ATI Pharmacology Proctored Test Bank-ATI Pharmacology Fall 2020

ATI Pharmacology Proctored Test Bank

ATI Pharmacology

1. 1) A nurse is caring 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 juice

3. 3.) Salicylic acid is prescribed for a client

with a diagnosis of psoriasis. The nurse

monitors the client, knowing that which of

thefollowing wouldindicatethe 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 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 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 (Miacalcin)

Rationale:

The normal serum calcium level is 8.6 to 10.0 mg/dL. This clientis experiencing

hypercalcemia.Calciumgluconateandcalciumchloridearemedicationsusedforthe

treatment of tetany, which occurs as a result of acute hypocalcemia. In

hypercalcemia, largedoses of vitamin D need to be avoided. Calcitonin, a thyroid

hormone, decreases the plasma calcium level by inhibiting bone resorption and

lowering the serum calciumconcentration.

4. Orange juice

Rationale:

Vitamin C increases the absorption of iron by the body. The mother should be

instructedtoadminister themedication witha citrus fruit or a juicethatis highin

vitaminC. Milkmayaffectabsorptionoftheiron.Waterwillnotassistinabsorption.

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)

canresult.Symptoms includetinnitus,dizziness,hyperpnea,andpsychological

disturbances. Constipation and diarrhea arenot associated with salicylism.

4. Atleast 30 minutes beforeexposureto thesun

Rationale:

Sunscreens aremost effective whenapplied atleast 30 minutes beforeexposureto

thesunso thattheycan penetratetheskin. All sunscreens should be reappliedafter

swimming or sweating.

3. Informing the clientthatthis is normal

Rationale:

Mafenideacetateisbacteriostaticforgram-negativeandgram-positiveorganisms

andis usedtotreatburns toreducebacteria presentinavascular tissues. Theclient

shouldbeinformedthatthemedication will causelocaldiscomfortandburningand

that this is a normal reaction; therefore options 1, 2, and 4 are incorrect

6. 6.) The burn client is receiving treatments of

topicalmafenideacetate(Sulfamylon)tothe

site of injury. The nurse monitors the client,

knowing that which of the following indicates

that a systemic effect has occurred?

1.Hyperventilation

2.Elevated blood pressure

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 count

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)

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

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. Hyperventilation

Rationale:

Mafenideacetateis acarbonicanhydraseinhibitorandcansuppress renalexcretion

of acid, thereby causing acidosis. Clients receiving this treatment should be

monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the

medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local

rather thansystemic effects. Anelevatedblood pressuremay be expectedfromthe

pain that occurs with a burn injury.

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 beenevaluated. Options 1, 3, and4 donotneedtobemonitored

specifically during this treatment.

1. Vitamin A

Rationale:

IsotretinoinisametaboliteofvitaminAandcanproducegeneralizedintensification

of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A

supplementsshouldbediscontinuedbeforeisotretinointherapy.Options2,3,and4

are not contraindicated with the use of isotretinoin.

2. Axilla

Rationale:

Topicalcorticosteroids canbeabsorbedintothesystemic circulation.Absorptionis

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).

1. Acne

Rationale:

Azelaic acid is a topical medication used to treatmild to moderateacne. The acid

appears to work by suppressing the growth of Propionibacterium acnes and

decreasing theproliferation of keratinocytes. Options 2, 3, and 4 areincorrect.

11. 11.) The health care provider has prescribed silver

sulfadiazine (Silvadene) for the client with a partialthickness burn, which has cultured positive for gramnegative bacteria. The nurse is reinforcing

information to the client about the medication. Which

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 applied directly to the

wound."

12. 12.) A nurse is caring for a client who is receiving an

intravenous (IV) infusion of an antineoplastic

medication. Duringtheinfusion,theclientcomplains

of pain at the insertion site. During an inspection of

the site, the nurse notes redness and swelling and

that the rate of infusion of the medication has

slowed. The nurse should take which appropriate

action?

