ATI PHARM PROCTORED EXAM 2019

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 scientifically proven, however. The nurse should teach the client to check with the provider about interactions between saw palmetto and other medications. 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 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 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) 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. Constipation - c. Bleeding A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as contraindication to ceftriaxone? a. Gentamicin b. Clindamycin c. Piperacillin d. Sulfamethoxazole-trimethroprim - c. Piperacillin A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? a. Hyperthyroidism b. Intestinal obstruction c. Glaucoma d. Low blood pressure - b. Intestinal obstruction A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? a. Amantadine b. Bupropion (aytpical antidepressant) c. Phenelzine (MAOI) d. Hydroxyzine (Antihistamine) - a. Amantadine 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 effects? a. Hypotension b. Hyperthermia c. Hypoglycemia d. Tachycardia - d. Tachycardia 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. 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 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 A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50mg po daily to treat hypertension. Which of the following 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. A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? a. Oxytocin b. Nifedipine c. Dinoprostone d. Misoprostol - b. Nifedipine A nurse is providing teaching to a client who has cirrhosis and new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? a. Increases blood pressure b. Prevents esophageal bleeding c. Decreases heart rate d. Reduce ammonia levels - d. Reduce ammonia levels A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication? a. Hearing examination b. Glucose tolerance test c. Electrocardiogram d. Pulmonary function test - c. Electrocardiogram 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 medications for which of the following adverse effects? a. Nausea b. Metallic taste c. Fever d. Drowsiness - c. Fever 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 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 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 A nurse is reviewing the lab values for a client who is receiving a continuous 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 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 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? a. Antiestrogenic b. Antimicrobial c. Androgenic d. Anti-inflammatory - a. Antiestrogenic A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects? a. Hyperkalemia b. Hypertension c. Constipation d. Nephrotoxicity - d. Nephrotoxicity A nurse is administering subQ heparin to a client who is at risk for DVT. Which of the following should the nurse take? a. Administer the medication into the client's abdomen b. Inject the medication into a muscle c. Massage the site after administering the medication d. Use a 22 gauge needle to administer the medication - a. Administer the medication into the client's abdomen A nurse is reviewing the lab results for a client who has prescription for filgastrim. The nurse should 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 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 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) 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 candidiasis is a manifestation of which of the following adverse effects? a. Allergic response b. Superinfection c. Renal toxicity d. Hepatotoxicity - b. Superinfection 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 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? a. Administer the medication to the client's before breakfast in the morning. b. Ambulate the client to a chair prior to administering the medication. c. Give the medication to the client with water rather than milk. d. Teach the client how to take the medication at home. - b. Ambulate the client to a chair prior to administering the medication. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary TB. The client reports his urine is an orange color. Which of the following statements should the nurse make? a. Stop taking isoniazid for 3 days and the discoloration should go away. b. Rifampin can turn body fluids orange. c. I'll make an appointment for you to see the provider this afternoon. d. Isoniazid can cause bladder distention. - b. Rifampin can turn body fluids orange. A nurse is caring for a client who had a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? a. Ecchymosis b. Jaundice c. Hypotension d. Hypokalemia - c. Hypotension 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. 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. A nurse is providing teaching to a newly licensed nurse about administering 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 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. A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching? A. I will administer a spray into each nostril daily B. I should expect nasal bleeding for the first week C. I will need to depress the side arms to activate the pump D. I should expect to take this medication for a short-term course of treatment - C. I will need to depress the side arms to activate the pump The nurse should instruct the client to activate the pump on the initial use by holding the bottle upright and depressing the two white side arms toward the bottle six times. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports that she has been taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated? A. urine specific gravity 1.035 B. distended neck veins C. BUN 18 mg/dL D. bounding radial pulse - A. urine specific gravity 1.035 Oliguria, increased urine concentration, and an increase in urine specific gravity greater than 1.030 are expected findings in clients who are dehydrated. A nurse is preparing to administer heparin 900 units/hr. via IV infusion. The amount available is heparin 25, 000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number) - 18 mL/hr 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 A nurse is providing teaching to a client who is to start taking Hydrochlorothiazide 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 potassiumrich foods to avoid the occurrence of hypokalemia. Foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins, and milk. 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. 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 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. A nurse is caring for a client who is in preterm labor and has a new prescription for Nifedipine. The client states she is concerned because her father takes Nifedipine for his angina pectoris. The nurse should explain to the client that Nifedipine works for clients who are pregnant by which of the following mechanisms? A. it decreases the incidence of bacterial vaginosis, thus preventing uterine contractions B. it inhibits uterine contraction by blocking entry of calcium into uterine cells C. it decreases the activity within the CNS, which regulates all smooth muscles D. it stimulates beta2 receptors in the uterus, which results in decreased frequency of contractions - B. it inhibits uterine contractions by blocking entry calcium into uterine cells Nifedipine, a calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to the myometrial cells of the uterus.