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ATI PHARMACOLOGY MIDTERM NR 293 QUESTIONS WITH ANSWERS LATEST 2023_2024 BEST GRADES, Exams of Health sciences

Academy For Nursing And Health OccupationsHealth sciences

ATI PHARMACOLOGY MIDTERM NR 293 QUESTIONS WITH ANSWERS LATEST 2023_2024 BEST GRADES

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2022/2023

Available from 08/25/2023

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NR 293 ATI PHARMACOLOGY
MIDTERM EXAM
1. A nurse is caring for a 4-year-old child who is resistant to taking medication.Which
of the following strategies should the nurse use to elicit the child’s cooperation?
a. Offer the child a choice of taking the medication with juice or water
b. Tell the child it is candy
c. Hide the medications in a large dish of ice cream
d. Tell the child he will have a shot instead
2. A nurse is caring for a client who has difficulty swallowing medications and is prescribed
enteric-coated aspirin PO once daily. The client asks if the medicationcan be crushed to
make it easier to swallow. Which of the following responses should the nurse provide?
a. "Crushing the medication might cause you to have a stomach-ache or
indigestion.
Rationale:
The pill is enteric-coated to prevent breakdown in the stomach and decrease the
possibility of GI distress. Crushing destroys protection.
b. "Crushing the medication is a good idea, and I can mix it in some ice
creamfor you.”
c. "Crushing the medication would release all the medication at once, ratherthan
over time."
d. "Crushing is unsafe, as it destroys the ingredients in the medication."
3. A nurse is caring for a client who has congestive heart failure and is taking digoxin
daily. The client refused breakfast and is complaining of nausea andweakness.
Which of the following actions should the nurse take first?
a. Check the client's vital signs.
Rationale:
It is possible that the client's nausea is secondary to digoxin toxicity. Assess for
bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication
and call the provider if the client's heart rate is less than 60 bpm.
b. Request a dietitian consult.
c. Suggest that the client rests before eating the meal.
d. Request an order for an antiemetic.
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Download ATI PHARMACOLOGY MIDTERM NR 293 QUESTIONS WITH ANSWERS LATEST 2023_2024 BEST GRADES and more Exams Health sciences in PDF only on Docsity!

NR 293 ATI PHARMACOLOGY

MIDTERM EXAM

  1. A nurse is caring for a 4-year-old child who is resistant to taking medication.Which of the following strategies should the nurse use to elicit the child’s cooperation? a. Offer the child a choice of taking the medication with juice or water b. Tell the child it is candy c. Hide the medications in a large dish of ice cream d. Tell the child he will have a shot instead
  2. A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medicationcan be crushed to make it easier to swallow. Which of the following responses should the nurse provide? a. "Crushing the medication might cause you to have a stomach-ache or indigestion. Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing destroys protection. b. "Crushing the medication is a good idea, and I can mix it in some ice creamfor you.” c. "Crushing the medication would release all the medication at once, ratherthan over time." d. "Crushing is unsafe, as it destroys the ingredients in the medication."
  3. A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea andweakness. Which of the following actions should the nurse take first? a. Check the client's vital signs. Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm. b. Request a dietitian consult. c. Suggest that the client rests before eating the meal. d. Request an order for an antiemetic.

Pharmacology Midterm

  1. A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nursegive? a. "It usually takes heparin at least 2 to 3 days to reach a therapeutic bloodlevel." b. "A pharmacist is the person to answer that question." c. "Heparin does not dissolve clots. It stops new clots from forming." Rationale: This statement accurately answers the client's question. d. "The oral medication you will take after this IV will dissolve the clot.
  2. A nurse is caring for a client who has bipolar disorder and has been taking lithiumfor 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed? a. Thyroid hormone assay Rationale: Thyroid testing is important because long-term use of lithium maylead to thyroid dysfunction. b. Liver function tests: Rationale: LFTs must be monitored before and during valproic acid therapy c. Erythrocyte sedimentation rate Rationale: This is not a necessary test related to lithium therapy. d. Brain natriuretic peptide
  3. A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? a. “If my breathing begins to feel tight, I will use the cromolyn immediately.” b. “I will be sure to take the albuterol before taking the cromolyn.” Rationale: The client should always use the bronchodilator (albuterol) prior to using the leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be opened, ensuring that the maximum dose of medication will getto the client's lungs. c. “I will use both medications immediately after exercising.” d. “I will administer the medications 10 minutes apart.”

