ATI Pharmacology Proctored Exam
A nurse is assessing a client who takes levothyroxine for hypothyroidism. the nurse should identify which of the
following findings indicates the need for an increase in dosage? Select all that apply
a. Heart rate 46/min
b. Diaphoresis - dry skin
c. Impaired short term memory
d. Cold intolerance
e. BP 178/90 mm Hg
Heart rate 46
Cold intolerance
Impaired short-term memory
A nurse manager is planning an in-service about pain management with opioids for a client who has cancer.
Which of the following information should the nurse manager include?
a. IM administration is recommended if PO opioids are ineffective
b. Respiratory depression decreases as opioid tolerance develops
c. Meperidine is the opioid of choice for treating chronic pain
d. Withhold PRN pain medication for the client who is receiving opioids every 6 hr
a. IM administration is recommended if PO opioids are ineffective
A nurse is reviewing the list of current medications for a client who is to start a prescription for carbamazepine.
The nurse should identify which of the following medications interacts with carbamazepine?
a. Nicotine transdermal system
b. Diphenhydramine
c. Estrogen-progestin combination
d. Beclomethasone
c. Estrogen-progestin combination (Non-hormonal forms of contraception)
A nurse is caring for a client who has a respiratory infection and is receiving an antibiotic. Which of the following
medications puts the client at risk for developing hearing loss?
a. Rifampin
b. Ciprofloxacin
c. Penicillin G
d. Gentamicin
d. Gentamicin
A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose
inhaler. Which of the following information should the nurse include in the teaching? (SATA)
a. "Soak the inhaler in water after use."
b. "Have your child take one inhalation as needed for shortness of breath."
c. "Shake the device prior to administration."
d. "A spacer will make it easier to use the device."
e. "Rinse your child's mouth following administration."
c. "Shake the device prior to administration."
d. "A spacer will make it easier to use the device."
e. "Rinse your child's mouth following administration."
A nurse is preparing to administer potassium chloride elixir 20 mEq/day PO to divide equally 12 hr. available is
6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest
tenth. Use a leading zero if it applies. Do not use a trial zero.)
7.5 mL
,A nurse is instructing a client who has a new prescription for a daily dose of lovastatin extended release. Which
of the following information should the nurse include in the teaching?
a. "You will need liver function tests before beginning therapy."
b. "Avoid consuming dairy products while taking this medication."
c. "You may crush the medication and mix it with applesauce."
d. "You should take the medication in the morning."
a. "You will need liver function tests before beginning therapy."
A nurse is assessing a client who is receiving a peripheral IV infusion and notes infiltration of fluid into the tissue
surrounding the insertion site. Which of the following actions should the nurse take?
a. Flush the IV catheter
b. Apply pressure to the IV site
c. Elevate the extremity
d. Slow the infusion rate
c. Elevate the extremity
A nurse is preparing to administer 4000 units of heparin subcutaneously to a client who has deep-vein
thrombosis. Available is heparin 10,000 units. How many mL of heparin should the nurse administer?
(Round to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
a. 0.4 mL
0.4 mL
A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following
findings should the nurse expect?
a. Oxygen saturation 96%
b. PaCO2 30 mm Hg
c. Increase in BP
d. Decrease in protein
c. Increase in BP
A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse.
Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (SATA)
a. Polypharmacy
b. Increased rate of absorption
c. Decreased percentage of body fat
d. Multiple health problems
e. Decreased renal function
a. Polypharmacy
c. Decreased percentage of body fat
d. Multiple health problems
e. Decreased renal function
A nurse is reviewing the laboratory data of a client prior to administering IV tobramycin. Which of the following
laboratory values should the nurse report to the provider?
a. Sodium 137 mEq/L
b. Hct 4.3%
c. Hgb 15 g/dL
d. Creatinine 2.5 mg/dL
d. Creatinine 2.5 mg/dL
A nurse is assessing a client who is receiving intravenous therapy. The nurse should identify which of the
following findings as a manifestation of fluid volume excess?
a. Decreased bowel sounds
, b. Distended neck veins
c. Bilateral muscle weakness
d. Thread pulse
b. Distended neck veins
A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic
solution. Which of the following findings should indicate to the nurse that the treatment is effective?
a. Absent Chvostek's sign
b. Improved cognition
c. Decreased vomiting
d. Cardiac arrhythmias absent
b. Improved cognition
A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch. Which of the
following instructions should the nurse include?
a. "Discontinue the patch if you experience a headache."
b. "Apply a new patch if you have chest pain."
c. "Cover the patch with dry gauze when taking a shower."
d. "Remove the patch prior to going to bed."
d. "Remove the patch prior to going to bed."
