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Ati pharmacology assessment 1

Total Questions : 47

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Question 1:

A nurse is caring for a client who has hyperlipidemia and a new prescription for colesevelam. The nurse should monitor the client for which of the following manifestations as an adverse effect of colesevelam?

Explanation

Choice A rationale

Hyperglycemia is not a common adverse effect of colesevelam. Colesevelam is primarily used to lower cholesterol levels and can also help control blood sugar levels in patients with type 2 diabetes.

Choice B rationale

Stomatitis, or inflammation of the mouth, is not typically associated with colesevelam. This medication works in the intestines and is not absorbed into the bloodstream, so it does not commonly cause systemic side effects.

Choice C rationale

Fever is not a known adverse effect of colesevelam. The medication’s side effects are generally limited to the gastrointestinal system.

Choice D rationale

Constipation is a common adverse effect of colesevelam. This medication binds to bile acids in the intestines, which can lead to gastrointestinal side effects such as constipation.


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Question 2:

A nurse is caring for a client who has a new diagnosis of adrenal insufficiency. Which of the following prescriptions should the nurse anticipate from the provider?

Explanation

Choice A rationale

Phenytoin is an anticonvulsant used to control seizures and is not indicated for the treatment of adrenal insufficiency.

Choice B rationale

Calcitonin is used to treat conditions like osteoporosis and hypercalcemia, not adrenal insufficiency.

Choice C rationale

Buspirone is an anxiolytic used to treat anxiety disorders and is not used for adrenal insufficiency.

Choice D rationale

Fludrocortisone is a synthetic corticosteroid that is used to replace aldosterone in patients with adrenal insufficiency. It helps maintain sodium balance and blood pressure.


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Question 3:

A nurse is providing teaching to a client who has a new prescription for methimazole for the treatment of hyperthyroidism. Which of the following statements by the client indicates an understanding of the teaching?

Explanation

Choice A rationale

Methimazole does not typically cause constipation. It is used to treat hyperthyroidism by inhibiting the production of thyroid hormones.

Choice B rationale

A sore throat can be a sign of agranulocytosis, a serious side effect of methimazole that involves a dangerously low white blood cell count. Patients are advised to contact their provider if they experience a sore throat.

Choice C rationale

While monitoring weight is important for patients with hyperthyroidism, it is not a specific instruction related to methimazole use.

Choice D rationale

Methimazole should be taken regularly as prescribed, not on an as-needed basis.


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Question 4:

A nurse is caring for a client in the emergency department. The client is at risk for developing which of the following conditions?

Explanation

Choice A rationale

Hypercalcemia is not typically a risk in the emergency department unless the patient has a specific condition that causes elevated calcium levels.

Choice B rationale

Hypotension can occur in the emergency department, especially in cases of shock or severe dehydration, but it is not the most common risk.

Choice C rationale

Hypokalemia can occur, particularly in patients with certain medical conditions or those taking diuretics, but it is not the most common risk.

Choice D rationale

Hypernatremia can occur, especially in patients with dehydration or certain medical conditions, but it is not the most common risk.

Choice E rationale

Hypoglycemia is a common risk in the emergency department, especially in patients with diabetes or those who have not eaten for an extended period.


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Question 5:

A nurse is providing teaching to a client who has a new prescription for folic acid. The client states, “I thought that was only given during pregnancy.”. Which of the following statements should the nurse make?

Explanation

Choice A rationale

Folic acid is not primarily used to stimulate the immune system. Its main role is in the production of red blood cells and DNA synthesis.

Choice B rationale

Folic acid does not increase the absorption of other medications. It is used to prevent and treat folate deficiency.

Choice C rationale

Folic acid is not used to treat benign prostatic hyperplasia. It is important for cell growth and the production of red blood cells.

Choice D rationale

Folic acid is crucial for the building of blood cells and is especially important during periods of rapid cell division, such as pregnancy.


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Question 6:

A nurse is preparing to administer mannitol IV to a client. The nurse should monitor the client for which of the following manifestations as an expected outcome of this medication?

