ATI Pharmacology Practice A
A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of
the following statements by the client indicates an understanding of the teaching?
A. "I should apply a patch every 5 minutes if I develop chest pain."
B. "I will take the patch off right after my evening meal."
C. "I will leave the patch off at least 1 day each week."
D. "I should discard the used patch by flushing it down the toilet." - ANSAnswer: B
B. Clients should remove the patch each evening for a medication free time of 12 to 14 hr
before applying a new patch to avoid developing a tolerance to the medication's effects.
A nurse receives a verbal order from the provider to administer morphine five milligrams every 4
hours subcutaneously for severe pain as needed. The nurse should identify which of the
following entries as the correct format for the medication administration record (MAR)?
A. MSO4 5 mg subcut every 4 hr PRN severe pain
B. Morphine 5 mg subcut every 4 hr PRN severe pain
C. MSO4 5 mg SQ every 4 hr PRN severe pain
D. Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain - ANSAnswer: B
B. The nurse should identify this entry as the correct format for the MAR. The medication name
is spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use"
list included in the transcription.
A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For
which of the following adverse effects should the nurse instruct the client to monitor and report?
A. Tingling of fingers
B. Constipation
C. Weight gain
D. Oliguria - ANSAnswer: A
A. The nurse should instruct the client to report the adverse effect of paresthesia, a tingling
sensation in the extremities, when taking acetazolamide.
A nurse administers a dose of metformin to a client instead of the prescribed dose of
metoclopramide. Which of the following actions should the nurse take first?
A. Report the incident to the charge nurse.
B. Notify the provider.
,C. Check the client's blood glucose.
D. Fill out an incident report. - ANSAnswer: C
C. The first action the nurse should take using the nursing process is to assess the client. The
client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and
provide the client with a snack to reduce the risk for hypoglycemia.
A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium.
The nurse should instruct the client that taking the docusate sodium daily can minimize which of
the following adverse effects of morphine?
A. Constipation
B. Drowsiness
C. Facial flushing
D. Itching - ANSAnswer: A
A. Constipation is a common adverse effect of morphine that can be minimized by taking
docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water
and fat in the intestine.
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's
BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should
withhold the medication and contact the provider for which of the following findings?
A. Diastolic BP
B. Systolic BP
C. Heart rate
D. Respiratory rate - ANSAnswer: C
C. Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the
heart rate. The nurse should withhold the medication and notify the provider for a heart rate of
55/min because this is an early indication of digoxin toxicity.
A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8
hr as prescribed. Which of the following information should the nurse enter as a complete
documentation of the incident?
A. IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider
notified.
B. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified.
C. 1 L of 0.9% sodium chloride completed at 0900. Client denies shortness of breath.
D. IV fluid initiated at 0500. Lungs clear to auscultation. - ANSAnswer: B
, B. The nurse should document the type and amount of fluid, how long it took to infuse, provider
notification, and the client's physical status.
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new
prescription for sucralfate. Which of the following actions of sucralfate should the nurse include
in the teaching?
A. Decreases stomach acid secretion
B. Neutralizes acids in the stomach
C. Forms a protective barrier over ulcers
D. Treats ulcers by eradicating H. pylori - ANSAnswer: C
C. Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the
ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the
ulcer, creating a barrier to hydrochloric acid and pepsin.
A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The
nurse should identify which of the following findings as an indication of hypokalemia?
A. Tall, tented T-waves
B. Presence of U-waves
C. Widened QRS complex
D. ST elevation - ANSAnswer: B
B. The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an
adverse effect of furosemide.
A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse
should report which of the following findings to the provider as an adverse effect of the
medication?
A. Constipation
B. Tinnitus
C. Hypoglycemia
D. Joint pain - ANSAnswer: B
B. Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and
deafness. The nurse should monitor the client for high-pitched ringing in the ears and
headaches and should notify the provider if these occur.
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following
actions should the nurse plan to take?
A. Administer the medication outside the 5-cm (2-in) radius of the umbilicus.
B. Aspirate for blood return before injecting.
A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of
the following statements by the client indicates an understanding of the teaching?