A nurse is reviewing the laboratory results of a client who has a prescription for sodium polystyrene sulfonate
(Kayexalate) every 6 hr. Which of the following should the nurse report to the provider?
a. Creatinine 0.72 mg/dL
b. Sodium 138 mEq/L
c. Magnesium 2 mEq/L
d. Potassium 5.2 mEq/L
d. Potassium 5.2 mEq/L - Hyperkalemia (serum potassium level greater than 5.0 mEq/L) increases the client risk
for fatal cardiac dysrhythmias. Kayexalate is used to decrease the serum potassium level so the PN should
monitor the client's serum potassium level
A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of the following
outcomes indicates that the client is adhering to the medication regimen?
a. The client has a negative sputum culture
b. The client tests negative for HIV
c. The client has a positive purified protein derivative test
d. The client's liver function test results are within the expected reference range
a. The client has a negative sputum culture
A client is caring for a client who develops an anaphylactic reaction to IV administration. After assessing the
client's respiratory status and stopping the medication infusion. Which of the following actions should the
nurse take next?
a. Replace the infusion with 0.9% sodium chloride
b. Give diphenhydramine IM
c. Elevate the client's legs and feet
d. Administer epinephrine IM
d. Administer epinephrine IM
A nurse is caring for a client who is taking sertraline and reports a desire to begin taking supplements. Which of
the following supplements should the nurse advise the client to avoid?
a. St. John's Wort
b. Ginger root
c. Black cohosh
d. Coenzyme Q10
a. St. John's Wort
A nurse is assessing a client who takes levothyroxine for hypothyroidism. the nurse should identify which of the
following findings indicates the need for an increase in dosage? Select all that apply
a. Heart rate 46/min
b. Diaphoresis - dry skin
c. Impaired short term memory
d. Cold intolerance
e. BP 178/90 mm Hg
Heart rate 46
Cold intolerance
Impaired short-term memory
A nurse manager is planning an in-service about pain management with opioids for a client who has cancer.
Which of the following information should the nurse manager include?
a. IM administration is recommended if PO opioids are ineffective
b. Respiratory depression decreases as opioid tolerance develops
c. Meperidine is the opioid of choice for treating chronic pain
d. Withhold PRN pain medication for the client who is receiving opioids every 6 hr
a. IM administration is recommended if PO opioids are ineffective
A nurse is reviewing the list of current medications for a client who is to start a prescription for carbamazepine.
The nurse should identify which of the following medications interacts with carbamazepine?
a. Nicotine transdermal system
b. Diphenhydramine
c. Estrogen-progestin combination
d. Beclomethasone
c. Estrogen-progestin combination (Non-hormonal forms of contraception)
A nurse is caring for a client who has a respiratory infection and is receiving an antibiotic. Which of the following
medications puts the client at risk for developing hearing loss?
a. Rifampin
b. Ciprofloxacin
c. Penicillin G
d. Gentamicin
d. Gentamicin
A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose
inhaler. Which of the following information should the nurse include in the teaching? (SATA)
a. "Soak the inhaler in water after use."
b. "Have your child take one inhalation as needed for shortness of breath."
c. "Shake the device prior to administration."
d. "A spacer will make it easier to use the device."
e. "Rinse your child's mouth following administration."
c. "Shake the device prior to administration."
d. "A spacer will make it easier to use the device."
e. "Rinse your child's mouth following administration."
A nurse is preparing to administer potassium chloride elixir 20 mEq/day PO to divide equally 12 hr. available is
6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest
tenth. Use a leading zero if it applies. Do not use a trial zero.)
