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ATI PN PHARMACOLOGY PROCTORED NEWEST 2025 ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
“Patient identifiers - CORRECT ANSWER -Medical record number
-home telephone number"
"RBC Blood transfusion - CORRECT ANSWER
http://www.atitesting.com/ati_next_gen/FocusedReview/data/datacontext/RM%20AMS %20RN%208.0%20Chp%2044.pdf (prime with normal saline and infuse with sodium chloride)."
"What to understand about Parkinson's Meds? - CORRECT ANSWER -they don't cure
disease, they slow the process."
"NEUPOGEN (filgrastim)-what is the appropriate route of this med? - CORRECT ANSWER
administered by subcutaneous injection or IV infusion" "1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
- Calcium chloride
- Calcium gluconate
- Calcitonin (Miacalcin)
4. Large doses of vitamin D - CORRECT ANSWER 3. Calcitonin (Miacalcin)
Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration." "2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item?
- Milk
- Water
- Apple juice
4. Orange juice - CORRECT ANSWER 4. Orange juice
Rationale: Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect
absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice." "3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?
- Tinnitus
- Diarrhea
- Constipation
4. Decreased respirations - CORRECT ANSWER 1. Tinnitus
Rationale: Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism." "4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:
- Immediately before swimming
- 15 minutes before exposure to the sun
- Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - CORRECT ANSWER 4. At least 30 minutes
before exposure to the sun Rationale: Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating." "5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?
- Notifying the registered nurse
- Discontinuing the medication
- Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site - CORRECT ANSWER 3. Informing
the client that this is normal Rationale: Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect"
- Soles of the feet
4. Palms of the hands - CORRECT ANSWER 2. Axilla
Rationale: Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is poor (back, palms, soles)." "10.) A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication?
- Hypouricemia, hyperkalemia
- Increased risk of osteoporosis
- Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy - CORRECT ANSWER 3. Hypokalemia,
hyperglycemia, sulfa allergy Rationale: Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a client with a sulfa allergy is at risk for an allergic reaction. Also, clients are at risk for hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia." "11.) A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education?
- "Constipation and bloating might be a problem."
- "I'll continue to watch my diet and reduce my fats."
- "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store." - CORRECT ANSWER 4. "I'll
continue my nicotinic acid from the health food store." Rationale: Nicotinic acid, even an over-the-counter form, should be avoided because it may lead to liver abnormalities. All lipid-lowering medications also can cause liver abnormalities, so a combination of nicotinic acid and cholestyramine resin is to be avoided. Constipation and bloating are the two most common side effects. Walking and the reduction of fats in the diet are therapeutic measures to reduce cholesterol and triglyceride levels." "12.) A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions?
- "It is not necessary to avoid the use of alcohol."
- "The medication should be taken with meals to decrease flushing."
- "Clay-colored stools are a common side effect and should not be of concern."
- "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing."
- CORRECT ANSWER 4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid
should decrease the flushing." Rationale: Flushing is a side effect of this medication. Aspirin or a nonsteroidal anti-inflammatory drug can be taken 30 minutes before taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it will enhance this side effect. The medication should be taken with meals, this will decrease gastrointestinal upset. Taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic dysfunction and should be immediately reported to the health care provider (HCP)." "13.) A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Select the appropriate actions that the nurse should take. Select all that apply.
- Call a code blue.
- Contact the registered nurse.
- Contact the client's family.
- Assess the client's pain level.
- Check the client's blood pressure.
6. Administer a second nitroglycerin, 0.4 mg, sublingually. - CORRECT ANSWER 2. Contact
the registered nurse.
- Assess the client's pain level.
- Check the client's blood pressure.
