ATI Pharm Proctored Exam

An immunizing agent that confers active immunity protects by:

Antacids should be given one hour apart from most other drugs. Which is the rationale?

Vancomycin should not be used to treat minor infections because it:

The antagonist for a client who has overdosed on morphine is:

The most serious adverse reaction to oral contraceptives is:

When a client develops tolerance to a drug, the nurse would expect:

Antihyperglycemic agents are prescribed for clients with:

The nurse assesses a client shortly after an intravenous infusion of the osmotic diuretic mannitol is started. Which finding represents an early adverse effect of mannitol?

Compared to other beta adrenergic blockers, cardioselective beta adrenergic blockers:

A client who experiences motion sickness during airplane flights obtains a prescription for meclizine (Antivert). When is the best time to take the drug?

Before prescribing a cephalosporin, the nurse practitioner asks if the client is allergic to penicillin. Why is this important to assess?

The use of which class of antibiotics should be avoided in children?

In a walk-in clinic, clients are often given intramuscular injections. Which drug should be readily available in case a client has an anaphylactic reaction?

Thiazide and loop (high ceiling) diuretics are similar in that both:

Which of the statements by the nurse most accurately describes the effects of declined plasma albumin levels in older adults?

To prevent oral fungal infections, the nurse should instruct the client who uses a beclomethasone inhaler to take which action?

A client takes ethinyl estradiol/norgestimate (Ortho Tri-Cyclen) birth control pills. She calls the clinic and relates that she missed her medication yesterday. Which instructions will the nurse give?

The nurse may administer acetylcysteine (Mucomyst) inhalation to:

Development of a chronic cough is an adverse effect associated with which class of anti-hypertensive drugs?

The nurse may administer baclofen (Lioresal) for the treatment of which condition?

Oral diazepam (Valium), a benzodiazepine, has been prescribed for a client who has anxiety and muscle spasms. Which nursing intervention is appropriate for the care of this client?

The nurse practitioner prescribed anhydrous theophylline (Theo-Dur) for the client with chronic bronchitis. With which disorder would the nurse practitioner reconsider the use of this medication?

When a client is receiving intravenous fluid with supplementary potassium chloride, it is especially important for the nurse to monitor for which potential adverse effect?

Which adverse effect is common for a client being treated with the antidepressant fluoxetine (Prozac)?

After giving a dose of dextromethorphan, an antitussive, which data reflects evaluation of the drug's effectiveness?

Prior to giving a client a dose of digoxin, the nurse counts the apical pulse. If the rate is 62 bpm and regular, which is the appropriate nursing action?

Digoxin is started for a client with an atrial arrhythmia. Within three days, the client's heart rate has decreased from 94 to 74. What action of digitalis explains this change?

One mechanism by which antihypertensive drugs lower blood pressure is to:

There are many agents that are useful in the treatment of gastric ulcers. Which agent reacts with hydrochloric acid to form a viscous protective barrier over the ulcer?

A client whose asthma has been poorly controlled is prescribed cromolyn sodium (Intal) for inhalation. Client teaching should include which statement by the nurse?

The combination of aluminum and magnesium in many antacids decreases the risk of:

A client who is taking one daily dose of a thiazide diuretic should be instructed to:

Which phase of pharmacokinetics is affected most by abnormal liver function?

A medication order is written for ciprofloxacin (Cipro). For which client should the nurse question use of this medication?

A home health client tells the nurse that she is taking triamterene (Dyrenium) for fluid retention. She tells the nurse she is using a salt substitute so she will not retain so much water. What is the most appropriate nursing response?

Orders are written for anticholinergic drugs for each of the following clients. Which order should the nurse question?

A client with Type I diabetes mellitus is given an injection of neutral protamine hagedorn (NPH) insulin at 7:00 a.m. In order to prevent a hypoglycemic reaction, the client should have:

Why is carbidopa-levodopa preferred over levodopa alone?

Which findings are most likely in the client who has taken a toxic dose of a salicylate (aspirin)?

Which nursing intervention is specifically important when a client is taking an alpha- blocker, such as doxazosin (Cardura) for hypertension?

A client reports taking large amounts of vitamins because she believes they increase her energy level and will prevent various diseases. Client teaching should include which nursing response?

