ATI PHARM PROCTORED EXAM QUESTIONS AND ANSWERS VERIFIED SOLUTION GRADE A+ 2022

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ATI PHARM PROCTORED EXAM QUESTIONS AND ANSWERS VERIFIED SOLUTION GRADE A+ 2022 An immunizing agent that confers active immunity protects by:ANSWERS: providing antibodies obtained from immune huma... ns or animals. Antacids should be given one hour apart from most other drugs. Which is the rationale?ANSWERS: Antacids may interfere with absorption of drugs taken at the same time. Vancomycin should not be used to treat minor infections because it:ANSWERS: can cause "red man syndrome", a hypertensive crisis that is almost always fatal. The antagonist for a client who has overdosed on morphine is:ANSWERS: narcan. The most serious adverse reaction to oral contraceptives is:ANSWERS: thromboembolism. When a client develops tolerance to a drug, the nurse would expect:ANSWERS: higher dose needed to achieve same effect. Antihyperglycemic agents are prescribed for clients with:ANSWERS: Type 2 diabetes mellitus. The nurse assesses a client shortly after an intravenous infusion of the osmotic diuretic mannitol is started. Which finding represents an early adverse effect of mannitol?ANSWERS: Bounding pulse Compared to other beta adrenergic blockers, cardioselective beta adrenergic blockers:ANSWERS: are less likely to cause bronchoconstriction. A client who experiences motion sickness during airplane flights obtains a prescription for meclizine (Antivert). When is the best time to take the drug?ANSWERS: One hour before the flight Before prescribing a cephalosporin, the nurse practitioner asks if the client is allergic to penicillin. Why is this important to assess?ANSWERS: A client who is allergic to penicillin can have a cross sensitivity to cephalosporins. The use of which class of antibiotics should be avoided in children?ANSWERS: Tetracyclines In a walk-in clinic, clients are often given intramuscular injections. Which drug should be readily available in case a client has an anaphylactic reaction?ANSWERS: Epinephrine Thiazide and loop (high ceiling) diuretics are similar in that both:ANSWERS: decrease tubular reabsorption of sodium and water. Which of the statements by the nurse most accurately describes the effects of declined plasma albumin levels in older adults?ANSWERS: "There is an increased risk for adverse effects." To prevent oral fungal infections, the nurse should instruct the client who uses a beclomethasone inhaler to take which action?ANSWERS: Rinse the mouth after each use. A client takes ethinyl estradiol/norgestimate (Ortho Tri-Cyclen) birth control pills. She calls the clinic and relates that she missed her medication yesterday. Which instructions will the nurse give?ANSWERS: "Take two pills today then continue on a daily basis." The nurse may administer acetylcysteine (Mucomyst) inhalation to:ANSWERS: facilitate mucus expectoration. Development of a chronic cough is an adverse effect associated with which class of anti-hypertensive drugs?ANSWERS: Angiotensin converting enzyme (ACE) inhibitors The nurse may administer baclofen (Lioresal) for the treatment of which condition?ANSWERS: Protracted muscle spasticity Oral diazepam (Valium), a benzodiazepine, has been prescribed for a client who has anxiety and muscle spasms. Which nursing intervention is appropriate for the care of this client?ANSWERS: Assess for incoordination and daytime drowsiness. The nurse practitioner prescribed anhydrous theophylline (Theo-Dur) for the client with chronic bronchitis. With which disorder would the nurse practitioner reconsider the use of this medication?ANSWERS: Hypertension When a client is receiving intravenous fluid with supplementary potassium chloride, it is especially important for the nurse to monitor for which potential adverse effect?ANSWERS: Cardiac dsyrhythmias Which adverse effect is common for a client being treated with the antidepressant fluoxetine (Prozac)?ANSWERS: Sexual dysfunction After giving a dose of dextromethorphan, an antitussive, which data reflects evaluation of the drug's effectiveness?ANSWERS: Client states that cough has been relieved. Prior to giving a client a dose of digoxin, the nurse counts the apical pulse. If the rate is 62 bpm and regular, which is the appropriate nursing action?ANSWERS: Give the drug and document the heart rate. Digoxin is started for a client with an atrial arrhythmia. Within three days, the client's heart rate has decreased from 94 to 74. What action of digitalis explains this change?ANSWERS: Slowed impulse conduction One mechanism by which antihypertensive drugs lower blood pressure is