ATI Pharmacology Proctored exam
A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many
times per day should the nurse expect to administer this medication?
A. One
B. Two
C. Three
D. Four
A. One
(Medications with long half-lives remain at their therapeutic levels between doses for long periods of time. The nurse should expect
to administer this medication once a day.)
A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-
service presentation. Which of the following factors should the educator include as a reason to administer lower medication
dosages? (Select all that apply.)
A. Increased renal secretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication the same pathway metabolizes
C. Liver failure
E. Concurrent use of medication the same pathway metabolizes
C. Liver failure decreases metabolism and thus increases the concentration of a medication. This requires decreasing the dosage.
E. When the same pathway metabolizes two medications, they compete for metabolism, thereby increasing the concentration of one
or both medications. This requires decreasing the dosage of one or both
A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.)
A. Have the client lie on her side.
B. Ask the client to look up at the ceiling.
C. Tell the client to blink when the drops enter her eye.
D. Drop the medication into the center of the client's conjunctival sac.
E. Instruct the client to close her eye gently after instillation
B. Ask the client to look up at the ceiling.
D. Drop the medication into the center of the client's conjunctival sac.
E. Instruct the client to close her eye gently after instillation
(B. The client should look upward to keep the drops from falling onto her cornea.
D. The nurse should drop the medication into the
center of the conjunctival sac to promote distribution.
E. The client should close her eye gently to promote distribution of the medication)
A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following
statements should the nurse identify as an indication that the client understands the instructions?
A. "I will clean the site with an alcohol swab before I apply the patch."
B. "I will rotate the application sites weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch.
C. "I will apply the patch to an area of skin with no hair."
(The client should apply the patch to a hairless area of skin to promote absorption of the medication.)
A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of
the following actions should the nurse take?
,A. Obtain a blood specimen immediately prior to administering the next dose of medication.
B. Verify that the client has been taking the medication for 24 hr before obtaining a blood specimen.
C. Ask the client to provide a urine specimen after the next dose of medication.
D. Administer the medication,and obtain a blood specimen 30 min late
A. Obtain a blood specimen immediately prior to administering the next dose of medication.
(To verify trough levels of a medication, the nurse should obtain a blood specimen immediately before administering the next dose
of medication.)
A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice
guidelines? (Select all that apply.)
A. Maintain skill competency.
B. Determine the dosage.
C. Monitor for adverse effects.
D. Safeguard medications.
E. Identify the client's diagnosis
A. Maintain skill competency.
C. Monitor for adverse effects.
D. Safeguard medications.
(A.maintaining skill competency and using appropriate administration techniques are legal responsibilities of the nurse
C. A nurse is legally responsible for monitoring for side and adverse effects of medication
D. Safeguarding of medications, such as controlled substances, is a legal responsibility of the nurse)
A nurse reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once every day. The nurse should
identify this as which of the following types of prescription?
A. Single
B. Stat
C. Routine
D. Standing
C. Routine
(A routine or standard prescription identifies medications to give on a regular schedule with or without a termination date or a
specific number of doses. The nurse will administer
this medication every day until the provider discontinues it.)
A nurse is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis
Gravidarum. The nurse should clarify which of the following parts of the prescription with the provider?
A. Name
B. Dosage
C. Route
D. Frequency
D. Frequency
(This prescription does not include the time or frequency of medication administration. The nurse must clarify this with the
prescribing provide)
A nurse is admitting a client and completing a preassessment before administering medications. Which of the following data should
the nurse include in the preassessment? (Select all that apply.)
A. Use of herbal teas
B. Daily fluid intake
C. Current health status
,D. Previous surgical history
E. Food allergies
A. Use of herbal teas
C. Current health status
E. Food allergies
(A. The nurse should inquire about the client's use of herbal products, which often contain caffeine, prior to medication
administration because caffeine can affect medication biotransformation
C. The nurse should review the client's current health status because new prescriptions can cause alterations in current health
status
E. The nurse should inquire about food allergies during the preassessment to identify any potential reactions or interactions)
A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following
statements should the nurse identify as an indication that the newly licensed nurse understands the process?
A. "A second nurse enters the prescription into the client's medical record."
B. "Another nurse should listen to the phone call."
C. "The provider can clarify the prescription when he signs the health record."
D. "I should omit the 'read back' if this is a one-time prescription
B. "Another nurse should listen to the phone call."
(A second nurse should listen to a telephone prescription to prevent errors in communication.)
A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in
water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV
infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.
22
A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200
mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many
mL/hr? (Round
the answer to the nearest whole number. Do not use a trailing zero.
200
A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is furosemide oral
solution 10 mg/1 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Do not use a
trailing zero.)
