RN ATI PHARMACOLOGY PROCTORED EXAM

lOMoAR cPSD|19500986 lOMoAR cPSD|19500986 RN ATI PHARMACOLOGY PROCTORED EXAM 2020 1. A nurse is caring for a client who is taking phenytoin . For which of the following adverse effects should the nurse monitor and report to the provider? a. Cognitive impairment i. Phenytoin: Anticonvulsant, Antiarrhythmic. Adverse effects: suicidal thoughts, ataxia, agitation, confusion, dizziness, drowsiness, dysarthria. (davis drug guide). b. Tachycardia c. Elevated Blood Pressure d. Tinnitus 2. A nurse is teaching a client who has a history of acute myocardial infarction about taking metoprolol to treat angina. Which of the following instructions should the nurse include? a. “Stop taking the medication if you become dizzy.” i. Advise pt. To sit or lie down if experiencing dizziness or faintness b. “Check your pulse rate daily.” i. Adverse effects is bradycardia. Monitor patient’s pulse. If below 60/min, hold medication and notify provider. Pg.263 ati 6.0 c. “Expect to see an increase in your urinary output.” d. “Call your provider if you lose more than 1 lb per week.” 3. A nurse is caring for a client who develops an anaphylactic reaction to IV antibiotic administration. After assessing the client’s respiratory status and stopping the medication infusion, which of the following actions should the nurse take next? a. Elevate the client’s legs and feet b. Administer epinephrine IM i. Anaphylactic reaction: Treat with epinephrine, bronchodilators, and antihistamines. Provide respiratory support, and inform the provider. Pg.36 (ati 7.0) c. Replace the infusion with 0.9% sodium chloride d. Give diphenhydramine IM lOMoAR cPSD|19500986 4. A nurse is assessing a client who is receiving oxytocin via continuous IV infusion for labor augmentation. The nurse notes six contractions in a 10 -min period with a nonreassuring FHR. Which of the following actions should the nurse take first? a. Administer terbutaline 0.25mg subq b. Discontinue the oxytocin IV infusion c. Turn the client to her left side d. Apply O2 at 10L/min via face mask 5. A nurse is preparing to administer lactated ringer’s solution at 100ml/hr. The drop factor of the manual IV tubing is 15gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the neare st whole number. Use a leading zero if it applies. Do not use a trailing zero.) a. (100 mL/hr)(15 gtt/mL) = 1500 gtt/hr /60min= 25 gtt/min 6. A client who has active tuberculosis and is taking rifampin reports that his urine and sweat have developed a red-orange tinge. Which of the following actions should the nurse take? a. Prepare the client for dialysis b. Instruct the client to increase his fluid intake c. Check the client’s liver function test results i. For hepatotoxicity (jaundice, anorexia, and fatigue), monitor liver function. Pg. 376 (ati 7.0). d. Document this as an expected finding i. Discoloration of body fluids: inform patients of expected orange color of urine, saliva, sweat, and tears. Pg.376 (ati 7.0) 7. A nurse is teaching a client about self-administration of enoxaparin (Lovenox) . Which of the following instructions should the nurse include? SATA a. “Grasp the skin between the thumb and forefinger while injecting the medication.” i. Pinch up an area of skin, inject at a 90 degree angle. Pg. 193 (ati 7.0) ii. Medications Affecting Coagulation: Self-Administration of Enoxaparin (Active Learning Template - Medication, RM Pharm RN 7.0 Chp 25) b. “Alternate injection sites between the sides of the abdomen.” i. Rotate sites b/w right and left anterolateral and posterolateral abdominal walls at least 2 inches from umbilicus. Pg. 193 lOMoAR cPSD|19500986 c. “Expel the air bubble from the prefilled syringe.” i. DO NOT expel the air bubble in the syringe unless adjustments must be made to the dose. Pg. 193 d. “Massage the insertion site after injecting the medication.” i. DO NOT rub the site 1 to 2 min after injection. Pg. 193 (ati 7.0) e. “Insert the entire length of the needle into the skin during injection.” i. Insert needle completely pg. 193 (ati 7.0) 8. A nurse is caring for a client who is receiving warfarin to treat atrial fibrillation. Which of the following laboratory values should the nurse identify as outside the expected reference range for this client? a. aPTT 36 seconds b. Hgb 15.2 g/dL i. Normal: 12-18 c. Hct 43% i. 36-54% d. INR 4.5 i. INR of 2-3 for treatment of acute myocardial infarction, atrial fibrillation, pulmonary embolism, venous thrombosis, or tissue heart valves. Pg. 194 (ati 7.0) 9. A nurse is caring for a client who is receiving ondansetron IV. Which of the following findings is an indication that the ondansetron is effective ? a. Increased urinary output b. Decreased nausea i. Ondansetron is an antiemetic. Administer antiemetic such as ondansetron for GI discomfort (nausea and vomiting). Pg. 334 (ati 7.0). ii. Serotonin antagonist: prevents emesis pg. 221 (ati 7.0) c. Absence of peripheral neuropathy d. Reduced dizziness i. Complication dizziness, diarrhea, headache. Pg. 222 (ati 7.0)