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Pharm 2010 ATI_RN_Pharm_Form_B_with_answers - University of Texas | Pharm 2010 ATI_RN_Pharm_Form_B_with_answers

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Pharm 2010 ATI_RN_Pharm_Form_B_with_answers - University of Texas ,-----,- ati i ,----------------------------------------------------- RN Pharmacology 2010 Form -------------------~ B 1. A client... who is taking propranolol ( Inderal) is being admitted to the medical unit. During the admission assessment, which of the following should the nurse document as an adverse effect of this medication? 0 Chest Pain 0 Hypotention • Hyperglycemia 0 Tachycardia 2. In which of the following situations is the administration of a dose of DTap contraindicated? ( Select all that apply) o Severe febrile illness • History of prior anaphylactic reaction to DTap vaccination' • Occurrence of encephalopathy 7 days after administration of DTaP immunization ., Occurrence of seizures within 3 days of previous vaccination 3. A nurse is teaching a client with PUD how to properly self-administer ranitidine ( Zantac ). Which of the following client statements indicates effective teaching by the nurse? 41> I will call my doctor if my stools look black and sticky o I will take Zantac regularly until my burning symptoms disappear o I need to take Zantac on an empty stomach o I can take ibuprofen if I have minor aches and pains . • • ._._ -.-_._-------------_.- •• _. 0 __ • __ -----_.-------_·---_._-._. ----------- -- 4. A client who is taking rifampin ( Rifadin ) for active Tuberculosis report that his urine, sweat, saliva, and tears have developed a red-orange tinge. How should the nurse interpret these discolorations? • The client has developed renal failure and will need dialysis. o These fire common harmless side effects that should be documented. o These are signs that the client has developed hepatic failure. o The effects indicate a need for increased fluid intake. S. A nurse is caring for a client who is receiving a dopamine ( Intropin ) infusion for shock. Which of the following assessment findings indicate to the nurse that he should increase the infusion? 0 Tachycardia 0 Dysrhythmia • Hypotension 0 Chest pain/ 6. A nurse is providing teaching to a client receiving tamoxifen ( Nolvadex ) for breast cancer prevention. Which of the following statements indicates the client has understood the teaching? • "I may experience hot flashes" o "I will be so excited when I finally get pregnant" o "I should be sure to drink plenty of milk" o "I will eat a diet high in fat to prevent weight loss" 7. Terbutaline ( Brethine ) is indicated in preterm labor to • Stop uterine contraction. o Prevent bleeding. o Promote placental blood flow. o Increase prostaglandin production 8. A client exhibits a ventricular dysrhythmia. Which of the following medications should the nurse prepare to administer? o Atropine o Lidocaine • Epinephrine o Calcium gluconate 9. A client is taking cromolyn ( Intal ) to manage asthma. During exercise the client develops an acute asthmatic attack. The client's mother contacts the nurse to inquire if an increased dose of cromolyn will .__. be_effective.fot:-this-sudde-n-episode-.-Which-of the-following-responses- by trrerrursats appro-pnafer----------- -.-- .- e "Cromolyn is a long term management medication." o "Cromolyn will dilate the bronchioles and is very effective" o "Cromolyn will take effect in only a few minutes." o "Cromolyn can be used after exercising." o A client who is over 40 years of age. • A client who is pregnant o A client who is 5 kg ( llib ) underweight 10. For which of the following clients would radioactive iodine ( 131 I ) be contraindicated? a A client who is scheduled for thyroid surgery. AT! Document. Mak.InR copy of thiS document IS Drohiblr~rlJ 11. Client teaching to prevent first-dose hypotension should include which of the following? o Taking the medication with a full glassof water. • Taking the medication at bedtime. o Taking the medication right before driving to work. o Taking the medication at the same time as a diuretic .. 