2019 ATI Pharmacology Proctored Exam with Answers (246 Solved Questions)

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Ati pharm Proctor test 2019Ati pharm Proctor test 2019lOMoARcPSD|13445102

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Pharmacology1. 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. OneB. TwoC. ThreeD. Four2. A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the followingfactors should the educator include as a reason to administer lower medication dosages? (Select all thatapply.)A. Increased renal excretionB. Increased medication-metabolizing enzymesC. Liver failureD. Peripheral vascular diseaseE. Concurrent use of medication the same pathway metabolizes3. A nurse is preparing to administer eye drops to a client. Which of the following actions should the nursetake? (Select all that apply.)A. Have the client lie on one side.B. Ask the client to look up at the ceiling.C. Tell the client to blink when the drops enter the eye.D. Drop the medication into the client's conjunctival sac.E. Instruct the client to close the eye gently after instillation.4. A nurse is teaching a client about transdermal patches. Which of the following statements should the nurseidentify as an indication that the client understands?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."5. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of theclient'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 24hr 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 later.6. A nurse is preparing a client's medications. Which the of following actions should the nurse take infollowing legal practice guidelines? (Select all that apply.)A. Teach the client about the medication.lOMoARcPSD|13445102

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B. Determine the dosage.C. Monitor for adverse effects.D. Lock compartments for controlled substances.E. Determine the client's insurance status.7. A nurse is preparing to administer digoxin to a client who states, "I don't want to take that medication. I donot want one more pill." Which of the following responses should the nurse make?A. "Your physician prescribed it for so you really should take it."B. "Well, let's just get it over quickly then." you,C. "Okay, I'll just give you your other medications."D. "Tell me your concerns about taking this medication."8. A nurse is reviewing a client's prescribed medications. Which of the following situations represents acontraindication to medication administration?A. The client drank grapefruit juice, which could reduce a medication's effectiveness.B. The medication has orthostatic hypotension as an adverse effect.C. A medication is approved for ages 12 and older, and the client is 8 years old.D. An antianxiety medication that has an adverse effect of drowsiness is prescribed as a preoperative sedative.9. A nurse is assessing a client before administering medications. Which of the following data should thenurse obtain? (Select all that apply.)A. Use of herbal productsB. Daily fluid intakeC. Ability to swallowD. Previous surgical historyE. Allergies10. A nurse is working with a newly licensed nurse who is administering medications to clients. Which of thefollowing actions should the nurse identify as an indication that the newly hired nurse understands medicationerror prevention?A. Taking all medications out of the unit-dose wrappers before entering the client's roomB. Checking the prescription when a single dose requires administration of multiple tabletsC. Administering a medication, then looking up the usual dosage rangeD. Relying on another nurse to clarify a medication prescription11. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potentialcontraindication to a medication for which of the following clients? (Select all that apply.)A. A client at 8 weeks of gestation who asks for an influenza immunizationB. A client who takes prednisone and has a possible fungal infectionC. A client who has chronic liver disease and is taking hydrocodone / acetaminophenD. A client who has peptic ulcer disease, takes sucralfate, and has started taking OTC aluminum hydroxideE. A client who has a prosthetic heart valve, takes warfarin, and reports a suspected pregnancylOMoARcPSD|13445102

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12. A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. Theclient states when they took penicillin 3 years ago, they developed a rash. Which of the following actionsshould the nurse take?A. Administer the prescribed dose.B. Withhold the medication.C. Ask the provider to change the prescription to an oral form.D. Administer an oral antihistamine the same time.13. A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensivemedication. Which of the following statements should the nurse give?A. "Be sure to limit your potassium intake while taking the medication."B. "You should check your blood pressure every 8 hours while taking this medication."C. "Your medication dosage will be increased if you develop tachycardia."D. "Change positions slowly when you move from sitting to standing."14. A nurse is reviewing a client's health record and notes that the client experienced permanentextrapyramidal effects caused by a previous medication. The nurse should recognize that the medicationaffected which of the following systems in the client?A. CardiovascularB. ImmuneC. Central nervousD. Gastrointestinal15. A nurse is caring for a client who is taking oral oxycodone. The client is also taking ibuprofen in threerecommended doses daily. The nurse should identify that an interaction between these two medications willcause which of the following findings?A. A decrease in blood levels of ibuprofen, possibly leading to a need for increased doses of this medicationB. A decrease in blood levels of oxycodone, possibly leading to a need for increased doses of this medication.C. An increase in the expected therapeutic effect of both medicationsD. An increase in expected adverse effects for both medications16. A nurse is preparing to administer medications to a 4-month-old infant. Which of the followingpharmacokinetic principles should the nurse consider when administering medications to this client? (Selectall that apply.)A. Infants have a more rapid gastric emptying time.B. Infants have immature liver function.C. Infants' blood-brain barrier is poorly developed.D. Infants have an increased ability to absorb topical medications.E. Infants have an increased number of protein-binding sites.17. A nurse in a provider's office is reviewing the medical record of a client who is pregnant and at the firstprenatal visit. Which of the following immunizations can the nurse administer safely to this client?A. Varicella vaccinelOMoARcPSD|13445102

