
o Decreases inflammation associated with an allergic reaction
o Suppresses the immune system to prevent fetal respiratorydistress.
34.A nurse is providing teaching to a client who had a total gastrectomy. The client has anew prescription for Cyanocobalamin (Vitamin B12). Which of the following clientstatements indicates understanding of theteaching?
o“Iwillhavetotakethis medicationfortherestofmylife.”
o “After I receive injections for a week, I will be able to switch to apill.” o “I need to have my vitamin B12 levels measured once amonth.”
o “Increasing my intake of green, leafy vegetables will increase my vitamin B12levels.”
35. A nurse is planning teaching for a client who has leukemia and is receivingchemotherapy. The client is taking Allopurinal (Zyloprim). The nurse should instruct the client thatthis medicationwill?
o Decrease blood glucoselevels o Prevent cardiactoxicity.
o Prevent urinary tractinfections. o Decrease uric acidlevels.
36.A nurse receives a phone call from a client who has heart failure and reports a dry coughfor the last week. After reviewing the client’s medical record, the nurse asks the client to come tothe provider’s office. The nurse should then instruct the client to stop taking which of thefollowing daily medications until he sees hisprovider?
o Isosorbide(Imdur)
o Hydroclorothiazide(Hydrodiuril) o Nifedipine(Procardia)
o Lisinopril(Zestril)
37.A nurse is planning discharge teaching for a client who is to start therapy withrepaglinide (Prandin). Which of the following should the nurse include in theteaching?
o “Take the medication 1 hour beforemealtime.”
o “Hold themedicationifyourblood glucoseislessthan120mg/dL.” o “Monitor for irritability anddiaphoresis.”
o “Increase your proteinintake.”
38.A nurse is caring for a client who is receiving anticoagulant therapy withWarfarin (Coumadin). The client is prescribed Cefotetan (Cefotan) by intermittent IV bolusfor pneumonia. The nurse should monitor the client for which of thefollowing?
o Hemorrhage
o Hypoglycemia oHyperkalemia oParesthesias
39. A nurse is assessing a client who has been taking anti-tuberculosis medications for the past3 months. The nurse should instruct the client to notify the provider if which of thefollowing occurs?
o Weightgain o Jaundice
o Alopecia oPolyuria
40. A client who has supraventricular tachycardia (SVT) is receiving procainamide. Thenurse recognizes that the primary pharmacological action of this medication isto:
o Decrease cardiacpreload
o Promote systemicvasoconstriction
o Decrease sinoatrial nodeconduction. o Control the rate of cardiaccontraction.
41. A client is receiving extended-release morphine sulfate (Avinza) 30mg PO every 12hr. Three hours after the last dose, the client requests pain medication. Which of thefollowing assessment finding is the best indicator of the patient’s need for more painmedication?
o Facialgrimacing
o Elevated bloodpressure o Flushedskin
o Selfreport
42. A nurse is caring for a client who has a systemic infection. During the infusionof vancomycin (Vancocin) the client develops a rash and becomes flushed. Which of thefollowing is an appropriate action for the nurse totake?
o Document aPenicillinallergyintheclient’schart. o Decrease the rate ofadministration.
o Obtain a prescription for oralvancomycin. o Administer naloxone (Narcan) 1mgIV.
43. A nurse is caring for a client who has open angle glaucoma and was prescribedpilocarpine (Pilocar) 1 gtt of 3% solution. The nurse should recognize that which of the followingfindings indicates the client is developing systemic cholinergictoxicity?
o Stinging and burning sensation in hereye oHypertension
o Tachycardia
o Salivation andsweating
44. A client who has been taking atenolol (Tenormin) receives a new prescription fornifedipine (Procardia). For which of the following interactions should the nursemonitor?
o Tachycardia oHypotension oBleeding
o Angina
45. A client has an IV infusion of nitroprusside (Nitropress) at 2 mcg/kg/min. The order readsto titrate the nitroprusside by 0.5 mcg/kg/min to maintain mean arterial pressure (MAP) to 70to 110 mm HG. The client has a MAP of 120 mm Hg. The nurse should next titratethe nitroprusside to which of the following dosages? (Round to the nearesttenth.)
