ATI Pharmacology Practice Test A Questions and Answers 2023

ATI Pharmacology Practice Test A Questions and Answers 2023 A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 300 mg/dose Follow these steps for the Dimensional Analysis method of calculation: Step 1: What is the unit of measurement the nurse should calculate? (Place the unit of measure being calculated on the left side of the equation.) Step 2: Determine the ratio that contains the same unit as the unit being calculated. (Place the ratio on the right side of the equation, ensuring that the unit in the numerator matches the unit being calculated.) 15 mgX mg/dose = 1 kg Step 3: Place any remaining ratios that are relevant to the item on the right side of the equation, along with any needed conversion factors, to cancel out unwanted units of measurement. 15 mg1 kg44 lb12 hrX mg/dose = × × × x2.2 lb12 hr1 dose Step 4: Solve for X. X mg/dose = 300 mg/dose Step 5: Round if necessary. Step 6: Determine whether the amount to administer makes sense. If the prescription reads 15 mg/kg every 12 hr and the child weighs 20 kg, it makes sense to give 300 mg/dose every 12 hr. A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.) a. Report muscle pain to the provider. b. Avoid taking the medication with grapefruit juice. c. Take the medication in the early morning. d. Expect a flushing of the skin as a reaction to the medication. e. Expect therapy with this medication to be lifelong. a. b. e. Report muscle pain to the provider is correct. Myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis. The nurse should instruct the client to report this to the provider. Avoid taking the medication with grapefruit juice is correct. When taken with grapefruit juice, simvastatin increases the risk of muscle injury from elevations in creatine kinase. Expect therapy with this medication to be lifelong is correct. If medication therapy is discontinued, cholesterol levels will return to their pretreatment range within several weeks to months. Take the medication in the early morning is incorrect. This medication is most effective when taken in the evening because cholesterol production generally increases overnight. Expect a flushing of the skin as a reaction to the medication is incorrect. The nurse should identify flushing of the skin as an adverse effect of the medication niacin, which can be used to decrease the client's triglyceride levels. A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? a. Decrease in WBC count b. Decrease in amount of time sleeping c. Increase in appetite d. Increase in ability to focus Increase in ability to focus: client who has Graves' disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medication has been effective. Propylthiouracil is a thyroid hormone antagonist used in the treatment of hyperthyroidism, or thyroid storms. A decreased WBC count is an adverse effect of propylthiouracil, which can cause myelosuppression. Therefore, a decrease in WBC count indicates the medication has not been effective. Graves' disease, a form of hyperthyroidism, has neurologic manifestations, including insomnia. Therefore, a decrease in the amount of time sleeping indicates the medication has not been effective. Graves' disease can result in gastrointestinal manifestations such as increased appetite, weight loss, and increased gastrointestinal motility. Therefore, an increase in appetite indicates the medication has not been effective. 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. c. Rub vigorously after the injection to promote absorption. d. Place a pressure dressing on the injection site to prevent bleeding. Administer the medication outside the 5-cm (2-in) radius of the umbilicus: The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away from the umbilicus. The nurse should not aspirate by pulling back on the plunger of the heparin syringe to check for a blood return, because this will cause the injection site to bruise. The nurse should apply firm pressure to the injection site for 1 to 2 min after the administration of the heparin to prevent bruising. The nurse does not need to apply a dressing over the injection site if pressure is held for at least 1 min to prevent bleeding. A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? a. Tingling toes b. Sexual dysfunction c. Absence of dreams d. Pica Sexual dysfunction: Sexual dysfunction, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of clients who take this SSRI antidepressant. Fluoxetine is an SSRI that can cause muscle twitching. However, distorted sensations in the extremities are not adverse effects of fluoxetine. Fluoxetine can cause CNS adverse effects including abnormal dreaming, sedation, delusions, hallucinations, and psychosis. However, an absence of dreams is not associated with fluoxetine. Fluoxetine can cause neurologic adverse effects such as agitation, euphoria, and sedation. However, an eating disorder such as pica is not associated with fluoxetine. A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? a. "I will drink a glass of milk when I take the risedronate." b. "I will take the risedronate 15 minutes after my evening meal." c. "I should take an antacid with the risedronate to avoid nausea." d. "I should sit up for 30 minutes after taking the risedronate." "I should sit up for 30 minutes after taking the risedronate.": Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time. The nurse should reinforce that risedronate should be taken with a full glass of water, rather than any other liquid. Although the delayed release form of the medication can be taken after eating, the immediate release form