ATI PN PHARMACOLOGY PROCTORED
EXAM REVIEW 2022/2023 QUESTIONS
ANSWERS AND RATIONALE
A provider prescribes phenobarbital for a client who has a seizure disorder.
The medication has a long half-life of 4 days. How many times per day
should the nurse expect to administer this medication?
A. One
B. Two
C. Three
D. Four
A (Medications with long half-lives remain at their therapeutic levels between
doses for long periods of time. The nurse should expect to administer this
medication once a day.)
A staff educator is reviewing medication dosages and factors that influence
medication metabolism with a group of nurses at an in-service presentation.
Which of the following factors should the educator include as a reason to
administer lower medication dosages? (Select all that apply.)
A. Increased renal secretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication the same pathway metabolizes
Answer:
C, E
(C. Liver failure decreases metabolism and thus increases the concentration
of a medication. This requires decreasing the dosage.
E. When the same pathway metabolizes two medications, they compete for
metabolism, thereby increasing the concentration of one or both
medications. This requires decreasing the dosage of one or both)
,A nurse is preparing to administer eye drops to a client. Which of the
following actions should the nurse take? (Select all that apply.)
A. Have the client lie on her side.
B. Ask the client to look up at the ceiling.
C. Tell the client to blink when the drops enter her eye.
D. Drop the medication into the center of the client's conjunctival sac.
E. Instruct the client to close her eye gently after instillation
b, d, e
(B. The client should look upward to keep the drops from falling onto her
cornea.
D. The nurse should drop the medication into the
center of the conjunctival sac to promote distribution.
E. The client should close her eye gently to promote distribution of the
medication)
A nurse is completing discharge teaching for a client who has a new
prescription for transdermal patches. Which of the following statements
should the nurse identify as an indication that the client understands the
instructions?
A. "I will clean the site with an alcohol swab before I apply the patch."
B. "I will rotate the application sites weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch.
C (The client should apply the patch to a hairless area of skin to promote
absorption of the medication.)
A nurse reviewing a client's medical record notes a new prescription for
verifying the trough level of the client's medication. Which of the following
actions should the nurse take?
A. Obtain a blood specimen immediately prior to administering the next dose
of medication.
B. Verify that the client has been taking the medication for 24 hr before
obtaining a blood specimen.
C. Ask the client to provide a urine specimen after the next dose of
medication.
D. Administer the medication,and obtain a blood specimen 30 min late
A (To verify trough levels of a medication, the nurse should obtain a blood
specimen immediately before administering the next dose of medication.)
,A nurse is preparing a client's medications. Which of the following actions
should the nurse take in following legal practice guidelines? (Select all that
apply.)
A. Maintain skill competency.
B. Determine the dosage.
C. Monitor for adverse effects.
D. Safeguard medications.
E. Identify the client's diagnosis
a, c, d
(A.maintaining skill competency and using appropriate administration
techniques are legal responsibilities of the nurse
C. A nurse is legally responsible for monitoring for side and adverse effects
of medication
D. Safeguarding of medications, such as controlled substances, is a legal
responsibility of the nurse)
A nurse reviewing a client's health record notes a new prescription for
Lisinopril 10 mg PO once every day. The nurse should identify this as which
of the following types of prescription?
A. Single
B. Stat
C. Routine
D. Standing
C (A routine or standard prescription identifies medications to give on a
regular schedule with or without a termination date or a specific number of
doses. The nurse will administer
this medication every day until the provider discontinues it.)
A nurse is reviewing a new prescription for Ondansetron 4 mg PO PRN for
nausea and vomiting for a client who has Hyperemesis Gravidarum. The
nurse should clarify which of the following parts of the prescription with the
provider?
A. Name
B. Dosage
C. Route
D. Frequency
, D (This prescription does not include the time or frequency of medication
administration. The nurse must clarify this with the prescribing provide)
A nurse is admitting a client and completing a preassessment before
administering medications. Which of the following data should the nurse
include in the preassessment? (Select all that apply.)
A. Use of herbal teas
B. Daily fluid intake
C. Current health status
D. Previous surgical history
E. Food allergies
a, c, e
(A. The nurse should inquire about the client's use of herbal products, which
often contain caffeine, prior to medication administration because caffeine
can affect medication biotransformation
C. The nurse should review the client's current health status because new
prescriptions can cause alterations in current health status
E. The nurse should inquire about food allergies during the preassessment to
identify any potential reactions or interactions)
A nurse orienting a newly licensed nurse is reviewing the procedure for
taking a telephone prescription. Which of the following statements should
the nurse identify as an
indication that the newly licensed nurse understands the process?
A. "A second nurse enters the prescription into the client's medical record."
B. "Another nurse should listen to the phone call."
C. "The provider can clarify the prescription when he signs the health
record."
D. "I should omit the 'read back' if this is a one-time prescription
B (A second nurse should listen to a telephone prescription to prevent errors
in communication.)
A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus.
Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to
infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL.
