RN ATI PHARMACOLOGY PROCTORED EXAM (245+
PRACTICE QUESTIONS AND SOLUTIONS) 2024 A+
GRADED
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium
level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the
client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D
3. Calcitonin (Miacalcin) Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia.
Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be
avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice
4. Orange juice Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to
administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect
absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of
vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the
client, knowing that which of the following would indicate the presence of systemic toxicity
from this medication? 1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
1. Tinnitus Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and
diarrhea are not associated with salicylism.
,4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen.
The nurse reminds the children that chemical sunscreens are most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun
4. At least 30 minutes before exposure to the sun Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that
they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the
medication, the client complains of local discomfort and burning. Which of the following is the most
appropriate nursing action? 1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site
3. Informing the client that this is normal Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to
treat burns to reduce bacteria present in avascular tissues. The client should be informed that the
medication will cause local discomfort and burning and that this is a normal reaction; therefore
options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site
of injury. The nurse monitors the client, knowing that which of the following indicates that a
systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site
1.Hyperventilation Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby
causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base
imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be
expected from the pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this
medication, the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count
2. Triglyceride level Rationale:
,Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated.
Options 1, 3, and 4 do not need to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the
client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
1. Vitamin A Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be
discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of
isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor
for the potential for increased systemic absorption of the medication if the medication were being
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands
2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from
regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia),
and lower from regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the
client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would
suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex
1. Acne Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by
suppressing the growth of Propionibacterium acnes and decreasing the proliferation of
keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
partialthickness burn, which has cultured positive for gram-negative bacteria. The nurse is
reinforcing information to the client about the medication. Which statement made by the client
indicates a lack of understanding about the treatments? 1. "The medication is an antibacterial."
, 2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound."
3. "The medication will permanently stain my skin." Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against
gramnegative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist
in healing. It does not stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic
medication. During the infusion, the client complains of pain at the insertion site. During an
inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the
medication has slowed. The nurse should take which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion.
1. Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care
must be taken to prevent the medication from escaping into the tissues surrounding the injection
site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of
extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If
extravasation occurs, the registered nurse needs to be notified; he or she will then contact the
health care provider.
13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The
nurse caring for the client anticipates that which diagnostic study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies
4. Pulmonary function studies Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial
pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with
hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor
lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to
be discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the
specific use of this medication.
14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which
laboratory value would the nurse specifically monitor during treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level
PRACTICE QUESTIONS AND SOLUTIONS) 2024 A+
GRADED
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium
level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the
client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D
3. Calcitonin (Miacalcin) Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia.
Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be
avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice
4. Orange juice Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to
administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect
absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of
vitamin C than apple juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the
client, knowing that which of the following would indicate the presence of systemic toxicity
from this medication? 1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
1. Tinnitus Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and
diarrhea are not associated with salicylism.
,4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen.
The nurse reminds the children that chemical sunscreens are most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun
4. At least 30 minutes before exposure to the sun Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that
they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the
medication, the client complains of local discomfort and burning. Which of the following is the most
appropriate nursing action? 1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site
3. Informing the client that this is normal Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to
treat burns to reduce bacteria present in avascular tissues. The client should be informed that the
medication will cause local discomfort and burning and that this is a normal reaction; therefore
options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site
of injury. The nurse monitors the client, knowing that which of the following indicates that a
systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site
1.Hyperventilation Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby
causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base
imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be
expected from the pain that occurs with a burn injury.
7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this
medication, the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count
2. Triglyceride level Rationale:
,Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated.
Options 1, 3, and 4 do not need to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the
client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
1. Vitamin A Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be
discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of
isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor
for the potential for increased systemic absorption of the medication if the medication were being
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands
2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from
regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia),
and lower from regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the
client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would
suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex
1. Acne Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by
suppressing the growth of Propionibacterium acnes and decreasing the proliferation of
keratinocytes. Options 2, 3, and 4 are incorrect.
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
partialthickness burn, which has cultured positive for gram-negative bacteria. The nurse is
reinforcing information to the client about the medication. Which statement made by the client
indicates a lack of understanding about the treatments? 1. "The medication is an antibacterial."
, 2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound."
3. "The medication will permanently stain my skin." Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against
gramnegative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist
in healing. It does not stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic
medication. During the infusion, the client complains of pain at the insertion site. During an
inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the
medication has slowed. The nurse should take which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion.
1. Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care
must be taken to prevent the medication from escaping into the tissues surrounding the injection
site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of
extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If
extravasation occurs, the registered nurse needs to be notified; he or she will then contact the
health care provider.
13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The
nurse caring for the client anticipates that which diagnostic study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies
4. Pulmonary function studies Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial
pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with
hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor
lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to
be discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the
specific use of this medication.
14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which
laboratory value would the nurse specifically monitor during treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level
