ATI PN Pharmacology Proctored Exam Review Q&A WITH
RATIONALE 2022 GRADED A
ATI PN 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: 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. 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. 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. 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. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn
in- jury. 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. 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
2.Elevated blood pressure
3.Local pain at the burn
site
4.Local rash at the burn site:
1.Hyperventilation Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excre-
tion 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 than systemic effects. An elevated blood pressure may be expected from
the pain that occurs with a burn injury.
, 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: 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 med-
ication 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 isotretinoin 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).
RATIONALE 2022 GRADED A
ATI PN 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: 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. 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. 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. 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. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn
in- jury. 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. 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
2.Elevated blood pressure
3.Local pain at the burn
site
4.Local rash at the burn site:
1.Hyperventilation Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excre-
tion 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 than systemic effects. An elevated blood pressure may be expected from
the pain that occurs with a burn injury.
, 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: 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 med-
ication 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 isotretinoin 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).