The nurse should adjust the manual IV infusion to deliver how many
EXAM REVIEW 2022/2023 QUESTIONS
ANSWERS AND RATIONALE
A provider prescribes phenobarbital for a client who has a seizure disorder.
The medication has a long half-life of 4 days. How many times per day
should the nurse expect to administer this medication?
A. One
B. Two
C. Three
D. Four
A (Medications with long half-lives remain at their therapeutic levels between
doses for long periods of time. The nurse should expect to administer this
medication once a day.)
A staff educator is reviewing medication dosages and factors that influence
medication metabolism with a group of nurses at an in-service presentation.
Which of the following factors should the educator include as a reason to
administer lower medication dosages? (Select all that apply.)
A. Increased renal secretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication the same pathway metabolizes
Answer:
C, E
(C. Liver failure decreases metabolism and thus increases the concentration
of a medication. This requires decreasing the dosage.
E. When the same pathway metabolizes two medications, they compete for
metabolism, thereby increasing the concentration of one or both
medications. This requires decreasing the dosage of one or both)
,A nurse is preparing to administer eye drops to a client. Which of the
following actions should the nurse take? (Select all that apply.)
A. Have the client lie on her side.
B. Ask the client to look up at the ceiling.
C. Tell the client to blink when the drops enter her eye.
D. Drop the medication into the center of the client's conjunctival sac.
E. Instruct the client to close her eye gently after instillation
b, d, e
(B. The client should look upward to keep the drops from falling onto her
cornea.
D. The nurse should drop the medication into the
center of the conjunctival sac to promote distribution.
E. The client should close her eye gently to promote distribution of the
medication)
A nurse is completing discharge teaching for a client who has a new
prescription for transdermal patches. Which of the following statements
should the nurse identify as an indication that the client understands the
instructions?
A. "I will clean the site with an alcohol swab before I apply the patch."
B. "I will rotate the application sites weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch.
C (The client should apply the patch to a hairless area of skin to promote
absorption of the medication.)
A nurse reviewing a client's medical record notes a new prescription for
verifying the trough level of the client's medication. Which of the following
actions should the nurse take?
A. Obtain a blood specimen immediately prior to administering the next dose
of medication.
B. Verify that the client has been taking the medication for 24 hr before
obtaining a blood specimen.
C. Ask the client to provide a urine specimen after the next dose of
medication.
D. Administer the medication,and obtain a blood specimen 30 min late
A (To verify trough levels of a medication, the nurse should obtain a blood
specimen immediately before administering the next dose of medication.)
,A nurse is preparing a client's medications. Which of the following actions
should the nurse take in following legal practice guidelines? (Select all that
apply.)
A. Maintain skill competency.
B. Determine the dosage.
C. Monitor for adverse effects.
D. Safeguard medications.
E. Identify the client's diagnosis
a, c, d
(A.maintaining skill competency and using appropriate administration
techniques are legal responsibilities of the nurse
C. A nurse is legally responsible for monitoring for side and adverse effects
of medication
D. Safeguarding of medications, such as controlled substances, is a legal
responsibility of the nurse)
A nurse reviewing a client's health record notes a new prescription for
Lisinopril 10 mg PO once every day. The nurse should identify this as which
of the following types of prescription?
A. Single
B. Stat
C. Routine
D. Standing
C (A routine or standard prescription identifies medications to give on a
regular schedule with or without a termination date or a specific number of
doses. The nurse will administer
this medication every day until the provider discontinues it.)
A nurse is reviewing a new prescription for Ondansetron 4 mg PO PRN for
nausea and vomiting for a client who has Hyperemesis Gravidarum. The
nurse should clarify which of the following parts of the prescription with the
provider?
A. Name
B. Dosage
C. Route
D. Frequency
, D (This prescription does not include the time or frequency of medication
administration. The nurse must clarify this with the prescribing provide)
A nurse is admitting a client and completing a preassessment before
administering medications. Which of the following data should the nurse
include in the preassessment? (Select all that apply.)
A. Use of herbal teas
B. Daily fluid intake
C. Current health status
D. Previous surgical history
E. Food allergies
a, c, e
(A. The nurse should inquire about the client's use of herbal products, which
often contain caffeine, prior to medication administration because caffeine
can affect medication biotransformation
C. The nurse should review the client's current health status because new
prescriptions can cause alterations in current health status
E. The nurse should inquire about food allergies during the preassessment to
identify any potential reactions or interactions)
A nurse orienting a newly licensed nurse is reviewing the procedure for
taking a telephone prescription. Which of the following statements should
the nurse identify as an
indication that the newly licensed nurse understands the process?
A. "A second nurse enters the prescription into the client's medical record."
B. "Another nurse should listen to the phone call."
C. "The provider can clarify the prescription when he signs the health
record."
D. "I should omit the 'read back' if this is a one-time prescription
B (A second nurse should listen to a telephone prescription to prevent errors
in communication.)
A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus.
Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to
infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL.
The nurse should adjust the manual IV infusion to deliver how many
