ATI PHARMACOLOGY FINAL EXAM REVIEW

1.A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhos ...

1.A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? a. Glucose b. Ammonia c. Potassium d. Bicarbonate Rationale: Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma. 2. A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.) a. Furosemide b. Telmisartan c. Duloxetine d. Clopidogrel e. Atorvastatin 3. A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide? a. "Crushing the medication might cause you to have a stomach-ache or indigestion b. "Crushing the medication is a good idea, and I can mix it in some ice cream for you.” c. "Crushing the medication would release all the medication at once, rather than over time." d. "Crushing is unsafe, as it destroys the ingredients in the medication." Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing destroys protection. 4. A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describes the action of glipizide? a. "Glipizide absorbs the excess carbohydrates in your system." b. "Glipizide stimulates your pancreas to release insulin." c. "Glipizide replaces insulin that is not being produced by your pancreas." d. "Glipizide prevents your liver from destroying your insulin." Rationale: Glipizide is an oral antidiabetic medication in the pharmacological classification of sulfonylurea agents. These medications help to lower blood glucose levels in clients who have type 2 diabetes mellitus using several methods, including reducing glucose output by the liver, increasing peripheral sensitivity to insulin, and stimulating the release of insulin from the functioning beta cells of the pancreas. 5. A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started on intravenous revamping therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? a. Constipation b. Black coloured stools c. Staining of teeth d. Body secretions turning a red-orange colour Rationale: Revamping is used in combination with other medicines to treat TB. revamping will cause the urine, stool, saliva 6. A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? a. A. Check the client's vital signs. b. Request a dietitian consult. c. Suggest that the client rests before eating the meal. d. Request an order for an antiemetic. Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm. 7. A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed? a. Thyroid hormone assay i. Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction. b. Liver function tests: i. Rationale: LFTs must be monitored before and during valproic acid therapy c. Erythrocyte sedimentation rate i. Rationale: This is not a necessary test related to lithium therapy. d. Brain natriuretic peptide 8. A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? a. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." b. "A pharmacist is the person to answer that question." c. "Heparin does not dissolve clots. It stops new clots from forming." d. "The oral medication you will take after this IV will dissolve the clot. Rationale: This statement accurately answers the client's question. 9. A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions? a) Asthma b) Glaucoma b) Depression c) Migraines Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents smooth muscle relaxation. 19. A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include? a. "Take this medication with food if nausea develops." b. "Monitor for muscle pain." c. "Expect to have increased bruising." d. "Increase your intake of grapefruit juice” Rationale: This medication can cause rhabdomyolysis. The client should monitor and report muscle pain. 20. A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client? a. "If the medicine causes an upset stomach, take an antacid at the same time." b. "Limit your daily fluid intake while taking this medication." c. "This medication can cause photophobia, so be sure to wear sunglasses outdoors." d. "You should report any tendon discomfort you experience while taking this medication.