Explanation

Choice A rationale

Mannitol is an osmotic diuretic used primarily to reduce intracranial pressure (ICP) and treat cerebral edema. It does not affect thyroxine levels, which are related to thyroid function. Thyroxine levels are regulated by the thyroid gland and are not influenced by mannitol administration.

Choice B rationale

Mannitol is not used to correct atrial flutter. Atrial flutter is a type of arrhythmia that requires specific antiarrhythmic medications or procedures such as cardioversion. Mannitol’s primary action is to increase osmotic pressure in the kidneys, leading to diuresis and reduction of fluid in tissues, including the brain.

Choice C rationale

Mannitol is effective in reducing intracranial pressure by creating an osmotic gradient that draws fluid from the brain tissue into the bloodstream, which is then excreted by the kidneys. This reduction in intracranial pressure is a desired therapeutic outcome when treating conditions like cerebral edema.

Choice D rationale

Mannitol does not increase hemoglobin levels. Hemoglobin levels are influenced by factors such as red blood cell production and destruction, iron levels, and overall health status. Mannitol’s mechanism of action is related to fluid balance and diuresis, not hematopoiesis.


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Question 7:

A nurse is reviewing the health history of a client who experiences migraine headaches and has asked about a prescription for sumatriptan.

 

Which of the following conditions should the nurse identify as a contraindication for taking sumatriptan?

Explanation

Choice A rationale

Asthma is not a contraindication for sumatriptan. Sumatriptan is a selective serotonin receptor agonist used to treat migraines by constricting blood vessels in the brain. It does not have a significant impact on respiratory conditions like asthma.

Choice B rationale

Kidney disease is not a contraindication for sumatriptan. However, caution is advised when using sumatriptan in patients with severe renal impairment due to potential accumulation of the drug and its metabolites.

Choice C rationale

Rheumatoid arthritis is not a contraindication for sumatriptan. Sumatriptan’s mechanism of action does not interfere with the inflammatory processes involved in rheumatoid arthritis.

Choice D rationale

Coronary artery disease (CAD) is a contraindication for sumatriptan. Sumatriptan can cause vasoconstriction of coronary arteries, which can exacerbate CAD and increase the risk of myocardial infarction or other cardiac events.


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Question 8:

A nurse is teaching a client who has a new prescription for benzonatate. Which of the following statements by the client indicates an understanding of the teaching?

Explanation

Choice A rationale

Benzonatate is a non-narcotic cough suppressant that works by numbing the throat and lungs, making the cough reflex less active. It can cause drowsiness and dizziness, so patients are advised not to drive or operate heavy machinery while taking this medication.

Choice B rationale

Benzonatate does not help in coughing up mucus. It suppresses the cough reflex, which can be beneficial for dry, irritating coughs but is not suitable for productive coughs where mucus needs to be expelled.

Choice C rationale

There is no need to decrease dietary fiber intake while taking benzonatate. Dietary fiber does not interact with the medication or its effectiveness.

Choice D rationale

Benzonatate capsules should not be chewed or crushed, as this can cause numbness of the mouth and throat, leading to potential choking hazards.


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Question 9:

A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting to take immediate-release exenatide.

 

Which of the following client statements indicates an understanding of the teaching?

Explanation

Choice A rationale

Immediate-release exenatide pens should be discarded 30 days after the first use, not two months. This ensures the medication remains effective and free from contamination.

Choice B rationale

Exenatide is administered subcutaneously, not intramuscularly. The preferred injection sites are the abdomen, thigh, or upper arm.

Choice C rationale

Open exenatide pens should be stored at room temperature, but this is not the most critical aspect of patient education. Proper storage ensures the medication’s stability and effectiveness.

Choice D rationale

Immediate-release exenatide should be taken one hour before morning and evening meals to optimize its glucose-lowering effects by enhancing insulin secretion in response to meals.


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Question 10:

A nurse is caring for a client who requires a transfusion of one unit of packed RBCs. The nurse receives the following prescription: “Diphenhydramine 50 mg by mouth once, one hour prior to transfusion.”. The nurse should identify this as which of the following types of prescription?

Explanation

Choice A rationale

A standing prescription is an order that applies to all patients who meet certain criteria and is not specific to a single administration. It is used for routine treatments and does not apply to a one-time pre-transfusion medication.

