2023 NGN ATI RN PHARMACOLOGY PROCTORED EXAM QUESTIONS AND VERIFIED ANSWERS

A nurse is providing teaching to a group of new parents about medications. The nurse should include that ASPIRIN is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? A. Reye's Syndrome B. Visual Disturbances C. Diabetes mellitus D. Wilm's Tumor - ANS A A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? A. Reduces Blood pressure B. Inhibits clotting of fistula C. Promotes RBC production D. Stimulates growth of neutrophils - ANS C A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? A. Ibuprofen (NSAID) B. Naproxen (NSAID) C. Aspirin (NSAID) D. Acetominophen (ANALGESIC) - ANS D A nurse is caring for a client who has prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? A. Insomnia B. Hypotension C. Bleeding D. Constipation - ANS C A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as contraindication to ceftriaxone? A. Gentamicin B. Clindamycin C. Piperacillin D. Sulfamethoxazole- Trimethroprim - ANS C A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication? A. Hyperthyroidism B. Intestinal obstruction C. Glaucoma D. Low blood pressure - ANS B A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has. mask like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? A. Amantadine B. Bupropion (Atypical antidepressant) C. Phenelzine (MAOI) D. Hydroxyzine (Antihistamine) - ANS A A nurse is administering subQ epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects? A. Hypotension B. Hyperthermia C. Hypoglycemia D. Tachycardia - ANS D A nurse is providing teaching to a client who has UTI and new prescription for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching? A. If the phenazopyridine upsets my stomach, I can take it with meals. B. The phenazopyridine will relieve my discomfort, but the cipro will get rid of the infections. C. I need to drink 2 liters of fluid per day while I am taking cipro. D. I should notify my provider immediately if my urine turns an orange color. - ANS D A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects? A. Echoymosis B. Decreased urine output C. Increased blood pressure D. Dizziness - ANS D A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications? A. Methimazole B. Somatropin C. Levothyroxine D. Propythiouracil - ANS C A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? A. Take the hydrochlorothiazide as needed for edema B. Check your weight once each week C. Take the hydrochlorothiazide on an empty stomach D. Take the hydrochlorothiazide in the morning. - ANS D A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? A. Oxytocin B. Nifedipine C. Dinoprostone D. Misoprostol - ANS B A nurse is providing teaching to a client who has cirrhosis and new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? A. Increases blood pressure B. Prevents esophageal bleeding C. Decreases heart rate D. Reduces Ammonia - ANS D A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to preform prior to starting the client on this medication? A. Hearing examination B. Glucose tolerance test C. Electrocardiogram D. Pulmonary Function tests - ANS C A nurse is providing teaching to a client who has gout and new prescription for allopurinol. The nurse should instruct client to discontinue taking the medications for which of the following adverse effects? A. Nausea B. Metallic taste C. Fever D. Drowsiness - ANS C A nurse is assessing a client who is recieving IV Gentamicin 3x daily. Which of the following findings indicates that the client is experiencing an adverse effevt of this medication? A. Hypogycemia B. Proteinuria C. Nasal congestion D. Visual disturbances - ANS B A nurse is providing teaching to a newly nurse about caring for a client who has prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following lab tests. A. Platelet count B. Electrolyte levels C. Thyroid Functions D. Liver - ANS D A nurse is caring for a client who has a new precscription for ergotamine. The nurse should recognize that ergotamine is administerd to treat which of the following conditions? A. Raynaud's Phenomenon B. Migraine Headaches C. Ulcerative colitis D. Anemia - ANS B A nurse is reviewing the lab values for a client who is recieving a continuous IV heparin infusion and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take? A. Administer Vit K B. Reduce the Infusion rate C. Give the client a low dose aspirin D. Request an INR - ANS B A nurse is providing teaching to a client who had rheumatoid arthritis and a prescription for long term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects? A. Stress fractures B. Orthostatic hypotension C. Gingival ulcerations D. Weight loss - ANS A A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects? A. Antiestrogenic B. Antimicrobial C. Androgenic D. Anti-inflammatory - ANS A A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects? A. Hyperkalemia B. Hypertension C. Constipation D. Nephrotoxicity - ANS D A nurse is administering subQ heparin to a client who is at risk for DVT. Which of the following should the nurse take? A. Administer the medication into the client's abdomen B. Inject the medication into a muscle C. Massage the site after administering the medication D. Use a 22 gauge needle to administer the medication - ANS A A nurse is reviewing the lab results for a client who has a prescription for filgastrim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication? A. Erythrocyte count B. Neutrophil count C. Lymphocyte count D. Thrombocyte count - ANS B A nurse is providing teaching to a client who has a ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Jaundice B. Constipation C. Oral Candidiasis D. Sedation - ANS A A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following lab