ATI Pharmocology Practice Exam

a nurse is preparing to administer dextrose 5% in water 400 ml IV to infuse over 1 hr. the drop factor of the manual IV tubing is 15 gtt/ml. the nurse should set the manual IV infusion to deliver how many gtt/min?

100 400 ml/ 60 min X 15 gtt/ml = 6,000/60 = 100

A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor? A) Creatinine kinase B) Erythrocyte sedimentation rate C) International normalized ratio D) Potassium

CK The client who is taking atorvastatin can develop an adverse effect called rhabdomyolysis, which causes muscle weakness or pain and can progress to myositis.

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in her instructions? take tid with meals take 1 tab at onset of headache take up to 8 tabs prn within 24 hours take 1 tab po q 15 minutes until headache subsides

take at onset of headache

A nurse at an urgent care clinic is collecting a history from a female client who has a urinary tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? "I have tendonitis, so I haven't been able to exercise." I take a stool softener for a chronic constipation i take medicine for my thyroid i am allergic to sulfa

"I have tendonitis, so I haven't been able to exercise."

A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understating of the teaching? i should apply the patch every 5 minutes if I develop chest pain "I will take the patch off right after my evening meal" I will leave the patch off at least one day per week I should discard the used patch by flushing it down the toilet

"I will take the patch off right after my evening meal" remove in evening, wait 12-14 hours before reapplying patch will take 30-60 mins, pills will repeat q 5 mins dilates cornary arteries , apply to sustain prophlayxis to discard fold the patch together and into a closed container to children and pets cant not get to it

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? use beclomethasone to avoid an acute attack use beclomethasone 5 minutes before albuterol limit your calcium and vitamin d intake when using beclomathasone rinse your mouth after inhaling the beclomethasone

"Rinse your mouth after inhaling the beclomethasone"; The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness. increase ca and vit d bc it could be depleted when taking a glucocorticoid use a bronchodilator 1st (albuterol)

the nurse is assessing a client 1 hour post morphine adminsitration for pain. the nurse should identify which of the following findings as the best indication that the morphine as been effective? vitals are WNL the pt has not requested additional pain medication the client is resting comfortably with eyes closed the client rates pain as a 3

- client rates pain as a 3 this is the most accurate measurement of pain

A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident? 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified IV infused over 4 hours instead of the prescribed 8 hours. client tolerated fluids well, provider notified 1 L of 0.9% sodium chloride completed at 0900, client denies SOB IV fluid initiated at 0500. Lungs clear

0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified

The nurse is preparing to administer heparin subcutaneous to a client. Which of the following actions should the nurse take? Administer the medication outside the 5cm (2in radius) of the umbilicus Aspiriate the blood return before injecting rub vigiours after injection to promote absorption Place a pressure dressing on the injection site to prevent bleeding

Administer the medication outside the 5cm (2in radius) of the umbilicus the nurse should apply firm pressure after injection to prevent bruising

The nurse is preparing to administer PO sodium polystyrene solfonate to a client who has hyperkalemia. Which of the following actions should the nurse take? Hold the clients other oral medications for 8 hours post admin Inform the client that this medication can turn stool to a light tan color Keep the clients solution in the refridgerator for up to 72 hours Monitor the client for constipation

Constipation because this can cause fecal impaction hold pts oral meds 6 hours pre and post administration of sodium polystyrene it will not affect the color of stool it is stable for 24 hour when administrated

A nurse is administering diazepam to a client who is having a colonoscopy. Which of the following actions should the nurse take? monitor for hypertension Ensure flumazenil is available to administer for toxicity management. expect the pt to become unconscous within 30 secs measurethe campnography level every hour until pt is AAO

Ensure flumazenil is available to administer for toxicity management. (s/s toxicty are: hypotension, resp depression) iv diazepam would work in 2 minuts canpography level is measured every 30 minutes until aao

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? i should take the medication with food i should take naproxen if i develop joint pain I should tell my provider if I develop a sore throat i should expect the medication to cause my urine to look orange

I should tell my provider if I develop a sore throat bc this can indicate neutropenia

A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methlypredinisolone. which of the following instructions should the nurse include? SELECT ALL THAT APPLY Monitor Blood glucose Avoid contact with people with have infections take med 1 hour before breakfast decrease dietary intake of calcium Grapefruit juice can increase effects of medication

Monitor Blood glucose Avoid contact with people with have infections Grapefruit juice can increase effects of medication med should be taken with food should increase K foods

A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications? aspirin ibuprofen ranitidine bisacodyl

NSAIDs increase lithium levels

A nurse is reviewing the ECG of a client who is receiving IV furosemide for the heart failure. The nurse should identify which of the following finding of hypokalemia? tall, tented T waves presence of U waves widened QRS complex ST elevation

Presence of U-waves; The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide

A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia during surgery. Which of the following actions should the nurse take? adminster the med sowly over 5 mins store the reconsitited med in the fridge use the reconstituted med within 12 hours Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent.

Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent. and inject RAPIDLY

A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication that she should complete an incident report? A) The client reports shortness of breath. B) The client is also taking lisinopril. C) The client's pulse rate is 60/min. D) The client's WBC count is 14,000/mm3.

SOB potential for cross sensitivty with pcn and ceftazidime (a cephalospoirin)

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry flavored lozenges on a stick. Which of the following information should the nurse include in the teaching? chew on the medication stick to release the medication Store unused medication sticks in a storage container leave the med stick on one location of the mouth of the mouth until melted allow the medication 1 hour or analgesic effects to begin

Store used/unused medication sticks in a storage container stick should be placed btwn cheek and gum move the stick to increase absorption analgesic effects within 10-15 minutes

A nurse is caring for a client who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of the following findings indicates a therapeutic response to the medication? positive chvosteks decrease in parasthesias an increase in thirst calcium of 8.8

a + chvosteks is an indication of hypocalcemia parasthesias is a manifestation of hypocalcemia so a decrease indicates a therapetuc response to calcium citrate an increase in thirst is a manifestation of hypercalcemia ca refrence range should be 9-10.5

A nurse in the emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? A) Potassium iodide B) Glucagon C) Atropine D) Protamine

atropine a cholinergic crisis is caused by excess amounts of cholinesterase inhibitor, such as neostigamine. the nurse should give atropine bc it is an anticholinergic inhibitor to reverse toxicity protamine is a heparin antagonist used to revrse heparin toxicity

A nurse is planning care for a client who is receiving mannitol via continuous infusion. The nurse should monitor for which adverse effects? increased intraocular pressure auditory hallucinations bibasilar crackles weight loss

bibasilar intraocular pressure Mannitol, an osmotic diuretic, can precipitate HF and pulmonary edema therefore bibasilar crackles are an adverse effect

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. What instructions should the nurse include?a. "Take the medication on an empty stomach for full effectiveness."b. "You may discontinue this medication when stomach discomfort subsides."c. "Report yellowing of the skin."d. "Store the medication in the refrigerator." a. "Take the medication on an empty stomach for full effectiveness." b. "You may discontinue this medication when stomach discomfort subsides." c. "Report yellowing of the skin." d. "Store the medication in the refrigerator."

c. "Report yellowing of the skin."(ranitidine can be hepatotoxic and cause jaundice. client should report any yellowing of the eyes or skin to provider) food does not affect the medication effectiveness must be taken for the full course of therpay to be effective store at room temperature

A nurse is teaching a client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication? A) Diarrhea B) Cough C) Urinary retention D) Inc libido

can cause anticholinergic effect of urinary retention

A nurse is caring for a client who has developed hypomagnesemia due to long-term therapy with lansoprazole (prevacid). The nurse should monitor the client for which of the following manifestations? bradycardia hypotension muscle weakness disorientation

disorentation and confusion are manifestations of hypomagnesium also check for + chvosteks and troussous sign tachycardia, hypertension and muscle irritablity are manifestations for hypomagnesium

the nurse is providing teaching to a pt starting oxybutynin for urinary incontience. which of the follwing effects should the nurse include in teaching? SATA dry mouth tinnitus blurred vision bradycardia dry eyes

dry mouth. oxybuntin is an anticholinergic blurred vision . oxybuntin is an anticholinergic that can cause blurred vision due to intraocular pressure can cause tachycardia not bradycardia

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? ondansteron magnesium sulfate flumazenil protamine sulfate

flumazenil is an antidote used to reverse benzos

The nurse is teaching a client who is beginning taking tamoxifen for the treatment of breast cancer. Which of the following adverse affects should the nurse include in teaching? hot flashes urinary retention constipation bradycardia

hot flashes tamoxifen is estrogen receptor blocking agent that can cause hot flashes (an antiestrogen medication that works by blocking medication) urinary retention, constipation and bradycardia are not expected adverse effects of tamoxifen

A nurse is caring for a client who has heart failure and is prescribed enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication? bradycardia hyperkalemia loss of smell hypoglycemia

hyperkalemia enalapril is an ace inhibitior

the nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of therapy? increased neutrophil count increased RBC decreased prothrombin time decreased triglycerides

increased neutophil count filgrastim increases the bone marrow to produce neutrophils to minimize risk of infection

