ATI RN Pharmacology Exam Questions and Correct Explained Answers Which of the following are the five main rights of medication administration? (Select all that apply.) A. Right route B. Right to refuse C. Right dose D. Right person E. Right documentation F. Right medication RATIONALES Choice A reason: The right route means that the medication is given through the appropriate and prescribed method, such as oral, intravenous, subcutaneous, intramuscular, etc. This ensures that the medication reaches the intended site of action and avoids complica tions or adverse effects. Choice B reason: The right to refuse means that the patient has the autonomy and capacity to decline the medication after being informed of the benefits and risks. This is not one of the main rights of medication administration, b ut it is an ethical and legal principle that nurses should respect and document. Choice C reason: The right dose means that the medication is given in the correct and safe amount, as prescribed by the doctor or authorized prescriber. This ensures that the medication achieves the desired therapeutic effect and prevents overdose or underdose. Choice D reason: The right person means that the medication is given to the intended and identified patient, by checking their name, identification band, and other ident ifiers. This prevents medication errors and ensures patient safety and quality of care. Choice E reason: The right documentation means that the medication is recorded accurately and timely in the patient's chart, medication administration record, or other relevant documents. This provides evidence of care, facilitates communication, and enables evaluation and monitoring of the medication's effectiveness and outcomes. Choice F reason: The right medication means that the medication is given as prescribed, wit h the correct name and form. This prevents confusion and errors with lookalike or soundalike medications, and ensures that the patient receives the appropriate and intended drug. A nurse is caring for a client with asthma who is prescribed metoprolol. The nurse should monitor the client for which of the following? A. Increased respiratory rate B. Bronchodilation C. Decreased sputum production D. Wheezing RATIONALES Choice A reason: Increased respiratory rate is not a sign of adverse reaction to metoprolo l, but rather a normal response to hypoxia or distress. Metoprolol is a betablocker that can lower the heart rate and blood pressure, but it does not affect the respiratory rate directly. Choice B reason: Bronchodilation is not a sign of adverse reaction t o metoprolol, but rather a desired effect of asthma medications such as betaagonists or anticholinergics. Metoprolol is a betablocker that can block the beta receptors in the lungs, which can cause bronchoconstriction or narrowing of the airways. This is w hy metoprolol is contraindicated or used with caution in clients with asthma. Choice C reason: Decreased sputum production is not a sign of adverse reaction to metoprolol, but rather a result of effective asthma management. Metoprolol is a betablocker that does not have any direct effect on the mucus secretion or inflammation in the lungs. Choice D reason: Wheezing is a sign of adverse reaction to metoprolol, as it indicates bronchoconstriction or narrowing of the airways. Metoprolol is a betablocker that c an block the beta receptors in the lungs, which can reduce the bronchodilation effect of beta agonists or other asthma medications. This can worsen the asthma symptoms and cause wheezing, coughing, dyspnea, or chest tightness. The nurse should monitor the client for these signs and report them to the prescriber immediately. A nurse prepares to replace the nearly empty container of total parenteral nutrition (TPN) for a client when she finds that there has been a delay in receiving the new container of solu tion from the pharmacy. Which of the following solutions should the nurse infuse until the next container of TPN solution becomes available? A. 3% sodium chloride B. Dextrose 10% in water C. Lactated Ringer's D. 0.9% sodium chloride RATIONALES Choice A r eason: 3% sodium chloride is a hypertonic solution that can cause fluid shifts and dehydration. It is not a suitable replacement for TPN, which is also hypertonic but provides calories, electrolytes, vitamins, and minerals. Infusing 3% sodium chloride can lead to hypernatremia, increased intracranial pressure, and cellular damage. Choice B reason: Dextrose 10% in water is a hypertonic solution that can provide some calories and prevent hypoglycemia. It is the best option among the choices to replace TPN temporarily, until the new container arrives. However, it does not provide adequate nutrition or electrolytes, so it should not be used for a long time. Choice C reason: Lactated Ringer's is an isotonic solution that can maintain fluid balance and electrolyte s. It is not a suitable replacement for TPN, which is hypertonic and provides more calories and nutrients. Infusing Lactated Ringer's can lead to fluid overload, hyponatremia, and metabolic alkalosis. Choice D reason: 0.9% sodium chloride is an isotonic so lution that can maintain fluid balance and sodium levels. It is not a suitable replacement for TPN, which is hypertonic and provides more calories and nutrients. Infusing 0.9% sodium chloride can lead to fluid overload, hyponatremia, and metabolic acidosis . The nurse is monitoring a client taking a potassium sparing diuretic. Which of the following findings would prompt the nurse to