ATI RN
ATI Pharmocology Exam Fletcher NRSG 106 Questions
Extract:
Question 1 of 5
A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?
Correct Answer: D
Rationale: The correct answer is D. This statement indicates a need for further teaching because phenytoin is an antiepileptic medication that should not be abruptly stopped. A sudden discontinuation can lead to rebound seizures or other withdrawal symptoms. It is important for the client to understand the importance of taking the medication as prescribed by the healthcare provider.
Explanation of other choices:
A: This statement shows understanding of the importance of consistency in taking the same brand of medication to maintain therapeutic levels.
B: This statement indicates awareness of dental care, which is important due to the side effects of phenytoin on gum health.
C: This statement demonstrates the understanding of the potential drug interactions with phenytoin and the importance of consulting the doctor before taking any other medications.
Question 2 of 5
A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment?
Correct Answer: B
Rationale: The correct answer is B: Methadone. Methadone is commonly used in opioid withdrawal management due to its ability to alleviate withdrawal symptoms and reduce cravings without producing the euphoric effects of opioids. It helps stabilize patients and prevent relapse.
A: Bupropion is used for smoking cessation and depression, not opioid withdrawal.
C: Disulfiram is used for alcohol aversion therapy, not opioid withdrawal.
D: Phenobarbital is a barbiturate used for seizure control, not opioid withdrawal.
In summary, Methadone is the correct choice as it is specifically indicated for opioid withdrawal management, while the other options are used for different purposes.
Question 3 of 5
The opioid acetaminophen/hydrocodone is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply.)
Correct Answer: A,B,D
Rationale: The correct adverse effects of acetaminophen/hydrocodone are constipation, lightheadedness, and urinary retention. Constipation is a common side effect due to the opioid's effect on the gastrointestinal system. Lightheadedness can occur due to the central nervous system depressant properties of hydrocodone. Urinary retention is a potential side effect because opioids can affect bladder function. Pain and diarrhea are not common adverse effects of this medication.
Therefore, choices C and E are incorrect.
Question 4 of 5
A nurse is caring for a client who is postoperative following an appendectomy and is prescribed Ds lactated Ringer's at 150 mL/hr by continuous IV infusion for 12 hr. The drop factor of the manual IV tubing is 20 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: A
Rationale:
To determine the correct rate of IV infusion in drops per minute (gtt/min), first calculate the total volume to be infused in 12 hours: 150 mL/hr x 12 hr = 1800 mL.
Then convert this to drops using the drop factor of 20 gtt/mL: 1800 mL x 20 gtt/mL = 36000 gtt. Finally, divide the total drops by the total time in minutes (12 hr x 60 min/hr = 720 min): 36000 gtt ÷ 720 min = 50 gtt/min (rounded to the nearest whole number).
Therefore, the correct answer is A: 50 gtt/min. Other choices are incorrect because they do not result from the accurate calculation based on the prescribed infusion rate and drop factor.
Question 5 of 5
During a routine appointment, a patient with a history of seizures is found to have a phenytoin level of 23 mcg/mL. What concern will the nurse have, if any?
Correct Answer: A
Rationale: The correct answer is A. A phenytoin level of 23 mcg/mL is above the therapeutic range (10-20 mcg/mL) and indicates toxicity.
To address this, the dosage should be reduced to prevent adverse effects such as ataxia and nystagmus.
Choice B is incorrect because a high phenytoin level does not guarantee seizure control, and adding another antiepileptic drug may increase the risk of adverse effects.
Choice C is incorrect as a high phenytoin level does not necessarily mean an increased risk of seizures, but rather toxicity.
Choice D is incorrect because a phenytoin level of 23 mcg/mL is above the therapeutic range, indicating toxicity rather than efficacy.