Pharmacology Midterm Use of glucocorticoids by metered dose inhaler can allow a fungal overgrowth in themouth. Rinsing the mouth after administration can lessen the likelihood of this complication. d. Limit caffeine intake.

  1. A nurse is teaching a client who has a new prescription for colchicine to treatgout. Which of the following instructions should the nurse include? a. "Take this medication with food if nausea develops." b. "Monitor for muscle pain." Rationale: This medication can cause rhabdomyolysis. The client should monitor and reportmuscle pain. c. "Expect to have increased bruising." d. "Increase your intake of grapefruit juice”
  2. A nurse is caring for a client who has active pulmonary tuberculosis (TB) and isto be started on intravenous revamping therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? a. Constipation b. Black coloured stools c. Staining of teeth d. Body secretions turning a red-orange color Rationale: Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva, sputum, sweat, and tears to turn reddish-orange toreddish- brown.
  3. A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

Pharmacology Midterm i. a) Asthma Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma because itcan cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation. b) Glaucoma c) Depression d) Migraines

  1. A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances? a. Iron Rationale: Epoetin alfa is a synthetic form of erythropoietin, a substance produced by thekidneys that stimulates the bone marrow to produce red blood cells. b. Protein c. Potassium d. Sodium
  2. A nurse is assessing a client who is receiving IV vancomycin. The nurse notes aflushing of the neck and tachycardia. Which of the following actions should the nurse take? a. A. Document that the client experienced an anaphylactic reaction to the medication. b. Change the IV infusion site. c. Decrease the infusion rate on the IV. Rationale:

Pharmacology Midterm i. d. Muscle pain

  1. A nurse is caring for a client who has a fungal infection and has a new prescription for amphotericin B. Which of the following laboratory values shouldthe nurse report to the provider before initiating the medication? a. Sodium 140 mEq/L b. Potassium 4.5 mEq/L c. BUN 55 mg/dL Rationale: This BUN level is above the expected reference range (10-20 mg/dL). AmphotericinB is nephrotoxic and is contraindicated if BUN is > 40mg/dL. d. D. Glucose 120 mg/dL e. Glucose 120 mg/dL
  2. A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminium hydroxide mg PO three times daily. For which of the following adverse effects should the nurse inform the client? a. Constipation Rationale: Constipation is a common side effect of aluminium-based antacids. The nurse should instruct the client to increase fibre intake and that stool softeners or laxativesmay be needed b. B. Metallic taste c. Headache d. Muscle spasms
  3. A nurse is teaching a client who has been taking prednisone to treat asthma andhas a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects? a. Hyperglycaemia b. Adrenocortical insufficiency Rationale: Prednisone, a corticosteroid, is similar to cortisol, the glucocorticoid hormone produced by the adrenal glands. It relieves inflammation and is used to treat certainforms of arthritis, severe allergies, autoimmune disorders, and asthma. Administration of glucocorticoids can suppress production of glucocorticoids, and anabrupt withdrawal of the drug can lead to a syndrome of adrenal insufficiency. c. Severe dehydration