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B. Rubella vaccineC. Inactivated influenza vaccineD. Measles vaccine18. A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. Thenext morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the followingfactors should the nurse identify as a possible reason for the client's drowsiness?A. Reduced cardiac functionB. First-pass effectC. Reduced hepatic functionD. Increased gastric motility19. A nurse is caring for a client who has increased liver enzymes and is taking herbal supplements. Which ofthe following herbal supplements should the nurse report to the provider as the potential cause?A. GlucosamineB. Saw palmettoC. KavaD. St. John's Wort2. A nurse is caring for a client who requests information on the use of feverfew. Which of the tallowingresponses should the nurse make?A. "It is used to treat skin infections."B. "It can decrease the frequency of migraine headaches."C. "It can lessen the nasal congestion in the common cold."D. "It can relieve nausea of morning sickness during pregnancy."20. A nurse is reviewing a client's current medications. The client states, "I also take ginkgo biloba." Which ofthe following medications has the potential to interact with ginkgo biloba?A. AcetaminophenB. WarfarinC. DigoxinD. Lisinopril21. A nurse is caring for a client who asks about the potential adverse effects of smoking cannabis. Which ofthe following manifestations should the nurse include in the response? (Select all that apply.)A. Decreased heart rateB. Dry mouthC. HallucinationsD. HypertensionE. Increased urination22. A nurse is teaching about the use of medical marijuana with a group of newly licensed nurses. Which ofthe following statements indicates an understanding of the teaching?lOMoARcPSD|13445102

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A. A health care provider must write a prescription for medical marijuana.B. Medical marijuana is a Schedule V controlled substance in the United States.C. Pharmacies must obtain certification prior to dispensing medical marijuana.D. The FDA does not recognize the marijuana plant as a form of medicine.23. A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity. Whichof the following actions is the nurse's priority?A. Administer flumazenil.B. Identify the client's level of orientation.C. Infuse IV fluids.D. Prepare the client for gastric lavage.24. A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalizedanxiety disorder. Which of the following statements by the client indicates understanding of the teaching?A. "I should take the medication on an empty stomach."B. "I will follow a low-sodium diet while taking this medication."C. "I need to discontinue this medication slowly."D. "I should not crush this medication before swallowing."25. A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Whichof the following information should the nurse include?A. "Take this medication on an empty stomach."B. "Expect optimal therapeutic effects within 24 hr."C. "Take this medication when needed for anxiety."D. "This medication has a low risk for dependency."26. A nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription forparoxetine. Which of the following instructions should the nurse include?A. "It can take several weeks before you feel like the medication is helping."B. "Take the medication just before bedtime to promote sleep."C. "You should take the medication when needed for obsessive urges."D. "Monitor for weight gain while taking this medication."27. A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder and reports thatthey grind their teeth during the night. The nurse should identify which of the following interventions tomanage bruxism? (Select all that apply.)A. Concurrent administration of buspironeB. Administration of a different SSRIC. Use of a mouth guardD. Changing to a different class of antidepressant medicationE. Increasing the dose of paroxetinelOMoARcPSD|13445102

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28. A nurse is teaching the guardians of a child who has a new prescription for desipramine. The nurse shouldinclude that which of the following adverse effects is the priority to report to the provider?A. ConstipationB. Suicidal thoughtsC. PhotophobiaD. Dry mouth2. A nurse is teaching an adolescent client who has a new prescription for clomipramine for OCD. Which ofthe following instructions should the nurse include to minimize an adverse effect of his medication?A. Wear sunglasses when outdoors.B. Check your temperature daily.C. Take this medication in the morning.D. Add extra calories to your diet.29. A nurse is caring for a school-age child who has a new prescription for atomoxetine. The nurse shouldmonitor the client for which of the following manifestations as an adverse effect of this medication?A. Kidney toxicityB. Liver damageC. Seizure activityD. Adrenal insufficiency30. A nurse is teaching the caregiver of a school-age child about transdermal methylphenidate. Which of thefollowing instructions should the nurse include?A. Apply one patch twice per day.B. Leave the patch on for 9 hr.C. Apply the patch to the child's waist.D. Use opened tray within 6 months.31. A nurse is teaching the guardians and their school-age child about a new prescription forlisdexamfetamine. Which of the following information should the include in the teaching? (Select all thatapply.)A. An adverse effect of this medication is CNS stimulation.B. Administer the medication before bedtime.C. Monitor blood pressure while taking this medication.D. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop.E. This medication raises the levels of dopamine in the brain.32. A nurse is providing teaching to a group of new parents about medications. The nurse should include thataspirin is contraindicated for children who have a viral infection due to the risk of developing which of thefollowing adverse effects?Reye's syndromeVisual disturbancesDiabetes mellituslOMoARcPSD|13445102