An elderly client is prescribed a new drug. Because of the age-related changes in the kidneys and liver, it is most important that the nurse assess for:

Evidence of effective treatment with a nucleoside reverse transcriptase inhibitor (NRTI), such as zidovudine is:

When oral iron supplements are prescribed, client teaching should include the fact that:

If corticosteroids are discontinued abruptly, a problem that may develop is:

An antiulcer drug that forms a gel to coat and protect the ulcer so that healing can occur is:

The nurse would describe a penicillinase to a client receiving this medication as:

Drugs given for a systemic effect by any route must be capable of:

Which statement is made by a client who is experiencing an adverse reaction to levothyroxine (Synthroid)?

Clients receiving intravenous gentamicin (Garamycin) should be assessed closely for:

The best laxative for clients who have chronic constipation and cannot or will not consume adequate dietary fiber is a:

The presence of Helicobacter pylori is confirmed in a client with peptic ulcer disease. The nurse may anticipate the use of multiple antibiotics because:

"A disease process characterized by the continued use of a specific psychoactive substance despite physical, psychologic, or social harm" is the definition of:

Which group may represent an increased risk for substance abuse?

The only drug commonly used both to prevent and to treat tuberculosis is:

The most serious adverse reaction to morphine is:

A client who has received an injection of regular insulin at 0800 complains of feeling sweaty, weak, hungry, and shaky two hours after the injection. Which drug is indicated for this client?

When a client is prescribed an aminoglycoside, such as gentamicin (Garamycin), which instruction should be included in the teaching plan?

When a client is being treated with trimethoprim-sulfamethoxazole (Bactrim) for a urinary tract infection, it is important to:

Histamine 2 receptor antagonists such as cimetidine (Tagamet) are used to treat peptic ulcers because they:

To administer eardrops to a child, the nurse should straighten the external ear canal by pulling the auricle:

A client who has a history of thrombophlebitis is taking warfarin to prevent new clot formation. He should be cautioned not to take salicylic acid because:

Which statement by the nurse best explains why nausea, vomiting, and bone marrow suppression are common adverse effects of cytotoxic antineoplastic drugs?

Glucocorticoids, such as prednisone (Deltasone), are given cautiously to clients with:

Client teaching for the use of sublingual nitroglycerin tablets to relieve angina should include which nursing instruction:

Two days after abdominal surgery, a client's bowel sounds are hypoactive and the abdomen is distended. The physician orders bethanechol (Urecholine), a cholinergic agonist, which acts to:

A client who has been on furosemide (Lasix) for one year reports weakness in her legs, constipation, palpitations, and lethargy. Her bowel sounds are hypoactive. The nurse should suspect which complication?

The drug of choice to treat a client with status epilepticus is:

A nurse cautions a client with Parkinson's disease who is taking carbidopa/levodopa (Sinemet) against taking any monoamine oxidase (MAO) inhibitors because the drug interaction can cause:

A client who is scheduled for cataract surgery has an order for acetazolamide (Diamox) preoperatively. Is this an appropriate order and, if so, why?

The purpose of a spacer with a metered-dose inhaler is to:

When a client is using a sympathomimetic (adrenergic) bronchodilator such as albuterol, the nurse would expect which effect?

Fluconazole (Diflucan) is prescribed for the client with a fungal infection in the toenails. The nurse should instruct the client to contact the nurse practitioner immediately if which adverse effect occurs?

The effects of epinephrine include:

To administer heparin subcutaneously, the nurse should:

Digoxin (lanoxin)

Guaifenesin

Estrogen (premarin)

Doxepin (Sinequan)

Albuterol (Proventil)

Levothryoxine (T4) Indication

Cephalosporins (Keflex

Phenobarbital [Barbiturates

Sumatriptan (Imitrex):

Route—fastest/most effective:

Narcan [opioid antagonist]:

Baclofen (Lioresal

Spironolactone (Aldactone)

Erythromycin (Erythrocin)

Insulin

Chloroquine phosphate (Aralen):

Heparin (anticoagulant)

Warfarin (Coumadin)

Clopidogrel (Plavix

Alteplase (Activase)

Methylphenidate (Concerta)

Testosterone IM

Diphenoxylate & Atropine (Lomotil)

Loperamide (Imodium)

Methylcellulose (Citrucel)

Psyllium (Metamucil

Acetazolamide (Diamox)

Metoprolol (Lopressor)

Propanolol

Norgestrel (Ovrette)

Medroxyprogesterone (Provera);