- Administer a second nitroglycerin, 0.4 mg, sublingually. Rationale: The usual guideline for administering nitroglycerin tablets for a hospitalized client with chest pain is to administer one tablet every 5 minutes PRN for chest pain, for a total dose of three tablets. The registered nurse should be notified of the client's condition, who will then notify the health care provider as appropriate. Because the client is still complaining of chest pain, the nurse would administer a second nitroglycerin tablet. The nurse would assess the client's pain level and check the client's blood pressure before administering each nitroglycerin dose. There are no data in the question that indicate the need to call a code blue. In addition, it is not necessary to contact the client's family unless the client has requested this." "14.) Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client?
- Discontinuation of warfarin sodium (Coumadin)
- A decrease in the warfarin sodium (Coumadin) dosage
- An increase in the warfarin sodium (Coumadin) dosage
4. A decrease in the usual dose of nalidixic acid (NegGram) - CORRECT ANSWER 2. A
decrease in the warfarin sodium (Coumadin) dosage
should be taken after meals to reduce the possibility of gastrointestinal upset. A headache is an occasional side effect of the medication and does not warrant discontinuation of the medication." "18.) Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?
- Gastric atony
- Urinary strictures
- Neurogenic atony
4. Gastroesophageal reflux - CORRECT ANSWER 2. Urinary strictures
Rationale: Bethanechol chloride (Urecholine) can be harmful to clients with urinary tract obstruction or weakness of the bladder wall. The medication has the ability to contract the bladder and thereby increase pressure within the urinary tract. Elevation of pressure within the urinary tract could rupture the bladder in clients with these conditions." "19.) A nurse who is administering bethanechol chloride (Urecholine) is monitoring for acute toxicity associated with the medication. The nurse checks the client for which sign of toxicity?
- Dry skin
- Dry mouth
- Bradycardia
4. Signs of dehydration - CORRECT ANSWER 3. Bradycardia
Rationale: Toxicity (overdose) produces manifestations of excessive muscarinic stimulation such as salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. Treatment includes supportive measures and the administration of atropine sulfate subcutaneously or intravenously." "20.) Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?
- Pallor
- Drowsiness
- Bradycardia
4. Restlessness - CORRECT ANSWER 4. Restlessness
Rationale: Toxicity (overdosage) of this medication produces central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity include hypotension or hypertension, confusion, tachycardia, flushed or red face, and signs of respiratory depression. Drowsiness is a frequent side effect of the medication but does not indicate overdosage."
"21.) A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply.
- Tinnitus
- Ototoxicity
- Hyperkalemia
- Hypercalcemia
- Nephrotoxicity
6. Hypomagnesemia - CORRECT ANSWER 1. Tinnitus
- Ototoxicity
- Nephrotoxicity
- Hypomagnesemia Rationale: Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin to reduce the potential for renal toxicity." "22.) A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:
- Treat thyroid storm.
- Prevent cardiac irritability.
- Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - CORRECT ANSWER 3. Treat hypocalcemic
tetany. Rationale: Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside." "23.) A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?
- Keep insulin vials refrigerated at all times.
- Rotate the insulin injection sites systematically.
- Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - CORRECT ANSWER 2.
Rotate the insulin injection sites systematically. Rationale:
When alcohol is combined with glimepiride (Amaryl), a disulfiram-like reaction may occur. This syndrome includes flushing, palpitations, and nausea. Alcohol can also potentiate the hypoglycemic effects of the medication. Clients need to be instructed to avoid alcohol consumption while taking this medication. The items in options 2, 3, and 4 do not need to be avoided." "27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?
- Neuralgia
- Insomnia
- Use of nitroglycerin
4. Use of multivitamins - CORRECT ANSWER 3. Use of nitroglycerin
Rationale: Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus cavernosum of the penis, thus sustaining an erection. Because of the effect of the medication, it is contraindicated with concurrent use of organic nitrates and nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia and insomnia are side effects of the medication." "28.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention?
- The medication is administered within 60 minutes before the morning and evening meal.
- The medication is withheld and the HCP is called to question the prescription for the client.
- The client is monitored for gastrointestinal side effects after administration of the medication.
