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Pharm ATI PROCTORED EXAM QUESTIONS WITH
SOLUTION
1. A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw
palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects
A. urinary health promotion
B. immune system stimulation
C. decreased leg pain from arterial disease
D. prevention of nausea caused by motion sickness: A. urinary health promotion
Saw palmetto is used primarily for manifestations related to prostatic conditions, such as benign prostatic hypertrophy (BPH). Its effectiveness has not been scientif- ically proven, however. The nurse should teach the client to check with the provider about interactions between saw palmetto and other medications.
2. A nurse is providing teaching to a group of new parents about medications.
The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects?
a. Reye's syndrome
b. Visual disturbances
c. Diabetes mellitus
d. Wilm's tumor: a. Reye's syndrome
3. A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis
and new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching?
a. Reduces blood pressure
b. Inhibits clotting of fistula
c. Promotes RBC production
d. Stimulates growth of neutrophils: c. Promotes RBC production
4. A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the
following medications should the nurse plan to administer?
a. Ibuprofen (NSAIDS)
b. Naproxen (NSAIDS)
c. Aspirin (NSAIDS)
d. Acetaminophen (anlagesics): d. Acetaminophen (anlagesics)
5. A nurse is caring for a client who has prescription for clopidogrel. The nurse should monitor the client for
which of the following adverse effects?
a. Insomnia
b. Hypotension
c. Bleeding
d. Hydroxyzine (Antihistamine): a. Amantadine
9. A nurse is administering subQ epinephrine for a client who is experiencing anaphylaxis.
The nurse should monitor the client for which of the following adverse ef- fects?
a. Hypotension
b. Hyperthermia
c. Hypoglycemia
d. Tachycardia: d. Tachycardia
10. A nurse is providing teaching to a client who has UTI and new prescription for
phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?
a. If the phenazopyridine upsets my stomach, I can take it with meals.
b. The phenazopyridine will relieve my discomfort, but the cipro will get rid of the
infections.
c. I need to drink2 liters of fluid per day while I am taking cipro.
d. I should notify my provider immediately if my urine turns an orange color.: d. I should notify my provider
immediately if my urine turns an orange color.
11. A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep.
The nurse should plan to monitor the client for which of the following adverse effects?
a. Ecchymosis
b. Decreased urine output
c. Increased blood pressure
d. Dizziness: d. Dizziness
12. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has
an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications?
a. Methimazole
b. Somatropin
c. Levothyroxine
d. Propylthiouracil: c. Levothyroxine
13. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50mg po daily
to treat hypertension. Which of the follow- ing instructions should the nurse include in the teaching?
a. Take the hydrochlorothiazide as needed for edema
b. Check your weight once each week
c. Take the hydrochlorothiazide on an empty stomach
d. Take the hydrochlorothiazide in the morning.: d. Take the hydrochlorothiazide in the morning.
17. A nurse is providing teaching to a client who has gout and new prescription for
allopurinol. The nurse should instruct client to discontinue taking the medica- tions for which of the following adverse effects?
a. Nausea
b. Metallic taste
c. Fever
d. Drowsiness: c. Fever
18. A nurse is assessing a client who is receiving IV gentamicin 3 x daily. Which of the following findings indicates
that the client is experiencing an adverse effect of this medication?
a. Hypoglycemia
b. Proteinuria
c. Nasal congestion
d. Visual disturbances: b. Proteinuria
19. A nurse is providing teaching to a newly nurse about caring for a client who has prescription for gemfibrozil.
The nurse should instruct the newly licensed nurse to monitor which of the following lab tests?
a. Platelet count
b. Electrolyte levels
c. Thyroid functions
d. Liver function: d. Liver function
20. A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that
ergotamine is administered to treat which of the following conditions?
a. Raynaud's phenomenon
b. Migraine headaches
c. Ulcerative colitis
d. Anemia: b. Migraine headaches
21. A nurse is reviewing the lab values for a client who is receiving a continu- ous IV heparin infusion and has
an aPTT (TR-60-80 sec) of 90 seconds. Which of the following actions should the nurse prepare to take?
a. Administer Vit K
b. Reduce the infusion rate
c. Give the client a low dose aspirin
d. Request an INR: b. Reduce the infusion rate
22. A nurse is providing teaching to a client who had rheumatoid arthritis and a prescription for long term
prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects?
a. Stress fractures
b. Orthostatic hypotension
c. Gingival ulcerations
d. Weight loss: a. Stress fractures
23. A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that
tamoxifen has which of the following therapeutic effects?
recognize that an increase in which of the following values indicates a therapeutic effect of this medication?
a. Erythrocyte count
b. Neutrophil count
c. Lymphocyte count
d. Thrombocyte count: b. Neutrophil count
27. A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for
sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
a. Jaundice
b. Constipation
c. Oral candidiasis
d. Sedation: a. Jaundice
28. A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid.
Which of the following lab values should the nurse plan to monitor? Select all that apply.
a. BUN
b. PTT
c. Aspartate aminotransferase (AST)
d. Urinalysis
e. Alanine aminotransferase (ALT): b. PTT
c. Aspartate aminotransferase (AST) e. Alanine aminotransferase (ALT)
29. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days.