IM injection site

Nausea tx

Allopurinol (Zyloprim)

TB

ACE Inhib. Lisinopril (Zestril)

Synergistic drugs

Furosemide (Lasix

Ticlopidine (Ticlid)

PRBC (packed red blood cells)

IV medications

Collagenase (Santy

Interferon

Isotretinoin (Accutane)

Vaccine

Epoetin Alfa (Procrit)

Urofollitropin (Fertinex)

Hypertensive crisis

Acetylcysteine (Mucomyst)

Montelukast (Singulair)

Metoclopramide (Reglan

Mannitol

Diphenhydramine (Benadryl) Precaution

Anaphylaxis rxn S/S

Mafenide acetate (sulfamylon) Interventions:

Zidovudine (AZT

Thrombocytopenia

Prothrombin time

Sulfisoxazole (Gantrisin uses

Cyclosporine (Neoral)

Hexacholorphene (pHisoHex

Auranofin (Ridaura)

Thiazides

Simvastatin (Zocor)—

• Amitriptyline (Elavil)

• Narcotic (opiate) analgesic

• Antihistamines

• Mucolytic

• Antitussive

• Decongestant

• Bulk-forming laxatives (Metamucil)

• Gentamicin (Garamycin)

• Digoxin [cardiac glycoside]

• Lorazepam (ativan)

• Dantrolene sodium (Dantrium)

• Synergistic effect

• Zidovudine (AZT

• Psuedoephedrine (Sudafed)

• Asthma therapy

• Acyclovir (Zovirax)—

• Fluoxetine (Prozac)

• Succinylcholine

• Vecuronium (Norcuron)

• Tolerance

• Addiction

• Substance abuse

• Tissue dependence---

• Antidysrhythmic agents—

• Prednisone (Deltasone)

• Tamoxifen citrate (Nolvadex)

• Aluminum hydroxide (amphojel)

• Corticosteroids

• Furosemide (lasix)—

• Mannitol (Osmitrol)

• Triaterene/hydrochlorthiazide (maxzide)—

• Levothyroxine (synthroid)—

• Liver & kidney disease

• Dopamine (Intropin)—

• Parkinson's

• Terbutaline (Brethine

• Dexamethasone (Decadron

• Narcotics

• Diuretics

• Oral Iron supplement

• Trimethoprim/Sulfamethoxazole (Bactrim)[sulfonamide antibiotic]

• Triazolam (Halcion)

• Theophylline

• Treatment for constipation in children

• Cromolyn sodium (Intal

• IM site for 18 month old child

• Metronidazole (Flagyl)

• Fluticasone (Flovent

• Status epilepticus

• Barbiturate overdose

• Penicillin allergy may ? risk for allergy to

• Transdermal patch

• Proton pump inhibitors for treatment of:

• Ibuprofen (Motrin)—

• Phenobarbital (Luminal

• Insulin

• Eye drop administration:

• Ventricula dysrhythmias

• Diltizem (Cardizem

• Tocainide HCl (Tonocard)

• Propranolol (Inderal)

• Unconscious type 1 diabetic

• Anti-convulsant for infants/children

• Bipolar

• Tricyclic drugs

• MAOI drugs

• Benztropine mesylate

• Nasal congestion

• Anti-tussive

• Mucolytic

• Atropine

• Verapamil (Calan

• Phenytoin (Dilantin)

A 60-year-old client questions a nurse about her prescribed medication, raloxifene (Evista). Recognizing that this medication is a selective estrogen receptor modulator (SERM), the nurse replies that the medication

A 12-year-old client is to receive oral cefaclor (Ceclor) for otitis media. A nurse monitors the client for which of the following symptoms that may indicate an allergic reaction to the medication?

Which of the following instructions should be included in the discharge teaching plan for a client taking tetracycline (Tetracyn) to prevent the development of the suprainfection, Candida albicans?

A nurse working on a gynecological-obstetrics unit is preparing equipment in anticipation for prescriptions from the primary care provider for Pitocin (oxytocin) administration to several of the clients on the unit. For which of the following clients should the nurse anticipate oxytocin administration? (Select all that apply.)

A male client comes to the clinic requesting sildenafil (Viagra). Viagra should not be combined with which of the following?

A nurse has just completed teaching a 71-year-old client about the flu vaccine. Which of the following client statements indicates that the nurse's teaching was effective?