1. Notify the registered nurse.

2. Administerpainmedicationtoreducethe

discomfort.

3. Apply ice and maintain the infusion rate, as

prescribed.

4. Elevate the extremity of the IV site, and slow the

infusion.

13. 13.) The client with squamous cell carcinoma of the

larynx is receiving bleomycin intravenously. The

nurse caring for the client anticipates that which

diagnostic study will be prescribed?

1. Echocardiography

2. Electrocardiography

3. Cervical radiography

4. Pulmonary function studies

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

3. "Themedication will permanently stain my skin."

Rationale:

Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum

ofactivityagainstgram-negativebacteria,gram-positivebacteria,and

yeast. Itis applied directly to the wound to assist in healing. It does not

stain the skin.

1. Notify the registerednurse.

Rationale:

When antineoplastic medications (Chemotheraputic Agents) are

administeredviaIV,greatcaremustbetakentopreventthemedicationfrom

escaping into the tissues surrounding the injection site, because pain, tissue

damage, and necrosis can result. The nurse monitors for signs of

extravasation, such as redness or swelling at the insertion site and a

decreasedinfusionrate.Ifextravasationoccurs,theregisterednurseneeds

to be notified; he or she will then contact the health care provider.

4. Pulmonary function studies

Rationale:

Bleomycinisanantineoplasticmedication(ChemotheraputicAgents)that

can cause interstitial pneumonitis, which can progress to pulmonary fibrosis.

Pulmonary functionstudies along withhematological, hepatic, andrenal

function tests need to be monitored. The nurse needs to monitor lung

sounds fordyspnea andcrackles, which indicatepulmonary 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 acidlevel

Rationale:

Busulfan (Myleran) can cause an increase in the uric acid level.

Hyperuricemiacanproduceuricacidnephropathy,renalstones,andacute

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 assisting 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

16. 16.) The clinic nurse is reviewing a teaching plan

for the client receiving an antineoplastic

medication. When implementing the plan, the

nurse tells the client:

1. To take aspirin (acetylsalicylic acid) as

needed for headache

2. Drink beverages containing alcohol in

moderate amounts each evening

3. Consult with health care providers (HCPs)

before receiving immunizations

4. That it is not necessary to consult HCPs

before receiving a flu vaccine at the local

health fair

17. 17.) The client with ovarian cancer is being

treated with vincristine (Oncovin). The nurse

monitors the client, knowing that which of the

following indicates a side effect specific to this

medication?

1. Diarrhea

2. Hair loss

3. Chest pain

4. Numbness and tingling in the fingers and

toes

18. 18.) The nurse is reviewing the history and

physical examination of a client who will be

receiving asparaginase (Elspar), an

antineoplastic agent. The nurse consults with

the registered nurse regarding the

administration of the medication if which of the

following is documented in the client's history?

1. Pancreatitis

2. Diabetes mellitus

3. Myocardial infarction

4. Chronic obstructive pulmonary disease

4. Orthostatic hypotension

Rationale:

Asideeffectspecific toetoposideis orthostatichypotension. Theclient'sblood

pressureis monitored during the infusion. Hair loss occurs with nearly allthe

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

beinformednottoreceiveimmunizations withouta 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. Numbnessandtinglinginthefingersandtoes

Rationale:

A side effect specific to vincristine is peripheral neuropathy, which occurs in

almosteveryclient.Peripheralneuropathycanbemanifestedas numbness and

tingling in the fingers and toes. Depression oftheAchilles tendon reflex may be

thefirst clinical signindicatingperipheralneuropathy.Constipationrather 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.

1. Pancreatitis

Rationale:

Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or

if the client has a history of pancreatitis. The medication impairs pancreatic

functionand pancreatic functiontests should beperformed beforetherapybegins

and whena weekor morehas elapsed betweenadministration ofthedoses. The

client needs to be monitored for signs of pancreatitis, which include nausea,

vomiting,andabdominalpain.Theconditionsnotedinoptions2,3, and4arenot

contraindicated with this medication.