Choice B rationale

A stat prescription is an urgent order that requires immediate administration, typically within minutes. It is used for emergency situations and does not apply to a pre-transfusion medication given one hour before the procedure.

Choice C rationale

A single prescription is a one-time order for a specific medication to be given at a specific time. In this case, diphenhydramine 50 mg by mouth once, one hour prior to transfusion, fits the definition of a single prescription.

Choice D rationale

A PRN (pro re nata) prescription is an order for medication to be given as needed based on the patient’s condition. It is not applicable to a scheduled pre-transfusion medication.


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Question 11:

A nurse is providing teaching to a client who has erectile dysfunction and has a new prescription for tadalafil. Which of the following client statements indicates an understanding of the teaching?

Explanation

Choice A rationale

Crushing tadalafil is not recommended as it can alter the medication’s effectiveness and absorption. Tadalafil should be taken whole to ensure proper dosage and efficacy.

Choice B rationale

Tadalafil can decrease blood pressure by relaxing blood vessels, which allows for increased blood flow. This is a known effect of phosphodiesterase type 5 (PDE5) inhibitors like tadalafil.

Choice C rationale

Tadalafil should not be taken more than once a day. Taking it twice a day can increase the risk of side effects and is not recommended.

Choice D rationale

The effects of tadalafil can last up to 36 hours, not just 4 hours. This prolonged duration is one of the reasons it is preferred by some patients.


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Question 12:

A nurse is providing teaching to a client who has a duodenal ulcer and is starting to take sucralfate. Which of the following instructions should the nurse include in the teaching?

Explanation

Choice A rationale

Sucralfate should be taken on an empty stomach, not with meals, to ensure it coats the ulcer effectively.

Choice B rationale

There is no need to reduce dietary fiber while taking sucralfate. Fiber intake does not interfere with the medication’s effectiveness.

Choice C rationale

Antacids should not be taken within 30 minutes before or after taking sucralfate, as they can interfere with its action.

Choice D rationale

Increasing fluid intake is recommended while taking sucralfate to help prevent constipation, a common side effect of the medication.


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Question 13:

A nurse is caring for a client who received excessive IV fluids in error. Which of the following actions should the nurse take? (Select all that apply.)

Explanation

Choice A rationale

Contacting the provider is essential to inform them of the error and receive further instructions on managing the client’s condition.

Choice B rationale

Reporting the error to the charge nurse is necessary for proper documentation and to ensure that corrective actions are taken to prevent future errors.

Choice C rationale

Incident reports should not be placed in the client’s chart. They are for internal use to improve safety and quality of care.

Choice D rationale

Auscultating the client’s lungs is important to check for signs of fluid overload, such as crackles or wheezing.

Choice E rationale

Checking for peripheral edema helps assess the extent of fluid overload and its impact on the client’s condition.


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Question 14:

A nurse is caring for a client who has been taking lisinopril for several months. The nurse should plan to check which of the following laboratory values to monitor for adverse effects of the medication?

Explanation

Choice A rationale

Monitoring calcium levels is not typically necessary for patients taking lisinopril, as it does not significantly affect calcium levels.

Choice B rationale

Sodium levels are not commonly affected by lisinopril, so routine monitoring is not required.

Choice C rationale

Lisinopril can cause hyperkalemia (high potassium levels), so monitoring potassium levels is crucial to prevent complications.

Choice D rationale

Magnesium levels are not significantly impacted by lisinopril, so routine monitoring is not necessary.


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Question 15:

A nurse is caring for a client receiving an intermittent IV bolus of gentamicin twice daily. Which of the following laboratory values should the nurse monitor while the client is receiving this medication? (Select all that apply.)

Explanation

Choice A rationale

Monitoring glucose levels is not typically necessary for patients receiving gentamicin, as it does not significantly affect glucose metabolism.

Choice B rationale

Prothrombin time is not commonly affected by gentamicin, so routine monitoring is not required.

Choice C rationale

Serum creatinine levels should be monitored to assess kidney function, as gentamicin can cause nephrotoxicity.