notify the health care provider? A. Serum sodium level of 140 mEq/L B. Blood pressure of 130/80 mmHg C. Serum potassium level of 5.5 mEq/L D. Serum potassium level of 3.5 mEq/L RATIONALES Choice A reason: Serum sodium level of 140 mEq/L is within the normal range of 135145 mEq/L. It does not indicate any adverse effect of the potassium sparing diuretic, which does not affect s odium excretion significantly. The nurse does not need to notify the health care provider about this finding. Choice B reason: Blood pressure of 130/80 mmHg is slightly above the normal range of 120/80 mmHg, but it is not a cause for concern. The potassium sparing diuretic can lower the blood pressure by reducing the fluid volume and preventing sodium retention. The nurse should monitor the blood pressure regularly but does not need to notify the health care provider about this finding. Choice C reason: Serum potassium level of 5.5 mEq/L is above the normal range of 3.55.0 mEq/L. It indicates hyperkalemia, which is a serious and potentially life -threatening complication of the potassium sparing diuretic. The potassium sparing diuretic can increase the potass ium level by inhibiting its secretion in the distal tubule of the kidney. The nurse should notify the health care provider immediately and prepare to administer interventions such as calcium gluconate, insulin, or sodium bicarbonate to lower the potassium level and prevent cardiac arrhythmias. Choice D reason: Serum potassium level of 3.5 mEq/L is at the lower end of the normal range of 3.55.0 mEq/L. It does not indicate any adverse effect of the potassium sparing diuretic, which does not cause potassium lo ss. The nurse does not need to notify the health care provider about this finding. A patient who has been taking opioids for several weeks tells the nurse, "The medication doesn't seem to work as well anymore." The nurse recognizes this as a sign of: A. Allergy B. Addiction C. Withdrawal D. Tolerance RATIONALES Choice A reason: Allergy is an immune mediated reaction to a substance that causes symptoms such as rash, itching, swelling, or anaphylaxis. It is not related to the duration or effectiveness of t he medication. The patient does not report any signs of allergy to the opioids. Choice B reason: Addiction is a chronic and compulsive disorder that involves seeking and using a substance despite harmful consequences. It is characterized by loss of control , craving, and impaired functioning. The patient does not show any signs of addiction to the opioids, such as increasing the dose, obtaining the medication illegally, or neglecting other responsibilities. Choice C reason: Withdrawal is a syndrome that occu rs when a substance is abruptly discontinued or reduced after prolonged use. It causes physical and psychological symptoms such as anxiety, agitation, sweating, nausea, or tremors. The patient does not experience any signs of withdrawal from the opioids, a s they are still taking the medication as prescribed. Choice D reason: Tolerance is a phenomenon that occurs when a substance loses its effectiveness over time due to repeated exposure. It requires higher doses or more frequent administration to achieve th e same effect. The patient reports a sign of tolerance to the opioids, as they feel that the medication does not work as well anymore. The nurse should assess the patient's pain level, monitor the opioid dose, and consult with the prescriber about possible adjustments or alternatives. The nurse is preparing to administer Reglan to a patient. She is most concerned by the following information in the patient's medical record? A. Past medical history of benign prostatic hyperplasia (BPH) B. Blood pressure of 132/82 C. Allergy to corn D. Past medical history of gout RATIONALES Choice A reason: Past medical history of benign prostatic hyperplasia (BPH) is not a contraindication or a concern for administering Reglan, which is a medication that stimulates the mo tility of the upper gastrointestinal tract and treats nausea, heartburn, and gastroparesis¹. Reglan does not affect the prostate or urinary function. Choice B reason: Blood pressure of 132/82 is slightly above the normal range of 120/80, but it is not a ca use for concern or a reason to withhold Reglan. Reglan can lower the blood pressure by reducing the fluid volume and preventing sodium retention¹. The nurse should monitor the blood pressure regularly, but does not need to notify the health care provider a bout this finding. Choice C reason: Allergy to corn is a concern for administering Reglan, as some formulations of Reglan may contain corn starch as an inactive ingredient. Corn starch can trigger an allergic reaction in people who are sensitive to corn, c ausing symptoms such as rash, itching, swelling, or anaphylaxis. The nurse should check the label of the Reglan product and avoid using it if it contains corn starch. The nurse should also notify the health care provider and the pharmacy about the patient' s allergy and request an alternative medication or formulation. Choice D reason: Past medical history of gout is not a contraindication or a concern for administering Reglan, which is a medication that stimulates the motility of the upper gastrointestinal tract and treats nausea, heartburn, and gastroparesis¹. Reglan does not affect the uric acid levels or the joints. A patient is prescribed Flexeril (cyclobenzaprine) for muscle spasms. Which of the following is the most common side effect that the nurse s hould educate the patient about? A. Tinnitus
