ATI PN Pharmacology Proctored Exam
Review
Patient identifiers - -Medical record number
-home telephone number
What lab values should a nurse monitor for a patient with chronic renal failure? - ■
Urinalysis
☐ Hematuria, proteinuria, and alterations in specific gravity
☐ Serum creatinine
- Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal
failure (ARF)
- Gradual increase over months to years for chronic renal failure (CRF)
exceeding 4 mg/dL
■ Blood urea nitrogen (BUN)
- 80 to 100 mg/dL within 1 week with ARF
- Gradual increase with elevated serum creatinine over months to years for
CRF
- 180-200 mg/dL with (CRF)
■ Serum electrolytes
- Decreased sodium (dilutional) and calcium, increased potassium,
phosphorus, and magnesium
■ Complete blood count (CBC)
- Decreased hemoglobin
What food should you increase when taking Lasix? - -increased amounts of potassium-
rich foods (e.g., bananas, prunes, raisins, and orange juice)
Patient reports IV discomfort, what is your first action? - color and temperature
Sumatriptan (treats migraine headaches) adverse effect - pain, tightness, pressure, or
heaviness in the chest, throat, neck, and/or jaw
slow or difficult speech
Know about Transdermal patch - -• Apply at the same time once each day,
preferably in the morning. Keep patch on
for 12 to 14 hr each day.
• Remove the patch at night to reduce
the risk of developing tolerance to
nitroglycerin. Be medication-free a
minimum of 10 to 12 hr each day (usually
at night).
• Do not cut patches to ensure appropriate
,dosage.
• Place the patch on a hairless area of skin
(chest, back, or abdomen) and rotate sites
to prevent skin irritation.
• Wash skin with soap and water and dry
thoroughly before applying new patch.
RBC Blood transfusion -
http://www.atitesting.com/ati_next_gen/FocusedReview/data/datacontext/RM%20AMS
%20RN%208.0%20Chp%2044.pdf (prime with normal saline and infuse with sodium
chloride).
What to understand about Parkinson's Meds? - -they don't cure disease, they slow the
process.
NEUPOGEN (filgrastim)-what is the appropriate route of this med? - administered by
subcutaneous injection or IV infusion
Lisinopril therapeutic effect - blood pressure answer (e.g. 120/80)
Medication for Schizophrenia - risperidone, Risperdal
Macrodantin medication - used to treat or prevent certain urinary tract infections
Haldol-inform if you are taking ____________ medication. - -benzodiazepine class of
anti-anxiety drugs (all ending with "pam") and even, Xanax.
Fosomax - same as-Alendronate is used for treating osteoporosis in men and
postmenopausal women.
Lipitor - -lowers cholesterol in blood, "statins". Reduce LDL and total cholesterol. Raise
HDL.
Garamycin- - Antibiotic that is toxic to the kidney, injected for radiology studies.
Digoxin side effects - -Fatigue
-Bradycardia
-Anorexia
-Nausea/Vomiting
Singulair - used before exercise to prevent breathing problems during exercise
(bronchospasm).
What medication to administer with Tylenol overdose? - acetylcysteine (Mucomyst)
must be given IV
,HPV vaccine - Human Papilloma Virus (HPV2, HPV4) - -Three doses should be given
over a 6 month
-interval for females at 11 to 12 years of age (minimum age is 9 years).
-The second dose should be administered 2 months after the first dose, and the third
dose should be administered 6 months after the first dose.
-HPV4 may be given to males starting at age 9 years of age.
Opioid toxicity-what to check first - oxygen saturation
Valporic Acid lab - liver
Lithium report immediately - slurred speech
Prednisone report - sore throat
Food to avoid when taking Lithium - -salty foods
-alcoholic beverages
Labs for patients taking hydrothiazide - Periodic determination of serum electrolytes to
detect possible electrolyte imbalance should be done at appropriate intervals.
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 - 3. Calcitonin (Miacalcin)
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 calcium
concentration.
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 - 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.
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 - 1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can
result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
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 - 4. At least 30 minutes before
exposure to the sun
Rationale:
Sunscreens are most effective when applied 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.
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. 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 reaction; therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to
the site of injury. The nurse monitors the client, knowing that which of the following
indicates that a systemic effect has occurred?
