ATI PN PHARMACOLOGY
1. 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?
• ANSWER: Forms a protective barrier over ulcers
• Rationale: Sucralfate is a mucosal protectant. In the acidic environment of the stomach, it
polymerizes into a thick, paste-like substance that selectively adheres to ulcer craters,
forming a protective barrier against acid, bile, and pepsin.
2. A nurse is planning care for a client who is receiving mannitol via IV continuous
infusion. The nurse should monitor the client for which of the following adverse effects?
• ANSWER: Bibasilar crackles
• Rationale: Mannitol is an osmotic diuretic. If given too rapidly or in excess, it can pull
fluid from the intracellular space into the intravascular space, leading to fluid volume
overload and heart failure. Bibasilar crackles indicate pulmonary edema secondary to this
fluid overload.
3. A nurse is providing teaching for a client who has multiple sclerosis and a new
prescription for methylprednisolone. Which of the following instructions should the nurse
include? (SATA)
• ANSWERS:
o A. Blood glucose levels will be monitored during therapy. (Rationale: Corticosteroids
like methylprednisolone can cause hyperglycemia by promoting gluconeogenesis and
insulin resistance. Blood glucose monitoring is standard.)
o B. Avoid contact with people who have known infections. (Rationale:
Methylprednisolone is an immunosuppressant. It masks signs of infection and decreases
the body's ability to fight off pathogens, making the client more susceptible to severe
infections.)
o C. Grapefruit juice can increase the effects of this medication. (Rationale: Grapefruit
juice inhibits the CYP3A4 enzyme in the liver, which metabolizes methylprednisolone.
This leads to increased serum levels and a higher risk of toxicity/adverse effects.)
,4. A nurse is providing discharge teaching about handling medication to a client who is to
continue taking oral transmucosal fentanyl raspberry flavored lozenges on a stick. Which
of the following information should the nurse include in the teaching?
• ANSWER: Store unused medication sticks in a storage container.
• Rationale: Fentanyl is a potent opioid with a high risk of abuse, accidental exposure
(especially to children), and diversion. The FDA requires that unused fentanyl lozenges be
stored in the special child-resistant storage container they come in and later disposed of
using the provided flushable disposal system.
5. 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 as an indication of hypokalemia?
• ANSWER: Presence of U-waves
• Rationale: Furosemide is a loop diuretic that causes potassium loss. Hypokalemia on an
ECG presents with ST-segment depression, T-wave flattening/inversion, and the
appearance of prominent U waves.
6. The nurse is caring for a client who has cancer and is taking oral morphine and docusate
sodium. The nurse should instruct the client that takin the docusate sodium daily can
minimize which of the following adverse effects of morphine?
• ANSWER: Constipation
• Rationale: Morphine is an opioid that slows gastrointestinal motility, leading to severe
constipation. Docusate sodium is a stool softener (surfactant laxative) that allows water
and fats to penetrate the stool, preventing this common adverse effect.
7. A nurse is providing teaching to a client who has gastric ulcer and a new prescription for
ranitidine. Which of the following instructions should the nurse include?
• ANSWER: "Report yellowing of the skin."
, • Rationale: Ranitidine (an H2-receptor antagonist) can cause hepatotoxicity, though
rarely. Yellowing of the skin (jaundice) is a sign of liver damage and should be reported
immediately.
8. A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse
notes the client has anxiety, hypotension, and dyspnea. Which of the following medications
should the nurse administer first?
• ANSWER: Epinephrine
• Rationale: The client is experiencing anaphylaxis (a severe Type I hypersensitivity
reaction) to cefazolin. Epinephrine is the first-line treatment for anaphylaxis because it
causes bronchodilation, vasoconstriction, and increased cardiac output, counteracting the
life-threatening effects.
9. A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who
weighs 44 lb. How many mg should the nurse administer per dose?
• ANSWER: 300 mg
• Rationale: First, convert pounds to kilograms: 44 lbs / 2.2 = 20 kg. Then calculate the
dose: 15 mg/kg x 20 kg = 300 mg per dose.
10. A nurse in an emergency department is caring for a client whose family reports the
client has taken large amounts of diazepam. Which of the following medications should the
nurse anticipate administering?
• ANSWER: Flumazenil
• Rationale: Diazepam is a benzodiazepine. Flumazenil is a competitive antagonist at
benzodiazepine receptors and is the specific antidote used to reverse benzodiazepine
overdose.
11. A nurse is reviewing laboratory results for a client who is receiving heparin via
continuous IV infusion for DVT. The nurse should discontinue the medication infusion for
which of the following client findings?