values should the nurse plan to monitor? Select all that apply. A. BUN B. PTT C. Aspartate amintransferase (AST) D. Urinalysis E. Alanine aminotransferase - ANS B, C, E A nurse is caring for a client who has a new diagnosis of oral candidiasis after takinng tetracyline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects? A. Allergic response B. Superinfection C. Renal toxicity D. Hepatotoxicity - ANS B A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? A. Thrombophlebitis B. Hyperactive reflexes C. Muscle weakness D. Hypoglycemia - ANS C A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority. A. Administer the medication to the client's before breakfast in the morning B. Ambulate the client to a chair prior to administering the medication. C. Give the medication to the client with water rather than milk D. Teach the client how to take the medication at home. - ANS B A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary TB. The client reports his urine is an orange color. Which of the following statements should the nurse make? A. Stop taking isoniazid for 3 days and discoloration should go away. B. Rifampin can turn body fluids orange C. I'll make an appointment for you to see the provider this afternoon D. Isoniazid can cause bladder distention - ANS B A nurse is caring for a client who had a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? A. Ecchymosis B. Jaundice C. Hypotension D. Hypokalemia - ANS C A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching? A. Respiratory depression can occur 7 min after the morphine is administered. B. The morphine will peak in 10 min C. Withold the morphine if the client has a respiratory rate of less than 16/min. D - ANS A A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching? A. I will give my child a dose as soon as wheezing starts. B. My child should rinse out his mouth after using the inhaler. C. My child should exhale completely before placing the inhaler in his mouth. D. If my child has difficulty breathing in the dose, a spacer can be used - ANS A A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he experiences chest pain. Place them in order of performance. Stop activity Place a tablet under the tongue Wait 5 min Call 911 if the pain is not relieved. - ANS 1. Stop activity 2. Place a tablet under the tongue 3. Wait 5 min 4. Call 911 if the pain is not relieved. A nurse is caring for a client who is in preterm labor and has a new prescription for nifedipine (Calcium blocker). The client states she is concerned because her father takes nifedipine for his angina pectoris. The nurse should explain to the client that nifedipine works for clients who are pregnant by which of the following mechanism? A. It decreases the incidence of bacterial vaginosis, thus preventing uterine contractions. B. It inhibits uterine contractions by blocking entry of calcium into uterine cells. C. It decreases the activity within the CNS, which regulates smooth muscle. D. It stimulates beta2 receptors in the uterus, which results in decreased frequency of contractions. - ANS B A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take? a. Place the oxytocin from a pre-filled syringe into the posterior fornix of the vagina every 10 min until effective labor occurs. b. Check the client's blood pressure and pulse every 15 min while induction of labor is occurring. c. Stop the oxytocin for contractions that continue longer than 30 seconds D. Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min. - ANS D A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg 3 x daily, to the client for restlessness and anxiety during the past few days. For which of the following effects should the nurse assess the client? A. Low-grade fever B. Sedation C. Diuresis D. Tonic-clonic seizures - ANS B A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching? A. I should take naproxen if I have a headache because aspirin can cause lithium toxicity B. I can develop lithium toxicity if I eat foods with lots of sodium C. I can develop lithium toxicity if I experience vomiting or diarrhea. D. I might need to take a daily diuretic along with my lithium to prevent lithium toxicity. - ANS C A nurse is providing teaching to a client who has heart failure and is taking spironolactone. Which of the following statements by the client indicates an understanding of the teaching? A. I will increase my intake of citrus fruits, bananas, and potatoes. B. I will use salt substitutes on my food C. I will drink as much water as I can while taking this medication. D. I will watch for increased breast tissue growth while taking this medication. - ANS D A nurse is assessing a client who takes oral theophylline for relief of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity to theophylline? A. Constipation B. Tremors C. Fatigue D. Bradycardia - ANS B A nurse is caring for a client who has heart failure and is taking oral furosemide 40mg daily. For which of the following adverse effects should the client taught to monitor and notify the provider if occurs? A. Nasal congestion B. Tremors C. Tinnitus D. Frontal headache - ANS C A nurse is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of diltiazem? A. Hypotension B. Tachycardia C. Decreased level of consciousness D. History of diuretic use - ANS A A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect? A. Diarrhea B. Anxiety C. Nausea and vomiting D. Dry mouth - ANS D A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching? A. I will administer a spray into each nostril daily. B. I should expect nasal bleeding for the first week. C. I will need to depress the side arms to activate the pump. D. I should expect to take this medication for a short-term course of treatment - ANS C A nurse