of the medication should be taken at least 30 min prior to consuming food or other liquids. Both forms of medication should be taken in the morning. The absorption of risedronate, a bisphosphonate, will be reduced if it is taken with antacids containing calcium, aluminum, or magnesium. The nurse should instruct the client to take the antacid 2 hr after taking risedronate. A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include? a. "Take the medication on an empty stomach for full effectiveness." b. "You may discontinue this medication when stomach discomfort subsides." c. "Report yellowing of the skin." d. "Store the medication in the refrigerator." "Report yellowing of the skin.": Ranitidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider. The client can take ranitidine with or without food because food does not affect the medication's effectiveness. For clients who have a gastric ulcer, ranitidine is prescribed to inhibit gastric secretion and must be taken for the full course of therapy to be effective. The client should store ranitidine at room temperature. A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? a. "I should take the medication with food." b. "I should take naproxen if I develop joint pain." c. "I should tell my provider if I develop a sore throat." d. "I should expect the medication to cause my urine to look orange." "I should tell my provider if I develop a sore throat.": The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is identified early and the medication is promptly discontinued. The client should take captopril on an empty stomach because food reduces absorption of the medication. The nurse should instruct the client to take the medication 1 hr before or 2 hr after a meal. Naproxen and other NSAIDs can interact with captopril, which can decrease the effect of the antihypertensive and increase the risk of kidney dysfunction. Captopril affects the urinary system by causing dysuria, urinary frequency, and changes in the normal amount of urine. However, captopril does not affect the color of the urine. A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first? a. Obtain the client's blood pressure. b. Contact the client's provider. c. Inform the charge nurse. d. Complete an incident report. Obtain the client's blood pressure: When using the nursing process, the first action the nurse should take to prevent injury to the client is to assess the client for adverse effects of atenolol, such as hypotension. The nurse should contact the provider, who can provide direction to the nurse to prevent injury to the client. However, there is another action the nurse should take first. The nurse should alert the charge nurse about the medication error. However, there is another action the nurse should take first. The nurse should complete an incident report, which is used as part of a facility's quality assurance program. However, there is another action the nurse should take first. A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? a. Muscle weakness b. Sedation c. Tinnitus d. Peripheral edema Sedation: Metoclopramide has multiple CNS adverse effects, including dizziness, fatigue, and sedation. Metoclopramide is a central dopamine receptor antagonist that increases gastrointestinal motility and prevents nausea. Tardive dyskinesia is an adverse effect of metoclopramide. However, metoclopramide does not cause muscle weakness. Metoclopramide does not cause ringing in the ears. Metoclopramide does not cause peripheral edema. A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report? a. 1000 b. 0900 c. 0830 d. 1200 0830: The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report. A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)? a. Temperature of 39.7° C (103.5° F) b. Urinary retention c. Heart rate 56/min d. Muscle flaccidity Temperature of 39.7° C (103.5° F): The nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency. Other manifestations can include respiratory distress, diaphoresis, and either hyper- or hypotension. The nurse should report incontinence as a manifestation of NMS. The nurse should report tachycardia as a manifestation of NMS. The nurse should report severe muscle rigidity as a manifestation of NMS. A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider? a. Vomiting b. Blood in the urine c. Positive Chvostek's sign d. Ringing in the ears Blood in the urine: The nurse should report blood in the urine to the provider because this can be a manifestation of heparin toxicity. Other manifestations can include bruising, hematomas, hypotension, and tachycardia. Vomiting is not an expected adverse effect of heparin therapy. The nurse should assess the client for other causes for vomiting. Chvostek's sign is seen in clients who have hypocalcemia or hypomagnesemia. Ringing in the ears is not an expected adverse effect of heparin therapy. Aminoglycosides, such as vancomycin, are medications that cause ringing in the ears. 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 Constipation: 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. Drowsiness, facial flushing, and ithching are not adverse effects of morphine that can be minimized by taking docusate sodium. A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? a. "Take beclomethasone to avoid an acute attack." b. "Use beclomethasone 5 minutes before using albuterol." c. "Limit your calcium and vitamin D intake when taking beclomethasone." d. "Rinse your mouth after inhaling the beclomethasone." "Rinse your mouth after inhaling the beclomethasone.": The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness. The client should take albuterol, a short-acting beta2-adrenergic agonist, to avoid an acute asthma attack. The client should use the bronchodilator, albuterol, prior to taking beclomethasone, a glucocorticoid inhaler, to enhance its absorption. The client should increase the intake of calcium and vitamin D to minimize bone loss while taking beclomethasone, a glucocorticoid inhaler. 