1.Hyperventilation
Review
Patient identifiers - -Medical record number
-home telephone number
What lab values should a nurse monitor for a patient with chronic renal failure? - ■
Urinalysis
☐ Hematuria, proteinuria, and alterations in specific gravity
☐ Serum creatinine
- Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal
failure (ARF)
- Gradual increase over months to years for chronic renal failure (CRF)
exceeding 4 mg/dL
■ Blood urea nitrogen (BUN)
- 80 to 100 mg/dL within 1 week with ARF
- Gradual increase with elevated serum creatinine over months to years for
CRF
- 180-200 mg/dL with (CRF)
■ Serum electrolytes
- Decreased sodium (dilutional) and calcium, increased potassium,
phosphorus, and magnesium
■ Complete blood count (CBC)
- Decreased hemoglobin
What food should you increase when taking Lasix? - -increased amounts of potassium-
rich foods (e.g., bananas, prunes, raisins, and orange juice)
Patient reports IV discomfort, what is your first action? - color and temperature
Sumatriptan (treats migraine headaches) adverse effect - pain, tightness, pressure, or
heaviness in the chest, throat, neck, and/or jaw
slow or difficult speech
Know about Transdermal patch - -• Apply at the same time once each day,
preferably in the morning. Keep patch on
for 12 to 14 hr each day.
• Remove the patch at night to reduce
the risk of developing tolerance to
nitroglycerin. Be medication-free a
minimum of 10 to 12 hr each day (usually
at night).
• Do not cut patches to ensure appropriate
,dosage.
• Place the patch on a hairless area of skin
(chest, back, or abdomen) and rotate sites
to prevent skin irritation.
• Wash skin with soap and water and dry
thoroughly before applying new patch.
RBC Blood transfusion -
http://www.atitesting.com/ati_next_gen/FocusedReview/data/datacontext/RM%20AMS
%20RN%208.0%20Chp%2044.pdf (prime with normal saline and infuse with sodium
chloride).
What to understand about Parkinson's Meds? - -they don't cure disease, they slow the
process.
NEUPOGEN (filgrastim)-what is the appropriate route of this med? - administered by
subcutaneous injection or IV infusion
Lisinopril therapeutic effect - blood pressure answer (e.g. 120/80)
Medication for Schizophrenia - risperidone, Risperdal
Macrodantin medication - used to treat or prevent certain urinary tract infections
Haldol-inform if you are taking ____________ medication. - -benzodiazepine class of
anti-anxiety drugs (all ending with "pam") and even, Xanax.
Fosomax - same as-Alendronate is used for treating osteoporosis in men and
postmenopausal women.
Lipitor - -lowers cholesterol in blood, "statins". Reduce LDL and total cholesterol. Raise
HDL.
Garamycin- - Antibiotic that is toxic to the kidney, injected for radiology studies.
Digoxin side effects - -Fatigue
-Bradycardia
-Anorexia
-Nausea/Vomiting
Singulair - used before exercise to prevent breathing problems during exercise
(bronchospasm).
What medication to administer with Tylenol overdose? - acetylcysteine (Mucomyst)
must be given IV
,HPV vaccine - Human Papilloma Virus (HPV2, HPV4) - -Three doses should be given
over a 6 month
-interval for females at 11 to 12 years of age (minimum age is 9 years).
-The second dose should be administered 2 months after the first dose, and the third
dose should be administered 6 months after the first dose.
-HPV4 may be given to males starting at age 9 years of age.
Opioid toxicity-what to check first - oxygen saturation
Valporic Acid lab - liver
Lithium report immediately - slurred speech
Prednisone report - sore throat
Food to avoid when taking Lithium - -salty foods
-alcoholic beverages
Labs for patients taking hydrothiazide - Periodic determination of serum electrolytes to
detect possible electrolyte imbalance should be done at appropriate intervals.
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 - 3. Calcitonin (Miacalcin)
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 calcium
concentration.
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 - 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.
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 - 1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can
result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
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 - 4. At least 30 minutes before
exposure to the sun
Rationale:
Sunscreens are most effective when applied 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.
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. 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 reaction; therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to
the site of injury. The nurse monitors the client, knowing that which of the following
indicates that a systemic effect has occurred?
1.Hyperventilation
