ATI RN Pharmacology 2019 A
A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which
of the following statements by the client indicates an understanding of the teaching?
a. "I should apply a patch every 5 mins if I develop chest pain."
b. "I will take the patch off right after my evening meal."
c. "I will leave the patch off at least 1 day each week."
d. "I should discard the used patch by flushing it down the toilet." - ANSb. "I will take the
patch off right after my evening meal."
-clients should remove the patch each evening for a medication free time of 12-14 hr before
applying a new patch to avoid developing a tolerance to the medication's effects
-nitroglycerin sublingual tablets are used to treat new onset of angina pain. A client who uses
sublingual tablets should place one tablet under their tongue at the onset of angina pain and
continue taking a table every 5 min for a total of three doses of nitroglycerin. The effects of a
nitroglycerin patch will take 30-60 min to occur and are not useful to prevent an ongoing
angina attack
-nitroglycerin is an antianginal medication that results in dilation of the coronary vessels.
Clients should apply the patch daily to sustain prophylaxis
-medication remains in the transdermal patch after removing it from the body and must be
discarded safely. The nurse should instruct the client to fold the patch ends together with the
medication on the inside and place the discarded patch in a closed container so that children
and pets cannot gain access to the medication
A nurse receives a verbal order from the provider to administer morphine five milligrams
every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of
the following entries as the correct format for the medication administration record (MAR)?
a. MSO4 5 mg subcut every 4 hr PRN severe pain
b. Morphine 5 mg subcut every 4 hr PRN severe pain
c. MSO4 5 mg SQ every 4 hr PRN severe pain
d. Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain - ANSb. Morphine 5 mg
subcut every 4 hr PRN severe pain
-the medication name is spelled out and there are not any abbreviations from The Joint
Commission's "Do Not Use" list included in the transcript
-the use of the abbreviation MSO4 is prohibited by The Joint Commission. The medication
name morphine must be spelled out to reduce the risk for error
-SQ is prohibited by The Joint Commission; this route should be written as subcut, subq, or
subcutaneously
-the trailing zero on 5.0 can be mistaken for 50 if the decimal point is missed
A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma.
For which of the following adverse effects should the nurse instruct the client to monitor and
report?
a. tingling of fingers
b. constipation
c. weight gain
,d. oliguria - ANSa. tingling of fingers
-the nurse should instruct the client to report the adverse effect of paresthesia, a tingling
sensation in the extremities, when taking acetazolamide
-diarrhea is an adverse effect of acetazolamide due to gastrointestinal disturbances
-weight loss is an adverse effect of acetazolamide due to GI disturbances causing reduced
appetite
-polyuria is an adverse effect of acetazolamide
A nurse administers a dose of metformin to a client instead of the prescribed dose of
metoclopramide. Which of the following actions should the nurse take first?
a. report the incident to the charge nurse
b. notify the provider
c. check the client's blood glucose
d. fill our an incident report - ANSc. check the client's blood glucose
-the first action the nurse should take using the nursing process is to assess the client. The
client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and
provide the client with a snack to reduce the risk of hypoglycemia
-the rest of these answers are also correct, but there is another action the nurse should take
first
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 - ANSa. 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 intestines
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The
client's BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse
should withhold the medication and contact the provider for which of the following findings?
a. diastolic BP
b. systolic BP
c. heart rate
d. respiratory rate - ANSc. heart rate
-digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the
heart rate. The nurse should withhold the medication and notify the provider for a heart rate
of 55/min because this is an early indication of digoxin toxicity
-digoxin increased cardiac output and reduces the heart rate, a diastolic BP of 86, systolic
BP of 140, and respiratory rate of 20/min is not cause for holding the medication and
contacting the provider
-
, A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead 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 - ANSb. 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
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new
prescription for sucralfate. Which of the following actions of sucralfate should the nurse
include in the teaching?
a. decreases stomach acid secretion
b. neutralizes acids in the stomach
c. forms a protective barrier over ulcers
d. treats ulcers by eradicating H. pylori - ANSc. forms a protective barrier over ulcers
-secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate
the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats
the ulcer, creating a barrier to hydrochloric acid and pepsin
-peptic ulcer disease manifests as an erosion of the gastric or duodenal mucosa. The acid
production in the stomach causes further irritation and pain. H2 receptor antagonists, such
as famotidine, decrease stomach acid secretion
-acid production in the stomach causes further irritation and pain to a client who has a peptic
ulcer. Antacids, such as aluminum hydroxide, neutralize acids in the stomach and prevent
pepsin formation, a digestive enzyme the can further damage the eroded epithelium
-a common cause of peptic ulcers is a bacterial infection with Helicobacter pylori. Treatment
of the ulcer includes a combination of antibiotics, such as metronidazole, tetracycline,
clarithromycin, or amoxicillin, to eradicate the H. pylori infection
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 - ANSb. 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 tall, tented T-waves as a manifestation of hyperkalemia. Flattened
or inverted T-waves are a manifestation of hypokalemia
-the nurse should identify a widened QRS complex as a manifestation of hyperkalemia
-the nurse should identify ST elevation as an indication of ischemia. ST depression is a
manifestation of hypokalemia
A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which
of the following statements by the client indicates an understanding of the teaching?
a. "I should apply a patch every 5 mins if I develop chest pain."
b. "I will take the patch off right after my evening meal."
c. "I will leave the patch off at least 1 day each week."
d. "I should discard the used patch by flushing it down the toilet." - ANSb. "I will take the
patch off right after my evening meal."
