ATI RN PHARM PRACTICE C EXAM - COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: A client receives benztropine (Cogentin) and tells the
nurse he is going on a cruise. Which statement would be included
in the best plan of the nurse?
A. "Limit your activity while on the cruise."
B. "Be sure to take a hat and sunglasses."
C. "Take a multivitamin for additional energy."
D. "If you forget a few doses, that is all right."
Answer:
B
Rationale: Rationale: Benztropine (Cogentin) can cause photophobia;
the client needs sunglasses. There isn't any need to limit activity. A
multivitamin is not necessary. The dosage schedule should be
maintained.
Question 2: The client receives trihexyphenidyl (Artane) for
Parkinson's disease. Which assessment data will the nurse report
to the physician?
A. Dry mouth
B. Urinary retention
C. Hypertension
D. Anorexia
Answer:
B
Rationale: Rationale: Urinary retention is a serious side effect that must
be reported to the physician. Dry mouth is a common side effect of
trihexyphenidyl (Artane) that does not need reporting. Hypertension is
,not a side effect of trihexyphenidyl (Artane). Anorexia is not a side effect
of trihexyphenidyl (Artane).
Carbidopa / levodopa (Sinemet) is preferred over regular levodopa in
drug treatment of Parkinson disease because it
A. is better absorbed from the GI tract
B. induces fewer CNS adverse effects
C. allows more dopamine to reach the brain
Question 3: A client is taking carbidopa/levodopa (Sinemet). While
assessing the client, which of the following statements made by the
client would require the nurse to intervene?
A. "I just love avocado's! I could eat them everyday."
B. "I tend to watch my meat intake because it just bothers my
stomach."
C. "I eat bran flakes every morning."
D. "I drink at least 8 glasses of water a day."
Answer:
A
Rationale: Rationale: The question is asking the nurse to figure out
which food is not good to eat with carbidopa / levodopa (Sinemet) and
the guidelines are low proteins foods. A is correct because this food is
high in protein. B is incorrect, because although meat is high in protein
and avoiding it would be useful, the exam item is stating the patient
avoids meat. C and D are incorrect because they are irrelevant with
carbidopa / levodopa (Sinemet).
Question 4: The wife of a patient with Parkinson's disease state
"Will my husband have to take this medication forever? -
ANSWER-All patients with Parkinson's disease will require
medication therapy to allow for muscular movement. This is a
chronic condition. Other signs and symptoms such as postural
instability are not as treatable with medications
, A. What is the goal of treatment for Parkinson's Disease?
Answer:
Knowing why we are treating PD is important for patient teaching so
patients know what to expect. The drugs improve ADL's only that is they
help the patient eat, drink, ambulate. The drugs do not prevent muscle
wasting that might occur due to declining activity or stop the tremors that
eventually occur. The drugs also do not treat the depression that may
occur with Parkinson's disease.
Question 5: What is the difference between "wearing off" and "on -
off" syndrome? - ANSWER-Wearing off syndrome occurs when the
patient experiences a recurrence of the signs and symptoms of
Parkinson's Disease. It is caused by low drug levels and thus it
occurs at predictable times - when the drug level is the lowest. The
physician should be notified because the physician may change
the medication dosage.
A. As patient with PD progresses and their condition deteriorates the
medications become less effective, an 'On' / 'Off' syndrome may
develop. The period of time when the medication does not work (the
'OFF' period) becomes longer with a corresponding reduction in the
time when it does work (the 'ON' period). The 'On' period is often
marked by an increased instance of dyskinesia while dystonia can be
experienced during the change from one status to the other. During
the 'Off' period the true Parkinsonian symptoms of tremor, rigidity, and
slow movement are experienced. The severity of the symptoms is
determined by the level to which the condition has progressed. On -
off syndrome occurs at random times because it is not related to drug
levels.
B. The client has epilepsy and receives valproic acid (Depakote). The
client has been seizure-free, and asks the nurse why he still needs
blood tests when he is not having seizures. What is the best response
by the nurse?
C. "Because Depakote can deplete your system of potassium."
, D. "Because Depakote can cause Stevens-Johnson syndrome, which
will show up in the blood tests."
E. "Because Depakote has a very narrow range between a
therapeutic dose and a toxic dose."
F. "Because Depakote can cause blood-thinning in some clients."
Answer:
C
Rationale: Rationale: Depakote has a very narrow range between a
therapeutic dose and a toxic dose; blood levels must be monitored to
ensure a therapeutic level and to prevent toxicity. There isn't any
evidence to support that Depakote causes potassium depletion.
Stevens-Johnson Syndrome is not associated with Depakote. Depakote
is not an anticoagulant, and does not cause thinning of the blood.
Question 6: The physician is initiating a new order for intravenous
phenytoin (Dilantin). The client is also receiving 5% dextrose in
water (D5W) intravenously (IV). The nurse plans which of the
following interventions?
A. Flush the intravenous (IV) line with saline.
B. Monitor the client for hypertension.
C. Administer the dose in the smallest bore IV
D. Monitor the client for Stevens-Johnson Syndrome.
Answer:
A
Rationale: Rationale: A - Intravenous lines of 5% dextrose in water
(D5W) must be flushed with saline, as traces of dextrose can cause
microscopic precipitate formations that become emboli, if infused.
Phenytoin (Dilantin) is a soft-tissue irritant that will cause local tissue
damage if extravasation occurs, so a large vein must be used for
infusion not a small vessel. Clients receiving phenytoin (Dilantin) are at
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: A client receives benztropine (Cogentin) and tells the
nurse he is going on a cruise. Which statement would be included
in the best plan of the nurse?