to:ANSWERS: dilate peripheral blood vessels. There are many agents that are useful in the treatment of gastric ulcers. Which agent reacts with hydrochloric acid to form a viscous protective barrier over the ulcer?ANSWERS: Sucralfate (Carafate) A client whose asthma has been poorly controlled is prescribed cromolyn sodium (Intal) for inhalation. Client teaching should include which statement by the nurse?ANSWERS: "Using this drug regularly will reduce the frequency of acute attacks." The combination of aluminum and magnesium in many antacids decreases the risk of:ANSWERS: diarrhea or constipation. A client who is taking one daily dose of a thiazide diuretic should be instructed to:ANSWERS: take the medication in morning to avoid nighttime voiding. Which phase of pharmacokinetics is affected most by abnormal liver function?ANSWERS: Metabolism A medication order is written for ciprofloxacin (Cipro). For which client should the nurse question use of this medication?ANSWERS: Child age 10 A home health client tells the nurse that she is taking triamterene (Dyrenium) for fluid retention. She tells the nurse she is using a salt substitute so she will not retain so much water. What is the most appropriate nursing response?ANSWERS: "Using a salt substitute with this medication could cause you to have too much potassium." Orders are written for anticholinergic drugs for each of the following clients. Which order should the nurse question?ANSWERS: Atropine combined with opioid analgesics to relieve pain in a 30-yearold client with urinary calculi. A client with Type I diabetes mellitus is given an injection of neutral protamine hagedorn (NPH) insulin at 7:00 a.m. In order to prevent a hypoglycemic reaction, the client should have:ANSWERS: a mid-afternoon snack. Why is carbidopa-levodopa preferred over levodopa alone?ANSWERS: It decreases the amount of levodopa needed. Which findings are most likely in the client who has taken a toxic dose of a salicylate (aspirin)?ANSWERS: Tinnitus and dizziness Which nursing intervention is specifically important when a client is taking an alpha- blocker, such as doxazosin (Cardura) for hypertension?ANSWERS: Teach the client how to manage orthostatic hypotension. A client reports taking large amounts of vitamins because she believes they increase her energy level and will prevent various diseases. Client teaching should include which nursing response?ANSWERS: "Large amounts of fat-soluble vitamins can be toxic." An elderly client is prescribed a new drug. Because of the age-related changes in the kidneys and liver, it is most important that the nurse assess for:ANSWERS: signs of drug toxicity. Evidence of effective treatment with a nucleoside reverse transcriptase inhibitor (NRTI), such as zidovudine is:ANSWERS: decreased HIV RNA level. When oral iron supplements are prescribed, client teaching should include the fact that:ANSWERS: diarrhea or constipation may occur. If corticosteroids are discontinued abruptly, a problem that may develop is:ANSWERS: adrenal gland shut-down. An antiulcer drug that forms a gel to coat and protect the ulcer so that healing can occur is:ANSWERS: sucralfate (Carafate). The nurse would describe a penicillinase to a client receiving this medication as:ANSWERS: a bacterial enzyme that can inactivate many penicillins. Drugs given for a systemic effect by any route must be capable of:ANSWERS: distribution throughout the body. Which statement is made by a client who is experiencing an adverse reaction to levothyroxine (Synthroid)?ANSWERS: "I feel like my heart is pounding." Clients receiving intravenous gentamicin (Garamycin) should be assessed closely for:ANSWERS: hearing loss. The best laxative for clients who have chronic constipation and cannot or will not consume adequate dietary fiber is a:ANSWERS: saline cathartic. The presence of Helicobacter pylori is confirmed in a client with peptic ulcer disease. The nurse may anticipate the use of multiple antibiotics because:ANSWERS: Helicobacter pylori commonly develop resistance to single drugs. "A disease process characterized by the continued use of a specific psychoactive substance despite physical, psychologic, or social harm" is the definition of:ANSWERS: addiction. Which group may represent an increased risk for substance abuse?ANSWERS: Socioeconomically advantaged clients The only drug commonly used both to prevent and to treat tuberculosis is:ANSWERS: isoniazid The most serious adverse reaction to morphine is:ANSWERS: respiratory depression. A client who has received an injection of regular insulin at 0800 complains of feeling sweaty, weak, hungry, and shaky two hours