is providing discharge teaching to a client who had venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching? A. Take ibuprofen as needed for headache or other minor pains B. Carry a medic alert ID card C. Report to the lab weekly to have a blood drawn for aPTT D. Increase intake of dark green vegetables. - ANS B A nurse is assessing a client who has hypothyroidism and takes levothyroxine. Which of the following findings should alert the nurse that the client is experiencing acute levothyroxine overdose? A. Bradycardia B. Cold intolerance C. Tremor D. Hypothermia - ANS C A nurse is providing discharge to a client who has angina pectoris and a new prescription for verapamil. The client tells the nurse, "my brother takes verapamil for high blood pressure. Do you think the provider made a mistake?" which of the following responses should the nurse make? A. Verapamil is used to treat both high blood pressure and angina. B. You should talk to your provider to make sure the prescription is correct for you. C. Are you concerned that you might have high blood pressure? D. Your provider has prescribed verapamil so that you will not develop high blood pressure. - ANS A A nurse is providing teaching to a client who is to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client indicates an understanding of the teaching? A. This medication will not work unless I have enough potassium. B. Potassium will increase the therapeutic effect of my blood pressure medication. C. Potassium will lower my blood pressure. D. This medication can cause loss of potassium. - ANS D A nurse is caring for a client who was brought to the ED by friends who report the client has overdosed on heroin. Which of the following findings should the nurse expect to assess? A. Temperature 39.2 (102.6) B. Respiratory rate 30/min C. Pinpoint pupils D. Severe abdominal cramping - ANS C A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40mg daily, but the client reports that she has been taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated? A. Urine specific gravity 1.035 B. Distended neck veins C. BUN 18mg/dL D. Bounding radial pulse - ANS A A nurse is providing discharge teaching to a client who had kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching? A. I will be able to stop this medication 6 months after my surgery. B. I am likely to develop higher blood pressure while taking this medication. C. I am likely to lose my hair while taking this medication. D. I am taking this medication to boost my immune system. - ANS B A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg 3 x daily po and gabapentin 1,800mg 3 x daily po to manage pain. The client tells the nurse, "I'm having pain that keeps me from doing what I'd like most of the time." which of the following additions should the nurse anticipate to the client's medication regimen? A. Oral meperidine B. Parenteral naloxone C. Parenteral diazepam D. Oral oxycodone - ANS D A nurse is caring for a client who has CHF and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first? a. Encourage the client to eat the toast on the breakfast tray. b. Administer an antiemetic c. Inform the client's provider. d. Check the client's apical pulse - ANS D A nurse is preparing a discharge teaching plan for a client who is to begin long term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan? A. Stop taking medication if a rash occurs. B. Take the medication on an empty stomach to enhance absorption. C. Schedule the medication on alternate days to decrease adverse effects. D. Treat SOB with an extra dose of medication. - ANS C A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects? A. Urinary health promotion B. Immune system stimulation C. Decreased leg pain from arterial disease D. Prevention of nausea caused by motion sickness. - ANS A A nurse is providing discharge teaching to a client who has been hospitalized for MDD and has a prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching? A. I will take amitriptyline in the morning because I'm likely to have trouble falling asleep if I take it in the evening. B. I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease. C. I can drink a glass of beer or wine with my evening meal because amitriptyline doesn't interact with alcohol. D. I will avoid goods high in fiber because amitriptyline can cause diarrhea. - ANS B A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for isoniazid. The nurse should teach the client that which of the following laboratory values should be monitored while taking isoniazid? A. Thyroid stimulating hormone level (TSH) B. Aspartate aminotransferase (AST) C. Potassium D. Sodium - ANS B A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25mg po to the client instead of the prescribed digoxin 0.125 mg po. Which of the following actions should the nurse take first? a. Notify the provider b. Contact the nursing supervisor c. Assess the client's apical pulse d. Complete an incident report - ANS C A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea (IBS-D) and a new prescription for alosetron. Which of the following interventions should the nurse include in the plan of care? A. The nurse must sign an agreement with the provider before beginning alosetron. B. The client must stop taking alosetron if diarrhea continues 1 week after beginning the medication. C. The client should expect to have a slower heart rate while taking alosetron. D. The client should use a barrier birth control method because alosetron interacts with oral contraceptives. - ANS A A nurse is planning to administer epoetin alfa to a client who had chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication.? A. Blood pressure B. Temperature C. Blood glucose levels D. Total protein