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Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 1. The nurse answers a patient's call light and finds the patient sitting up in bed and requesting pain medication. What will the nurse do first? A. Check the orders and give the patient the requested pain medication B. Provide comfort measures to the patient @-C. Assess the patient's pain and pain level D. Evaluate the effectiveness of previous pain medications 2. The nurse is preparing to administer a transdermal patch to a patient and finds that the patient already has a medication patch on his right upper chest. What will the nurse do? A. Remove the old medication patch and notify the health care provider B. Apply the new patch without removing the old one C. Remove the old patch and apply the new one in the same spot @®-D. Remove the old patch and apply the new patch to a different clean area 3. A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief is which route? AL IV @-B. PO C. Subcutaneous D. IM 4.A patient is recovering from an appendectomy. She also has asthma and allergies to shellfish and iodine. To manage her postoperative pain, the physician has prescribed hydromorphone (Dilaudid). Which vital sign is of greatest concern? A. Temperature @>B. Respirations C. Pulse D. Blood pressure LL Created on:06/16/2019 Page 1 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 5. The patient is diagnosed with Parkinson's disease and has been started on a dopaminergic replacement drug therapy with carbidopa-levodopa, it is important for the nurse to A. assess the patient for dizziness and syncope when the patient is walking @>B. administer the medication first thing in the morning C. administer the medication on an empty stomach D. remove protein from the patient's diet 6. Which drug will the nurse anticipate administering to a patient experiencing a benzodiazepine overdose? @-A. Flumazenil B. Narcan Cc. Methadone D. Antabuse 7.Which statement is important for the nurse to include when teaching a patient about disulfiram (Antabuse) therapy? A. This medication will cure your alcoholism if you take as directed B. This medication will cause your blood pressure to get very high if you drink alcohol after taking it @®-C. "You cannot drink alcohol for at least 3-4 days after taking this medication D. "If you miss a dose of Antabuse, double up the next time it is due" 8. A patient on a dobutamine drip starts complaining that her IV line "hurts really bad" The nurse on assessing the site notices that it is red, swollen and cool to touch. What will the nurse do first? A. Slow the infusion rate @-B. Stop the infusion C. Inject the area with phentolamine D. Notify the health care provider 9. A nursing is planning care for a client who is receiving furosemide (lasix) IV for peripheral edema. Which of the Created on:06/16/2019 Page 2 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 13. During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first? @» A. Discontinue the infusion immediately. B. Reduce the infusion rate gradually until the adverse effects subside. C. Administer the medication by rapid IV infusion to reduce these effects. D. Nothing; these are expected side effects of this medication. 14.A patient is taking nystatin (Mycostatin) oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate? A. “Chew the lozenges until they are completely dissolved.” @> B. “Let the lozenge dissolve slowly and completely in your mouth without chewing it.” C. “Rinse your mouth with water before taking the inhaler.” D. “Rinse your mouth with mouthwash after taking the inhaler.” 15.A patient with active HIV has been taking zidovudine (Retrovir). Which is potential adverse effect may limit the length of time this medication can be taken? A. Lactic Acidosis @~- B. Bone marrow suppression C. Hepatomegaly D. Fatigue 16.A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching? A. Report clear-colored sputum to the prescriber. @» B. Force fluids to help loosen and liquefy secretions. C. Avoid driving a car or operating heavy machinery because of the sedating effects. D. Report symptoms that last longer than 2 days. Created on:06/16/2019 Page 4 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 17.A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient's medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain? A. Antidepressant B. Anticonvulsant @> C. Corticosteroid D. Local anesthesia 18. The nurse on educating the patient on the common side/adverse effects of opioids will educate on which of the following: (Select all that apply) @» A. decreased respirations B. heartburn @> C. constipation @+ D. nausea E. insomnia 19.A patient who is receiving high-dose chemotherapy with methotrexate is also receiving leucovorin. The purpose of the leucovorin is to: A. produce an additive effect with the methotrexate by increasing its potency against the cancer cells. B. reduce the incidence of cardiomyopathy caused by the methotrexate. @~ C. reduce the Bone Marrow Suppression caused by the methotrexate. D. add its antiinflammatory effects to the treatment regimen. 