- The insulin is withdrawn from the Penlet into an insulin syringe to prepare for administration.
- CORRECT ANSWER 2. The medication is withheld and the HCP is called to question the
prescription for the client. Rationale: Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus only. It is not recommended for clients taking insulin. Hence, the nurse should hold the medication and question the HCP regarding this prescription. Although options 1 and 3 are correct statements about the medication, in this situation the medication should not be administered. The medication is packaged in prefilled pens ready for injection without the need for drawing it up into another syringe." "29.) A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:
- 2 to 4 hours after administration
- 4 to 12 hours after administration
- 16 to 18 hours after administration
4. 18 to 24 hours after administration - CORRECT ANSWER 2. 4 to 12 hours after
administration Rationale: Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time." "30.) A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- Prednisone
- Phenelzine (Nardil)
- Atenolol (Tenormin)
4. Allopurinol (Zyloprim) - CORRECT ANSWER 1. Prednisone
Rationale: Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and potassium supplements. Option 2, a monoamine oxidase inhibitor, and option 3, a β-blocker, have their own intrinsic hypoglycemic activity. Option 4 decreases urinary excretion of sulfonylurea agents, causing increased levels of the oral agents, which can lead to hypoglycemia." "31.) A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client and the nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?
- "I can take aspirin or my antihistamine if I need it."
- "I need to take the medication every day at the same time."
- "I need to avoid coffee, tea, cola, and chocolate in my diet."
4. "If I gain more than 5 pounds a week, I will call my doctor." - CORRECT ANSWER 1. "I can
take aspirin or my antihistamine if I need it." Rationale: Aspirin and other over-the-counter medications should not be taken unless the client consults with the health care provider (HCP). The client needs to take the medication at the same time every day and should be instructed not to stop the medication. A slight weight gain as a result of an improved appetite is expected, but after the dosage is stabilized, a weight gain of 5 lb or more weekly should be reported to the HCP. Caffeine-containing foods and fluids need to be avoided because they may contribute to steroid-ulcer development." "32.) Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?
- Decreased urinary output
- Decreased blood pressure
- Decreased peripheral edema
The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab (Remicade) is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication." "35.) The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?
- Constipation
- Abdominal pain
- An episode of diarrhea
4. Hematest-positive nasogastric tube drainage - CORRECT ANSWER 3. An episode of
diarrhea Rationale: Loperamide is an antidiarrheal agent. It is used to manage acute and also chronic diarrhea in conditions such as inflammatory bowel disease. Loperamide also can be used to reduce the volume of drainage from an ileostomy. It is not used for the conditions in options 1, 2, and 4." "36.) The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client?
- Paralytic ileus
- Incisional pain
- Urinary retention
4. Nausea and vomiting - CORRECT ANSWER 4. Nausea and vomiting
Rationale: Ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well as nausea and vomiting associated with chemotherapy. The other options are incorrect." "37.) The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?
- Weight loss
- Relief of heartburn
- Reduction of steatorrhea
4. Absence of abdominal pain - CORRECT ANSWER 3. Reduction of steatorrhea
Rationale: Pancrelipase (Pancrease MT) is a pancreatic enzyme used in clients with pancreatitis as a digestive aid. The medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could be improved nutritional status. It is not used to treat abdominal pain or heartburn. Its use could result in weight gain but should not result in weight loss if it is aiding in digestion." "38.) An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?
- Tremors
- Dizziness
- Confusion
4. Hallucinations - CORRECT ANSWER 3. Confusion
Rationale: Cimetidine is a histamine 2 (H2)-receptor antagonist. Older clients are especially susceptible to central nervous system side effects of cimetidine. The most frequent of these is confusion. Less common central nervous system side effects include headache, dizziness, drowsiness, and hallucinations." "39.) The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse schedules the medication for which times?