12. A nurse is providing teaching to an older adult client to promote compliance with medication administration. Which of the following instructions should be included? ( Select all that apply) • Placepills in daily pill holders. o Only take medications when not feeling well. • Ask a relative to check in periodically. o Wait until all medications are finished before refilling prescriptions. 13. A nurse is providing discharge teaching to a client who is taking amoxicillin clavulanate (Augmentin). During teaching, the client reports taking other medications. Which of the following medications taken by the client alerts the nurse to the need for further teaching? o Atenolol ( Tenormin ) o Ethinyl estradiol and norethindrone ( Ortho- Novum 1/50) o Hydrochlorothiazide (HydroDiuril) • Metformin ( Glucophage ) 14. A 65-year-old client's laboratory work indicates hypoalbuminemia. Related to medication therapy, this may-result-irr.----·------------ .-.-- .------- . ----------·------·-------.----------.- ----- ..---- o Reduced therapeutic effect. o Decreased medication metabolism. o Prolonged half-life of the medication . ., Excessfree medication and possible toxicity. o NPH insulin ( Humulin N ) • Warfarin ( Coumadin ) o Furosemide (Lasix) o Pantoprazole ( Protonix ) 15. A client presents to the emergency department and is diagnosed with gastrointestinal bleeding. Which of the following prescribed medications reported by the client should the nurse anticipate the primary care provider will discontinue?16. A nurse 22-year-old female is being treated for mycobacterium tuberculosis with rifampin ( Rifadin ) 600 mg Po daily. Which of the following should the nurse question the patient about? a Her diet. a Sun exposure. a Type of exercise she does. • Use of contact lenses. 17. When taking a client's medication history, a nurse knows that. a Smoking will have no effect on medication action. • Over-the-counter medications need to be included. a Most medications are not affected by the use of alcohol. a Use of herbal products usually has no effect on prescribed medications. 18. A nurse is caring for a client who is receiving a fentanyl transdermal system ( Duragesic ). Which of the following is most important to document in the client's record. • Respiratory rate. a Skin integrity. a Fluid intake. a Pulse rate ..._ .._. . ... ___._._ ..19.-After: adrnlnlstrating.verapamtl.Lcatan.l.to. a.dlent.via.Iv. push., The...nurse...shouldmonitorJor: CL.-_- .. _ a Sudden decrease in heart rate. • Sudden increase in heart rate. a Rapid increase of aPTI. a Rapid decrease of aPTI. 20. A client starting on cyclobenzaprine ( Flexeril ) should be informed that he may experience which of the following anticholinergic side effects? •Dry mouth a Bradycardia a Diarrhea ;I:' a Urinary frequency.21. Which of the following statements by a client receiving warfarin ( Coumadin ) indicates a need for further teaching? o U I will use a laxative every other day U o U I ate some caramel corn yesterday." o "I use antacids once in a while." ., "1 always have aspirin with me to use for my headaches." 22. A nurse is administrating 2mg of morphine sulfate via IV route to a client for postoperative pain. Which of the following actions should the nurse take next? o Ask the client to rate his pain. o Monitor the client's fluid intake. • Record the administration of the medication. o Provide the client with a quiet environment. 23. Which of the following agents is used to treat cytomegalovirus ( CMV ) and is administered only intravenously? o Cidofovir ( Vistide ) o Ganciclovir ( Cytovene ) • Foscarnet ( Foscavir ) o Valganciclovir ( Valcyte ) ---------- - ------- --- --- ---- ------------- ~--'---'---"----'- .._-----.- ..----.--,--------~ -... -..-.- .-_. --_.'--".--- ---.- -.._-.---_._--_ .. .._- -- -- ---- - - --------- 24. A nurse is teaching a client and family about administering nitroglycerine ( Nitrostat ) sublingual tablets for chest pain. Which of the following statements by the family indicates an understanding of the teaching? o "1 can take a second pill after 15 min if I still have pain." o "1 will wait to take the medication until the pain becomes severe." o U I will place tablets in my pill holder to carry with me." • "1 should feel tingling under my tongue when I take the medication. " 25. When administering an oral medication to a client, a nurse should • Asses the client's ability to swallow. o Administer the medication with grapefruit Juice. o Not give oral medications to a client with a nasogastric tube in place. o Crush enteric coated tablets if the clients has trouble swallowing.