ATI Pharmacology Proctored Test Bank
1. 1) A nurse is caring for a client with
hyperparathyroidism and notes that the 3. Calcitonin (Miacalcin)
client's serum calcium level is 13 mg/dL. Rationale:
Which medication should the nurse The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
prepare to administer as prescribed to the hypercalcemia. Calcium gluconate and calcium chloride are medications used for the
client? 1. Calcium chloride
treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia,
2.Calcium gluconate
large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the
3.Calcitonin (Miacalcin)
plasma calcium level by inhibiting bone resorption and lowering the serum calcium
4. Large doses of vitamin D
concentration.
2. 2.) Oral iron supplements are prescribed for
a 6-year-old child with iron deficiency 4. Orange juice Rationale:
anemia. The nurse instructs the mother to Vitamin C increases the absorption of iron by the body. The mother should be instructed
administer the iron with which best food to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk
item? 1. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice
2.Water contains a greater amount of vitamin C than apple juice.
3.Apple juice
4. Orange juice
3. 3.) Salicylic acid is prescribed for a client
with a diagnosis of psoriasis. The nurse 1. Tinnitus Rationale:
monitors the client, knowing that which Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can
of the following would indicate the result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances.
presence of systemic toxicity from this Constipation and diarrhea are not associated with salicylism.
medication? 1. Tinnitus
2.Diarrhea
3.Constipation
4. Decreased respirations
4. 4.) The camp nurse asks the children 4. At least 30 minutes before exposure to the sun
preparing to swim in the lake if they have
Rationale:
applied sunscreen. The nurse reminds the
Sunscreens are most effective when applied at least 30 minutes before exposure to the
children that chemical sunscreens are
sun so that they can penetrate the skin. All sunscreens should be reapplied after
most effective when applied: 1.
swimming or sweating.
Immediately before swimming
2.15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the
sun
5. 5.) Mafenide acetate (Sulfamylon) is
prescribed for the client with a burn 3. Informing the client that this is normal
injury. When applying the medication, the Rationale:
client complains of local discomfort and Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is
burning. Which of the following is the most used to treat burns to reduce bacteria present in avascular tissues. The client should be
appropriate nursing action? 1. Notifying informed that the medication will cause local
the registered nurse
discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are
2.Discontinuing the medication
incorrect
3.Informing the client that this is normal 6. 6.) The burn client is receiving treatments of topical mafenide acetate
4. Applying a thinner film than prescribed to (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that
the burn site which of the following indicates that a systemic effect has occurred?
, 1.Hyperventilation 2.Elevated blood tion Rationale:
pressure 3.Local pain at the burn site Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid,
4.Local rash at the burn site thereby causing acidosis. Clients receiving this treatment should be monitored for signs of
7. 7.) Isotretinoin is prescribed for a client an acid-base imbalance (hyperventilation). If this occurs, the medication should be
with severe acne. Before the discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects.
administration of this medication, the An elevated blood pressure may be expected from the pain that occurs with a burn injury.
nurse anticipates that which laboratory test
will be prescribed? 2. Triglyceride level
1. Platelet count Rationale:
2.Triglyceride level Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured
3.Complete blood count before treatment and periodically thereafter until the effect on the triglycerides has been
4. White blood cell count evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this
8. 8.) A client with severe acne is seen in the treatment.
clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews
the client's medication record and would 1. Vita
contact the (HCP) if the client is taking min A
which medication? Rationale:
1. Vitamin A Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of
2.Digoxin (Lanoxin) isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements
3.Furosemide (Lasix) should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not
4. Phenytoin (Dilantin) contraindicated with the use of isotretinoin.
9. 9.) The nurse is applying a topical
corticosteroid to a client with eczema. The
nurse would monitor for the potential for
increased systemic absorption of the
medication if the medication were being
2. Axilla Rationale
applied to which of the following body areas? :
1. Back Topical corticosteroids can be absorbed into the systemic circulation.
2.Axilla Absorption is higher from regions where the skin is especially permeable (scalp, axilla,
3. Soles of the feet face, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
4. Palms of the hands poor (back, palms, soles).
10. 10.) The clinic nurse is performing an
admission assessment on a client. The
nurse notes that the client is taking azelaic
acid (Azelex). Because of the medication
prescription, the nurse would suspect that
1. A
the client is being treated for: cne Rationale
1. Acne :
2.Eczema Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears
3.Hair loss to work by suppressing the growth of Propionibacterium acnes and decreasing the
4. Herpes simplex proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
11. 11.) The health care provider has
1. H
y
p
e
r
v
e
n
t
i
l
a
, 3."The medication will permanently 2.Uric acid level
prescribed silver sulfadiazine (Silvadene) 4. "The medication should be applied directly to the wound." for the client with a partial-
thickness burn,
12. 12.) A nurse is caring for a client who is receiving an
which has cultured positive for gram- intravenous (IV) infusion of an antineoplastic medication. During
negative bacteria. The nurse is reinforcing the infusion, the client complains of pain at the insertion site.
information to the client about the
During an inspection of the site, the nurse notes redness and
medication. Which statement made by the swelling and that the rate of infusion of the medication has
client indicates a lack of understanding slowed. The nurse should take which appropriate action?
about the treatments?