20.A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? A. Increased bleeding tendencies @» B. Increased chance for GI bleeding C. Increased nephrotoxic effects D. Reduced antiinflammatory effects of the NSAID Created on:06/16/2019 Page 5 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 phenytoin 250 mg. The amount available is phenytoin oral solution 25 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) @- 50 mL Correct Rationale: Ratio and Proportion STEP 1: What is the unit of measurement the nurse should calculate? mL_STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 3: What is the dose available? Dose available = Have 25 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL_STEP 6: Set up an equation and solve for X. Have/Quantity = Desired/x 25 mg/S mL = 250 mg/X mL X= 50 STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. Desired Over Have STEP 1: What is the unit of measurement the nurse should calculate? mL_STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 3: What is the dose available? Dose available = Have 25 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL STEP 6: Set up an equation and solve for X. Desired x Quantity/Have = X 250 mg x 5 mL/25 mg = X mL 50 = X STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. Dimensional Analysis STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the quantity of the dose available? 5 mL STEP 3: What is the dose available? Dose available = Have 25 mL_ STEP 4: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 5: Should the nurse convert the units of measurement? No STEP 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion(Desired) x Desired/ X mL = 5 mL/25 mg x 250 mg/ X = 50STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. InCorrect Rationale: Ratio and Proportion STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 250 m STEP 3: What is the dose available? Dose available = Have 25 mg STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL STEP 6: Set up an equation and solve for X. Have/Quantity = Desired/X 25 mg/5 mL = 250 mg/X mL X=50 STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. Desired Over Have STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the dose the nurse should administer? Dose to administer= Desired 250 mi STEP 3: What is the dose available? Dose available = Have 25 mg STEP 4: Shoul the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 5 mL_ STEP 6: Set up an equation and solve for X. Desired x Quantity/Have = X 250 mg x 5 mL/25 mg = X mL _ 50=X STEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to LL Created on:06/16/2019 Page 7 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. Dimensional Analysis STEP 1: What is the unit of measurement the nurse should calculate? mL STEP 2: What is the quantity of the dose available? 5 mL STEP 3: What is the dose available? Dose available = Have 25 mL_ STEP 4: What is the dose the nurse should administer? Dose to administer= Desired 250 mg STEP 5: Should the nurse convert the units of measurement? No STEP 6: Set up an equation and solve for X. X = Quantity/Have x Conversion (Have)/Conversion(Desired) x Desired/ X mL = 5 mL/25 mg x 250 mg/ X = SOSTEP 7: Round if necessary. STEP 8: Reassess to determine whether the amount to administer makes sense. If there are 25 mg/5 mL and the prescription reads 250 mg, it makes sense to administer 50 mL. The nurse should administer phenytoin 50 mL via gastrostomy tube. 26.A nurse is edueatinga group of clients about the contraindications of warfarin therapy. Which of the following statements should the nurse include in the teaching? A. "Clients who have glaucoma should not take warfarin." Rationale: Liver disease is a contraindication for warfarin therapy. B. “Clients who have rheumatoid arthritis should not take warfarin." Rationale: Thrombocytopenia is a contraindication for warfarin therapy. @» C. “Clients who are pregnant should not take warfarin." Rationale: Warfarin therapy is contraindicated in the pregnant client because it crosses the placenta and places the fetus at risk for bleeding. D. "Clients who have hyperthyroidism should not take warfarin." Rationale: Peptic ulcer disease is a contraindication for warfarin therapy 27.A nurse is reviewing the medication list for a client who has a new prescription for warfarin. The nurse should recognize that which of the following medications is incompatible with warfarin? A. Furosemide Rationale: Furosemide can cause potassium loss and increase the risk for digoxin toxicity when used concurrently with digoxin. B. Alprazolam Rationale: Alprazolam, used with sedative hypnotic medications, can increase the risk for CNS depression. @> C. Vitamin K Rationale: These two medications are not compatible. Vitamin K antagonizes the action of warfarin and is the antidote for warfarin toxicity. LL Created on:06/16/2019 Page 8 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 30.A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching? A. Apply a new transdermal patch once a week. Rationale: The client should apply a new patch each day, not once a week. @> B. Apply the transdermal patch in the morning. Rationale: The client should apply the patch every morning and leave it in place for a 12 to 14 hr, then remove it in the evening. C. Apply the transdermal patch in the same location as the previous patch. Rationale: The client should rotate the sites used for patch placement to avoid areas of local skin irritation. D. Apply a new transdermal patch when chest pain is experienced. Rationale: The transdermal route of nitroglycerin has a delayed onset of action, making it suitable for prophylaxis use but not for immediate relief of chest pain. 31.A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? A. "A headache is an indication of an allergy to the medication." Rationale: Allergic reactions typically manifest as itching and a rash, and if worsening, laryngeal edema and bronchospasm. @- B. "Aheadache is an expected adverse effect of the medication.” Rationale: The vasodilation nitroglycerin induces increases blood flow to the head and typically results in a headache. C. "A headache indicates tolerance to the medication." Rationale: With tolerance, the client needs more of the medication to achieve a therapeutic response. A headache is not a sign of this phenomenon. D. "A headache is likely due to the anxiety about the chest pain." Rationale: This is a nontherapeutic communication technique and offers the nurse's opinion about the cause of the headache rather than a factual statement. 