A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. which of the following finding should the nurse identify as an adverse effect of the medication? joint pain insomnia alopecia cough

insomnia bupropion an atypical antidepressant has stimulant properties

A nurse is assessing a client who is taking tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse report to the provider? A) Hot flashes B)Gastrointestinal irritation C)Vaginal dryness D)Leg tenderness

leg tenderness risk of dvt/emobli with tamoxifen

a nurse is assessing a client who has myesthenia gravis and is taking neostigmine. which of the following findings should indicate to the nurse that the client is experiencing adverse affects? tachycardia oliguria xerostomia miosis

miosis (pupillary constriction) is a common adverse effect of neostigamine due to excessive musarinic stimulation neostigamine can cause bradycardia, urinary urgency, and increases salivation rather than dry mouth

A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer? methadone nalaxone diazepam bupropion

nalaxone

the nurse is preparing to administer a med to a client who has gout. The nurse discovers that an error was made during the previous shift and the client rec'd atenolol instead of allopurinolol. which of the following actions should the nurse take first? obtain the pts BP contact the clients provider inform the charge nurse complete an incident report

obtain BP

A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? drink a glass of milk with this med i will take risedronate 15 minutes after my evening meal i should take with an antacid to reduce nausea i should sit up for 30 minutes after taking med

sit up 30 minutes after taking med should be taken with water, not milk. should be taken prior to meals not post. do not take with antacids as they contain calcium, magnesium, aluminum - take antacid 2 hours after risederonate

A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves disease. Which of the following findings should the nurse identify as as an indication of the medication has been effective? decrease in WBC count derease in amount of time sleeping increase in appetite increase in ability to focus**

propylthiouracil is a thyroid hormone antagonist used in the treatment of hyperthyroidism or thyroid storm decreased WBC is an adverse effect of propylthiouracil , there for leukopenia indicates the med has not been effective graves disease is a form of hyperthyroidism and causes insomnia, therefore a decrease in the amount of sleep does not indicate effectiveness graves disease can cause gi manifestations such as increase appetite, weight loss, inceased GI motility , so an increased appetite indicates the med has not been effective a pt with graves disease can experience psychological manifestations such as difficult fucsin and restlessness , propylthiouracil is a thyroid hormone antagonist that decreased t4 reducing the manifestations of oh hyperthyroidism an increase in ability to focus indicates the med has been effective

A nurse is providing teaching to a client who has peptic ulcer disease and is starting a new script for sucralfate. Which of the following actions of sucralfate should the nurse include in teaching? decreases stomach acid secretion neutralizes acid in the stomach forms a protective barriers over ulcers treats ulcers by by eradicating H. pylori

provides protective barriers over ulcers

A nurse is assessing a client who is postoperative following an outpatient endoscopy using midazoam. A nurse should monitor for which of the following findings as an indication that the client is ready for discharge ? The client's capnography has returned to baseline. the client is passing flatus the client can response to their name when called the client is requesting oral intake

pt is ready for discharge when pts capnography level indicates that gas exchange is adequate passing of flatus is impt with general anesthesia

A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? muscle weakness sedation tinnitus peripheral edema

sedation metoclopramide has multiple cns adverse effects metoclopramide is a central dopamine receptor antagonist

A nurse is providing discharge instruction to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective? A) Avoid getting rid of air bubble in syringe B) Inject insulin into thigh for fastest absorption C) Store unopened bottles in fridge D) Shake insulin before using

store vials in fridge Do Not Shake - roll in hand ot prevent frothing and inaccurate drawing up

A nurse is teaching a client about flexeril. which of the follow statements indicates that teaching was effective? i will have increased salivia production i will continue taking the med until the rash disappears i will taper off the medication before d'cing it i will report urinary incontience

taper off to prevent abstinece syndrome or reboud insomnia

A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)? temp of 103.5 urinary retention hr 56 muscle flaccidity

temp 103.5 this is an acute life threatening emergnency

A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? tingling of fingers constipation weight gain oliguria

tingling of fingers

A nurse is on the acute care unit is caring for a client who is receiving genatmicin IV. the nurse should report which of the following findings to the provider as an adverse effect of the medication? constipation tinnitus hypoglycemic joint pain

tinnitus amioglycosides can be ototoxic can alter liver and spleen (not pancreas) gi side effects are common side effect

A nurse is caring for a client who is experiencing acute alcohol withdrawawl. For which of the following should the nurse adminsiter chlordiazepoxide? minimize diaphoresis maintain abistence lessen craving prevent DTs

to prevent DTS propanolol is used to lessen cravings clonidide used for diaphroesis and minimze other autonomic components