____________________________________ __ 26. A woman who is lactating is to begin taking an antimicrobial medication. Shetells the nurse she doesn't want to take the medication because it may harm her baby who is breastfeeding. An appropriate response by the nurse should be. o /I You don't have to take the medication if you don't want to" • " Taking the medication immediately after breastfeeding will minimize any effect on your baby" o "You can bottle feed your baby while taking this medication." o "The medication cannot passthrough your breast milk to your baby." 27. A client taking colchicine to prevent acute gout attacks calls his primary care provider reporting diarrhea, nausea, and vomiting. Which of the following instructions should the client be given. o Take an antacid, and call back in the morning. o Get plenty of rest to prevent dehydration. • Stop taking the medication, and come in to see his primary care provider now. o Take the medication every other day until the symptoms subside 28. A nurse is caring for a group of clients in a long-term care facility. The nurse knows that she must obtain a written versus verbal order before administering which of the following medications in a non-emergent situation? • Butorphanol ( Stadol ) o Fentanyl ( Sublimaze ) a Propoxyphene ( Darvocet ) o Phenobarbital ( Luminal) ..--- .-.------- ..--.----~--.----.---.. ---------- -- - ---------_ .. - -- - ---- --- --- ---_.- -- -.- 29. A nurse is aware that contraindications to topical antifungals are limited to patients with which of the following? • Known allergy to any of the antifungal drugs. o Hepatic impairment. o Congestive heart failure o Renalimpairment. 30. A nurse is caring for a client who is wearing the clonidine ( Catapres) transdermal patch. The client reports lightheadedness and drowsiness. Which of the following actions should the nurse take? o Administer a prescribed antiemetic • Removethe patch. o Elevate the head of the bed. o Measure blood pressure.31. Which of the following nursing interventions is most effective in promoting excretion of a general anesthetic agent from a postsurgical client? a Increase intravenous fluid rate. a Offer oral fluid as soon as possible. • Assist to turn, cough, and deep breathe. a Use passive range-of -motion exercises. 32. A client taking Valproic acid ( Depakote ) for seizure control tells the nurse that he drinks a 6 pack of beer a day. What priority assessment should take place? a Plasma levels of valproic acid. a Brain CT scan • Liver function studies a ECG. 33. A nurse is providing discharge teaching to a client who is prescribed penicillin G ( Bicillin LA). Which of the following symptoms should the nurse instruct the client to observe for as an early manifestation of anaphylaxis? a Runny Nose • Skin rash a Slow pulse a Excessive salivation 34. A client is diagnosed with a urinary tract infection. Her past history reveals an allergy to a thiazide diuretic. Which of the following medications is contraindicated? a Nitrofurantoin ( Macrodantin ) a Ciprofloxacin ( Cipro ) a Amoxicillin/ clavulanate ( Augmentin ) ., Trimethoprim/Sulfamethoxazole ( Bactrim ) 35. Which of the following foods should be avoided by a client who is taking an MAOI? a Orange Juice •Cheese a Apples a Grilled steak*"P ••••••••• 36. A nurse is preparing 300,000 units of procaine penicillin ( Wycillin ). The vial contains 1,500,000 units/2 ml. How many milliters should the nurse administer? o 0.10 o 2 • 0.4 o 1 37. A client is taking a cough medication containing codeine every 8 hr. Which of the following assessment findings should alert a nurse to an adverse effect of this medication? • Respiratory rate of 10/min. o Frequent diarrhea. o Blood pressure of 180/106 mm HG. o Urinary incontinence. 38. In the emergent phase immediately after a severe burn injury, care is centered on replacement therapy by IV fluids. The nurse question should the physician's order if it is designed to provide: o Water • Potasium o Lactated Ringer's o Plasmaexpanders. 