8
A nurse is preparing to administer Haloperidol 2 mg PO every 12 hr. The amount available is haloperidol 1 mg/tablet. How many
tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.
2
A nurse is preparing to administer Amoxicillin 20 mg/kg/day PO to divide equally every 12 hr to a preschooler who weighs 44 lb. The
amount available is amoxicillin suspension 250 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer
to the nearest whole number. Do not use a trailing zero.)
4
A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection
20,000 units/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Do not use a trailing
zero.
0.8
A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen
liquid 500 mg/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 trailing zero.
6.5
, A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to
deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.
125
A nurse is assessing a client's IV infusion site. Which of the following findings should the nurse identify as an indication of phlebitis?
(Select all that apply.)
A. Pallor
B. Dampness
C. Erythema
D. Coolness
E. Pain
C. Erythema
E. Pain
(C. Erythema at the insertion site is a manifestation of phlebitis.
E.Pain at the insertion site is a manifestation of phlebitis.)
A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind
the team that which of the following techniques helps minimize the risk of catheter embolism?
A. Performing hand hygiene before and after IV insertion
B. Rotating IV sites at least every 72 hr
C. Minimizing tourniquet time
D. Avoiding reinserting the needle into an IV catheter
D. Avoiding reinserting the needle into an IV catheter
(The nurse manager should remind the members of the team to avoid reinserting the stylet needle into an IV catheter. This action
can result in severing the end of the catheter and consequently cause a catheter embolism)
A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?
A. Use a disposable razor to remove excess hair on the extremity.
B. Select the back of the client's hand to insert the IV catheter.
C. Distend the veins by using a blood pressure cuff.
D. Direct the client to raise his arm above his heart
C. Distend the veins by using a blood pressure cuff.
(The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the vein,which can result in a hematoma)
A nurse assessing a client's IV catheter insertion site notes a hematoma. Which of the following actions should the nurse take?
(Select all that apply.)
A. Stop the infusion.
B. Apply alcohol to the insertion site.
C. Apply warm compresses to the insertion site
D. Elevate the client's arm.
E. Obtain a specimen for culture at the insertion site
C. Apply warm compresses to the insertion site
D. Elevate the client's arm.
(C. Warm compresses can help promote healing of a hematoma.
D. Elevation of the arm helps reduce edema, which can cause pressure and pain and additional bleeding in the area of the
hematoma.)
A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many
times per day should the nurse expect to administer this medication?
A. One
B. Two
C. Three
D. Four
A. One
(Medications with long half-lives remain at their therapeutic levels between doses for long periods of time. The nurse should expect
to administer this medication once a day.)
A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-
service presentation. Which of the following factors should the educator include as a reason to administer lower medication
dosages? (Select all that apply.)
A. Increased renal secretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication the same pathway metabolizes
C. Liver failure
E. Concurrent use of medication the same pathway metabolizes
C. Liver failure decreases metabolism and thus increases the concentration of a medication. This requires decreasing the dosage.
E. When the same pathway metabolizes two medications, they compete for metabolism, thereby increasing the concentration of one
or both medications. This requires decreasing the dosage of one or both
A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.)
A. Have the client lie on her side.
B. Ask the client to look up at the ceiling.
C. Tell the client to blink when the drops enter her eye.
D. Drop the medication into the center of the client's conjunctival sac.
E. Instruct the client to close her eye gently after instillation
B. Ask the client to look up at the ceiling.
D. Drop the medication into the center of the client's conjunctival sac.
E. Instruct the client to close her eye gently after instillation
(B. The client should look upward to keep the drops from falling onto her cornea.
D. The nurse should drop the medication into the
center of the conjunctival sac to promote distribution.
E. The client should close her eye gently to promote distribution of the medication)
A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following
statements should the nurse identify as an indication that the client understands the instructions?
A. "I will clean the site with an alcohol swab before I apply the patch."
B. "I will rotate the application sites weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch.
C. "I will apply the patch to an area of skin with no hair."
(The client should apply the patch to a hairless area of skin to promote absorption of the medication.)
A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of
the following actions should the nurse take?
,A. Obtain a blood specimen immediately prior to administering the next dose of medication.
B. Verify that the client has been taking the medication for 24 hr before obtaining a blood specimen.
C. Ask the client to provide a urine specimen after the next dose of medication.
D. Administer the medication,and obtain a blood specimen 30 min late
A. Obtain a blood specimen immediately prior to administering the next dose of medication.
(To verify trough levels of a medication, the nurse should obtain a blood specimen immediately before administering the next dose
of medication.)
A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice
guidelines? (Select all that apply.)
