ATI Pharmacology Final

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Sample questions from ATI Pharmacology Final

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

1. 1.During a home visit, an older adult with chronic kidney disease is receiving IV gentamicin. The nurse reviews the medication record and notes that the client's serum creatinine has increased from 1.4 mg/dL to 2.2 mg/dL over 48 hours; the next dose is due now. Which action should the nurse take first?

   • A.Ask the client to drink extra fluids, then administer the dose.
   • B.Hold the dose and contact the prescriber to review renal function and the dosing plan.
   • C.Give half the prescribed dose to account for the creatinine increase.
   • D.Administer the dose because the prescribed interval has not changed.

   Rationale: Gentamicin is primarily eliminated by the kidneys, so worsening renal function can cause accumulation and ototoxicity or nephrotoxicity; the dose should be held while the prescriber reviews the regimen. Giving the full dose ignores a significant change, and independently halving the dose is outside the nurse's authority. Fluids do not reliably correct impaired drug clearance and should not delay addressing the unsafe dose.

2. 2.A caregiver at a pediatric clinic reports that a 6-year-old weighing 18 kg has an order for amoxicillin 375 mg by mouth per dose. The pharmacy label reads 250 mg/5 mL. How many milliliters should the caregiver measure for each dose?

   • A.9 mL
   • B.5 mL
   • C.6.5 mL
   • D.7.5 mL

   Rationale: The concentration is 50 mg/mL, so 375 mg requires 7.5 mL. Five milliliters provides only 250 mg, while 6.5 mL and 9 mL provide doses that do not match the prescription. The exam takeaway is to convert the labeled concentration to mg per mL before calculating a liquid dose.

3. 3.Refer to the client's chart. Which actions should the nurse take in response to the current findings? Select all that apply.

   • A.Encourage the client to take an extra dose if the next apical pulse is above 60/min.
   • B.Place the client on a cardiac monitor and assess the apical pulse and rhythm.
   • C.Give the scheduled dose with food to reduce nausea.
   • D.Hold the next digoxin dose and notify the prescriber.
   • E.Review the client's renal function and recent medication changes with the prescriber.

   Rationale: The client has nausea, new visual color changes, bradycardia, and a digoxin level above the stated therapeutic range, so the dose should be held and the prescriber notified. Cardiac monitoring is appropriate because digoxin toxicity can cause dysrhythmias, and reduced renal clearance or interacting medicines can contribute to accumulation. Giving the dose with food does not treat toxicity, and an extra dose is unsafe even if a later pulse is above 60/min.

4. 4.A client receiving an enteric-coated aspirin tablet after a transient ischemic attack says, "I cannot swallow this tablet whole. Can I crush it into applesauce?" Which response is most appropriate?

   • A."Crush it finely and mix it with a full glass of water."
   • B."Split it and take one half now and the other half later."
   • C."Do not crush it; contact the prescriber or pharmacist for a formulation you can take safely."
   • D."Chew it thoroughly so the coating dissolves in your mouth."

   Answer and rationale are in the full material.

5. 5.A client using a prescribed fentanyl transdermal patch calls the clinic after placing a heating pad over the patch for back pain. The client now feels unusually drowsy. Which instruction should the nurse give first?

   • A.Remove the heating pad and call emergency services because increased absorption can cause respiratory depression.
   • B.Drink water and rest; heat only changes how quickly the patch adheres.
   • C.Leave the heating pad in place but remove the patch at the next scheduled change.
   • D.Apply a second patch to maintain analgesia after removing the first.

   Answer and rationale are in the full material.