A. "Limit your activity while on the cruise."
B. "Be sure to take a hat and sunglasses."
C. "Take a multivitamin for additional energy."
D. "If you forget a few doses, that is all right."
Answer:
B
Rationale: Rationale: Benztropine (Cogentin) can cause photophobia;
the client needs sunglasses. There isn't any need to limit activity. A
multivitamin is not necessary. The dosage schedule should be
maintained.
Question 2: The client receives trihexyphenidyl (Artane) for
Parkinson's disease. Which assessment data will the nurse report
to the physician?
A. Dry mouth
B. Urinary retention
C. Hypertension
D. Anorexia
Answer:
B
Rationale: Rationale: Urinary retention is a serious side effect that must
be reported to the physician. Dry mouth is a common side effect of
trihexyphenidyl (Artane) that does not need reporting. Hypertension is
,not a side effect of trihexyphenidyl (Artane). Anorexia is not a side effect
of trihexyphenidyl (Artane).
Carbidopa / levodopa (Sinemet) is preferred over regular levodopa in
drug treatment of Parkinson disease because it
A. is better absorbed from the GI tract
B. induces fewer CNS adverse effects
C. allows more dopamine to reach the brain
Question 3: A client is taking carbidopa/levodopa (Sinemet). While
assessing the client, which of the following statements made by the
client would require the nurse to intervene?
A. "I just love avocado's! I could eat them everyday."
B. "I tend to watch my meat intake because it just bothers my
stomach."
C. "I eat bran flakes every morning."
D. "I drink at least 8 glasses of water a day."
Answer:
A
Rationale: Rationale: The question is asking the nurse to figure out
which food is not good to eat with carbidopa / levodopa (Sinemet) and
the guidelines are low proteins foods. A is correct because this food is
high in protein. B is incorrect, because although meat is high in protein
and avoiding it would be useful, the exam item is stating the patient
avoids meat. C and D are incorrect because they are irrelevant with
carbidopa / levodopa (Sinemet).
Question 4: The wife of a patient with Parkinson's disease state
"Will my husband have to take this medication forever? -
ANSWER-All patients with Parkinson's disease will require
medication therapy to allow for muscular movement. This is a
chronic condition. Other signs and symptoms such as postural
instability are not as treatable with medications
, A. What is the goal of treatment for Parkinson's Disease?
Answer:
Knowing why we are treating PD is important for patient teaching so
patients know what to expect. The drugs improve ADL's only that is they
help the patient eat, drink, ambulate. The drugs do not prevent muscle
wasting that might occur due to declining activity or stop the tremors that
eventually occur. The drugs also do not treat the depression that may
occur with Parkinson's disease.
Question 5: What is the difference between "wearing off" and "on -
off" syndrome? - ANSWER-Wearing off syndrome occurs when the
patient experiences a recurrence of the signs and symptoms of
Parkinson's Disease. It is caused by low drug levels and thus it
occurs at predictable times - when the drug level is the lowest. The
physician should be notified because the physician may change
the medication dosage.
A. As patient with PD progresses and their condition deteriorates the
medications become less effective, an 'On' / 'Off' syndrome may
develop. The period of time when the medication does not work (the
'OFF' period) becomes longer with a corresponding reduction in the
time when it does work (the 'ON' period). The 'On' period is often
marked by an increased instance of dyskinesia while dystonia can be
experienced during the change from one status to the other. During
the 'Off' period the true Parkinsonian symptoms of tremor, rigidity, and
slow movement are experienced. The severity of the symptoms is
determined by the level to which the condition has progressed. On -
off syndrome occurs at random times because it is not related to drug
levels.
B. The client has epilepsy and receives valproic acid (Depakote). The
client has been seizure-free, and asks the nurse why he still needs
blood tests when he is not having seizures. What is the best response
by the nurse?
C. "Because Depakote can deplete your system of potassium."
, D. "Because Depakote can cause Stevens-Johnson syndrome, which
will show up in the blood tests."
E. "Because Depakote has a very narrow range between a
therapeutic dose and a toxic dose."
F. "Because Depakote can cause blood-thinning in some clients."
Answer:
C
Rationale: Rationale: Depakote has a very narrow range between a
therapeutic dose and a toxic dose; blood levels must be monitored to
ensure a therapeutic level and to prevent toxicity. There isn't any
evidence to support that Depakote causes potassium depletion.
Stevens-Johnson Syndrome is not associated with Depakote. Depakote
is not an anticoagulant, and does not cause thinning of the blood.
Question 6: The physician is initiating a new order for intravenous
phenytoin (Dilantin). The client is also receiving 5% dextrose in
water (D5W) intravenously (IV). The nurse plans which of the
following interventions?
A. Flush the intravenous (IV) line with saline.
B. Monitor the client for hypertension.
C. Administer the dose in the smallest bore IV
D. Monitor the client for Stevens-Johnson Syndrome.
Answer:
A
Rationale: Rationale: A - Intravenous lines of 5% dextrose in water
(D5W) must be flushed with saline, as traces of dextrose can cause
microscopic precipitate formations that become emboli, if infused.
Phenytoin (Dilantin) is a soft-tissue irritant that will cause local tissue
damage if extravasation occurs, so a large vein must be used for
infusion not a small vessel. Clients receiving phenytoin (Dilantin) are at
