ATI CAPSTONE PHARMACOLOGY 2 EXAM 50 QUESTIONS & ANSWERS WITH RATIONALES

1. A nurse is caring for a client who reports using the herbal medication garlic along with prescribed warfarin. The nurse should identify that which of the following is a potential adverse effect of taking both of these products concurrently? • Altered renal perfusion • Elevated blood pressure • Increased ecchymosis- The nurse should identify that ecchymosis occurs when there is bleeding under the skin. Additionally, the nurse should recognize that, garlic has antiplatelets effects that can result in bleeding. When taken concurrently with an anticoagulant, such as warfarin, there is an increased risk for bleeding. 2. A nurse is providing teaching t a client who is starting to take aspirin. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of this medication? • Black, tarry stools- A client who takes aspirin can have an increased risk for bleeding because aspirin suppresses platelet aggregation. The nurse should instruct the client to monitor for and report indications of bleeding, such as bruising, petechiae, and blood in stools or urine. • Nystagmus • Dry mouth 3. A nurse is caring for a client who has an infection and is starting to take gentamicin. Which of the following client laboratory tests should the nurse monitor to detect an adverse effect of the medication? • B-type natriuretic peptide (BNP) • Creatinine - The nurse should monitor creatinine, BUN and urine output for a client who is receiving gentamicin, and aminoglycoside antibiotic. Gentamicin is an aminoglycoside that has both nephrotoxic and ototoxic adverse effects. • Amylase level 4. A nurse is assessing a client who has diabetes insipidus and is starting intranasal desmopressin. Which of the following findings should indicate to the nurse that medication is effective? • The client has clear mucus • The client’s 24 hr urine output is 1.256 mL - Desmopressin is effective for the treatment of diabetes insipidus, a disorder of the posterior pituitary gland in which large amount of dilute urine are produced due to a deficiency in vasopressin. The action of desmopressin causes reabsorption of water and a decrease in urine volume. A urine output of 1.256 mL over 24 hr is within the expected reference range and indicates the medication is effective. 5. A nurse is assessing a client who has a prescription for haloperidol 0.5 mg PO three times daily. The medication administration record shows that the client received 5 mg per dose on the previous day. Which of the following manifestations is the nurse’s priority to assess? • Muscle stiffness - The nurse should recognize tha the greatest risk to the client is developing neuroleptic malignant syndrome, and adverse reaction to haloperidol that is potentially fatal if not treated promptly. Manifestations of neuroleptic malignant 1 syndrome include extreme muscle stiffness, sudden increase in temperature, diaphoresis, dysrhythmias, and fluctuations in blood pressure. • Blurred vision • Constipation 6. A nurse is assessing a client who received ondansetron 1 hr. ago. Which of the following findigns should the nurse identify as a therapeutic effect of the medication? • Decreased pain • Suppressed emesis – Ondansetron suppresses nausea and vomiting induced by chemotherapy, anesthesia, radiation therapy, or morning sickness by blocking serotonin receptors in the upper GI tract and in the CNS • Supresed cough • Decreased fever 7. A nurse is caring for a client who is receiving morphine. Which of the following assessments should the nurse perform first? • Apical heart rate • Blood pressure • Respiratory rate – When using the airway, breathing, circulation approach to client care, the nurse should determine that the priority assessment is respiratory rate. The nurse should withhold the morphine and notify the provider if the respiratory rate is less than 12/min. 8. A nurse is caring for a client who is at risk for alcohol withdrawal delirium. Which of the following medications should the nurse expect the provider to prescribe? • Naloxone • Bupropion • Methadone • Chlordiazepoxide – The nurse should expect the provider to prescribe chlordiazepoxide, a benzodiazepine, to a client who is at risk for alcohol withdrawal delirium. Chlordiazepoxide can prevent the client form experiencing seizures as a result of withdrawal and lessen the effects of withdrawal. 9. A nurse is teaching a client who is to start taking methyldopa for the treatment of hypertension. Which of the following information should the nurse include in the teaching? • The medication can cause dizziness- Methyldopa can cause orthostatic hypotension and dizziness when the client is changing position. Therefore, the nurse should instruct the client to change position slowly while taking methyldopa. • This medication can cause insomnia • Expect to experience depression while taking this medication 10. A nurse is providing discharge instructions to a client who has a new prescription for omeprazole for the treatment of GERD. Which of the following statements by the client indicates an understanding of the teaching? • This medication kiss the bacteria in my stomach. • This medication neutralizes stomach acid • This medication coats the lining of my stomach. • This medication reduces stomach acid – GERD is a condition in which gastric acids reflux from the stomach to the esophagus. Omeprazole is a proton inhibitor that suppresses the production of gastric acid. The medication reduces baseline acid levels