32. A patient has an order for the monoclonal antibody adalimumab (Humira). The nurse notes that the patient does not have a history of cancer. What is another possible reason for administering this drug? a Created on:06/16/2019 Page 10 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 A. Severe anemia @> B. Rheumatoid arthritis C. Thrombocytopenia D. Osteoporosis 33.A patient who has received chemotherapy has a critically low platelet count. The nurse expects which drug or drug class to be used to stimulate platelet cell production? A. filgrastim (Neupogen) B. Interferons @> C. oprelvekin (Neumega) D. epoetin alfa (Epogen) 34.A patient asks about his cancer treatment with monoclonal antibodies. The nurse tells him that which is the major advantage of treating certain cancers with monoclonal antibodies? A. They will help the patient improve more quickly than will other antineoplastic drugs. B. They are more effective against metastatic tumors. @> C. Monoclonal antibodies target certain tumor cells and bypass normal cells. D. There are fewer incidences of opportunistic infections with monoclonal antibodies. 35. The nurse is monitoring a patient who has severe bone marrow suppression following antineoplastic drug therapy. Which is considered the principal early sign of infection? @> A. Fever B. Diaphoresis C. Tachycardia D. Elevated white blood cell count 36.A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal antiinflammatory drug (NSAID) and misoprostol (Cytotec). The patient asks the nurse, “Why am I now taking two pills for arthritis?” What is the nurse's best response? a Created on:06/16/2019 Page 11 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 A. Anxiolytic B. Sedative @> C. Antipyretic D. Antimicrobial 41.A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which condition? A. Lyme disease B. Toxoplasmosis @> C. Systemic lupus erythematosus D. Intestinal tapeworms 42.A patient has an infestation with flukes. The nurse anticipates the use of which drug to treat this infestation? @> A. praziquantel (Biltricide) B. pyrantel (Pin-X) C. metronidazole (Flagyl) D. ivermectin (Stromectol) 43.When monitoring patients on antitubercular drug therapy, the nurse knows that which drug may cause a decrease in visual acuity? A. rifampin (Rifadin) B. isoniazid (INH) @> C. ethambutol (Myambutol) D. streptomycin 44.A young adult calls the clinic to ask for a prescription for “that new flu drug.” He says he has had the flu for almost 4 days and just heard about a drug that can reduce the symptoms. What is the nurse’s best response to his request? A. “Now that you've had the flu, you will need a booster vaccination, not the antiviral drug.” Created on:06/16/2019 Page 13 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 B. “We will need to do a blood test to verify that you actually have the flu.” @~ C. “Drug therapy should be started within 2 days of symptom onset, not 4 days.” D. “We'll get you a prescription. As long as you start treatment within the next 24 hours, the drug should be effective.” 45.A patient is receiving aminoglycoside therapy and will be receiving a beta-lactam antibiotic as well. The patient asks why two antibiotics have been ordered. What is the nurse’s best response? @~ A. “The combined effect of both antibiotics is greater than each of them alone.” B. “One antibiotic is not strong enough to fight the infection.” C. “We have not yet isolated the bacteria, so the two antibiotics are given to cover a wide range of microorganisms.” D. “We can give a reduced amount of each ane if we give them together.” 46. The nurse is administering a vancomycin (Vancocin) infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug’s administration? A. Monitoring blood pressure for hypertension during the infusion @~ B. Discontinuing the drug immediately if red man syndrome occurs C. Restricting fluids during vancomycin therapy D. Infusing the drug over at least 1 hour 47. The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct? @> A. “Avoid direct sunlight and tanning beds while on this medication.” B. “Milk and cheese products result in increased levels of tetracycline.” C. “Antacids taken with the medication help to reduce gastrointestinal distress.” D. “Take the medication until you are feeling better.” 