ATI Pharmacology Pre-assessment

Question 1

A nurse is teaching a client who has iron deficiency anemia about ferrous sulfate. Which of the following instructions should the nurse include in the teaching?

Answer 1

Take the ferrous sulfate bw meals

the client should take the meds bw meals for optimal absorption

Question 1

A nurse is caring for a client who has acute respiratory distress syndrome (ARDS), and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes

Answer 1

Suppress respiratory effort

Neuromuscular blocking agents, such as pancuronium, induce paralysis and suppress the client’s respiratory efforts to the point of apnea, allowing the mechanical ventilator to take over the work of breathing for the client. This therapy is especially helpful for a client who has ARDS and poor lung compliance.

Question 2

A nurse is caring for a client who is receiving mydriatic eye drops. Which of the following manifestations indicates to the nurse that the client has developed a systemic anticholinergic effect?

Answer 2

Constipation

Mydriatic eye drops can cause systemic anticholinergic effects, such as constipation and dry mouth

Question 3

A nurse is caring for a client who has Wernicke-Korsakoff psychosis as a result of chronic alcohol use disorder. Which of the following interventions should the nurse anticipate?

Answer 3

Administration of thiamine

Thiamine is administered to the client who has Wernicke-Korsakoff psychosis due to hepatic dysfunction and inadequate intake of sufficient vitamins.

Question 4

A nurse is evaluating teaching with a client who is receiving continuous subq insulin via an external insulin pump. Which of the following statements by the client indicates a need for further teaching?

Answer 4

“I will use insulin glargine in my insulin pump”

The client should use a short-acting insulin in the insulin pump. The insulin pump is designed to administer rapid-acting or short-acting insulin 24 hr a day. Insulin glargine is classified as a long-acting insulin and is administered at the same time each day to maintain stable blood glucose concentration for a 24-hr period.

Question 5

A nurse is teaching a client about taking diphenhydramine. The nurse should explain to the client that which of the following is an adverse effect of this medication?

Answer 5

Sedation

Diphenhydramine can cause sedation. It is used to treat rhinitis, allergies, and insomnia.

Question 6

A nurse is teaching a client who has a new prescription for docusate. Which of the following information should the nurse include in the teaching?

Answer 6

“take the med with a full glass of water”

The nurse should instruct the client to take this medication with a full glass of water, unless contraindicated, to reduce the risk for constipation.

Question 7

A nurse in a critical care unit is caring for a client who is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?

Answer 7

Semi-Fowler’s

Pneumonectomy is the surgical removal of the lung, which is most commonly performed to remove a tumor in a client who has lung cancer. Following extubation from the ventilator, the client should be placed in semi-Fowler’s position to help to ensure adequate ventilation and decrease the risk of complications. This position also offers the client the most comfort.

Question 8

A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following actions is appropriate?

a. withholding the med if HR is above 100/min
b. instructing the client to eat foods that are low in potassium
c. measuring apical pulse rate for 30 sec before administration
d. evaluating the client for nausea, vomiting, and anorexia

Answer 8

D is correct: Loss of appetite, nausea, vomiting, and blurred or yellow vision may be signs of digoxin toxicity.

a is incorrect: The nurse should withhold the medication if the client’s heart rate is below 60/min.

b is incorrect: The client should eat foods high in potassium to prevent hypokalemia, which increases the risk of digoxin toxicity.

c is incorrect: Measuring apical pulse rate for 30 seconds before administration
MY ANSWER
The nurse should measure the apical pulse rate for 1 min.

Question 9

A nurse is providing teaching to a client who has oral candidiasis and a new prescription for nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching?

a. “I will store the med at room temp”
b. “I will take the med every morning on an empty stomach”
c. “I will spit the med out after swishing it around my mouth”
d. “I will only need to take the med for a few days.”

Answer 9

a is correct: Nystatin oral suspension should be stored at room temperature.

b is incorrect:
The action of nystatin is local, and it is not absorbed through intact skin or mucous membranes. There is no reason to take the medication on an empty stomach.

c is incorrect: Nystatin must be swallowed to maximize the medication’s local effects on the mucosal lining of the upper gastrointestinal tract.

d is incorrect: Long-term therapy may be needed to clear candidiasis. The client should be instructed to complete the entire dose of medication.

Question 10

A nurse is caring for a child who is allergic to penicillin. The nurse should verify which of the following prescriptions with the provider?

Answer 10

Amoxicillin- calvulanate

Penicillin is the most common medication allergy. Clients who are allergic to one penicillin medication should be considered allergic to all penicillins, which would include amoxicillin-clavulanate. Reactions may mild or life-threatening.

Question 11

A nurse is caring for a client who has hemophilia A and hemarthrosis of the left knee. Which of the following actions should the nurse take?

a. administer low dose aspiring
b. apply heat to the knee
c. prepare for autologous blood transfusion
d. obtain a stool specimen

Answer 11

D is correct: The nurse should obtain a stool specimen, as the client is at risk for bleeding in the gastrointestinal track. The stool specimen would show presence of blood.

a is incorrect: It is not appropriate for the nurse to administer aspirin to a client who has hemophilia. Aspirin, NSAIDS, and some herbal products should be avoided, as they increase the risk of bleeding.
b is incorrect: It is not appropriate for the nurse to apply heat to the affected extremity, as this this may increase the bleeding in the joint.
c is incorrect: An autologous transfusion would involve transfusing the client’s own blood. As the client is deficient in clotting factors, this would not be of benefit. Products that are given to clients who have hemophilia include clotting factors, fresh-frozen plasma, and possibly whole blood.

