ATI CAPSTONE PHARMACOLOGY EXAM 2021 VERSION WITH VERIFIED SOLUTIONS AND RATIONALE/A+ GRADE ASSURED

A nurse is providing care to a client with staphylococcus epidermis, who is prescribed vancomycin. Identifythe adverse effect associated with this antibiotic therapy. f) Hepatotoxicity g) Constipation h) Infusion reaction i) Immunosuppression Rationale: Red Man Syndrome or an infusion reaction that results in rashes, flushing, tachycardia and hypotension can occur as an adverse reaction. For this reason, vancomycin should be administered over a 60 minute period. Ototoxicity and renal toxicity are adverse effects of this therapy. A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site? a) 90 degrees angle b) 60 degrees angle c) 75 degrees angle d) 45 degrees angle A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients? a) A client with glaucoma. b) A client with renal failure c) A client with hypertension d) A client with insomnia A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism? a) Osteoporosis. b) Sclerodema c) Asthma d) Peripheral vascular disease Caution should be used to prevent overtreatment with levothyroxine and monitor drug levels. Chronic overtreatment can cause atrial fibrillation and an increased risk of fractures from bone loss, especially in older adults. A nurse is caring for a client prescribed digoxin. Which the following should alert the nurse to possible digitalis toxicity? a) Anorexia and weakness b) Hyperactivity and hunger c) Tachycardia and increased urination d) Polyphagia and polydipsia Before administering blood products, which action should be taken? a) Assess pt's temperature. b) Document pt’s response c) Prime IV tubing with 0.45% sodium chloride d) Administer epinephrine When administering blood products, assess the client's vital signs, obtain consent for the procedure and ensure compatibility. Prime the IV tubing with 0.9% sodium chloride. The nurse would not document client response or administer epinephrine prior to starting the transfusion. A nurse is caring for a client prescribed the HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed? a) Liver function test. b) Renal function test c) Hearing screenings d) Visual acuity screenings Statins (HMG CoA reductase inhibitors) like atorvastatin (Lipitor) can cause hepatotoxicity. Prior to initiating therapy the client's baseline liver function should be determined then liver function tests should be checked after 12 weeks of therapy and then every 6 months. The nurse should advise the client to observe for symptoms of liver dysfunction (anorexia, vomiting, nausea, jaundice) and to notify the provider if these occur. A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication? a) Take the medication on an empty stomach to maximize absorption. b) Notify your provider if your stool becomes dark green. c) Decrease dietary fiber intake while taking this medication. d) Take prescribed antacids at the same time as this medication. Rationale: Take iron 1 hr before meals to maximize absorption. Stomach acid increases absorption. If GI adverse effects occur, the client can take with food to increase adherence to therapy even though absorption is also decreased. The client should anticipate dark green or black colored stools. The client should increase water and fiber intake (unless contraindicated) and to maintain an exercise program to counter the constipation effects of iron therapy. Co-administration of antacids or tetracycline reduces absorption of iron. The client should separate use by at least 2 hrs. A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacological action of this medication? a) To stimulate the pancreas to secrete insulin. b) To slow the absorption of glucose in the intestine. c) To increase reabsorption of water in the renal tubules. d) To increase blood pressure. A nurse is caring for a client newly prescribed doxazosin mesylate. Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication? a) Change positions slowly and lie down if dizziness occurs. b) There is no need to avoid normal activities. c) Avoid dairy products while taking this medication. d) Do not eat green leafy vegetables. Rationale: First-dose orthostatic hypotension can occur with doxazosin. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication? a) Advise the client to take the medication once daily at bedtime. b) This medication is for acute management of asthma. c) Avoid dairy products while taking this medication. d) If the client forgets to take the medication for a few days, he can double up on doses to catch up. Rationale: Leukotriene modifiers are used for long-term therapy of asthma in adults and children, and to prevent exerciseinduced bronchospasm. A 65-year-old client is taking methylprednisolone. What pharmacological action should the nurse expect with this therapy? a) Suppression of beta2 receptors. b) Suppression of airway mucus production. c) Fortification of bones. d) Suppression of candidiasis. Rationale: Corticosteroids, such as methylprednisolone will suppress airway mucus production. This therapy should promote responsiveness of beta2 receptors. An adverse effect of this form of therapy is bone loss, not bone fortification as well as the formation of candidiasis