A. Maintain skill competency.
B. Determine the dosage.
C. Monitor for adverse effects.
D. Safeguard medications.
E. Identify the client's diagnosis
A. Maintain skill competency.
C. Monitor for adverse effects.
D. Safeguard medications.
(A.maintaining skill competency and using appropriate administration techniques are legal responsibilities of the nurse
C. A nurse is legally responsible for monitoring for side and adverse effects of medication
D. Safeguarding of medications, such as controlled substances, is a legal responsibility of the nurse)
A nurse reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once every day. The nurse should
identify this as which of the following types of prescription?
A. Single
B. Stat
C. Routine
D. Standing
C. Routine
(A routine or standard prescription identifies medications to give on a regular schedule with or without a termination date or a
specific number of doses. The nurse will administer
this medication every day until the provider discontinues it.)
A nurse is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis
Gravidarum. The nurse should clarify which of the following parts of the prescription with the provider?
A. Name
B. Dosage
C. Route
D. Frequency
D. Frequency
(This prescription does not include the time or frequency of medication administration. The nurse must clarify this with the
prescribing provide)
A nurse is admitting a client and completing a preassessment before administering medications. Which of the following data should
the nurse include in the preassessment? (Select all that apply.)
A. Use of herbal teas
B. Daily fluid intake
C. Current health status
,D. Previous surgical history
E. Food allergies
A. Use of herbal teas
C. Current health status
E. Food allergies
(A. The nurse should inquire about the client's use of herbal products, which often contain caffeine, prior to medication
administration because caffeine can affect medication biotransformation
C. The nurse should review the client's current health status because new prescriptions can cause alterations in current health
status
E. The nurse should inquire about food allergies during the preassessment to identify any potential reactions or interactions)
A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following
statements should the nurse identify as an indication that the newly licensed nurse understands the process?
A. "A second nurse enters the prescription into the client's medical record."
B. "Another nurse should listen to the phone call."
C. "The provider can clarify the prescription when he signs the health record."
D. "I should omit the 'read back' if this is a one-time prescription
B. "Another nurse should listen to the phone call."
(A second nurse should listen to a telephone prescription to prevent errors in communication.)
A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in
water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV
infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.
22
A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200
mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many
mL/hr? (Round
the answer to the nearest whole number. Do not use a trailing zero.
200
A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is furosemide oral
solution 10 mg/1 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Do not use a
trailing zero.)
8
A nurse is preparing to administer Haloperidol 2 mg PO every 12 hr. The amount available is haloperidol 1 mg/tablet. How many
tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.
2
A nurse is preparing to administer Amoxicillin 20 mg/kg/day PO to divide equally every 12 hr to a preschooler who weighs 44 lb. The
amount available is amoxicillin suspension 250 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer
to the nearest whole number. Do not use a trailing zero.)
4
A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection
20,000 units/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Do not use a trailing
zero.
0.8
A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen
liquid 500 mg/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 trailing zero.
6.5
, A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to
deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.
125
A nurse is assessing a client's IV infusion site. Which of the following findings should the nurse identify as an indication of phlebitis?
(Select all that apply.)
A. Pallor
B. Dampness
C. Erythema
D. Coolness
E. Pain
C. Erythema
E. Pain
(C. Erythema at the insertion site is a manifestation of phlebitis.
E.Pain at the insertion site is a manifestation of phlebitis.)
A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind
the team that which of the following techniques helps minimize the risk of catheter embolism?
A. Performing hand hygiene before and after IV insertion
B. Rotating IV sites at least every 72 hr
C. Minimizing tourniquet time
D. Avoiding reinserting the needle into an IV catheter
D. Avoiding reinserting the needle into an IV catheter
(The nurse manager should remind the members of the team to avoid reinserting the stylet needle into an IV catheter. This action
can result in severing the end of the catheter and consequently cause a catheter embolism)
A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?
A. Use a disposable razor to remove excess hair on the extremity.
B. Select the back of the client's hand to insert the IV catheter.
C. Distend the veins by using a blood pressure cuff.
D. Direct the client to raise his arm above his heart
C. Distend the veins by using a blood pressure cuff.
(The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the vein,which can result in a hematoma)
A nurse assessing a client's IV catheter insertion site notes a hematoma. Which of the following actions should the nurse take?
(Select all that apply.)
A. Stop the infusion.
B. Apply alcohol to the insertion site.
C. Apply warm compresses to the insertion site
D. Elevate the client's arm.
E. Obtain a specimen for culture at the insertion site
C. Apply warm compresses to the insertion site
D. Elevate the client's arm.
(C. Warm compresses can help promote healing of a hematoma.
D. Elevation of the arm helps reduce edema, which can cause pressure and pain and additional bleeding in the area of the
hematoma.)