48. The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate? A. Itis indicated for the treatment of acute bronchospasms. LL Created on:06/16/2019 Page 14 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 C. Vaginal cultures @- D. Pregnancy test 53.A patient is receiving oxytocin (Pitocin) to induce labor. During administration of this medication, the nurse will also implement which action? A. Giving magnesium sulfate along with the oxytocin B. Administering the medication in an intravenous bolus @®- C. Administering the medication with an IV infusion pump D. Monitoring fetal heart rate and maternal vital signs every 6 hours 54. After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient’s adherence to the antidiabetic therapy over the past few months? A. Hemoglobin levels @> B. Hemoglobin A1C level C. Fingerstick fasting blood glucose level D. Serum insulin levels 55.A patient has been taking levothyroxine (Synthroid) for more than 1 decade for primary hypothyroidism. Today she calls because she has a cousin who can get her the same medication in a generic form from a pharmaceutical supply company. Which is the nurse’s best advice? A. “This would be a great way to save money.” B. “There's no difference in brands of this medication.” C. “This should never be done; once you start with a certain brand, you must stay with it.” ®~ D. “It’s better not to switch brands unless we check with your doctor.” 56.When reviewing the laboratory values of a patient who is taking antithyroid drugs, the nurse will monitor for which adverse effect? A. Decreased glucose levels @~ B. Decreased white blood cell count a Created on:06/16/2019 Page 16 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 C. Increased red blood cell count D. Increased platelet count 57.A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose? A. vitamin E B. vitamin K @- C. protamine sulfate D. potassium chloride 58.A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse's response is based on which rationale? A. The oral and injection forms work synergistically. B. The combination of heparin and an oral anticoagulant results in fewer adverse effects than heparin used alone. C. Oral anticoagulants are used to reach an adequate level of anticoagulation when heparin alane is unable to do so. @> D. Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels. 59. The nurse assesses the patient’s IV site, and it has infiltrated during the infusion of dopamine (Intropin). The nurse will prepare which medication to treat this infiltration? A. Naloxone (Narcan) B. Lidocaine (Xylocaine @> C. Phentolamine (Regitine) D. Norepinephrine (Levophed) 60.A patient who is prescribed tamsulosin (Flomax) does not have a history of hypertension. The nurse knows this medication is also used for what condition? A. Migraine headache Created on:06/16/2019 Page 17 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 C. Increased risk of tooth abscess ®~ D. Gingival hyperplasia 65.A patient is prescribed an opioid analgesic for chronic pain. Which information should the nurse discuss with the patient to minimize the Gl adverse effects? A. Avoid eating foods high in lactobacilli. @> B. Increase fluid intake and fiber in the diet C. Take the medication on an empty stomach. D. Take diphenoxylate—atropine (Lomatil) for diarrhea with each dose. 66.Which medication is used to treat a patient with severe adverse effects of a narcotic analgesic? @> A. Naloxone (Narcan) B. Acetyicysteine (Mucomyst) C. Methylprednisolone (Solu-Medrol) D. Flumazenil (Romazicon) 67.A nurse is teaching a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include? A. "You should expect brown-colored urine." Rationale: Brown-colored urine is a manifestation of liver dysfunction, an adverse effect of simvastatin. The client should report this to the provider. @> B. "You should avoid grapefruit juice." Rationale: Grapefruit inhibits the drug-metabolizing enzyme CYP3A4 which slows the metabolism of simvastatin. This can cause an increase in serum simvastatin. Potential adverse effects include elevated liver enzymes, and rhabdomyolysis. C. "You should monitor for ringing in the ears.” Rationale: Simvastatin can cause rhabdomyolysis and myopathy. D. "You should take the medication in the morning." Rationale: The nurse should instruct the client to take the medication in the evening to increase efficacy. Created on:06/16/2019 Page 19 Detailed Answer Key “ati Pharmacology Proctored Exam_Cloned_Assessment 1 68.A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect? A. Blurred vision Rationale: Blurred vision is not an adverse effect of simvastatin. B. Orthostatic hypotension Rationale: Orthostatic hypotension is not an adverse effect of simvastatin. @» C. Muscle aches Rationale: Myopathy is an adverse effect of this medication. Signs of myopathy include muscle aches, tenderness, and muscle weakness. D. Urinary retention Rationale: Urinary retention is not an adverse effect of simvastatin. 69.A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the following findings is a priority to report? A. Dry cough Rationale: Dry cough is non-urgent because it is a mild adverse effect of lisinopril; therefore, there is another finding that is the priority. @- B. Swelling of the tongue Rationale: When using the urgent vs non-urgent approach to client care, the nurse determines that the priority finding is swelling of the tongue, which is a manifestation of angioedema. The nurse should withhold the medication and notify the provider immediately if the client reports swelling of the tongue or throat. Other manifestations include giant wheals and edema of the tongue, glottis, and pharynx. Severe reactions are treated with subcutaneous epinephrine. If angioedema develops, ACE inhibitors are discontinued. C. Nausea Rationale: Nausea is non-urgent because it is a mild adverse effect of lisinopril; therefore, there is another finding that is the priority. D. Nasal congestion Rationale: Nasal congestion is non-urgent because it is a mild adverse effect of lisinopril; therefore, there is another finding that is the priority. 70.A nurse is assessing a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication? Dl Page 20 Created on:06/16/2019 
