ATI Pharmacology Proctored Exam, Test Bank
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level
is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D
3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium
gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin,
a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse
instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice
4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer
the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the
iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple
juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client,
knowing that which of the following would indicate the presence of systemic toxicity from this
medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms
,include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not
associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The
nurse reminds the children that chemical sunscreens are most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun
4. At least 30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they
can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the
medication, the client complains of local discomfort and burning. Which of the following is the most
appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site
3. Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat
burns to reduce bacteria present in avascular tissues. The client should be informed that the medication
will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4
are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury.
The nurse monitors the client, knowing that which of the following indicates that a systemic effect has
occurred?
1. Hyperventilation
2. Elevated blood pressure
3. Local pain at the burn site
4. Local rash at the burn site
1. Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby
causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base
imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected
from the pain that occurs with a burn injury.
,7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication,
the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count
2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1,
3, and 4 do not need to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is
taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued
before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for
the potential for increased systemic absorption of the medication if the medication were being applied
to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands
2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions
where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower
from regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is
taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the
client is being treated for:
1. Acne
, 2. Eczema
3. Hair loss
4. Herpes simplex
1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by
suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes.
Options 2, 3, and 4 are incorrect.
W
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-
thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing
information to the client about the medication. Which statement made by the client indicates a lack of
understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound."
3. "The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-
negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in
healing. It does not stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic
medication. During the infusion, the client complains of pain at the insertion site. During an inspection of
the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed.
The nurse should take which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion.
1. Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care must be
taken to prevent the medication from escaping into the tissues surrounding the injection site, because
pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as
redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the
registered nurse needs to be notified; he or she will then contact the health care provider.
13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The
nurse caring for the client anticipates that which diagnostic study will be prescribed?
1. Echocardiography
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level
is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D
3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium
gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin,
a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse
instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice
4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer
the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the
iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple
juice.
3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client,
knowing that which of the following would indicate the presence of systemic toxicity from this
medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms
,include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not
associated with salicylism.
4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The
nurse reminds the children that chemical sunscreens are most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun
4. At least 30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they
can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the
medication, the client complains of local discomfort and burning. Which of the following is the most
appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site
3. Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat
burns to reduce bacteria present in avascular tissues. The client should be informed that the medication
will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4
are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury.
The nurse monitors the client, knowing that which of the following indicates that a systemic effect has
occurred?
1. Hyperventilation
2. Elevated blood pressure
3. Local pain at the burn site
4. Local rash at the burn site
1. Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby
causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base
imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days.
Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected
from the pain that occurs with a burn injury.
,7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication,
the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count
2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before
treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1,
3, and 4 do not need to be monitored specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is
taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued
before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for
the potential for increased systemic absorption of the medication if the medication were being applied
to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands
2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions
where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower
from regions in which permeability is poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is
taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the
client is being treated for:
1. Acne
, 2. Eczema
3. Hair loss
4. Herpes simplex
1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by
suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes.
Options 2, 3, and 4 are incorrect.
W
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-
thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing
information to the client about the medication. Which statement made by the client indicates a lack of
understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound."
3. "The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-
negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in
healing. It does not stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic
medication. During the infusion, the client complains of pain at the insertion site. During an inspection of
the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed.
The nurse should take which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion.
1. Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care must be
taken to prevent the medication from escaping into the tissues surrounding the injection site, because
pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as
redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the
registered nurse needs to be notified; he or she will then contact the health care provider.
13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The
nurse caring for the client anticipates that which diagnostic study will be prescribed?
1. Echocardiography