A. "I should apply a patch every 5 minutes if I develop chest pain."
B. "I will take the patch off right after my evening meal."
C. "I will leave the patch off at least 1 day each week."
D. "I should discard the used patch by flushing it down the toilet." - ANSAnswer: B
B. Clients should remove the patch each evening for a medication free time of 12 to 14 hr
before applying a new patch to avoid developing a tolerance to the medication's effects.
A nurse receives a verbal order from the provider to administer morphine five milligrams every 4
hours subcutaneously for severe pain as needed. The nurse should identify which of the
following entries as the correct format for the medication administration record (MAR)?
A. MSO4 5 mg subcut every 4 hr PRN severe pain
B. Morphine 5 mg subcut every 4 hr PRN severe pain
C. MSO4 5 mg SQ every 4 hr PRN severe pain
D. Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain - ANSAnswer: B
B. The nurse should identify this entry as the correct format for the MAR. The medication name
is spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use"
list included in the transcription.
A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For
which of the following adverse effects should the nurse instruct the client to monitor and report?
A. Tingling of fingers
B. Constipation
C. Weight gain
D. Oliguria - ANSAnswer: A
A. The nurse should instruct the client to report the adverse effect of paresthesia, a tingling
sensation in the extremities, when taking acetazolamide.
A nurse administers a dose of metformin to a client instead of the prescribed dose of
metoclopramide. Which of the following actions should the nurse take first?
A. Report the incident to the charge nurse.
B. Notify the provider.
,C. Check the client's blood glucose.
D. Fill out an incident report. - ANSAnswer: C
C. The first action the nurse should take using the nursing process is to assess the client. The
client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and
provide the client with a snack to reduce the risk for hypoglycemia.
A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium.
The nurse should instruct the client that taking the docusate sodium daily can minimize which of
the following adverse effects of morphine?
A. Constipation
B. Drowsiness
C. Facial flushing
D. Itching - ANSAnswer: A
A. Constipation is a common adverse effect of morphine that can be minimized by taking
docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water
and fat in the intestine.
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's
BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should
withhold the medication and contact the provider for which of the following findings?
A. Diastolic BP
B. Systolic BP
C. Heart rate
D. Respiratory rate - ANSAnswer: C
C. Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the
heart rate. The nurse should withhold the medication and notify the provider for a heart rate of
55/min because this is an early indication of digoxin toxicity.
A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8
hr as prescribed. Which of the following information should the nurse enter as a complete
documentation of the incident?
A. IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider
notified.
B. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified.
C. 1 L of 0.9% sodium chloride completed at 0900. Client denies shortness of breath.
D. IV fluid initiated at 0500. Lungs clear to auscultation. - ANSAnswer: B
, B. The nurse should document the type and amount of fluid, how long it took to infuse, provider
notification, and the client's physical status.
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new
prescription for sucralfate. Which of the following actions of sucralfate should the nurse include
in the teaching?
A. Decreases stomach acid secretion
B. Neutralizes acids in the stomach
C. Forms a protective barrier over ulcers
D. Treats ulcers by eradicating H. pylori - ANSAnswer: C
C. Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the
ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the
ulcer, creating a barrier to hydrochloric acid and pepsin.
A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The
nurse should identify which of the following findings as an indication of hypokalemia?
A. Tall, tented T-waves
B. Presence of U-waves
C. Widened QRS complex
D. ST elevation - ANSAnswer: B
B. The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an
adverse effect of furosemide.
A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse
should report which of the following findings to the provider as an adverse effect of the
medication?
A. Constipation
B. Tinnitus
C. Hypoglycemia
D. Joint pain - ANSAnswer: B
B. Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and
deafness. The nurse should monitor the client for high-pitched ringing in the ears and
headaches and should notify the provider if these occur.
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following
actions should the nurse plan to take?
A. Administer the medication outside the 5-cm (2-in) radius of the umbilicus.
B. Aspirate for blood return before injecting.
