ATI Pharmacology / ATI Pharmacology Proctored Test Bank ACTUAL EXAM 2023 ( 313)QUESTION AND ANSWERS . 1. 1) A nurse is cari ng for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1. Calcium chloride 2. Calcium gluconate 3. Calcitonin (Miacalcin) 4. Large doses of vitamin D 2. 2.) Oral iron supplements are prescribed for a 6-year -old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item? 1. Milk 2. Water 3. Apple juice 4. Orange juic e 3. 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations 4. 4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied: 1. Immediately before swimming 2. 15 minutes before exposure to the su n 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 injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action? 1. Notifying the registered nurse 2. Discontinuing the medication 3. Informing the client that this is normal 4. Applying a thinner film than prescribed to the burn site 3. Calcitonin (Miac alcin) Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum c alcium concentration. 4. Orange juice Rationale: Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice. 1. Tinnitus Rationale: Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can r esult. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism. 4. At least 30 minutes before exposure to the sun Rationale: Sunscreens are most effective when a pplied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating. 3. Informing the client that this is normal Rationale: Mafenide acetate is bacteriostatic for gram -negative and gram -positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal rea ction; therefore options 1, 2, and 4 are incorrect 6. 6.) The burn client is receiving treatments of 1. Hyperventilation Rationale: topical mafenide acetate (Sulfamylon) to the Mafenide acetate is a carbonic anhydrase inhibitor and can suppressrenal excretion site of injury. The nurse monitors the client, of acid, thereby causing acidosis. Clients receiving this treatment should be knowing that which of the following indicates monitored for signs of an acid -base imbalan ce (hyperventilation). If this occurs, the that a systemic effect has occurred? medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local 1.Hyperventilation rather than systemic effects. An elevated blood pressure may be expected f rom the 2.Elevated blood pressure pain that occurs with a burn injury. 3.Local pain at the burn site 4.Local rash at the burn site 7. 7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1. Platelet count 2. Triglyceride level 3. Complete blood count 4. White blood cell c ount 2. Triglyceride level Rationale: Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured before treatment and periodically thereafter until the effect on the triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this treatment. 8. 8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication? 1. Vitamin A 2. Digoxin (Lanoxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin) 1. Vitamin A Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isot retinoin therapy. Options 2, 3, and 4 are not 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 applied to which of the following body areas? 1. Back 2. Axilla 3. Soles of the feet 4. Palms of the hands 2. Axilla Rationale: Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is 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 the client is being treated for: 1. Acne 2. Eczema 3. Hair loss 4. Herpes simplex 1. Acne Rationale: Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect. 3. "Themedication will permanently stain my skin." 11. 11.) The health care provider has prescribed silver Rationale: sulfadiazine (Silvadene) for the client with a partial - Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum thickness burn, which has cultured positive for gram - of activ ity against gram -negative bacteria, gram -positive bacteria, and negative bacteria. The nurse is reinforcing yeast. It is applied directly to the wound to assist in healing. It does not information to the client about the medication. Which stain the skin. statement made by the client indicates a lack of understanding about the treatments? 1. "The medication is an antibacterial." 2. "The medication will help heal the burn." 3. "The medication will permanently stain my skin." 4. "The medication should be appl ied directly to the wound." 1. Notify the registered nurse. 12. 12.) A nurse is caring for a client who is receiving an Rationale: intravenous (IV) infusion of an antineoplastic When antineoplastic medications (Chemotheraputic Agents) are medication. During the infusion, the client complains administered via IV, great care must be taken to prevent the medication from of pain at the insertion site. During an inspection of escaping into the tissues surrounding the injection site, because pain, tissue the site, the nurse notes redness and swelling and damage, and necrosis can result. The nurse monitors for signs of that the rate of infusion of the medication has extravasation, such as redness or swelling at the insertion site and a slowed. The nurse should take which appropriate decreased infusion rate. If extravasation occurs, the registered nurse needs action? 1. Notify the registered nurse. to be notified; he or she will then contact the health care provider. 2. Administer pain medication to reduce the discomfort. 3. Apply ice and maintain the infusion rate, as prescribed. 4. Elevate the extremity of the IV site, and slow the infusion. 4. Pulmonary function studies 13. 13.) The client with squamous cell carcinoma of the Rationale: larynx is receiving bleomycin intravenously. The Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that nurse caring for the client anticipates that which can cause interstitial pneumonitis, which can progress to pulmonary fibrosis. diagnostic study will be prescribed? 1. Echocardiography Pulmonary function studies along with hematological, hepatic, and renal 2. Electrocardiography function tests need to be monitored. The nurse needs to monitor lung 3. Cervical radiography sounds for dyspnea and crackles, which indicate pulmonary toxicity. The 4. Pulmonary function studies medication needs to be discontinued imm ediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the specific use of this medication. 14. 14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value would the nurse specifically monitor during treatment with this medication? 1. Clotting time 2. Uric acid level 3. Potassium level 4. Blood glucose level 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. 15. 15.) The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is as sisting in caring for the client during its administration understands that which side effect is specifically associated with this medication? 1. Alopecia 2. Chest pain 3. Pulmonary fibrosis 4. Orthostatic hypotension