Pharmacology Midterm d. Rebound pulmonary congestion

  1. A nurse is preparing a client for surgery. Prior to administering the prescribed hydroxyzine, the nurse should explain to the client that the medication is for which of the following indications? (Select all that apply.) a. Controlling emesis b. Diminishing anxiety c. Reducing the amount of narcotics needed for pain relief d. Preventing thrombus formation e.Drying secretions
  2. A nurse is caring for a client who has streptococcal pneumonia and a prescriptionfor penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first? a. Stop the infusion. Rationale: When using the airway, breathing, circulation approach to client care, the nurse should place the priority on stopping the infusion. The client is exhibiting signs ofpenicillin anaphylaxis and the first action that should be taken is to withdraw the medication. b. Call the client's provider. c. Elevate the head of the bed. d. Auscultate the client's breath sounds.
  3. A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? a. Decreased blood pressure Rationale: Lisinopril, an ACE inhibitor, may be used alone or in combination with other antihypertensives in the management of hypertension and congestive heart failure.A therapeutic effect of the medication is a decrease in blood pressure. b. Increase of HDL cholesterol c. Prevention of bipolar manic episodes d. Improved sexual function
  4. A nurse is caring for a client who has poison ivy and is prescribed diphenhydramine. Which of the following instructions should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine?

Pharmacology Midterm Disulfiram is given to clients who have a history of alcohol abuse. It produces a sensitivity to alcohol that results in a highly unpleasant reaction when the client ingests even small amounts of alcohol. When combined with alcohol, disulfiram produces nausea and vomiting. d.The client took an overdose of the medication.

  1. A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates atherapeutic response to the medication? a. Decrease in level of thyroxine (T4) b. Increase in weight c. Increase in hour of sleep per night d. Decrease in level of thyroid stimulating hormone (TSH).
  2. A nurse on an oncology unit is preparing to administer doxorubicin to a client whohas breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? a. An excess amount of doxorubicin can lead to myelosuppression. b. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. c. An excess amount of doxorubicin can lead to cardiomyopathy. Rationale: Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, evenyears after the client has stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m or 450 mg/m with a history of radiation to the mediastinum. d. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.

Pharmacology Midterm i.

  1. A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion by the nurse? a. "I signed up for a swimming class." b. "I've been taking an antacid to help with indigestion." Rationale. NSAIDs, like naproxen, can cause serious adverse gastrointestinal reactions such as ulceration, bleeding, and perforation. Warning manifestations such as nausea orvomiting, gastrointestinal burning, and blood in the stool reported by the client require further investigation by the nurse. The client might be taking an antacid because he is experiencing one or more of these manifestations.

Pharmacology Midterm The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? Rationale: a. Glucose b. Ammonia Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma. c. Potassium d. Bicarbonate

  1. A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the clientfor which of the following adverse effects of this medication? a. Cardiac dysrhythmia b. Metabolic alkalosis c. Renal failure d. Aplastic anaemia
  2. A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should thenurse review for an indication of a therapeutic effect of the medication? a. The leukocyte count b. The platelet count c. The haematocrit (Hct) i. Rationale: Epoetin alfa is an antianemia medication that is indicatedin the treatment of clients who have anaemia due to reduced production of endogenous erythropoietin, which may occur in clients who have end stage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is

Pharmacology Midterm enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct. d. The erythrocyte sedimentation rate (ESR)

  1. A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor fora therapeutic effect of warfarin? a. Haemoglobin b. Prothrombin time (PT) Rationale: This test is used to monitor warfarin therapy. For a client receiving full anticoagulant therapy should typically be approximately two to three times the normalvalue, depending on the indication for therapeutic anticoagulation. c. Bleeding time d. Activated partial thromboplastin time (aPTT)
  2. A nurse in a critical care unit is caring for a client who is postoperative following aright pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed? a. Prone b. On the nonoperative side Rationale: c. Sims' d. Semi-Fowler's Pneumonectomy is the surgical removal of the lung, which is most commonly performedto remove a tumour in a client who has lung cancer. Following extubation from the ventilator, the client should be placed in semi-Fowler's position to help to ensure adequate ventilation and decrease the risk of complications. This position also offers the client the most comfort.