- With meals and at bedtime
- Every 6 hours around the clock
- One hour after meals and at bedtime
4. One hour before meals and at bedtime - CORRECT ANSWER 4. One hour before meals and
at bedtime Rationale: Sucralfate is a gastric protectant. The medication should be scheduled for administration 1 hour before meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer before food intake stimulates gastric acid production and mechanical irritation. The other options are incorrect." "40.) The client who chronically uses nonsteroidal anti-inflammatory drugs has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted?
- Resolved diarrhea
- Relief of epigastric pain
- Decreased platelet count
4. Decreased white blood cell count - CORRECT ANSWER 2. Relief of epigastric pain
Rationale: The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) is prone to gastric mucosal injury. Misoprostol is a gastric protectant and is given specifically to prevent this occurrence. Diarrhea can be a side effect of the medication, but is not an intended effect. Options 3 and 4 are incorrect." "41.) The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving optimal intended effect of the medication if the client reports the absence of which symptom?
- Diarrhea
- Heartburn
- Flatulence
4. Constipation - CORRECT ANSWER 2. Heartburn
Rationale:
4. Suction equipment - CORRECT ANSWER 4. Suction equipment
Rationale: Acetylcysteine can be given orally or by nasogastric tube to treat acetaminophen overdose, or it may be given by inhalation for use as a mucolytic. The nurse administering this medication as a mucolytic should have suction equipment available in case the client cannot manage to clear the increased volume of liquefied secretions." "45.) A client has a prescription to take guaifenesin (Humibid) every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client states that he or she will:
- Watch for irritability as a side effect.
- Take the tablet with a full glass of water.
- Take an extra dose if the cough is accompanied by fever.
4. Crush the sustained-release tablet if immediate relief is needed. - CORRECT ANSWER 2.
Take the tablet with a full glass of water. Rationale: Guaifenesin is an expectorant. It should be taken with a full glass of water to decrease viscosity of secretions. Sustained-release preparations should not be broken open, crushed, or chewed. The medication may occasionally cause dizziness, headache, or drowsiness as side effects. The client should contact the health care provider if the cough lasts longer than 1 week or is accompanied by fever, rash, sore throat, or persistent headache." "46.) A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for:
- Pupillary changes
- Scattered lung wheezes
- Sudden increase in pain
4. Sudden episodes of diarrhea - CORRECT ANSWER 3. Sudden increase in pain
Rationale: Naloxone hydrochloride is an antidote to opioids and may also be given to the postoperative client to treat respiratory depression. When given to the postoperative client for respiratory depression, it may also reverse the effects of analgesics. Therefore, the nurse must check the client for a sudden increase in the level of pain experienced. Options 1, 2, and 4 are not associated with this medication." "47.) A client has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing:
- Hypercalcemia
- Peripheral neuritis
- Small blood vessel spasm
4. Impaired peripheral circulation - CORRECT ANSWER 2. Peripheral neuritis
Rationale: A common side effect of the TB drug INH is peripheral neuritis. This is manifested by numbness, tingling, and paresthesias in the extremities. This side effect can be minimized by pyridoxine (vitamin B6) intake. Options 1, 3, and 4 are incorrect." "48.) A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:
- Drink alcohol in small amounts only.
- Report yellow eyes or skin immediately.
- Increase intake of Swiss or aged cheeses.