after the injection. Which drug is indicated for this client?ANSWERS: Glucagon When a client is prescribed an aminoglycoside, such as gentamicin (Garamycin), which instruction should be included in the teaching plan?ANSWERS: "Report to your health care provider any ringing in your ears." When a client is being treated with trimethoprim-sulfamethoxazole (Bactrim) for a urinary tract infection, it is important to:ANSWERS: maintain good hydration. Histamine 2 receptor antagonists such as cimetidine (Tagamet) are used to treat peptic ulcers because they:ANSWERS: neutralize hydrochloric acid in the stomach. To administer eardrops to a child, the nurse should straighten the external ear canal by pulling the auricle:ANSWERS: down and toward the back of the head. A client who has a history of thrombophlebitis is taking warfarin to prevent new clot formation. He should be cautioned not to take salicylic acid because:ANSWERS: aspirin increases the effects of warfarin. Which statement by the nurse best explains why nausea, vomiting, and bone marrow suppression are common adverse effects of cytotoxic antineoplastic drugs?ANSWERS: Cytotoxic drugs affect the most rapidly dividing cells." Glucocorticoids, such as prednisone (Deltasone), are given cautiously to clients with:ANSWERS: peptic ulcer disease. Client teaching for the use of sublingual nitroglycerin tablets to relieve angina should include which nursing instruction:ANSWERS: "You can take up to three doses, five minutes apart, if needed." Two days after abdominal surgery, a client's bowel sounds are hypoactive and the abdomen is distended. The physician orders bethanechol (Urecholine), a cholinergic agonist, which acts to:ANSWERS: stimulate intestinal peristalsis and tone. A client who has been on furosemide (Lasix) for one year reports weakness in her legs, constipation, palpitations, and lethargy. Her bowel sounds are hypoactive. The nurse should suspect which complication?ANSWERS: Hypokalemia The drug of choice to treat a client with status epilepticus is:ANSWERS: diazepam (Valium). A nurse cautions a client with Parkinson's disease who is taking carbidopa/levodopa (Sinemet) against taking any monoamine oxidase (MAO) inhibitors because the drug interaction can cause:ANSWERS: severe hypertension. A client who is scheduled for cataract surgery has an order for acetazolamide (Diamox) preoperatively. Is this an appropriate order and, if so, why?ANSWERS: This type of drug is commonly used before ophthalmic surgery to reduce intraocular pressure. The purpose of a spacer with a metered-dose inhaler is to:ANSWERS: increase the amount of drug delivered to the lungs. When a client is using a sympathomimetic (adrenergic) bronchodilator such as albuterol, the nurse would expect which effect?ANSWERS: Central nervous system stimulation Fluconazole (Diflucan) is prescribed for the client with a fungal infection in the toenails. The nurse should instruct the client to contact the nurse practitioner immediately if which adverse effect occurs?ANSWERS: Bruising or sore throat The effects of epinephrine include:ANSWERS: increased pulse and blood pressure. To administer heparin subcutaneously, the nurse should:ANSWERS: use a 26-gauge, 1⁄2-inch needle to minimize trauma. Digoxin (lanoxin)ANSWERS: anti dysrhythmic] SE: blurred/double vision GuaifenesinANSWERS: can cause drowsiness Estrogen (premarin)ANSWERS: SE: ↑ risk of Thromboembolism with s/s: SOB, severe headache, vomiting, sudden acute pain in the calves, legs, chest, abdomen. Doxepin (Sinequan)ANSWERS: [anticholinergic] SE: urinary retension, constipation, drying of nasal/oral secretons, ↑HR Albuterol (Proventil)ANSWERS: [sympathomimetic/ adrenergic beta-2 agonist] Contraindicated: with MAOIs (can↑ action of albuterol and → HTN crisis); β-blockers can inhibit the therapeutic effects Use: invert canister, shake before use, rinse mouth after use, w/new inhaler perform test spray Levothryoxine (T4) IndicationANSWERS: hypothyroidism RT dysfxn of hypothalamus, pituitary, or thyroid gland Cephalosporins (KeflexANSWERS: allergy to cephalosporins is considered a precaution for taking penicillins Phenobarbital [BarbituratesANSWERS: interventions for anticonvulsant therapy: assess for resp. depression, excess sedation from toxic effects, IV at < 50mg/min, avoid extravasation (alkaline→skin damage) Sumatriptan (Imitrex):ANSWERS: Use: when migraine symptoms appear and again in 1 hr if symptoms persist Route—fastest/most effective:ANSWERS: intravenous Narcan [opioid antagonist]:ANSWERS: therapeutic action: improvement of respiratory rate. Baclofen (LioresalANSWERS: Therapeutic action: ↓ frequency & severity of muscle spasms Spironolactone (Aldactone)ANSWERS: [K sparing diuretic]—avoid foods w/ ↑ K such as salt substitutes Erythromycin (Erythrocin)ANSWERS: drug class macrolide SE: liver toxicity InsulinANSWERS: high dose (U-500) is 5 times stronger than U-100—divide dosage ordered by 5 Chloroquine phosphate (Aralen):ANSWERS: Indic.: malaria prevention; Use: take weekly starting 1 week before departure and continued for 4 weeks after return. Heparin (anticoagulant)ANSWERS: Use: w/alteplase for acute MI Warfarin (Coumadin)ANSWERS: Use:long-term prophylaxis of thrombosis [antidote—Vit K] Clopidogrel (PlavixANSWERS: Use: reduce long-term risk of clotting w/ atherosclerosis and recent MI of CVA Alteplase (Activase)ANSWERS: antithrombolytic] Use: Acute MI/CVA (has short half-life) Methylphenidate (Concerta)ANSWERS: Use: marcolepsy Precaution: avoid caffeine use Testosterone IMANSWERS: If use to correct delayed puberty→assess bone maturation with biannual x-rays of hand and wrist; monitor liver fxn (can ↑ hypoglycemia, potentiate sleep apnea, exacerbate heart failure due to fluid retension. Diphenoxylate & Atropine (Lomotil)ANSWERS: Caution: With Renal impairment ↓ elimination of atropine → ↑ anticholinergic effects of atropine like confusion Loperamide (Imodium)ANSWERS: Use: anti-diarrheal (poorly absorbed from GI tract; difficulty crossing the blood-brain barrier) Methylcellulose (Citrucel)ANSWERS: bulk-forming agent with minimal Side Effects (SE) Psyllium (MetamucilANSWERS: bulk-forming agent with minimal Side Effects (SE) Acetazolamide (Diamox)ANSWERS: Indic.: edema, epilepsy, acute mountain sickness, glaucoma (↓ intraocular pressure by ↓ amount of aqueous humor in the eye) Contra: allergy to sulfonamides Metoprolol (Lopressor)ANSWERS: [β-blocker] Hold dose for dyspnea (sign of exacerbation of CHF) PropanololANSWERS: Use. Dysrhythmia, HTN, angina; SE: bronchoconstriction/bronchospasm; can block glyconeogenesis Norgestrel (Ovrette)ANSWERS: Use: contraception; SE: excess progestin →weight gain from ↑ appetite; deficiency of progestin: late breakthrough bleeding, amenorrhea; excess estrogen → edema Medroxyprogesterone (Provera);ANSWERS: Contra: smoking/tobacco products; Risks: Thromboembolism & Cardiovascular complications; Interventions: use additional contraceptive measures w/antibiotic therapy IM injection siteANSWERS: locate dorsogluteal site Nausea txANSWERS: antiemetic plus cool, damp cloth to forehead, neck, and wrists. Allopurinol (Zyloprim)ANSWERS: Ind. Gout; MofA: ↓ serum uric acid levels & urinary uric acid secretion; Precaution: avoid foods that acidify urine such as corn TBANSWERS: multi drug tx: Isoniazid(INH), Rifampin, pyrazinamide, ethambutol—to deal w/ resistant strains ACE Inhib. Lisinopril (Zestril)ANSWERS: SE: dry/persistent cough for 1-2 wks from ↑ bradykinin Synergistic drugsANSWERS: Effect of giving both drugs > than the drugs individually Furosemide (LasixANSWERS: [loop diuretic] Intervention: check BP before giving to determine baseline; can cause ↓ BP by ↓ circulatory volume or by relaxing venous smooth muscle Ticlopidine (Ticlid)ANSWERS: prevent coronary artery thombosis; Intervention: check platelet count PRBC (packed red blood cells)ANSWERS: used as blood replacement when fluid overload is a concern IV medicationsANSWERS: Intervention: assess site for redness/swelling before administration Collagenase (SantyANSWERS: Use: Debride ulcers InterferonANSWERS: Use: Prevent viral replication Isotretinoin (Accutane)ANSWERS: Contra: pregnancy w/ 2 forms of birth control due to teratogenic effects VaccineANSWERS: adv. of live vs attenuated/killed vaccine: long-lasting active immunity vs partial (passive) Epoetin Alfa (Procrit)ANSWERS: Indic: treat anemia; SE: headache, HTN, seizures RT Hct rises too quickly Urofollitropin (Fertinex)ANSWERS: Dosage: admin. IM based on dose in preceding cycles SE: ovarian hyperstimulation syndrome. Hypertensive crisisANSWERS: S/S: flushed skin, headache, visual changes Acetylcysteine (Mucomyst)ANSWERS: Indic: prevent liver damage following acetaminophen (Tylenol) overdose. Most effective if given shortly after ingestion; some protection up to 24 hrs. Montelukast (Singulair)ANSWERS: Indic: prevent asthma exacerbations;Dose: daily at bedtime; SE: well tolerated Metoclopramide (ReglanANSWERS: has increased sedation when given with Morphine MannitolANSWERS: Caution with pts with heart disease (can precipitate CHF and pulmonary ededa) Diphenhydramine (Benadryl) PrecautionANSWERS: avoid other CNS depressants such as: alcohol, benzodiazepines, kava kava... [Show More]

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