Qcc Pharmacology ATI Exam

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Sample questions from Qcc Pharmacology ATI Exam

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the neonatal intensive care unit, a newborn weighing 1.8 kg has an order for gentamicin 4 mg/kg IV every 24 hr. The medication is supplied as 10 mg/mL, and the prescribed dose has been verified as appropriate. How many milliliters should the nurse administer for one dose?

   • A.7.2 mL
   • B.1.8 mL
   • C.0.72 mL
   • D.0.18 mL

   Rationale: The dose is 1.8 kg x 4 mg/kg = 7.2 mg, and 7.2 mg divided by 10 mg/mL equals 0.72 mL. An amount of 0.18 mL reflects using 1 mg/kg, while 1.8 mL and 7.2 mL result from misapplying the concentration or confusing milligrams with milliliters. Weight-based doses and small volumes require an independent calculation check and an appropriately calibrated syringe.

2. 2.At change of shift, the nurse receives report on four clients. Which client should the nurse assess first before administering scheduled medications?

   • A.A client taking furosemide who reports urinating twice overnight
   • B.A client taking digoxin who reports nausea and has an apical pulse of 54/min
   • C.A client taking prednisone who has an elevated postmeal glucose of 198 mg/dL
   • D.A client taking metformin who reports mild diarrhea after breakfast

   Rationale: Nausea with bradycardia in a client taking digoxin suggests possible toxicity, so the nurse should assess promptly and withhold the dose pending evaluation. Increased urination is an expected effect of furosemide, mild diarrhea can occur with metformin, and hyperglycemia can occur with prednisone; these findings still require follow-up but are less immediately concerning here. The key is to recognize a narrow therapeutic index medication and a concerning combination of symptoms and pulse before administration.

3. 3.A client states, "I take my levothyroxine with breakfast and my calcium tablet so I will not forget either one." Which response by the nurse is best?

   • A."Take both medications with breakfast; food reduces the risk of thyroid hormone toxicity."
   • B."Take calcium first and wait 30 minutes before taking levothyroxine."
   • C."Take levothyroxine at bedtime with calcium, because calcium improves its absorption."
   • D."Take levothyroxine on an empty stomach, and separate it from calcium by at least 4 hours."

   Rationale: Levothyroxine is best taken consistently on an empty stomach, typically 30 to 60 minutes before breakfast, and calcium can reduce its absorption, so the doses should be separated by at least 4 hours. Taking both with food does not prevent toxicity and can make absorption less predictable. Taking calcium first or taking both at bedtime does not address the interaction; the exam takeaway is to protect consistent thyroid medication absorption.

4. 4.A client's potassium is 6.1 mEq/L (reference range 3.5 to 5.0 mEq/L), and the client takes lisinopril and spironolactone at home. Which actions should the nurse take? Select all that apply.

   • A.Hold the potassium-raising medications and notify the provider.
   • B.Place the client on a cardiac monitor and assess for dysrhythmias.
   • C.Review the client's potassium-containing salt substitute use.
   • D.Document the result as expected and recheck it at the next routine visit.
   • E.Encourage a serving of dried fruit to prevent medication-related cramps.
   • F.Administer the scheduled lisinopril because it protects renal function.

   Answer and rationale are in the full material.

5. 5.A client with chronic kidney disease has a new prescription for a renally cleared medication. The client is alert and reports no symptoms, but the latest estimated glomerular filtration rate is substantially lower than the value documented one month ago. Which action should the nurse take before giving the first dose?

   • A.Clarify the dose or dosing interval with the prescriber using the current renal function.
   • B.Withhold all of the client's medications until the estimated glomerular filtration rate returns to baseline.
   • C.Administer the prescribed dose because the client is asymptomatic.
   • D.Give the dose with food to prevent accumulation in the kidneys.

   Answer and rationale are in the full material.