ATI PHARMACOLOGY PROCTORED 2019 B NGN COMPLETE EXAM ALL
70 QUESTIONS AND CORRECT ANSWERS WITH RATIONALES.
• A nurse is caring for a pt who is receiving Haloperidol. The nurse should identify which of the following findings as an adverse effect of the
med?
-Akathisia = CORRECT ANSWER
An adverse effect associated with haloperidol is the development of extrapyramidal manifestations such as dystonia,
pseudoparkinsonism, and akathisia.
-Paresthesia
Haloperidol, an antipsychotic neuroleptic medication, can cause CNS adverse effects such as seizures, confusion, and neuroleptic
syndrome. However, paresthesia is not an adverse effect of haloperidol.
-Excess tear production
Haloperidol has anticholinergic properties that can cause sensory adverse effects such as increased intraocular pressure, blurred
vision, and dry eyes.
-Anxiety
Haloperidol can be prescribed to treat severe agitation as well as psychotic manifestations.
• A nurse is providing teaching to a pt who is to start taking Sumatriptan. Which of the following adverse effects should the nurse instruct
the pt to monitor for and report to the provider?
-Chest pressure= CORRECT ANSWER
Sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest
pressure or heavy arms to the provider.
-White patches on the tongue
White patches on the tongue can indicate a fungal infection, which is not an adverse effect of sumatriptan.
-Bruising
Ecchymosis can indicate thrombocytopenia, which is not an adverse effect of sumatriptan.
-Insomnia
Sumatriptan can cause drowsiness and sedation as an adverse effect of the medication.
• A nurse is teaching a pt who is starting to take Amitriptyline. Which of the following findings should the nurse include in the teaching
as an adverse effect of the med?
-Diarrhea
Constipation is an adverse effect of amitriptyline.
-Cough
Developing a cough is not an adverse effect of amitriptyline.
-Urinary retention = CORRECT ANSWER
The nurse should instruct the client that amitriptyline causes the anticholinergic effect of urinary retention.
-Increased libido
A decrease in libido is an adverse effect of amitriptyline.
• A nurse is assessing a pt who is taking Tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse to report
to the provider?
-Hot flashes
The client is at risk for hot flashes as an adverse effect of tamoxifen; however, another finding is the priority to report to the
provider. The nurse should encourage the client to avoid caffeine and spicy foods to prevent hot flashes.
-Gastrointestinal irritation
The client is at risk for gastrointestinal irritation (GI) as an adverse effect of tamoxifen; however, another finding is the priority to
report to the provider. The nurse should administer the medication with food or fluids to reduce GI irritation.
-Vaginal dryness
The client is at risk for vaginal dryness as an adverse effect of tamoxifen; however, another finding is the priority to report to the
provider. The nurse should encourage the client to use vaginal moisturizers if dryness occurs.
, -Leg tenderness = CORRECT ANSWER
The greatest risk to this client is the development of a thromboembolism, which is an adverse effect of tamoxifen. The nurse
should also monitor the client for other manifestations of a thromboembolism, including leg tenderness, redness, swelling, and
shortness of breath.
• A nurse is teaching a pt who is taking Allopurinol for the treatment of gout. Which of the following info should the nurse include in the
teaching?
-Plan to increase the dosage each week by 200 mg increments.
The nurse should instruct the client to increase the dosage each week by 50 to 100 mg until they experience relief or reach a
maximum of 800 mg daily.
-Prolonged use of the medication can cause glaucoma.
The nurse should instruct the client that the prolonged use of allopurinol can cause cataracts; therefore, the client should have
periodic ophthalmic checkups.
-Drink 2 L of water daily. = CORRECT ANSWER
The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury,
because allopurinol is eliminated through the kidneys.
-A fine red rash is transient and can be treated with antihistamines.
The nurse should instruct the client to report a rash to the provider immediately as this can be an indication of hypersensitivity
syndrome, a life-threatening toxicity. Treatment for allopurinol toxicity can require hemodialysis or the administration of
glucocorticoid medications
• A nurse is caring for a pt who has diabetes mellitus and is taking Glyburide. The pt reports feeling confused and anxious. Which of the
following actions should the nurse take first?
-Perform a capillary blood glucose test. = CORRECT ANSWER
The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to
determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and
seizures.
-Provide the client with a protein-rich snack.