level - ANS A A nurse is monitoring lab values for a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following lab values should the nurse report to the provider? A. BUN 18mg/dL B. Platelets 78,000/mm3 C. Hgb 14.2 g/dL D. Aspartate aminotransferase (AST) 35 units/L - ANS B A nurse is caring for a client who has alcohol use disorder and is admitted with lower extremity fractures following a motor vehicle crash. A few hours after admission, the client develops restlessness and tremors. Which of the following medications should the nurse anticipate administering to the client first? a. Acamprosate b. Naltrexone c. Chlordiazepoxide d. Disulfiram - ANS C A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and is prescribed omeprazole. Which of the following statements should the nurse include in the teaching? A. You will need to take this medication for the next 6 months. B. Taking this medication will decrease your risk for acquiring pneumonia C. You should take this medication before breakfast everyday. D. Watch for the serious adverse effects of tachycardia and heart palpitations while taking this medications. - ANS C A nurse is providing teaching to the parents of a school age child who has asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to used to relieve an acute asthma attack? a. Salmeterol b. Cromolyn c. Fluticasone d. Albuterol - ANS D A nurse is administering insulin glulisine 10 units subQ at 0730 to an adolescent client who has type I diabetes mellitus. The nurse should anticipate onset of action of the insulin at which of the following times? a. 0800 b. 0745 c. 0900 d. 1030 - ANS B A nurse is providing teaching to a client who has hypertension and a new prescription for oral clonidine. Which of the following instructions should the nurse include in the teaching? A. Discontinue the medication if a rash develops. B. Expect increased salivation during the first few weeks of therapy. C. Minimize fiber intake to prevent diarrhea. D. Avoid driving until the client's reaction to the medication is known. - ANS D A nurse is providing teaching to a client who has hypertension and type I diabetes mellitus and a new prescription for metoprolol. Which of the following statements by the clients indicates an understanding of the teaching? A. I might have difficulty recognizing when my blood sugar is low. B. I will have less risk for developing an infection while I take this medication. C. I should be concerned about losing excess weight while I take this medication. D. I could have more problems with high blood sugars while taking this medication. - ANS A A nurse is administering adenosine via IV bolus for a client who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the client during administration of adenosine? A. Seizures B. Cinchonism C. Dyspnea D. Transient pallor of the face - ANS C A nurse is preparing a discharge teaching plan for a 6 year old client who has asthma and several prescription medication using metered dose inhalers (MDIs). Which of the following interventions should the nurse include in the plan? A. Add a spacer to each MDI. B. Instruct the child to inhale more rapidly than usual when using an MDI. C. Request that the provider change the child's medications from inhaled to oral formulation. D. Administer oxygen by facemask along with the MDI. - ANS A A nurse is providing discharge teaching to a client who has heart failure and a prescription for digoxin 0.125mg po daily and furosemide 20mg po daily. Which of the following statements by the clients indicates an understanding of the teaching? A. I know that blurred vision is something I will expect to happen while taking digoxin. B. I will measure my urine output each day and document it in my diary. C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute. D. I will eat fruits and vegetables that have high potassium content everyday - ANS D A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take? A. Administer a small test dose before giving the full dose. B. Infuse the medication over 30 seconds C. Monitor the client closely for hypertension after the infusion D. Administer cyanocobalamin as an antidote if iron dextran toxicity occurs. - ANS A A nurse is planning to administer diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take? A. Choose an IV post for IV bolus of the diphenhydramine as near as possible to the client's hanging IV bag B. Flush the IV tubing with 2 ml of o.9% sodium chloride before and after administering diphenhydramine. C. Allow the IV infusion to keep running while administering the diphenhydramine via IV bolus. D. Aspirate to check for IV patency before administering the diphenhydramine. - ANS D A nurse is administering ciprofloxacin and phenazopyridine to a client who has a severe UTI. The client asks why both medications are needed. Which of the following responses should the nurse make? A. Phenazopyridine decreases adverse effects of ciprofloxacin hydrochloride. B. Combining phenazopyridine with ciprofloxacin hydrochloride shortens the course of therapy. C. The use of phenazopyridine allows for a lower dosage of ciprofloxacin hydrochloride. D. Ciprofloxacin hydrochloride treats the infection and the phenazopyridine treats pain. - ANS D A nurse is providing teaching to a client who has type 2 diabetes mellitus and a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the clients to watch for and report to the provider? a. Weight gain B. Myalgia C. Hypoglycemia D. Severe constipation - ANS B A nurse is planning discharge teaching for a client who has MDD and a new prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for the client consume while taking phenelzine? A. Broiled beef steak B. Macaroni and cheese C. Pepperoni pizza D. Smoked salmon - ANS A