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. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified.: The nurse should document the type and amount of fluid, how long it took to infuse, provider notification, and the client's physical status. The nurse should only chart factual information in the client's medical record without indicating the error that occurred. This documentation is not complete because it does not include the amount of fluid that was infused over the amount of time. A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make? a. "It is safe to take an enteric-coated aspirin." b. "Aspirin will increase the risk of bleeding." c. "Acetaminophen may be substituted for aspirin." d. "The INR lab work must be monitored more frequently if aspirin is taken." "Aspirin will increase the risk of bleeding.": Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases the risk for bleeding. Although it is common for clients to consider an occasional aspirin harmless, salicylates inhibit platelet aggregation and increase the potential for hemorrhage. Therefore, the client should avoid taking enteric-coated aspirin. Acetaminophen, an analgesic, can potentiate the action of the anticoagulant warfarin when administered in high doses and is not a safe substitute for aspirin. The client should continue to follow the provider's prescription for monitoring the PT and INR levels to adjust warfarin dosages. However, the nurse should discourage the client from using aspirin products because these medications increase the antiplatelet action of the warfarin and can result in bleeding. A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching? a. The medication should be taken 1 hr prior to eating. b. It takes 48 hr for therapeutic effects to occur. c. Tablets should not be crushed or chewed. d. Decreased respirations might occur. Decreased respirations might occur.: The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression. The client should take hydrocodone and acetaminophen with food or milk to decrease gastric irritation. The nurse should instruct the client that they should experience the effects of hydrocodone with acetaminophen within 20 min of administration and that pain relief should last for 4 to 6 hr. The client should avoid crushing, chewing, or breaking the extended release or immediate release hydrocodone tablets to prevent an immediate increase in CNS effects. Hydrocodone with acetaminophen tablets can be crushed if needed. A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? a. Potassium iodide b. Glucagon c. Atropine d. Protamine Atropine: A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity. Potassium iodide is a thyroid hormone antagonist used in the treatment of radioactive iodine exposure. Glucagon is an antihypoglycemic medication used in the treatment of low blood glucose levels. Protamine is a heparin antagonist that is administered to reverse heparin toxicity evidenced by an aPTT greater than 70 seconds. A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate? a. Felodipine b. Guaifenesin c. Digoxin d. Regular insulin Digoxin: The nurse should identify that calcium gluconate can cause hypercalcemia, which increases the risk of digoxin toxicity. A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? Increased neutrophil count Increased RBC count Decreased prothrombin time Decreased triglycerides Filgrastim: Filgrastim stimulates the bone marrow to produce neutrophils. For clients receiving chemotherapy, the risk of infection is minimized. 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 Presence of U-waves: The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide. The nurse should identify a widened QRS complex as a manifestation of hyperkalemia. The nurse should identify tall, tented T-waves as a manifestation of hyperkalemia. Flattened or inverted T-waves are a manifestation of hypokalemia. The nurse should identify ST elevation is an indication of ischemia. ST depression is a manifestation of hypokalemia. A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications? a. Aspirin b. Ibuprofen c. Ranitidine d. Bisacodyl Ibuprofen: Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently. Although most NSAIDs interact with lithium to increase lithium levels, aspirin does not interact with lithium. A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications? a. Vitamin K b. Acetylcysteine c. Benztropine d. Physostigmine Acetylcysteine: Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr. A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching? a. The client's provider is required to complete medication reconciliation. b. Medication reconciliation at discharge is limited to the medication ordered at the time of discharge. c. A transition in care requires the nurse to conduct medication reconciliation. d. Medical reconciliation is limited to the name of the medications that the client is currently taking. A transition in care requires the nurse to conduct medication reconciliation: The nurse should conduct medication reconciliation anytime the client is undergoing a change in care such as admission, transfer from one unit to another, or discharge. A complete listing of all prescribed and over-the-counter medications should be reviewed.