The nurse should provide the client with a protein-rich snack after determining the client's blood glucose value and providing a
carbohydrate first. However, there is another action that the nurse should take first.
-Give the client 120 mL (4 oz) of orange juice.
The nurse should give the client 10 to 15 g of carbohydrates, such as 4 oz of orange juice, to treat hypoglycemia. However, there is
another action that the nurse should take first.
-Schedule an early meal tray.
The nurse should schedule an early meal tray to maintain the client's blood glucose level following the initial interventions for
hypoglycemia. However, there is another action the nurse should take first.
• A nurse is administering Cefotetan via intermittent IV bolus to a pt who suddenly develops dyspnea and widespread hives. Which of the
following actions should the nurse take first?
-Administer epinephrine 0.5 mL via IV bolus.
The nurse should administer epinephrine, which is a beta-adrenergic agonist that can stimulate the heart, cause vasoconstriction
of blood vessels in the skin and mucous membranes, and cause bronchodilation in the lungs. However, there is another action
the nurse should take first.
-Discontinue the medication IV infusion. = CORRECT ANSWER
The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to
discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not
remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV
infusion.
-Elevate the client's legs above the level of the heart.
The nurse should elevate the client's legs and feet to a level above the client's heart to facilitate blood flow to the vital organs.
However, there is another action the nurse should take first.
, -Collect a blood specimen for ABGs.
The nurse should collect a blood specimen for ABGs levels to evaluate the client's respiratory status. However, there is another
action the nurse should take first.
• A nurse is preparing to administer 0.9% Sodium Chloride 1000mL IV over 8hr to a pt. The drop factor of the manual IV tubing is 15gtt/mL.
The nurse should set the manual IV infusion to deliver how many gtt/min? (round to nearest whole #, do not use trailing zero)
The nurse should set the manual IV infusion to deliver 0.9% sodium chloride IV at 31 gtt/min. = CORRECT ANSWER
• A nurse is teaching about a new prescription for Ciprofloxan to a pt who has a UTI. The nurse should identify which of the following
statements as an indication that the pt understands the teaching?
-"I will take this medication with an antacid to prevent gastrointestinal upset."
The client should avoid taking ciprofloxacin with an antacid containing aluminum, magnesium, or calcium because this can
decrease the effectiveness of the medication. The nurse should instruct the client to take antacids 2 hr before or 6 hr after the
ciprofloxacin.
-"I will stop taking this medication when I no longer have pain upon urination."
The client should take the full course of ciprofloxacin to prevent reoccurring colonization of bacteria.
-"I will report any signs of tendon pain or swelling." = CORRECT ANSWER
Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so the
client should notify the provider at the onset of tendon pain or swelling.
-"I will take this medication with milk."
The client should take ciprofloxacin with water and increase fluids to 2 to 3 L daily to avoid the development of crystals in the
kidneys. Milk products will decrease the absorption of the medication.
• A nurse is preparing to teach a pt who is to start a new prescription for extended release Verapamil. Which of the following instructions
should the nurse plan to include?
-Take the medication on an empty stomach.
The nurse should instruct the client to take extended release verapamil with food to minimize gastric distress.
-Avoid crowds.
Avoiding crowds is not necessary for the client who is taking verapamil because it does not cause an immunosuppression disorder.
-Discontinue the medication if palpitations occur.
The nurse should instruct the client that verapamil can cause palpitations, which should be reported to the provider. The client
should never discontinue the medication abruptly because the client might experience chest pain.
-Change positions slowly. = CORRECT ANSWER
The nurse should instruct the client to change positions gradually to prevent orthostatic hypotension and syncope.
-A nurse is caring for a pt who is refusing to take their scheduled morning Furosemide. Which of the following statements should the nurse
make?
-"By not taking your furosemide, you might retain fluid and develop swelling." = CORRECT ANSWER
The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication,
notify the provider, and document the refusal. Furosemide is a loop diuretic given to reduce edema.
-"You can double your dose of furosemide this evening if that would be better for you."
The nurse should respect the client's right to refuse the medication and identify that the client should not double the medication
dose if missed.
-"If you do not take your furosemide, we might get in trouble."
The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication,
notify the provider, and document the refusal. This response uses nontherapeutic communication because the nurse is threatening
the client.
-"I'll go ahead and mix the furosemide into your breakfast cereal."