Pharmacology Midterm c. Erythrocyte sedimentation rate d. Brain natriuretic peptide

  1. A nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. The provider and nursing staffsuspect the client is not adhering to his medication therapy. Which of the following interventions should the staff use to encourage the client's adherence? (Select all that apply.) a. Perform mouth checks following the administration of the medication. b. Provide for once-daily dosing. c. Use sustained-release forms. d. Engage the client in conversation following medication administration. e.Rotate staff that administer the medications. Rationale: Perform mouth checks following the administration of medication is incorrect. Mouth checks may not find pills that the client has hidden in his mouth Provide for once-dailydosing is correct. Once-daily dosing of medications simplifies the therapy, making it easier for the client to comply Use sustained-release forms is correct. Sustained- release forms remain in the client's system longer, requiring less frequent dosing Engage the client in conversation following medication administration is correct. If the client is speaking, he will be less likely able to hide the medication in his mouth Rotatestaff that administers the medications is incorrect. Rotating treatment providers is an obstacle that increases the risk of a client's nonadherence to therapy.
  2. A nurse in a provider's clinic is caring for a client who reports erectile dysfunctionand requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil? a. Isosorbide Rationale: Clients who are on nitrates including isosorbide and nitro-glycerine preparations cannot take sildenafil, because of the serious medication interaction. There is the possibility of sudden death due to hypotension. b. Phenytoin

Pharmacology Midterm c. Metronidazole d. Prednisone

  1. A nurse is caring for a client who has developed gout. Which of the following medications should the nurse prepare to administer? a. Zolpidem b. Alprazolam Rationale: c. Spironolactone d. Allopurinol Allopurinol is a xanthene oxidase inhibitor that reduces uric acid synthesis. The medication is prescribed to treat gout.
  2. A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective? a. A decrease in blood sugar b. A decrease in blood pressure. c. A decrease in urine output Rationale: The major manifestations of diabetes insipidus are excessive urination and extremethirst. Vasopressin is used to control frequent urination, increased thirst, and loss ofwater associated with diabetes insipidus. A decreased urine output is the desired response. d.A decrease in specific gravity

Pharmacology Midterm Rationale: Ginger root can interfere with the blood clotting effect of warfarin and place the client atrisk for bleeding. This statement indicates the client needs further teaching. b. "I take this medication at the same time each day.” c. "I eat a green salad every night with dinner." d. "I had my INR checked three weeks ago."

  1. A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? a. Tinnitus Rationale: tinnitus and hearing loss are adverse effects b. Constipation c. Hyperkalaemia d. Weight gain
  2. A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which ofthe following actions by the client can potentiate the effects of warfarin? a. The client follows a low-fat diet to reduce cholesterol b. The client drinks a glass of grapefruit juice every day. c. The client sprinkles flax seeds on food 1 hr before taking the anticoagulant. d. The client uses garlic to lower cholesterol levels. Rationale:

Pharmacology Midterm The nurse should recognize that garlic can potentiate the action of thewarfarin.

  1. A nurse is caring for a client who has a new prescription for ferrous sulphate tablets twice daily for iron-deficiency anaemia. The client asks the nurse why theprovider instructed that she take the ferrous sulphate between meals. Which of the following responses should the nurse make? a. "Taking the medication between meals will help you avoid becoming constipated." b. "Taking the medication with food increases the risk of esophagitis." c. "Taking the medication between meals will help you absorb the medication more efficiently." Rationale: Ferrous sulphate provides the iron needed by the body to produce red bloodcells. Taking iron supplements between meals helps to increase the bioavailability of the iron. d. "The medication can cause nausea if taken with food."
  2. A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of thefollowing findings in the client's history is a contraindication to this medication? Rationale: a. Report of recent migraine headaches b. History of gastric ulcers Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding andpeptic ulcer disease because it impedes platelet aggregation. An adverse effect of aspirin is gastric bleeding. c. Current diagnosis of glaucoma d. Prior reports of amenorrhea