-clients should remove the patch each evening for a medication free time of 12-14 hr before
applying a new patch to avoid developing a tolerance to the medication's effects
-nitroglycerin sublingual tablets are used to treat new onset of angina pain. A client who uses
sublingual tablets should place one tablet under their tongue at the onset of angina pain and
continue taking a table every 5 min for a total of three doses of nitroglycerin. The effects of a
nitroglycerin patch will take 30-60 min to occur and are not useful to prevent an ongoing
angina attack
-nitroglycerin is an antianginal medication that results in dilation of the coronary vessels.
Clients should apply the patch daily to sustain prophylaxis
-medication remains in the transdermal patch after removing it from the body and must be
discarded safely. The nurse should instruct the client to fold the patch ends together with the
medication on the inside and place the discarded patch in a closed container so that children
and pets cannot gain access to the medication
A nurse receives a verbal order from the provider to administer morphine five milligrams
every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of
the following entries as the correct format for the medication administration record (MAR)?
a. MSO4 5 mg subcut every 4 hr PRN severe pain
b. Morphine 5 mg subcut every 4 hr PRN severe pain
c. MSO4 5 mg SQ every 4 hr PRN severe pain
d. Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain - ANSb. Morphine 5 mg
subcut every 4 hr PRN severe pain
-the medication name is spelled out and there are not any abbreviations from The Joint
Commission's "Do Not Use" list included in the transcript
-the use of the abbreviation MSO4 is prohibited by The Joint Commission. The medication
name morphine must be spelled out to reduce the risk for error
-SQ is prohibited by The Joint Commission; this route should be written as subcut, subq, or
subcutaneously
-the trailing zero on 5.0 can be mistaken for 50 if the decimal point is missed
A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma.
For which of the following adverse effects should the nurse instruct the client to monitor and
report?
a. tingling of fingers
b. constipation
c. weight gain
,d. oliguria - ANSa. tingling of fingers
-the nurse should instruct the client to report the adverse effect of paresthesia, a tingling
sensation in the extremities, when taking acetazolamide
-diarrhea is an adverse effect of acetazolamide due to gastrointestinal disturbances
-weight loss is an adverse effect of acetazolamide due to GI disturbances causing reduced
appetite
-polyuria is an adverse effect of acetazolamide
A nurse administers a dose of metformin to a client instead of the prescribed dose of
metoclopramide. Which of the following actions should the nurse take first?
a. report the incident to the charge nurse
b. notify the provider
c. check the client's blood glucose
d. fill our an incident report - ANSc. check the client's blood glucose
-the first action the nurse should take using the nursing process is to assess the client. The
client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and
provide the client with a snack to reduce the risk of hypoglycemia
-the rest of these answers are also correct, but there is another action the nurse should take
first
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 - ANSa. 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 intestines
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The
client's BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse
should withhold the medication and contact the provider for which of the following findings?
a. diastolic BP
b. systolic BP
c. heart rate
d. respiratory rate - ANSc. heart rate
-digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the
heart rate. The nurse should withhold the medication and notify the provider for a heart rate
of 55/min because this is an early indication of digoxin toxicity
-digoxin increased cardiac output and reduces the heart rate, a diastolic BP of 86, systolic
BP of 140, and respiratory rate of 20/min is not cause for holding the medication and
contacting the provider
-
, A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead 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 - ANSb. 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
A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new
prescription for sucralfate. Which of the following actions of sucralfate should the nurse
include in the teaching?
a. decreases stomach acid secretion
b. neutralizes acids in the stomach
c. forms a protective barrier over ulcers
d. treats ulcers by eradicating H. pylori - ANSc. forms a protective barrier over ulcers
-secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate
the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats
the ulcer, creating a barrier to hydrochloric acid and pepsin
-peptic ulcer disease manifests as an erosion of the gastric or duodenal mucosa. The acid
production in the stomach causes further irritation and pain. H2 receptor antagonists, such
as famotidine, decrease stomach acid secretion
-acid production in the stomach causes further irritation and pain to a client who has a peptic
ulcer. Antacids, such as aluminum hydroxide, neutralize acids in the stomach and prevent
pepsin formation, a digestive enzyme the can further damage the eroded epithelium
-a common cause of peptic ulcers is a bacterial infection with Helicobacter pylori. Treatment
of the ulcer includes a combination of antibiotics, such as metronidazole, tetracycline,
clarithromycin, or amoxicillin, to eradicate the H. pylori infection
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 - ANSb. 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 tall, tented T-waves as a manifestation of hyperkalemia. Flattened
or inverted T-waves are a manifestation of hypokalemia
-the nurse should identify a widened QRS complex as a manifestation of hyperkalemia
-the nurse should identify ST elevation as an indication of ischemia. ST depression is a
manifestation of hypokalemia