Question 12

A nurse is caring for a client who requires a med that is packaged in a single dose glass ampule. Which of the following techniques should the nurse use when opening the glass ampule?

Answer 12

Tap the top of the ampule, place a sterile gauze pad around the ampule neck, and break off the top by bending it toward the body

The nurse should tap the top of the ampule, place a sterile gauze pad around the ampule neck, and break off the top by bending it toward the body. The sterile gauze prevents broken glass coming in contact with the fingers, and bending the ampule top toward the body allows glass fragments to spray away from the nurse.

Question 13

The nurse is preparing a med for a client and observes the date of expiration on the vial occurred 2 months ago. Which of the following actions should the nurse take?

Answer 13

Return the medication to the pharmacy.

The nurse should return the med to pharmacy. Law requires that all medication include an expiration date.

Question 14

A nurse is providing teaching to a client who has a new prescription for hydroxychloroquine to treat mild manifestations of rheumatoid arthritis. Which of the following info should the nurse include in the teaching?

a. this medication should be taken bw meals
b. this med can turn skin an orange color
c. wear sunglasses when out in bright sunshine
d. avoid crushing the medication

Answer 14

C is correct: The nurse should instruct the client to wear sunglasses to decrease photophobia when taking hydroxychloroquine. Clients should have an ophthalmologic examination before treatment because the medication can cause retinopathy.

A is incorrect: The nurse should instruct the client to take the hydroxychloroquine with food or milk.
B is incorrect: The nurse should instruct the client that hydroxychloroquine can cause a blue-black discoloration of the skin and may turn urine a rust or brown color.
D is incorrect: The nurse should instruct the client that hydroxychloroquine can be crushed and mixed with food or fluids.

Question 15

A nurse is caring for an adolescent client who is receiving carbamazepine for partial seizure disorder. Which of the following statements by the client’s parent is the nurse’s priority?

Answer 15

“He has so many new bruises on his body”

When using the urgent vs non-urgent approach to client care, the nurse determines that the priority concern is frequent bruising because this is a manifestation of carbamazepine toxicity. Carbamazepine toxicity can cause bone marrow depression, including leukopenia, anemia, and thrombocytopenia. The parent should monitor the client for bruising, bleeding, and sore throat and have periodic blood work drawn to monitor for myelosuppression.

Question 16

A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at increased risk for which of the following conditions?

Answer 16

Infection

Agranulocytosis is a failure of the bone marrow to make enough white blood cells, causing neutropenia and lowering the body defenses against infection.

Question 17

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

a. the med will reduce inflammation
b. the med will stimulate flow of mucus
c. the med will prevent wheezing
d. the med will decrease coughing episodes
e. the med will open the airways

Answer 17

c,d,e

Question 18

A nurse is providing teaching to a client who has gastroesophageal reflux disease and a new prescription for omeprazole. Which of the following instructions should the nurse provide?

Answer 18

Report diarrhea to the provider

Omeprazole is associated with an increased risk of C. difficile infection. The nurse should instruct the client to contact the provider if diarrhea occurs.

Question 19

A nurse caring for a client who has HTN and asks the nurse about a prescription for propranolol. The nurse should inform the client that this med is contraindicated in clients who have a hx of which of the following conditions

Answer 19

Asthma

Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation.

Question 20

A nurse is assessing a client who has acute cocaine toxicity. Which of the following findings should the nurse expect? (Select all that apply.)

(Select All that Apply.)

Report of tinnitus
Tremor
Fever
Agitation
Bradycardia

Answer 20

Fever, tremor, agitation

Report of tinnitus is incorrect. Tinnitus is an adverse effect of aspirin toxicity.

Fever is correct. Hyperpyrexia is a manifestation of acute cocaine toxicity.

Bradycardia is incorrect. Ventricular dysrhythmias are a manifestation of acute cocaine toxicity.

Tremor is correct. Tremor and dizziness are manifestations of acute cocaine toxicity.

Agitation is correct. Agitation and hallucinations are manifestations of acute cocaine toxicity.

Question 21

A nurse is teaching a client who has a new prescription for codeine. Which of the following instructions should the nurse include in the teaching?

Answer 21

“you should change positions slowly”

The client should change positions slowly to avoid the risk of falls. Codeine is an opioid analgesic that causes CNS depression and orthostatic hypotension.

Question 22

A nurse is caring for a client who is postoperative following a transurethral resection of the prostate (TURP). The nurse should plan to administer the client’s PRN bethanechol when the client reports which of the following manifestations?

Answer 22

an inability to void

Bethanechol is a cholinergic medication that stimulates the parasympathetic nervous system, thus improving the tone and motility of the smooth muscles of the urinary tract enough to initiate urination.