• ANSWER: Platelets 96,000
1. 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?
• ANSWER: Forms a protective barrier over ulcers
• Rationale: Sucralfate is a mucosal protectant. In the acidic environment of the stomach, it
polymerizes into a thick, paste-like substance that selectively adheres to ulcer craters,
forming a protective barrier against acid, bile, and pepsin.
2. A nurse is planning care for a client who is receiving mannitol via IV continuous
infusion. The nurse should monitor the client for which of the following adverse effects?
• ANSWER: Bibasilar crackles
• Rationale: Mannitol is an osmotic diuretic. If given too rapidly or in excess, it can pull
fluid from the intracellular space into the intravascular space, leading to fluid volume
overload and heart failure. Bibasilar crackles indicate pulmonary edema secondary to this
fluid overload.
3. A nurse is providing teaching for a client who has multiple sclerosis and a new
prescription for methylprednisolone. Which of the following instructions should the nurse
include? (SATA)
• ANSWERS:
o A. Blood glucose levels will be monitored during therapy. (Rationale: Corticosteroids
like methylprednisolone can cause hyperglycemia by promoting gluconeogenesis and
insulin resistance. Blood glucose monitoring is standard.)
o B. Avoid contact with people who have known infections. (Rationale:
Methylprednisolone is an immunosuppressant. It masks signs of infection and decreases
the body's ability to fight off pathogens, making the client more susceptible to severe
infections.)
o C. Grapefruit juice can increase the effects of this medication. (Rationale: Grapefruit
juice inhibits the CYP3A4 enzyme in the liver, which metabolizes methylprednisolone.
This leads to increased serum levels and a higher risk of toxicity/adverse effects.)
,4. A nurse is providing discharge teaching about handling medication to a client who is to
continue taking oral transmucosal fentanyl raspberry flavored lozenges on a stick. Which
of the following information should the nurse include in the teaching?
• ANSWER: Store unused medication sticks in a storage container.
• Rationale: Fentanyl is a potent opioid with a high risk of abuse, accidental exposure
(especially to children), and diversion. The FDA requires that unused fentanyl lozenges be
stored in the special child-resistant storage container they come in and later disposed of
using the provided flushable disposal system.
5. 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 as an indication of hypokalemia?
• ANSWER: Presence of U-waves
• Rationale: Furosemide is a loop diuretic that causes potassium loss. Hypokalemia on an
ECG presents with ST-segment depression, T-wave flattening/inversion, and the
appearance of prominent U waves.
6. The nurse is caring for a client who has cancer and is taking oral morphine and docusate
sodium. The nurse should instruct the client that takin the docusate sodium daily can
minimize which of the following adverse effects of morphine?
• ANSWER: Constipation
• Rationale: Morphine is an opioid that slows gastrointestinal motility, leading to severe
constipation. Docusate sodium is a stool softener (surfactant laxative) that allows water
and fats to penetrate the stool, preventing this common adverse effect.
7. A nurse is providing teaching to a client who has gastric ulcer and a new prescription for
ranitidine. Which of the following instructions should the nurse include?
• ANSWER: "Report yellowing of the skin."
, • Rationale: Ranitidine (an H2-receptor antagonist) can cause hepatotoxicity, though
rarely. Yellowing of the skin (jaundice) is a sign of liver damage and should be reported
immediately.
8. A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse
notes the client has anxiety, hypotension, and dyspnea. Which of the following medications
should the nurse administer first?
• ANSWER: Epinephrine
• Rationale: The client is experiencing anaphylaxis (a severe Type I hypersensitivity
reaction) to cefazolin. Epinephrine is the first-line treatment for anaphylaxis because it
causes bronchodilation, vasoconstriction, and increased cardiac output, counteracting the
life-threatening effects.
9. A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who
weighs 44 lb. How many mg should the nurse administer per dose?
• ANSWER: 300 mg
• Rationale: First, convert pounds to kilograms: 44 lbs / 2.2 = 20 kg. Then calculate the
dose: 15 mg/kg x 20 kg = 300 mg per dose.
10. A nurse in an emergency department is caring for a client whose family reports the
client has taken large amounts of diazepam. Which of the following medications should the
nurse anticipate administering?
• ANSWER: Flumazenil
• Rationale: Diazepam is a benzodiazepine. Flumazenil is a competitive antagonist at
benzodiazepine receptors and is the specific antidote used to reverse benzodiazepine
overdose.
11. A nurse is reviewing laboratory results for a client who is receiving heparin via
continuous IV infusion for DVT. The nurse should discontinue the medication infusion for
which of the following client findings?
• ANSWER: Platelets 96,000