7.5 mL
,A nurse is instructing a client who has a new prescription for a daily dose of lovastatin extended release. Which
of the following information should the nurse include in the teaching?
a. "You will need liver function tests before beginning therapy."
b. "Avoid consuming dairy products while taking this medication."
c. "You may crush the medication and mix it with applesauce."
d. "You should take the medication in the morning."
a. "You will need liver function tests before beginning therapy."
A nurse is assessing a client who is receiving a peripheral IV infusion and notes infiltration of fluid into the tissue
surrounding the insertion site. Which of the following actions should the nurse take?
a. Flush the IV catheter
b. Apply pressure to the IV site
c. Elevate the extremity
d. Slow the infusion rate
c. Elevate the extremity
A nurse is preparing to administer 4000 units of heparin subcutaneously to a client who has deep-vein
thrombosis. Available is heparin 10,000 units. How many mL of heparin should the nurse administer?
(Round to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
a. 0.4 mL
0.4 mL
A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following
findings should the nurse expect?
a. Oxygen saturation 96%
b. PaCO2 30 mm Hg
c. Increase in BP
d. Decrease in protein
c. Increase in BP
A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse.
Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (SATA)
a. Polypharmacy
b. Increased rate of absorption
c. Decreased percentage of body fat
d. Multiple health problems
e. Decreased renal function
a. Polypharmacy
c. Decreased percentage of body fat
d. Multiple health problems
e. Decreased renal function
A nurse is reviewing the laboratory data of a client prior to administering IV tobramycin. Which of the following
laboratory values should the nurse report to the provider?
a. Sodium 137 mEq/L
b. Hct 4.3%
c. Hgb 15 g/dL
d. Creatinine 2.5 mg/dL
d. Creatinine 2.5 mg/dL
A nurse is assessing a client who is receiving intravenous therapy. The nurse should identify which of the
following findings as a manifestation of fluid volume excess?
a. Decreased bowel sounds
, b. Distended neck veins
c. Bilateral muscle weakness
d. Thread pulse
b. Distended neck veins
A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic
solution. Which of the following findings should indicate to the nurse that the treatment is effective?
a. Absent Chvostek's sign
b. Improved cognition
c. Decreased vomiting
d. Cardiac arrhythmias absent
b. Improved cognition
A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch. Which of the
following instructions should the nurse include?
a. "Discontinue the patch if you experience a headache."
b. "Apply a new patch if you have chest pain."
c. "Cover the patch with dry gauze when taking a shower."
d. "Remove the patch prior to going to bed."
d. "Remove the patch prior to going to bed."
A nurse is reviewing the laboratory results of a client who has a prescription for sodium polystyrene sulfonate
(Kayexalate) every 6 hr. Which of the following should the nurse report to the provider?
a. Creatinine 0.72 mg/dL
b. Sodium 138 mEq/L
c. Magnesium 2 mEq/L
d. Potassium 5.2 mEq/L
d. Potassium 5.2 mEq/L - Hyperkalemia (serum potassium level greater than 5.0 mEq/L) increases the client risk
for fatal cardiac dysrhythmias. Kayexalate is used to decrease the serum potassium level so the PN should
monitor the client's serum potassium level
A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of the following
outcomes indicates that the client is adhering to the medication regimen?
a. The client has a negative sputum culture
b. The client tests negative for HIV
c. The client has a positive purified protein derivative test
d. The client's liver function test results are within the expected reference range
a. The client has a negative sputum culture
A client is caring for a client who develops an anaphylactic reaction to IV administration. After assessing the
client's respiratory status and stopping the medication infusion. Which of the following actions should the
nurse take next?
a. Replace the infusion with 0.9% sodium chloride
b. Give diphenhydramine IM
c. Elevate the client's legs and feet
d. Administer epinephrine IM
d. Administer epinephrine IM
A nurse is caring for a client who is taking sertraline and reports a desire to begin taking supplements. Which of
the following supplements should the nurse advise the client to avoid?
a. St. John's Wort
b. Ginger root
c. Black cohosh
d. Coenzyme Q10
a. St. John's Wort
