ATI RN
ATI RN Pharmacology Proctored Exam Questions
Extract:
Question 1 of 5
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?
Correct Answer: D
Rationale: The correct answer is D: Notify the provider of the client's weight gain. This is the most appropriate action because sudden weight gain in a client with heart failure could indicate fluid retention, a potential worsening condition requiring immediate medical attention. By notifying the provider, the nurse ensures timely intervention and adjustment of the treatment plan to prevent complications.
A: Encouraging the client to dangle legs does not address the immediate concern of weight gain and potential fluid retention.
B: Teaching about low-sodium foods may be important for long-term management but is not the priority in this acute situation.
C: Determining medication adherence is important but does not address the urgent need for intervention in response to the weight gain.
In summary, notifying the provider is crucial in addressing the potential exacerbation of heart failure, making it the most appropriate action.
Question 2 of 5
A nurse is teaching a client about oral contraceptive. Which of the following information should the nurse include in the teaching?
Correct Answer: C
Rationale: The correct answer is C: Some herbal supplements can decrease the effectiveness of an oral contraceptive. The nurse should include this information in the teaching because certain herbal supplements like St. John's Wort can interact with oral contraceptives, reducing their effectiveness and potentially leading to unintended pregnancies. It is crucial for clients to be aware of this interaction to ensure the contraceptive's efficacy.
Choice A is incorrect because abdominal pain is not a common adverse effect of oral contraceptives.
Choice B is incorrect as fertility can return soon after stopping oral contraceptives, not necessarily taking up to 1 year.
Choice D is incorrect as a pelvic examination is not always required prior to starting oral contraceptives, depending on the client's medical history and age.
Question 3 of 5
A nurse is reviewing the list of current medications for a client who is to start a prescription for carbamazepine. The nurse should identify that which of the following medications interacts with carbamazepine?
Correct Answer: C
Rationale: The correct answer is C, the estrogen-progestin combination. Carbamazepine can decrease the effectiveness of hormonal contraceptives, such as estrogen-progestin combinations, leading to a potential decrease in contraceptive efficacy and an increased risk of unintended pregnancy. This interaction occurs because carbamazepine can induce the metabolism of estrogen and progestin components, reducing their blood levels.
Therefore, it is important for the nurse to recognize this interaction and advise the client to use alternative contraceptive methods while taking carbamazepine to prevent unintended pregnancy. The other choices (A, B, and
D) do not have significant interactions with carbamazepine and are not directly affected by its metabolism.
Question 4 of 5
A nurse is caring for a client who is 12 hr postpartum and has a third-degree perineal laceration. The client reports not having a bowel movement for 4 days. Which of the following medications should the nurse administer?
Correct Answer: A
Rationale: The correct answer is A: Bisacodyl 10 mg per rectum. This medication is a stimulant laxative that helps stimulate bowel movements and relieve constipation. In this scenario, the client's lack of bowel movement for 4 days postpartum, especially with a third-degree perineal laceration, can lead to discomfort and complications like fecal impaction. Administering a rectal suppository ensures a faster onset of action compared to oral medications.
Choices B, C, and D are incorrect:
B: Magnesium hydroxide is an oral laxative that may take longer to have an effect compared to a rectal suppository.
C: Famotidine is a medication used to reduce stomach acid and is not indicated for constipation.
D: Loperamide is an antidiarrheal medication and would worsen the client's constipation.
Question 5 of 5
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?
Correct Answer: B
Rationale:
Correct Answer: B - The potassium infusion rate is too rapid.
Rationale: Potassium replacement should be administered cautiously to prevent adverse effects such as hyperkalemia. A rapid infusion rate can lead to cardiac arrhythmias and other serious complications. The recommended rate for IV potassium replacement is typically 10-20 mEq/hour to minimize risks.
Therefore, the nurse should clarify this prescription with the provider to adjust the infusion rate to ensure the client's safety.
Incorrect
Choices:
A: Potassium chloride should be diluted in dextrose 5% in water - Incorrect. Potassium chloride can be safely administered in 0.9% sodium chloride solution.
C: Another formulation of potassium should be given IV - Incorrect. The prescribed formulation is appropriate for potassium replacement.
D: The client should be treated by giving potassium by IV bolus - Incorrect. IV bolus administration of potassium can be dangerous and should be avoided.
E, F, G: Not provided.