4. Avoid vitamin supplements during therapy. - CORRECT ANSWER 2. Report yellow eyes or
skin immediately. Rationale: INH is hepatotoxic, and therefore the client is taught to report signs and symptoms of hepatitis immediately (which include yellow skin and sclera). For the same reason, alcohol should be avoided during therapy. The client should avoid intake of Swiss cheese, fish such as tuna, and foods containing tyramine because they may cause a reaction characterized by redness and itching of the skin, flushing, sweating, tachycardia, headache, or lightheadedness. The client can avoid developing peripheral neuritis by increasing the intake of pyridoxine (vitamin B6) during the course of INH therapy for TB." "49.) A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:
- Should always be taken with food or antacids
- Should be double-dosed if one dose is forgotten
- Causes orange discoloration of sweat, tears, urine, and feces
4. May be discontinued independently if symptoms are gone in 3 months - CORRECT
ANSWER 3. Causes orange discoloration of sweat, tears, urine, and feces
Rationale: Rifampin should be taken exactly as directed as part of TB therapy. Doses should not be doubled or skipped. The client should not stop therapy until directed to do so by a health care provider. The medication should be administered on an empty stomach unless it causes gastrointestinal upset, and then it may be taken with food. Antacids, if prescribed, should be taken at least 1 hour before the medication. Rifampin causes orange-red discoloration of body secretions and will permanently stain soft contact lenses." "50.) A nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report:
- Impaired sense of hearing
- Problems with visual acuity
- Flu-like syndrome
- Low neutrophil count
- Vitamin B6 deficiency
- Ocular pain or blurred vision
6. Tingling and numbness of the fingers - CORRECT ANSWER 1. Signs of hepatitis
- Flu-like syndrome
- Low neutrophil count
- Ocular pain or blurred vision Rationale: Rifabutin (Mycobutin) may be prescribed for a client with active MAC disease and tuberculosis. It inhibits mycobacterial DNA-dependent RNA polymerase and suppresses protein synthesis. Side effects include rash, gastrointestinal disturbances, neutropenia (low neutrophil count), red- orange body secretions, uveitis (blurred vision and eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea, and flu-like syndrome. Vitamin B6 deficiency and numbness and tingling in the extremities are associated with the use of isoniazid (INH). Ethambutol (Myambutol) also causes peripheral neuritis." "54.) A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?
- "I will take my pills every day at the same time."
- "I will be certain to avoid alcohol consumption."
- "I have already called my family to pick up a Medic-Alert bracelet."
4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." -
CORRECT ANSWER 4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because
it is coated." Rationale: Ecotrin is an aspirin-containing product and should be avoided. Alcohol consumption should be avoided by a client taking warfarin sodium. Taking prescribed medication at the same time each day increases client compliance. The Medic-Alert bracelet provides health care personnel emergency information." "55.) A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?
- 3 to 5 ng/mL
- 0.5 to 2 ng/mL
- 1.2 to 2.8 ng/mL
4. 3.5 to 5.5 ng/mL - CORRECT ANSWER 2.) 0.5 to 2 ng/mL
Rationale:
Therapeutic levels for digoxin range from 0.5 to 2 ng/mL. Therefore, options 1, 3, and 4 are incorrect." "56.) Heparin sodium is prescribed for the client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication?
- Hematocrit level
- Hemoglobin level
- Prothrombin time (PT)
4. Activated partial thromboplastin time (aPTT) - CORRECT ANSWER 4. Activated partial
thromboplastin time (aPTT) Rationale: The PT will assess for the therapeutic effect of warfarin sodium (Coumadin) and the aPTT will assess the therapeutic effect of heparin sodium. Heparin sodium doses are determined based on these laboratory results. The hemoglobin and hematocrit values assess red blood cell concentrations." "57.) A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?
- The development of complaints of insomnia
- The development of audible expiratory wheezes
- A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
- A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min
after two doses of the medication - CORRECT ANSWER 2. The development of audible
expiratory wheezes Rationale: Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm. β-Blockers may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or asthma. Normal decreases in blood pressure and heart rate are expected. Insomnia is a frequent mild side effect and should be monitored." "58.) Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client:
- Cut the dose in half.
- Discontinue the medication.
- Take the medication with food.
4. Contact the health care provider (HCP). - CORRECT ANSWER 3. Take the medication with
food. Rationale: Isosorbide mononitrate is an antianginal medication. Headache is a frequent side effect of isosorbide mononitrate and usually disappears during continued therapy. If a headache occurs during therapy, the client should be instructed to take the medication with food or meals. It is not