Choice D rationale

Cardiac enzymes are not typically affected by gentamicin, so routine monitoring is not necessary.

Choice E rationale

Monitoring WBC count is important to detect any signs of infection or bone marrow suppression, which can occur with gentamicin use.


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Question 16:

A nurse is providing teaching to a client who has osteoporosis and is starting to take oral ibandronate. Which of the following instructions should the nurse include in the teaching?

Explanation

Choice A rationale

Taking ibandronate immediately after a meal is incorrect because food and beverages can significantly decrease the absorption of ibandronate. It should be taken on an empty stomach at least 60 minutes before any food or drink.

Choice B rationale

Drinking 8 ounces of milk when taking ibandronate is incorrect because calcium in milk can interfere with the absorption of the medication. It should be taken with plain water only.

Choice C rationale

Taking ibandronate before bedtime is incorrect because the patient needs to remain upright for at least 60 minutes after taking the medication to prevent esophageal irritation.

Choice D rationale

Taking one tablet of ibandronate on the same date each month is correct. This ensures consistent dosing and helps maintain the medication’s effectiveness.


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Question 17:

A nurse is reviewing laboratory data for a client who is taking simvastatin to correct plasma lipid levels. Which of the following findings should the nurse identify as an adverse effect of this therapy?

Explanation

Choice A rationale

Elevated alanine aminotransferase (ALT) is an adverse effect of simvastatin therapy. Statins, including simvastatin, can cause liver damage, which is indicated by elevated liver enzymes such as ALT2.

Choice B rationale

Elevated troponin T is not typically associated with simvastatin therapy. Troponin T is a marker for cardiac muscle damage, not a common adverse effect of statins.

Choice C rationale

Elevated WBC count is not a known adverse effect of simvastatin therapy. An elevated WBC count usually indicates an infection or inflammation.

Choice D rationale

Elevated thyroid-stimulating hormone (TSH) is not associated with simvastatin therapy. TSH levels are related to thyroid function, not the effects of statins.


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Question 18:

A nurse is caring for a client who has benign prostate hyperplasia (BPH) and a new prescription for doxazosin IR. Which of the following actions should the nurse plan to take first?

Explanation

Choice A rationale

Limiting caffeine is not the first action the nurse should take. While caffeine can exacerbate symptoms of BPH, it is not the priority action when starting doxazosin IR3.

Choice B rationale

Reporting headaches is important, but it is not the first action the nurse should take. Headaches can be a side effect of doxazosin, but monitoring the patient’s initial response to the medication is more critical.

Choice C rationale

Measuring the client’s intake and output is important for monitoring urinary symptoms, but it is not the first action the nurse should take when starting doxazosin IR3.

Choice D rationale

Administering the medication at bedtime is the correct first action. Doxazosin can cause dizziness and hypotension, especially after the first dose, so taking it at bedtime can help minimize these effects.


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Question 19:

A nurse is caring for a client who has been taking captopril for one year. Which of the following laboratory values should the nurse review? (Select all that apply.)

Explanation

Choice A rationale

Potassium level should be reviewed because captopril can cause hyperkalemia due to its effect on aldosterone secretion.

Choice B rationale

WBC with differential should be reviewed because captopril can cause neutropenia or agranulocytosis, especially in patients with renal impairment or collagen vascular disease.

Choice C rationale

BUN level should be reviewed because captopril can affect renal function, leading to increased BUN levels.

Choice D rationale

Hemoglobin level is not typically affected by captopril, so it is not a priority for review.

Choice E rationale

Glucose level is not typically affected by captopril, so it is not a priority for review.


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Question 20:

A nurse is caring for a client receiving an intermittent IV bolus of gentamicin twice daily. Which of the following laboratory values should the nurse monitor while the client is receiving this medication? (Select all that apply.)

Explanation

Choice A rationale

Glucose levels are not typically monitored for patients receiving gentamicin.

Choice B rationale

Prothrombin time is not typically monitored for patients receiving gentamicin.

Choice C rationale

Serum creatinine should be monitored because gentamicin can cause nephrotoxicity, and elevated serum creatinine levels can indicate kidney damage.

