ATI RN
ATI Pharmacology NRSG 106 Fletcher Exam Questions
Extract:
Question 1 of 5
A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels, the nurse notices that the level is still elevated. What is the best explanation for this elevation?
Correct Answer: B
Rationale: The correct answer is B: The corticosteroids may cause an increase in glucose levels. Corticosteroids can lead to insulin resistance, causing elevated blood glucose levels in patients with diabetes. This occurs due to the corticosteroids' effect on glucose metabolism in the liver, muscle, and adipose tissue. The other choices are incorrect because hypoxia from COPD would typically lead to decreased insulin sensitivity (
Choice
A), antibiotics do not directly impact blood glucose levels (
Choice
C), and type 2 diabetes does not convert to type 1 (
Choice
D).
Question 2 of 5
A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil. He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?
Correct Answer: D
Rationale: The correct answer is D: Significant decrease in blood pressure. Sildenafil is a phosphodiesterase type 5 inhibitor used to treat erectile dysfunction, while nitrates are vasodilators commonly used for angina. When taken together, they can cause a dangerous drop in blood pressure due to additive vasodilatory effects. This can lead to hypotension, dizziness, and even syncope. It is crucial to avoid combining sildenafil with nitrates to prevent this potentially life-threatening interaction.
Incorrect
Choices:
A: Reduced effectiveness of the sildenafil - This is incorrect because the issue is not about the effectiveness of sildenafil but rather the dangerous interaction with nitrates.
B: Significant increase in pulse rate - This is incorrect as the concern is more related to blood pressure rather than pulse rate.
C: Increased risk of bleeding - This is incorrect as the interaction between sildenafil and nitrates does not typically increase the risk of bleeding.
Question 3 of 5
The client with hyperparathyroidism is taking alendronate. Which statements by the client indicate an understanding of the proper way to take this medication? (Select all that apply)
Correct Answer: D,E
Rationale:
Correct
Answer: D,E
Rationale:
D: The client should avoid alcohol while taking alendronate as it can increase the risk of gastrointestinal side effects.
E: The client should sit up for at least 30 minutes after taking alendronate to prevent esophageal irritation and ensure proper absorption.
Incorrect
Choices:
A: Alendronate is not safe during pregnancy and can harm the fetus.
B: Lying down after taking alendronate can increase the risk of esophageal irritation.
C: Smoking can worsen bone health and counteract the effects of alendronate.
Question 4 of 5
After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months?
Correct Answer: A
Rationale: The correct answer is A: Hemoglobin A1C level. Hemoglobin A1C reflects the average blood sugar levels over the past 2-3 months, making it a reliable indicator of long-term glycemic control and treatment adherence. Consistent monitoring of A1C helps assess the effectiveness of the antidiabetic therapy. Serum insulin level (
B) is not a direct indicator of adherence and can fluctuate based on various factors. Fingerstick fasting blood glucose level (
C) provides a snapshot of current blood sugar levels, not adherence over time. Hemoglobin level (
D) is unrelated to diabetes management and does not reflect treatment adherence.
Question 5 of 5
A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?
Correct Answer: B
Rationale: The correct answer is B: Contact the prescriber to clarify orders. This is the best action because the patient is NPO, and oral antidiabetic drugs should not be administered without clear instructions from the prescriber. Withholding all medications (choice
A) can lead to uncontrolled blood sugar levels. Administering half the dose (choice
C) may not be appropriate without prescriber approval. Giving the medication with water (choice
D) is contraindicated when the patient is NPO. Contacting the prescriber ensures patient safety and proper management of diabetes during the procedure.