39. The client is receiving 5% dextrose in water at a slow rate. The nurse should be aware that the longest .. R~rj9(LQltime that .. one_bottle.canbe-infused-without-·pfOdueing-untowarcreffettis:--------:-·----- .-. ------.- ...-.--- -. - 0 6 hours 0 12 hours 0 18hours .,24 hours. 40. Spironolactone ( Aldactone ) is prescribed for a client with chronic heart failure. Wh~n teaching the client about his medication, the nurse emphasizes that every day the client should o Drink a glassof citrus juice o Eat a tomato, slice of melon, or a banana • Include milk, cheese, and meat in the diet o Include oatmeal and whole grain br~ad in the diet.--------------------- 41. A child with cerebral palsy is prescribed baclofen ( Lioresal ). Which of the following therapeutic effects should the nurse monitor? ., Decrease in spasticity o Increase in urine output o Increase in energy o Increase in anxiety. 42. An intravenous piggyback (IVPB) of cefazolin sodium ( Kefzol ) 500 mg in SO ml of 5% dextrose in water is to be administered over a 20 minute period. The tubing has a drop factor of 15 drops per milliliter. The nurse should regulate the infusion to run at what rate per minute . •37.5 0 72 0 3.75 0 14. 43. A client receiving an IV infusion has a prescription for 1,000 ml in 12 hr. Using a micro-drip system that delivers 60 micro drops/ml, the nurse should adjust the infusion for many drops per minute? o 4S o 68 • 83 o 96 44. The nurse on the medical-surgical unit tells other staff members, ••That client can just wait for his \ Lorazepam (Ativan ) ; he shouldn't have been drinking anyway." An accurate estimate of this nurse's care -,.---··wourd be------ ----.--.-..----.-....--..---.----... _--------- -< -< - - ------- --- - - - ----- ••••• ----- •• --.-------- •• --------- ---- ••• - •• -- •••••• ,---' •••.••••••• _-" •• - o Care would be adequate o Care presents many challenges • Qualitiy care will be compromised o Quality care is jeopardized due to its complexity. 45. A nurse is evaluating a client's response to heparin therapy for deep vein thrombosis. Which of the following findings should the nurse document as indicating effective heparin therapy? • No new thrombus development o Existing thrombus dissolves o Increase in platelets count o Minimal bleeding when injured. AT' n•..•,..- •.• .••. ,.•.A " ~~..,. -., _ .;~ L. •• _~46. What are the desired outcomes that the nurse would expect when administering a nonsteroidal antiinflammatory drug ( NSAID )? Select all that apply. •o Anticoagulation •~ Pain relief Antipyresis Reduced Inflammation 47. A client weighs 180 Lb and has a prescription for 0.5 ml of medication per kilogram of body weight. How many milliters of medication should the client receive? • 41 o 45 o 23 OlD 48. A young adult female client who has been experiencing migraine headaches has received a new prescription for ergotamine ( Ergostat). The nurse instructs the client to notify the primary care provider immediately if she o Develops diarrhea with abdominal cramps o Feels depressed for more than 1 week. • Experiences numbness and tingling in fingers o Experiences a fever with chills 49. A nurse is caring for a client receiving gentamicin sulfate( Garamycin). The nurse should monitor the client for which of the following adverse effects? • Hearing loss - - •• - •• --_._-_ •.• _-_._.", •• 0. __ -.- ••• ••••• __ " __ ,_., • - •• '- ----.-- ..--..o. --l·fypotenSlo-n--------------- o eNS depression o Tachycardia 50. A client's plasma lithium level is 0.2 mEq/L. The nurse can expect to implement which of following nursing interventions? o Prepare to give emergency resuscitation • Administer an additional oral dose of lithium. o Infuse 1 L of 0.9% NS over 4 hr. o Prepare the client immediately for another laboratory draw.___ • .••••• •••••••••• •••••W•• D••• !tft' ••_• •••· ••••• k!'i'I!tiIE1mscrm mr.-an" reil"'!'Re',....