Choice D rationale

Cardiac enzymes are not typically monitored for patients receiving gentamicin.

Choice E rationale

WBC count should be monitored because gentamicin can cause leukopenia or other changes in white blood cell counts.


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Question 21:

A nurse is assessing a client who is receiving gemfibrozil. The nurse should identify which of the following findings as an adverse effect of this medication?

Explanation

Choice A rationale

Dependent edema is not a common adverse effect of gemfibrozil. It is more commonly associated with other conditions such as heart failure.

Choice B rationale

Muscle tenderness is a known adverse effect of gemfibrozil. It can indicate myopathy or rhabdomyolysis, which are serious conditions that require medical attention.

Choice C rationale

Tremors are not a common adverse effect of gemfibrozil. They are more commonly associated with neurological conditions or other medications.

Choice D rationale

Hyperkalemia is not a common adverse effect of gemfibrozil. It is more commonly associated with medications that affect renal function or potassium balance. .


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Question 22:

A nurse is caring for a group of clients. The nurse should monitor which of the following clients for manifestations of hypokalemia? (Select all that apply.)

Explanation

Choice A rationale


Prednisone, a corticosteroid, can cause hypokalemia by increasing renal potassium excretion.


Choice B rationale


Torsemide, a loop diuretic, can lead to hypokalemia by promoting potassium loss through urine.


Choice C rationale


Polystyrene sulfonate is used to treat hyperkalemia, but it can cause hypokalemia as it removes potassium from the body.


Choice D rationale


A client taking spironolactone does not require monitoring for hypokalemia because spironolactone is a potassium-sparing diuretic. It helps the body retain potassium, so it is more likely to cause hyperkalemia (high potassium levels) than hypokalemia.


Choice E rationale


Hydrochlorothiazide, a thiazide diuretic, can cause hypokalemia by increasing potassium excretion in the urine.


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Question 23:

A nurse is caring for a client who refuses a prescribed influenza immunization. Which of the following actions should the nurse take first?

Explanation

Choice A rationale

Asking the client to describe their concerns allows the nurse to understand the client’s perspective and address any misconceptions or fears they may have about the influenza immunization.

Choice B rationale

Contacting the provider is important but should be done after understanding the client’s concerns to provide a comprehensive report.

Choice C rationale

Providing education is essential but should follow understanding the client’s specific concerns to tailor the information effectively.

Choice D rationale

Documenting the refusal is necessary but should be done after addressing the client’s concerns and providing education.


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Question 24:

A nurse is caring for a client who has an infection and is starting to take gentamicin. Which of the following client laboratory tests should the nurse monitor to detect an adverse effect of the medication?

Explanation

Choice A rationale

BNP is used to diagnose heart failure, not to monitor gentamicin’s adverse effects.

Choice B rationale

Creatinine levels should be monitored as gentamicin can cause nephrotoxicity, leading to impaired kidney function.

Choice C rationale

Amylase levels are not relevant for detecting gentamicin’s adverse effects.

Choice D rationale

ESR is used to detect inflammation, not specific to gentamicin’s adverse effects.


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Question 25:

A nurse is caring for a client who is taking a glucocorticoid. Which of the following findings should indicate to the nurse the client is experiencing hypokalemia? (Select all that apply.)

Explanation

Choice A rationale


Muscle weakness is a common symptom of hypokalemia due to decreased potassium levels affecting muscle function.


Choice B rationale


Hyperactive bowel sounds can indicate hypokalemia because potassium is essential for normal gastrointestinal motility. Low potassium levels can lead to increased activity in the intestines, resulting in hyperactive bowel sounds.

Choice C rationale


Tingling of fingers, or paresthesia, can be a symptom of hypokalemia, as low potassium levels may affect nerve conduction. This results in abnormal sensations like tingling or numbness.

Choice D rationale


Peaked T waves are more commonly associated with hyperkalemia rather than hypokalemia. Therefore, this option would not indicate hypokalemia. However, a nurse should be vigilant about monitoring potassium levels as both conditions can lead to significant cardiovascular effects.


Choice E rationale


Fatigue is another symptom of hypokalemia as low potassium levels can impair cellular function and energy production.


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