The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication,
notify the provider, and document the refusal. This response is dismissing the client's right to refuse a medication.
70 QUESTIONS AND CORRECT ANSWERS WITH RATIONALES.
• A nurse is caring for a pt who is receiving Haloperidol. The nurse should identify which of the following findings as an adverse effect of the
med?
-Akathisia = CORRECT ANSWER
An adverse effect associated with haloperidol is the development of extrapyramidal manifestations such as dystonia,
pseudoparkinsonism, and akathisia.
-Paresthesia
Haloperidol, an antipsychotic neuroleptic medication, can cause CNS adverse effects such as seizures, confusion, and neuroleptic
syndrome. However, paresthesia is not an adverse effect of haloperidol.
-Excess tear production
Haloperidol has anticholinergic properties that can cause sensory adverse effects such as increased intraocular pressure, blurred
vision, and dry eyes.
-Anxiety
Haloperidol can be prescribed to treat severe agitation as well as psychotic manifestations.
• A nurse is providing teaching to a pt who is to start taking Sumatriptan. Which of the following adverse effects should the nurse instruct
the pt to monitor for and report to the provider?
-Chest pressure= CORRECT ANSWER
Sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest
pressure or heavy arms to the provider.
-White patches on the tongue
White patches on the tongue can indicate a fungal infection, which is not an adverse effect of sumatriptan.
-Bruising
Ecchymosis can indicate thrombocytopenia, which is not an adverse effect of sumatriptan.
-Insomnia
Sumatriptan can cause drowsiness and sedation as an adverse effect of the medication.
• A nurse is teaching a pt who is starting to take Amitriptyline. Which of the following findings should the nurse include in the teaching
as an adverse effect of the med?
-Diarrhea
Constipation is an adverse effect of amitriptyline.
-Cough
Developing a cough is not an adverse effect of amitriptyline.
-Urinary retention = CORRECT ANSWER
The nurse should instruct the client that amitriptyline causes the anticholinergic effect of urinary retention.
-Increased libido
A decrease in libido is an adverse effect of amitriptyline.
• A nurse is assessing a pt who is taking Tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse to report
to the provider?
-Hot flashes
The client is at risk for hot flashes as an adverse effect of tamoxifen; however, another finding is the priority to report to the
provider. The nurse should encourage the client to avoid caffeine and spicy foods to prevent hot flashes.
-Gastrointestinal irritation
The client is at risk for gastrointestinal irritation (GI) as an adverse effect of tamoxifen; however, another finding is the priority to
report to the provider. The nurse should administer the medication with food or fluids to reduce GI irritation.
-Vaginal dryness
The client is at risk for vaginal dryness as an adverse effect of tamoxifen; however, another finding is the priority to report to the
provider. The nurse should encourage the client to use vaginal moisturizers if dryness occurs.
, -Leg tenderness = CORRECT ANSWER
The greatest risk to this client is the development of a thromboembolism, which is an adverse effect of tamoxifen. The nurse
should also monitor the client for other manifestations of a thromboembolism, including leg tenderness, redness, swelling, and
shortness of breath.
• A nurse is teaching a pt who is taking Allopurinol for the treatment of gout. Which of the following info should the nurse include in the
teaching?
-Plan to increase the dosage each week by 200 mg increments.
The nurse should instruct the client to increase the dosage each week by 50 to 100 mg until they experience relief or reach a
maximum of 800 mg daily.
-Prolonged use of the medication can cause glaucoma.
The nurse should instruct the client that the prolonged use of allopurinol can cause cataracts; therefore, the client should have
periodic ophthalmic checkups.
-Drink 2 L of water daily. = CORRECT ANSWER
The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury,
because allopurinol is eliminated through the kidneys.
-A fine red rash is transient and can be treated with antihistamines.
The nurse should instruct the client to report a rash to the provider immediately as this can be an indication of hypersensitivity
syndrome, a life-threatening toxicity. Treatment for allopurinol toxicity can require hemodialysis or the administration of
glucocorticoid medications
• A nurse is caring for a pt who has diabetes mellitus and is taking Glyburide. The pt reports feeling confused and anxious. Which of the
following actions should the nurse take first?
-Perform a capillary blood glucose test. = CORRECT ANSWER
The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to
determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and
seizures.
-Provide the client with a protein-rich snack.
The nurse should provide the client with a protein-rich snack after determining the client's blood glucose value and providing a
carbohydrate first. However, there is another action that the nurse should take first.