A postoperative client has a prescription for oxycodone (OxyContin) to be administered for postoperative pain. In monitoring the client and reviewing the client?s chart prior to the first administration of the medication, which of the following should give the nurse the most cause for concern?

A client is undergoing general anesthesia administered by inhalation for a cholecystectomy. The nurse in the operating room observes that the client has a temperature of 40° C (104° F) and significant muscle rigidity. The nurse prepares to assist in the care of the client for which of the following medical emergencies?

A nurse should anticipate that the primary care provider may prescribe polystyrene sulfonate (Kayexalate) for a client who has a serum potassium of

A client is admitted to the hospital with exacerbation of asthma and is receiving albuterol (Proventil) nebulizer treatments every 4 hr. If encountered, which central nervous system (CNS) side effect should the nurse attribute to this medication?

A client with active tuberculosis is started on a regimen of antitubercular medications. Which of the following is important for a nurse to stress to the client?

A client is admitted to the emergency department by an ambulance for a heroin overdose. The client is currently taking methadone (Methadose) that was prescribed through an outpatient clinic for opioid detoxification. The client is unresponsive and is administered naloxone (Narcan). The nurse evaluates for which of the following desired responses to this medication?

A client diagnosed with migraine headaches is prescribed sumatriptan (Imitrex). The nurse is reinforcing client teaching regarding side effects of the medication and advises the client to seek immediate medical attention for which of the following symptoms?

A client phones the primary care clinic and informs a nurse that he is having a "flare up" of his gout. He tells the nurse he has been prescribed several medications for his gout and questions which medication he should take. When reviewing the client?s medical record, the nurse notes the client has a history of migraine headaches. Based on this information, which of the following medications should the nurse anticipate the primary care provider will prescribe?

An older adult client treated for recurring episodes of heart failure has been on long- term thiazide diuretic therapy. Which of the following findings should the nurse report as an adverse effect of these medications?

A nurse recognizes that a client is experiencing an adverse reaction to a nebulized dose of ipratropium (Atrovent) if the client reports

A client is prescribed estrogen for the reversal of menopause symptoms. The nurse recognizes the need for further teaching when the client states,

A client newly diagnosed with peptic ulcer disease is started on the cytoprotective agent sucralfate (Carafate). What important information should the nurse provide the client regarding potential interactions of this medication?

A client diagnosed with bipolar disorder and stabilized with lithium is admitted to the hospital through the emergency department. The primary care provider's diagnosis includes accidental overdose of lithium. What is the most important information the nurse can provide the client with about precautions associated with the administration of lithium?

An adult female client is placed on cyclosporine (Neoral) after receiving a kidney transplant. Which of the following client statements indicates that the nurse's teaching about this medication was effective?

A nurse is administering oral levothyroxine (Levothroid) to an infant with congenital thyroid deficiency. Which of the following findings indicates a therapeutic response to this medication?

A pharmacy supplies a fluticasone (Flovent) inhaler for a client who is hospitalized. The nurse recognizes that this medication will be of the most benefit to the client with

A client is in a clinic for an annual physical exam. During the medication review the client reports daily use of loratadine (Claritin) and occasional use of diphenhydramine (Benadryl) for allergy relief. The nurse recognizes the potential for medication interactions when the client reports use of

A client is self-administering 5 units of lispro insulin (Humalog) every morning. The nurse should instruct the client that the best time to administer the lispro insulin is

A client who has hyperthyroidism (Graves' disease) is taking oral propylthiouracil (PTU). Which of the following client statements indicates effective teaching regarding this medication?

. A primary care provider has prescribed enoxaparin (Lovenox), 60 mg subcutaneously. The nurse should select which of the following as the recommended site to administer this medication?

A client is receiving the thrombopoietic growth factor oprelvekin (Interleukin-11). The nurse recognizes that this medication is being given to correct which abnormal laboratory finding?

A client is receiving naproxen (Aleve) 375 mg 3 times/day by mouth. The nurse observes the client's stools are becoming darker with a tarry consistency. Which of the following nursing interventions is most appropriate?

The parents of an adolescent male client question the nurse about the possibility of androgen therapy for their son. The nurse responds appropriately with which of the following statements?

A nurse is caring for a client with heart failure who is receiving spironolactone. The nurse should monitor for which of the following electrolyte imbalances related to side effects from this aldosterone antagonist?

