ATI PHARMACOLOGY PROCTORED TEST BANK QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES AGRADE (RASMUSSEN COLLEGE) The nurse is assessing a patient with diabetes who has hyperlipidemia. The patient asks the nurse to suggest either an herbal medication or a dietary modification to reduce cholesterol levels. Which suggestion, given by the nurse would be most beneficial t o the patient? - ANSWER>> "Eat foods rich in omega -3 fatty acids." Rationale: The patient has diabetes and hyperlipidemia; therefore, the nurse should suggest that the patient include foods rich in omega -3 fatty acids, such as fish oil, in her diet. They are also available as fish oil products under the brand name Lovaza. This reduces cholesterol levels without altering blood glucose levels. Flax intake should not be suggested to a diabetic patient, because it may have potential hypoglycemic effects due to drug interactions. Garlic is contraindicated in diabetic patients; the nurse should not suggest that the patient eat an excessive amount of garlic. St. John's wort is an herb used to treat depression and the symptoms associated with depression, such as anxiety, loss of appetite, and insomnia. This is not helpful in reduci ng the cholesterol level. The nurse is caring for a patient who has coronary heart disease (CHD). The nurse tells the patient, "Your cholesterol levels are abnormal; you are at a high risk of having a heart attack." What did the nurse discover regarding the lipoprotein levels in th e patient's blood report? Correct - ANSWER>> High levels of low -density lipoproteins (LDL) Rationale: High levels of low -density lipoproteins (LDL) refer to high cholesterol levels in the blood, because LDL is almost entirely composed of cholesterol. This cholesterol is bad cholesterol, which promotes the formation of atherosclerotic plaque, res ulting in CHD. High -density lipoproteins (HDL) are good cholesterol, which have a cardioprotective action. Low levels of very -low-density lipoproteins (VLDL) are due to a low-fat diet; however, these do not cause high cholesterol levels. Low levels of intermediate -density lipoproteins (IDL) do not increase the risk of CHD; they are useful for the production of bile acids. What are the common side effects of fenofibrate, a fibric acid derivative? Select all that apply. - ANSWER>> Impotence, nausea, abdominal pain, and an increase in gallstone formation The nurse plans which intervention to decrease flushing associated with niacin? - ANSWER>> Administer aspirin 30 minutes before nicotinic acid. Rationale: Administration of an antiinflammatory agent such as aspirin has been shown to decrease the flushing reaction associated with niacin. Antacids do not prevent cutaneous flushing. Applying cold compresses to the patient's head and neck may not diminish flushing. H1 antagonists, including drugs such as diphenhydramine hydrochloride, are of greatest value in the treatment of nasal allergies, particularly seasonal hay fever. Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin administration? - ANSWER>> Partial thromboplastin time (PTT) Rationale: Heparin therapy is guided by changes in the partial thromboplastin time (PTT). A client with metastatic cancer who has been receiving fentanyl for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which intervention should the nurse initiate? - ANSWER>> Notify the health care provider of the need to increase the dose. To evaluate whether the administration of an antihypertensive medication has caused a therapeutic effect, which action should the nurse implement? - ANSWER>> Compare the client's blood pressure before and after the client takes the medication. Rationale: Therapeutic effects are the expected or predictable physiologic responses to a medication. An antihypertensive medication is administered to lower blood pressure, so to determine if the therapeutic effect has been achieved, the nurse should compare the client's blood pressure before and after the client takes the medication. A child with cystic fibrosis is receiving ticarcillin disodium for Pseudomonas pneumonia. For which adverse effect should the nurse assess and report promptly to the health care provider? - ANSWER>> Petechiae Rationale: Adverse effects of ticarcillin disodium include hypothrombinemia and decreased platelet adhesion, which can result in the presence of petechiae During therapy with isoniazid, it is most important for the nurse to monitor which laboratory value closely? - ANSWER>> Liver enzyme levels Rationale: The client receiving isoniazid is at risk for the development of hepatitis; therefore, liver function test results should be monitored carefully during drug therapy A client is receiving acyclovir sodium IV for a severe herpes simplex infection. Which intervention should the nurse implement during this drug therapy? - ANSWER>> Increase daily fluids to 2000 to 4000 mL/day. Rationale: Increasing fluid intake during treatment prevents precipitation of the drug in the renal tubules, which could lead to obstructive problems that impair kidney function. Acute glomerulonephritis is a possible complication of acyclovir sodium thera py. A client has a positive skin test for tuberculosis. Which prophylactic drug should the nurse expect to administer to this client? - ANSWER>> Isoniazid A client receiving a continuous infusion of heparin IV starts to hemorrhage from an arterial access site. Which medication should the nurse anticipate administering to prevent further heparin -induced hemorrhaging? - ANSWER>> Protamine sulfate Rationale: Protamine sulfate is the antagonist for heparin and is given for episodes of acute hemorrhage Which class of antineoplastic chemotherapy agents resembles the essential elements required for DNA and RNA synthesis and inhibits enzymes necessary for cellular function and replication? - ANSWER>> Antimetabolites Rationale: Antimetabolites exert their action by inhibiting the enzymes necessary for cellular function and replication. Methylphenidate is prescribed for daily administration to a 10 -year-old child with attention -deficit/hyperactivity disorder (ADHD). In preparing a teaching plan for the parents of this child newly diagnosed with ADHD, which instruction is most important fo r the nurse to provide to the parents? - ANSWER>> Administer the medication in the morning before the child goes to school. Rationale: Methylphenidate is a central nervous system (CNS) stimulant. To be most effective in affecting the child's behavior, the dose of the drug should be administered in the morning before the child goes to school. Drug holidays are often prescribed t o assess the child's degree of recovery; however, such interruptions are not conducted in the early phase of treatment and are usually implemented when side effects occur over a period of time. A psychiatric client is discharged from the hospital with a prescription for haloperidol. Which instruction should the nurse include in the discharge teaching plan for this client? - ANSWER>> Use sunglasses and sunscreen when outdoors Rationale: Photosensitivity is a common adverse effect of haloperidol (Haldol); therefore, the use of sunglasses and sunscreen should be included in the discharge teaching for this client The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes atropine sulfate, IM STAT. What is the primary purpose for administering this drug to the child at this time? - ANSWER>> Decre ase the oral secretions.
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