1. Notify the registered nurse.
1. "The medication is an antibacterial."
2. Administer pain medication to reduce the discomfort.
2."The medication will help heal the burn."
3.Apply ice and maintain the infusion rate, as prescribed.
4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial pneumonitis, which can progress to pulmonary
fibrosis. Pulmonary function studies along with hematological, hepatic,
and renal function tests need to be monitored. The nurse needs to
monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to be discontinued immediately
if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the specific use of this medication.
2. Uric acid level Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level.
Hyperuricemia can produce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3, and 4 are not specifically related to
this medication.
stain my skin." 3.Potassium level
4. Elevate the extremity of the IV site, and 4. Blood glucose level
slow the infusion. 3. "The medication will permanently stain my skin." Rationale:
13. 13.) The client with squamous cell Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity
carcinoma of the larynx is receiving against gram-negative bacteria, gram-positive bacteria, and yeast. It is applied
bleomycin intravenously. The nurse directly to the wound to assist in healing. It does not stain the skin.
caring for the client anticipates that
which diagnostic study will be prescribed?
1. Echocardiography
2.Electrocardiography
3. Cervical radiography
4. Pulmonary function studies
1. Notify the registered nurse. Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great
14. 14.) The client with acute myelocytic care must be taken to prevent the medication from escaping into the tissues surrounding
leukemia is being treated with busulfan the injection site, because pain, tissue damage, and necrosis can result. The nurse monitors
(Myleran). Which laboratory value would for signs of extravasation, such as redness or swelling at the insertion site and a decreased
the nurse specifically monitor during infusion rate. If extravasation occurs, the registered nurse needs to be notified; he or she
treatment with this medication? will then contact the health care provider.
1. Clotting time
, 15. 15.) The client with small cell lung cancer is being 2. Drink beverages containing alcohol in moderate amounts each evening
treated with etoposide (VePesid). The nurse who 3. Consult with health care providers (HCPs) before receiving immunizations
is assisting in caring for the client during its 4. That it is not necessary to consult HCPs before receiving a flu vaccine at the loc
administration understands that which side health fair
effect is specifically associated with this
17. 17.) The client with ovarian cancer is being treated with vincristine
medication? 1. Alopecia
2.Chest pain (Oncovin). The nurse monitors the client, knowing that which of the followin
3. Pulmonary fibrosis indicates a side effect specific to this medication?
4. Orthostatic hypotension 1. Diarrhea
16. 16.) The clinic nurse is reviewing a teaching 2.Hair loss
plan for the client receiving an antineoplastic 3.Chest pain
medication. When implementing the plan, the 4. Numbness and tingling in the fingers and toes
nurse tells the client: 18. 18.)The nurse is reviewing the history and physical examination of a client who wi
1. To take aspirin (acetylsalicylic acid) as be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with
needed for headache the registered nurse regarding the administration of the medication if which of the
following is documented in the client's history?
1. Pancreatitis
4. Orthostatic hypotension
2.Diabetes mellitus
Rationale:
3.Myocardial infarction A side effect specific to etoposide is orthostatic hypotension. The client's
4. Chronic obstructive pulmonary blood pressure is monitored during the infusion. Hair loss occurs with nearly disease all the antineoplastic
medications. Chest pain and pulmonary fibrosis are unrelated to this medication.
3. Consult with health care providers (HCPs) before receiving
immunizations Rationale:
Because antineoplastic medications lower the resistance of the body, clients must be
informed not to receive immunizations without a HCP's approval. Clients also need to
avoid contact with individuals who have recently received a live virus vaccine. Clients need
to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and
they need to avoid alcohol to minimize the risk of toxicity and side effects.
4. Numbness and tingling in the fingers and toes Rationale:
A side effect specific to vincristine is peripheral neuropathy, which occurs in almost
every client. Peripheral neuropathy can be manifested as numbness and tingling in
the fingers and toes. Depression of the Achilles tendon reflex may be the first clinical
sign indicating peripheral neuropathy. Constipation rather than diarrhea is most likely
to occur with this medication, although diarrhea may occur occasionally. Hair loss
occurs with nearly all the antineoplastic medications.
Chest pain is unrelated to this medication.