~lIill, _lII1I!IliiJI 51. When measuring a client's output, the nurse records 300 ml of urine at 0800,450 ml of liquid stool at lBO, 225 ml of urine at BOO, and 35 ml of emesis at 1430. What is the client's total output for this shift? o 840 o 940 o 300 • 1,010 52. A client tells the nurse he is having difficulty sleeping due to his daughter's upcoming wedding. The primary care provider prescribes zolpidem ( Ambien ) 10 mg by mouth. Which of the following client statements indicates understanding regarding this medication? • It I will take my sleeping pill a half hour before bed" o It I will need to take this medication with food" o It I will stop taking my sleeping pill in 1 week so I don't get addicted." o "I will take melatonin to increase the effectiveness of the sleeping pill." 53. Which of the following statements made by a client receiving atorvastatin ( Lipitor) indicates a need for further teaching? o "I should take my medication with dinner" • It I will limit my alcohol intake to 1or 2 drinks per day It o It I will maintain a steady intake of green leafy vegetables." o It I will limit fluid intake to one-and-a-half to two liters dailv." 54. A nurse hasavailable meperidine ( Demerol ) 50 mg/ml. The order is to administer meperidine 35 mg. How many milliliters should the nurse safely administer? .- -0--0.9--- --- ..--~_..-_._------- ------------ -.-- ------ -------_ .._- -- • 0.7 o 0.17 o 0.14 55. A client with rheumatoid arthritis is prescribed gold salts to manage the disease. The nurse instructs the client to notify the primary care provider if he experiences which of the following medication side effects? • Bleeding gums o Urinary retention o Constipation o Palpitations56. While a pacemaker catheter is being inserted, the client's heart rate drops to 38. The drug the nurse should expect the physician to is ., Atropine sulfate o Digoxin ( Lanoxin ) o Lidocaine ( Xylocaine ) o Procainamide ( Pronestyl ) 57. A nurse is caring for four clients who are receiving IV morphine for pain. Which of the following clients is at greatest risk for developing respiratory depression? o A client who recently had a kidney transplant o A client with a history of drug abuse • A client experiencing a myocardial infarction o A client with head trauma. 58. When the IV rate is 100 ml/hr and the administration set is 15 drops/ml, how many drops per minute should the IV run? • 25 o 30 o 10 o 16 59. A client with upper gastrointestinal bleeding develops a mild anemia. The nurse should expect the client t~_.~e.!re()l~dwitl:L - - - - - -------------- -----.-- -_-.----00--- 0 Dextran 0 Epogen •Iron salts 0 Vitamin B 12 . 60. An older adult client is returning to the unit following major abdominal surgery. Which of the following characteristics of older adults is important for a nurse to consider when planning pain management? o Higher tolerance for pain o•o Increased hepatic metabolism Greater risk for drug-drug interactions , Requires larger dose of pain medication.61. Which of the following is correct regarding toxicity associated with amiodarone? o Visual Impairment resolves when the medication is withdrawn o Ototoxicity is irreversible • Lung damage can persist for months after the medication is discontinued o Myopathy is a common manifestation of toxicity. 62. A client with gastric ulcer disease asks the nurse the reason for antibiotic therapy that includes metronidazole ( Flagyl ). The nurse should explain that antibiotics are prescribed to : o Augment the immune response o Potentiate the effect of antacids • Treat Helicobacter pylory infection o Reduce hydrochloric acid secretion. 63. When assessing a client with cancer of the tongue the specific adaptation the nurse should expect to find is o Halitosis • Leukoplakia o Bleeding gums a Substernal pain 64. A nurse is providing discharge teaching to a client who is irl_a_C:lJte_ccm~.,IlJe cllent.has.a.new prescrtptlcn-c-> __· .. fofa medicatio-n-rereasedfor-useby--the--FDAd~~i~g the past 2 months. Which of the following rE!SOUrCes should the nurse use before providing teaching? o Pharmacology textbook o Physician's Desk Reference • Drug Guide for nurses o Drug Facts and Comparaisons. 65. A client has a prescription for 0.25 mg of lanoxin ( Digoxin ). There are 0.5 mg tablets of lanoxin on hand. How many tablets should the client receive? •0.5 0 0.25 0 0.05 0 0.10 ATI Document. Maklnl COpyof ttus document IS prohibued [Show More]

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