2.5 mcg
46. A nurse is reviewing the laboratory tests for a client who had an acute myocardialinfarction. The client is prescribed warfarin (Coumadin) 10mg PO. The nurse notes an INR of 2.6. Whichof the following actions should the nursetake?
o Give the dose asprescribed. o Hold the next dose.
o Increase the dose by2.5mg o Decrease the dose by5mg.
47. A nurse is caring for a client who has a new prescription for estrogen-progestincombination (Ortho-Novum). Which of the following medications may interact with this medicationand require the use of additional non-hormonal birthcontrol?
o Thiamine ( Vitamin B1) o Dilantin(Phenytoin)
o Amalodipine(Norvasc)
o Docusate sodium(colace)
48. A nurse is providing teaching to a school-age child and his parents. The child has anew prescription for methylphenidate (Concerta). For which of the following adverse effectsshould the nurse monitor? (Select all thatapply.)
o Nosebleed oOliguria
o Weightloss oPalpitationso Insomnia
49. A nurse is caring for a postoperative client with PCA containing IV morphine. Anurse should recognize which is the following priorityassessment?
o Hypotension oBradypnea
o Drowsiness oUrticaria
50. A nurse is caring for a client who is receiving therapy with the clonidine(Catapres) transdermal patch. The client reports light-headedness and drowsiness. Which of thefollowing actions should the nursetake?
o Administer a prescribedantiemetic o Remove thePatch
o Elevate the head of thebed o Measure Bloodpressure
51. A nurse is assessing a client who takes diphenoxylate with atropine (Lomotil)for inflammatory bowel disease. For which of the following should the nursemonitor?
o Hearingloss
o Increased oralsecretions oBradycardia
o Urinaryretention
52. A nurse is caring for a client with Parkinson’s disease. The client is takingcarbidopa levadopa (Sinemet) and reports nausea. Which of the following instructions should thenurse include to reducenausea?
o Give medication 1 hr beforemeals. o Give medication withmeals
o Give medication 1 hr aftermeals
o Give medication with high-proteinsnacks.
53. A nurse is caring for an older adult client who is receiving gentamicin (Garamycin)following abdominal surgery Which of the following physiological changes is most important for thenurse to consider when administering thismedication?
o Decreased serumalbumin o Decreased renal bloodflow
o Increased gastricpH o Increased bodyfat
54. A client has a new prescription for oral nitroglycerin sustained-release capsules once aday. During the nursing history the client reveals his usual medications. Which of thefollowing medications should the nurse question at thistime?
o Diazepam(Valium)
o Lansoprazole(Prevacid) o Gemfibrozil(Lopid)
o Sildenafil(Viagra)
55. The nurse is caring for a client who is receiving muromonab-CD3 (orthoclode OKT3) andis experiencing fever and 3+ pitting edema in the lower extremities. Which of the followingactions should the nurse take for theclient?
o Administer corticosteroids asprescribed. o Obtain a prescription for a WBCcount
oAuscultate theclient’slungsforadventitioussounds. o Maintain strict fluid intake and outputmeasurements.
56. A nurse is admitting a client who has chest pain to the emergency department.What medication should the nurse anticipate administering to reduce cardiacdemand?
o Heparin
o Pentazocine(Talwin) o Morphine
o Butorphanol(Stadol)
57. A nurse is caring for four older adult clients who are taking digoxin (Lanoxin). Which ofthe following clients is at greatest risk for developing digoxintoxicity?
o A client taking furosemide (Lasix) foredema o A client taking allopurinol (Zyloprim) forgout
o A client taking fluoxetine (Prozac) fordepression
o A client taking pramipexole (Mirapex) for Parkinson’sdisease
58. A nurse is caring for a 4 year old client, who is taking amoxicillin (Amoxil) 50 mg/kg/day PO in three divided doses. Which of the following resources should the nurse consult toverify that the dose is safe for theclient?