A client is receiving long-term glucocorticoid therapy for an inflammatory condition. Which of the following findings should be reported to the primary care provider?

A client is prescribed alprazolam (Xanax) 0.25 mg three times a day.

A client is started on haloperidol (Haldol) to control antipsychotic episodes associated with schizophrenia. The nurse should instruct the client to observe for which of the following potential adverse medication effects?

A nurse is administering glucagon intramuscularly to a client. Which of the following actions will help the nurse evaluate the medication's effectiveness?

A client is receiving amphotericin B intravenously. A nurse observes for what common side effects occurring within the first 1 to 3 hr of initiating the infusion?

A client is receiving digoxin (Lanoxin) for heart failure. Which of the following clinical manifestations is an early rather than late sign of medication toxicity?

A nurse is monitoring a client with a history of bulimia in regards to the use of the stimulant laxative, senna (Senokot). Which of the following client findings supports a suspicion of laxative abuse?

. A client is prescribed diphenoxylate/atropine (Lomotil) for severe diarrhea. Which of the following statements made by the client indicates a need for further nursing instruction regarding the self- administration of the medication?

A client recently diagnosed with peptic ulcer disease (PUD) is prescribed antacids by the primary care provider. The client is being instructed by the nurse on when to take the antacids. Which of the following responses by the client indicates a correct understanding of when to take the antacids?

A primary care provider has prescribed phenytoin (Dilantin) 200 mg extended release capsule every day by mouth for a client.

A client with a history of alcoholism is taking acetaminophen (Tylenol) for headaches. The nurse reviews the client's laboratory report. For which of the following laboratory values should the acetaminophen use be discontinued immediately?

A client is receiving ferrous sulfate orally. Which of the following findings reported by the client indicates that the medication is achieving its desired outcome?

. A client with Parkinson?s disease is taking carbidopa-levodopa (Sinemet) daily. The client reports he is frustrated that he has "good" days with few symptoms and "bad" days where he has poor symptom control.

A client is taking metoprolol (Lopressor) for heart failure. The nurse notes that the client's heart rate is 50 beats/min, and the client has a systolic blood pressure of 90 mm Hg. Which of the following should the nurse do first?

A client is prescribed intravenous (IV) heparin by a primary care provider. Which of the following client statements shows understanding of the rationale for the IV heparin that was prescribed by the primary care provider?

A nurse is assisting a client in planning a therapeutic diet to enhance the effectiveness of cholestyramine (Questran) and avoid possible adverse effects. Which of the following would be appropriate to incorporate into the plan?

A client is receiving the thrombolytic medication streptokinase (Kabikinase). Which of the following findings indicates that the client is experiencing an adverse reaction to the medication that should be reported to the primary care provider?

When reviewing medication teaching with a client, a nurse reinforces that which of the following food and medication interactions can lead to medication toxicity?

A client receives a prescription for calcium channel blockers. The nurse should expect which of the following diagnostic tests to be prescribed to obtain baseline data prior to starting the medication?

A client is being discharged with a prescription for warfarin (Coumadin) following treatment for deep vein thrombosis (DVT). The nurse recognizes that teaching has been effective when the client states,

A nurse should recognize that which of the following findings indicates the most serious side effect of vancomycin (Vancocin)?

A client who was prescribed oral contraceptives comes to the clinic for her 4 week follow-up visit. After discussing the use of oral contraceptives with the client, the nurse recognizes a need for further client education when the client states,

A primary care provider has prescribed dextromethorphan (Balminil DM) to a client with a persistent cough.

A client with a diagnosis of gastroesophageal reflux disease (GERD) is prescribed famotidine (Pepcid) 20 mg twice a day. When teaching this client about the proper self- administration schedule for this medication, the nurse should inform the client that famotidine should be taken

Which of the following assessment findings in a client receiving transdermal nitrate therapy for angina indicates an adverse effect?

At 1130, a nurse administers aspart insulin (NovoLog) to a client with diabetes mellitus. When is the client at greatest risk for hypoglycemia?

A client with a diagnosis of cystic fibrosis is prescribed acetylcysteine (Mucomyst).

A nurse is reinforcing teaching for a client who has colorectal cancer and is receiving the platinum compound oxaliplatin (Eloxatin). The client should be taught about which of the following nutritional interventions?

A client is receiving diuretics as part of the pharmacologic therapy for heart failure. Which of the following client statements indicates the need for further instruction?