-Give the client 120 mL (4 oz) of orange juice.
The nurse should give the client 10 to 15 g of carbohydrates, such as 4 oz of orange juice, to treat hypoglycemia. However, there is
another action that the nurse should take first.
-Schedule an early meal tray.
The nurse should schedule an early meal tray to maintain the client's blood glucose level following the initial interventions for
hypoglycemia. However, there is another action the nurse should take first.
• A nurse is administering Cefotetan via intermittent IV bolus to a pt who suddenly develops dyspnea and widespread hives. Which of the
following actions should the nurse take first?
-Administer epinephrine 0.5 mL via IV bolus.
The nurse should administer epinephrine, which is a beta-adrenergic agonist that can stimulate the heart, cause vasoconstriction
of blood vessels in the skin and mucous membranes, and cause bronchodilation in the lungs. However, there is another action
the nurse should take first.
-Discontinue the medication IV infusion. = CORRECT ANSWER
The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to
discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not
remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV
infusion.
-Elevate the client's legs above the level of the heart.
The nurse should elevate the client's legs and feet to a level above the client's heart to facilitate blood flow to the vital organs.
However, there is another action the nurse should take first.
, -Collect a blood specimen for ABGs.
The nurse should collect a blood specimen for ABGs levels to evaluate the client's respiratory status. However, there is another
action the nurse should take first.
• A nurse is preparing to administer 0.9% Sodium Chloride 1000mL IV over 8hr to a pt. The drop factor of the manual IV tubing is 15gtt/mL.
The nurse should set the manual IV infusion to deliver how many gtt/min? (round to nearest whole #, do not use trailing zero)
The nurse should set the manual IV infusion to deliver 0.9% sodium chloride IV at 31 gtt/min. = CORRECT ANSWER
• A nurse is teaching about a new prescription for Ciprofloxan to a pt who has a UTI. The nurse should identify which of the following
statements as an indication that the pt understands the teaching?
-"I will take this medication with an antacid to prevent gastrointestinal upset."
The client should avoid taking ciprofloxacin with an antacid containing aluminum, magnesium, or calcium because this can
decrease the effectiveness of the medication. The nurse should instruct the client to take antacids 2 hr before or 6 hr after the
ciprofloxacin.
-"I will stop taking this medication when I no longer have pain upon urination."
The client should take the full course of ciprofloxacin to prevent reoccurring colonization of bacteria.
-"I will report any signs of tendon pain or swelling." = CORRECT ANSWER
Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so the
client should notify the provider at the onset of tendon pain or swelling.
-"I will take this medication with milk."
The client should take ciprofloxacin with water and increase fluids to 2 to 3 L daily to avoid the development of crystals in the
kidneys. Milk products will decrease the absorption of the medication.
• A nurse is preparing to teach a pt who is to start a new prescription for extended release Verapamil. Which of the following instructions
should the nurse plan to include?
-Take the medication on an empty stomach.
The nurse should instruct the client to take extended release verapamil with food to minimize gastric distress.
-Avoid crowds.
Avoiding crowds is not necessary for the client who is taking verapamil because it does not cause an immunosuppression disorder.
-Discontinue the medication if palpitations occur.
The nurse should instruct the client that verapamil can cause palpitations, which should be reported to the provider. The client
should never discontinue the medication abruptly because the client might experience chest pain.
-Change positions slowly. = CORRECT ANSWER
The nurse should instruct the client to change positions gradually to prevent orthostatic hypotension and syncope.
-A nurse is caring for a pt who is refusing to take their scheduled morning Furosemide. Which of the following statements should the nurse
make?
-"By not taking your furosemide, you might retain fluid and develop swelling." = CORRECT ANSWER
The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication,
notify the provider, and document the refusal. Furosemide is a loop diuretic given to reduce edema.
-"You can double your dose of furosemide this evening if that would be better for you."
The nurse should respect the client's right to refuse the medication and identify that the client should not double the medication
dose if missed.
-"If you do not take your furosemide, we might get in trouble."
The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication,
notify the provider, and document the refusal. This response uses nontherapeutic communication because the nurse is threatening
the client.
-"I'll go ahead and mix the furosemide into your breakfast cereal."
The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication,
notify the provider, and document the refusal. This response is dismissing the client's right to refuse a medication.