o Medication administrationrecord o The client’s healthhistory
o Physician’s deskreference o The client’s BMIrecord
59. A nurse is caring for a client who has a new prescription for sucraflate (Carafate). Theclient also takes several other medications and herbal supplements. Which of the followingrequires that the nurse provide additional teaching for thisclient?
o Phentoin(Dilantin)
o Burpropion(Wellbutrin)
o Ginko biloba o Valerianroot
60. A nurse is caring for a client who has a prescription for levadopa carbidopa(Sinemet-CR). Which of the following should the nurse recognize as an adverse effect of thismedication?
o Constipation o Weightgain oHirsultism
o Dyskinesia
61.A nurse is caring for a client who has received acetaminophen (Tylenol) 650 mgand Hydrocodone (Vicodin) 5 mg every 4 hr for the past 24 hr. Which of the following isan appropriate action for the nurse totake?
o Complete an incidentreport
o Stagger the medications every 2hr o Suggest a time with thepharmacy.
o Decrease acetaminophen to 325 mg every 4hr.
62. A nurse is caring for a client who has a new prescription for buproion(Welbutrin). What should the nurse recognize as a contraindication for the use of thismedication? o Xerostomia
o GERD
o Seizure
o Bradycardia
63. A nurse is caring for a client with a urinary tract infection. Her past history reveals anallergy to thiazide diuretics. Which of the following medications iscontraindicated?
o Nitrofurantoin(Macrodantin) o Ciprofloxacin(Cipro)
o Amoxicillin/ clavulanate(Augmentin)
o Trimethoprim/ sulfamethoxazole(Bactrim)
64.A nurse is providing instruction to four clients regarding medicationself-administration. Which of the following actions by a client indicates a need for furtherteaching?
o Client rolls insulin suspension between hispalms o Client takes iron supplements atbedtime.
o Client uses cotton swab to apply antibioticointment.
o Client allows 1 min between puffs when he uses a metered-doseinhaler.
65. A nurse is caring for a client who is receiving penicillin by intermittent IV bolus. Theclient develops cyanosis and tachycardia. A nurse should administer which of thefollowing medicationsfirst?
o Epinephrine(Adrenalin) o Prednisone(Deltasone)
o Hydrocortisone sodium succinate(Solu-Cortef) o Isoproterenol(Isuprel)
66. A nurse is preparing to administer insulin to a client with diabetes mellitus. The client isto receive insulin aspart (NovoLog) 5 units and NPH insulin (Humulin N) 15 unitssubcutaneously in the morning. Which of the following actions should the nurse takefirst?
o Inject 5 units of air into the insulin aspartvial. o Inject 15 units of air into the NPH insulinvial. o Draw up 5 units of insulin aspart from thevial. o Draw up 15 units of NPH insulin from thevial.
67. A nurse is providing care to a client who has heart failure. While verifying the orderswith the medication administration record the nurse notes that the prescription for digoxin(Lanoxin) was transcribed incorrectly. As a result, the client received an extra dose of themedication yesterday. Which of the following actions should the nurse takefirst?
o Complete an incidentreport. o Notify the chargenurse.
o Obtain a set of vitalsigns. o Withhold the nextdose.
68. A nurse is caring for a client who is receiving haloperidol (Haldol). The nurseshould document which of the following findings aredystonia?
o Neckspasmso Lipsmacking oTremors
o Pacing
69. A nurse is completing discharge teaching for a client who has hypertension. The client hasa new prescription for spironolactone (aldactone). Which of the following statements by theclient indicates an understanding of theteaching?
o “I’ll increase my dietary fiber, because this medication causesconstipation.”
o“I’mawarethathismedicationcancauseheartpalpitations.”
o “I’ll take aspirin every day, because it makes this medication moreeffective.” o “I realize that I should use sugar substitutes when taking thismedication.”
70.A nurse is caring for a school age child who has been prescribeddiphenhydramine (Benadryl). Which of the following adverse effects has highestpriority?
o Sedation
o Dry mucousmembranes o Ataxia
o Diarrhea [Show Less]