ATI PN PHARMACOLOGY PROCTORED EXAM 2023 ACTUAL
EXAM WITH 245 QUESTIONS WITH DETAILED VERIFIED
ANSWERS AND RATIONALES NEWEST!/A+ GRADE ASSURED
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?
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.
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?
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.
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
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.
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:
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.
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?
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
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?
Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion 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.
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?
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.
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?
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.
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?
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).
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:
, Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to
work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation
of keratinocytes.
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
partial-thickness burn, which has cultured positive for gram-negative 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?
"The medication will permanently
stain my skin." Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity
against gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to
the wound to assist in healing. It does not stain the skin.
A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic
medication. During the infusion, the client complains 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.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care
must be taken to prevent the medication from 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 decreased infusion
rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then
contact the health care provider.
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?
Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause
interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies
along with hematological, hepatic, and renal function tests need to be monitored. The nurse
needs to monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity.
The medication needs to be discontinued immediately if pulmonary toxicity occurs.
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?
Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can produce
uric acid nephropathy, renal stones, and acute renal failure.
EXAM WITH 245 QUESTIONS WITH DETAILED VERIFIED
ANSWERS AND RATIONALES NEWEST!/A+ GRADE ASSURED
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?
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.
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?
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.
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
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.
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:
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.
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?
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
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?
Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion 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.
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?
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.
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?
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.
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?
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).
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:
, Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to
work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation
of keratinocytes.
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
partial-thickness burn, which has cultured positive for gram-negative 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?
"The medication will permanently
stain my skin." Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity
against gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to
the wound to assist in healing. It does not stain the skin.
A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic
medication. During the infusion, the client complains 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.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care
must be taken to prevent the medication from 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 decreased infusion
rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then
contact the health care provider.
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?
Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause
interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies
along with hematological, hepatic, and renal function tests need to be monitored. The nurse
needs to monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity.
The medication needs to be discontinued immediately if pulmonary toxicity occurs.
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?
Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can produce
uric acid nephropathy, renal stones, and acute renal failure.
