Pharm ATI

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Sample questions from Pharm ATI

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

1. 1.During a home visit, a client who takes warfarin reports starting an over-the-counter herbal supplement 3 days ago. The international normalized ratio (INR) was 2.4 one week ago and is now 5.1; the client has no bleeding. Which action is the priority?

   • A.Arrange for the client to take vitamin K immediately without contacting the provider.
   • B.Advise the client to take the next warfarin dose with food to reduce its absorption.
   • C.Tell the client to stop the supplement and continue warfarin at the prescribed dose.
   • D.Assess for occult bleeding and notify the prescribing provider of the INR and supplement use.

   Rationale: An INR of 5.1 increases bleeding risk, and a new supplement may alter warfarin metabolism; assess for bleeding and promptly report the result and medication history. Taking warfarin with food does not reliably correct an elevated INR, and continuing the same dose without direction is unsafe. Stopping the supplement may be appropriate after review, but it does not replace assessment or provider notification; vitamin K is not given automatically to an asymptomatic client without an order.

2. 2.A toddler with an acute infection is prescribed an oral medication. The caregiver says the child vomited 10 minutes after the dose and asks whether to give it again. Which response is best?

   • A.Do not repeat the dose until the prescriber or pharmacist advises, because the amount absorbed is uncertain.
   • B.Wait until the next scheduled dose, then double it to maintain the prescribed daily amount.
   • C.Give half the dose again to replace the portion that may have been lost.
   • D.Give the full dose again because vomiting within 30 minutes means none was absorbed.

   Rationale: The amount absorbed before vomiting depends on the medication, formulation, and timing, so an automatic repeat dose could cause toxicity. A full repeat dose, a guessed partial dose, or doubling the next dose can all lead to unsafe exposure. The caregiver should obtain medication-specific advice and follow the prescribed schedule.

3. 3.Refer to the client's chart. The client is due for the next dose of digoxin. Which actions are appropriate before administering it? Select all that apply.

   • A.Give an antacid with digoxin to reduce the likelihood of adverse effects.
   • B.Administer the dose because the potassium concentration is within the reference range.
   • C.Assess for nausea, anorexia, visual changes, and new confusion.
   • D.Verify the timing of the digoxin concentration in relation to the last dose.
   • E.Withhold the dose and promptly notify the provider about the bradycardia and elevated digoxin concentration.

   Rationale: The heart rate has fallen from 62 to 48/min and the digoxin concentration is 2.4 ng/mL, above the stated reference range, so withhold the dose and notify the provider. Nausea, anorexia, visual disturbance, and confusion can signal digoxin toxicity and should be assessed. A normal potassium value does not make the current findings safe, and an antacid does not prevent toxicity and may affect absorption; checking when the concentration was drawn helps interpret the result.

4. 4.A provider prescribes an extended-release tablet for a client who has difficulty swallowing pills. The client asks whether the tablet can be crushed and mixed into applesauce. Which response is most appropriate?

   • A.Split it and mix both halves into applesauce to preserve the full dose.
   • B.Crush it finely so the medication will be easier to swallow.
   • C.Check the product-specific instructions and request a suitable alternative if it cannot be swallowed whole.
   • D.Dissolve it in warm water, which preserves the extended-release action.

   Answer and rationale are in the full material.

5. 5.In the emergency department, a client with chronic kidney disease is prescribed a medication that is primarily eliminated unchanged by the kidneys. The current estimated glomerular filtration rate is substantially lower than the value documented last month. Which consideration is most important before administering the next scheduled dose?

   • A.The medication will be eliminated faster because reduced filtration increases renal blood flow.
   • B.The medication may accumulate, so verify whether the dose or dosing interval needs adjustment.
   • C.The medication is unaffected because renal impairment changes only drug absorption.
   • D.The medication will be less potent, so the dose should be increased to compensate.

   Answer and rationale are in the full material.