The nurse should recognize that candidia- sis is a manifestation of which of the following adverse effects?
a. Allergic response
b. Superinfection
c. Renal toxicity
d. Hepatotoxicity: b. Superinfection
30. A nurse is caring for a client who has a prescription for chlorothiazide to treat
hypertension. The nurse should plan to monitor the client for which of the following adverse effects?
a. Thrombophlebitis
b. Hyperactive reflexes
c. Muscle weakness
d. Hypoglycemia: c. Muscle weakness
31. A nurse on a medical unit is preparing to administer alendronate 40mg po for an older adult client who has
Paget's disease of the bone. Which of the following actions should be the nurse's priority?
d. Hypokalemia: c. Hypotension
34. A nurse is preparing a discharge teaching plan for a 6 year old client who has asthma and several
prescription medication using metered dose inhalers (MDIs). Which of the following interventions should the nurse include in the plan?
a. Add a spacer to each MDI.
b. Instruct the child to inhale more rapidly than usual when using an MDI.
c. Request that the provider change the child's medications from inhaled to oral
formulation.
d. Administer oxygen by facemask along with the MDI.: a. Add a spacer to each MDI.
35. A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn
sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching?
a. I will give my child a dose as soon as wheezing starts.
b. My child should rinse out his mouth after using the inhaler.
c. My child should exhale completely before placing the inhaler in his mouth.
d. If my child has difficulty breathing in the dose, a spacer can be used.: a. I will give my child a dose as soon as
wheezing starts.
36. A nurse is providing teaching to a newly licensed nurse about administer- ing morphine via
IV bolus to a client. Which of the following information should the nurse include in the teaching?
a. Respiratory depression can occur 7 min after the morphine is administered.
b. The morphine will peak in 10 min
c. Withhold the morphine if the client has a respiratory rate of less than 16/min
d. Administer the morphine over 2 min: a. Respiratory depression can occur 7 min after the morphine is
administered
37. A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma and several
prescription medications using metered dose inhalers [MDIs]. Which of the following interventions should the nurse include in the plan?
A. add spacer to each MDI
B. instruct the child to inhale more rapidly
C. request that the provider change the child's medications from inhaled to oral formulations
D. administer oxygen by facemask along with the MDI: A. add spacer to each
MDI
MDIs are difficult to use correctly and, even when properly used, only a portion of the medication is delivered to the lungs. A spacer applied to an MDI can make up for lack of hand-lung coordination by increasing the amount of medication delivered to the lungs.
(Round to the nearest whole number): 18 mL/hr
41. A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual
nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he experiences chest pain? Wait for 5 min Stop activity Call 911 if the pain is not relieved Place a tablet under the tongue: Stop activity Place a tablet under the tongue Wait for 5 min Call 911 if the pain is not relieved
42. A nurse is providing teaching to a client who is to start taking Hy- drochlorothiazide for hypertension. The
nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client indicates an understanding of the teaching?
A. this medication will not work unless I have enough potassium
B. potassium will increase the therapeutic effect of my blood medication
C. potassium will lower my blood pressure
D. this medication can cause a loss of potasium: D. this medication can cause a loss of potassium
Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion by the kidneys. The client should supplement his diet with potassium-rich foods to avoid the occurrence of hypokalemia. Foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins, and milk.
43. A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the
nurse she has been administering prescribed Lorazepam, 1 mg three times per day, to the client for restlessness and anxiety during the past few days. For which of the following adverse effects should the nurse assess the client?
A. low-grade fever
B. sedation
C. diuresis
D. tonic-clonic seizures: B. sedation
Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients, especially, are at risk for central nervous system depression even with low doses of benzodiazepines. Clients who are 50 years or older can have a more profound and prolonged sedation than younger clients.
44. A nurse is preparing to administer Digoxin 0.2 mg via IV bolus to a client. The amount available is Digoxin
0.25 mg/1ml. How many ml should the nurse administer?: 0.8 mL
45. A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for
oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching? A. I will be able to stop taking this medication 6 months after my surgery B. I am likely to develop higher bp while taking this medication C. I am likely to lose my hair while taking this medication D. I am taking this medication to boost my immune system: B. I am likely to develop higher bp while taking this medication Half the clients who take cyclosporine develop a 10% to 15% increase in blood pressure and might need to start antihypertensive therapy.
D. transient pallor of the face: C. dyspnea
Dyspnea can occur during administration of adenosine due to bronchoconstriction. Since adenosine has a very short half- life of about 10 seconds, this effect should be short-lived.
48. A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse
instruct the client to expect?
A. diarrhea
B. anxiety
C. nausea and vomiting
D. dry mouth: D. dry mouth
Hydroxyzine has anticholinergic properties. Dry mouth is a common adverse effect of this medication. The nurse should instruct the client to take sips of water or suck hard candies to minimize this effect.
49. A nurse is planning discharge teaching for a client who has Major Depres- sive Disorder and a new
prescription for Phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking Phenelzine?
A. broiled beef steak
B. macaroni and cheese
C. pepperoni pizza
D. smoked samon: A. broiled beef steak
Phenelzine, an MAOI, is an antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume.
50. A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of
the following adverse effects should the client be taught to monitor and notify the provider if it occurs?
A. nasal congestion
B. tremors
C. tinnitus
D. frontal headache: C. tinnitus
Loop diuretics, such as furosemide, can cause ototoxicity. The client should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs.
51. A nurse is planning to administer Diphenhydramine 50 mg via IV bolus to a client who is having an allergic
reaction. The client has an IV infusion con- taining a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take?
A. choose an IV port for IV bolus injection for the diphenhydramine as near as possible to the client's hanging
IV bag
B. flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering
diphenhydramine
C. allow IV infusion to keep running while administering the diphenhydramine via IV bolus
D. aspirate to check the IV patency before administering the diphenhydramine-
: D. aspirate to check for IV patency before administering the diphenhydramine
