ATI Pharmacology Edition 9

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Sample questions from ATI Pharmacology Edition 9

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

1. 1.At change of shift, an older adult with heart failure is due for digoxin. The apical pulse is 54/min, potassium is 3.1 mEq/L, and the client reports new nausea and blurred vision. Which action should the nurse take first?

   • A.Ask the client to ambulate and reassess the pulse afterward.
   • B.Administer the prescribed dose and reassess the pulse in 1 hr.
   • C.Hold the dose and notify the provider of the findings.
   • D.Give the dose with food to reduce gastrointestinal effects.

   Rationale: Holding digoxin and notifying the provider is the safest action because bradycardia, hypokalemia, nausea, and visual changes together suggest possible digoxin toxicity. Administering the dose could worsen dysrhythmias, and food does not make a potentially toxic dose safe. Ambulation is not an appropriate intervention for a client with a low pulse and possible medication toxicity. The exam takeaway is to connect narrow-therapeutic-index drugs with relevant assessment findings and laboratory values before administration.

2. 2.A parent brings a 6-year-old to a community clinic and reports giving an over-the-counter cough medicine along with the child's prescribed acetaminophen. Which actions should the nurse take to promote safe medication administration? Select all that apply.

   • A.Verify the child's current weight and the dose given in milligrams.
   • B.Recommend using a household teaspoon to measure liquid doses.
   • C.Ask the parent to bring in or read the labels of both products.
   • D.Check whether the cough medicine also contains acetaminophen.
   • E.Suggest alternating the products every 2 hr to maintain symptom relief.

   Rationale: Reviewing both labels helps identify active ingredients and prevent unintentional duplication, and pediatric dosing should be verified using the child's current weight and a dose in milligrams. Many combination cough products contain acetaminophen, so checking for the same ingredient is essential to prevent overdose. A household teaspoon is not an accurate measuring device, and alternating products every 2 hr without a specific prescribed schedule increases dosing-error risk. The exam takeaway is to verify the actual product, concentration, weight-based dose, and dosing interval rather than relying on brand names or household measures.

3. 3.During a home visit, a client taking warfarin says, "I started an herbal supplement last week, but I do not remember its name." Which response by the nurse is the priority?

   • A.Ask the client to identify the supplement and contact the anticoagulation prescriber.
   • B.Reassure the client that supplements do not affect prescription medications.
   • C.Advise the client to stop all foods that contain vitamin K.
   • D.Tell the client to take an extra warfarin dose if bruising does not occur.

   Rationale: The nurse should identify the supplement and consult the prescriber because some supplements alter warfarin metabolism or increase bleeding risk. Avoiding all vitamin K foods is not appropriate; consistent vitamin K intake is generally preferred over abrupt dietary restriction. An extra warfarin dose is unsafe without an order, and supplements can interact with prescription medications. The exam takeaway is to assess new nonprescription products and coordinate monitoring for narrow-therapeutic-index medications.

4. 4.Refer to the client's chart. Which actions should the nurse take regarding the prescribed unfractionated heparin infusion? Select all that apply.

   • A.Recheck the aPTT and platelet count according to the protocol.
   • B.Pause the infusion and promptly notify the provider of the bleeding and laboratory changes.
   • C.Assess the client for additional bleeding, including urine and stool changes.
   • D.Administer the scheduled aspirin because it has a different mechanism of action.
   • E.Increase the infusion rate because the aPTT is below the therapeutic range.

   Answer and rationale are in the full material.

5. 5.A client taking an oral medication with extensive first-pass metabolism is switched to an equivalent prescribed sublingual formulation. Which pharmacokinetic change should the nurse expect?

   • A.The medication will be absorbed more slowly because it must cross the stomach lining.
   • B.The medication will be metabolized more extensively before reaching systemic circulation.
   • C.The sublingual dose will have no systemic effect because it bypasses the gastrointestinal tract.
   • D.More of the dose will reach systemic circulation without first passing through the liver.

   Answer and rationale are in the full material.