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Wilms' tumor33. A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysisand a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should thenurse include in the teaching?Reduces blood pressureInhibits clotting of fistulaPromotes RBC productionStimulates growth of neutrophils34. A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the followingmedications should the nurse plan to administer?IbuprofenNaproxenAspirinAcetaminophen35. A nurse is preparing to administer heparin 8,000 units subcutaneously every 8hr. Available is heparin10,000 units/1mL. How many mL should the nurse administer per dose? (Round the answer to the nearesttenth. Use a leading zero if it applies. Do not use a trailing zero.)0.8 mL36. A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. Thenurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Usea leading zero if it applies. Do not use a trailing zero.)250/4 = 62.5} 63 mL/hr37. A nurse is preparing to administer amoxicillin 250 mg liquid supspension PO every 8 hr to an older adultclient. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose?(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)5 mL38. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client forwhich of the following adverse effects?InsomniaHypotensionBleedingConstipationlOMoARcPSD|13445102

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39. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse shouldinclude a severe allergy to which of the following medications as a contraindication to ceftriaxone?GentamicinClindamycinPiperacillinSulfamethoxazole-trimethoprim40. A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should include inthe teaching that which of the following conditions is a contraindication to this medication?HyperthyroidismIntestinal obstructionGlaucomaLow blood pressure41. A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. Theclient has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of thefollowing medications should the nurse anticipate administering?AmantadineBupropionPhenelzineHydroxyzine42. A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurseshould monitor the client for which of the following adverse effects?HypotensionHyperthermiaHypoglycemiaTachycardia43. A nurse is providing teaching to a client who has a urinary tract infection and new prescriptions forphenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need forfurther teaching?"If the phenazopyridine upsets my stomach, I can take it with meals.""The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the infection.""I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin.""I should notify my provider immediately if my urine turns an orange color."44. 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?EcchymosisDecreased urine outputIncreased blood pressurelOMoARcPSD|13445102

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Dizziness45. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client hasan increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse shouldanticipate a prescription for which of the following medications?MethimazoleSomatropinLevothyroxinePropylthiouracil46. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO dailyto treat hypertension. Which of the following instructions should the nurse include in the teaching?"Take hydrochlorothiazide as needed for edema.""Check your weight once each week.""Take the hydrochlorothiazide on an empty stomach.""Take the hydrochlorothiazide in the morning."47. A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which ofthe following medications should the nurse plan to administer?OxytocinNifedipineDinoprostoneMisoprostol48. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurseshould instruct the client that lactulose has which of the following therapeutic effects?Increases blood pressurePrevents esophageal bleedingDecreases heart rateReduces ammonia levels49. 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 perform prior to starting the client on thismedication?Hearing examinationGlucose tolerance testElectrocardiogramPulmonary function tests50. A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurseshould instruct the client to discontinue taking the medication for which of the following adverse effects?NausealOMoARcPSD|13445102

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Metallic tasteFeverDrowsiness51. A nurse is assessing a client who is receiving IV gentamicin three times daily. Which of the followingfindings indicates that the client is experiencing an adverse effect of this medication?HypoglycemiaProteinuriaNasal congestionVisual disturbances52. A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription forpropranolol. Which of the following information should the nurse include in the teaching?A. Increases the risk for seizure activityB. Provides a form of aversion therapyC. Decreases cravingsD. Can increase blood pressure53. A charge nurse is planning a staff education session to discuss medications used during the care of a clientexperiencing alcohol withdrawal . Which of the following medications should the charge nurse include thediscus (Select all that apply.)A. LorazepamB. DiazepamC. DisulfiramD. NaltrexoneE. Acamprosate54. A nurse is teaching a client who has a new prescription for clonidine to assist with maintenance ofabstinence from opioids. The nurse should instruct the client to monitor for which of the following adverseeffects?A. DiarrheaB. Dry mouthC. InsomniaD. Hypertension55. A nurse is teaching a client who has tobacco use disorder about nicotine replacement therapy. Which ofthe following statements by the client indicates understanding of the teaching?A. "I should avoid eating right before I chew a piece of nicotine gum."B. "I will need to stop using the nicotine gum after 1 year."C. "I know that nicotine gum is a safe alternative to smoking if I become pregnant."D. "I must chew the nicotine gum quickly for about 15 minutes."lOMoARcPSD|13445102

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56. A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioiduse and has a new prescription for clonidine. Which of the following actions should the nurse identify as thepriority?A. Administer the clonidine on the prescribed schedule.B. Provide ice chips at the client's bedside.C. Educate the client on the effects of clonidine.D. Obtain baseline vital signs.57. A nurse in the post-anesthesia recovery unit is caring for a client who received a nondepolarizingneuromuscular blocking agent and has muscle weakness. The nurse should expect a prescription for which ofthe following medications?A. NeostigmineB. NaloxoneC. DantroleneD. Vecuronium58. A nurse is providing information to a client who has early Parkinson's disease and a new prescription forpramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of thismedication?A. HallucinationsB. Increased salivationC. DiarrheaD. Discoloration of urine59. A nurse is teaching a client who has a new prescription for levodopa / carbidopa for Parkinson's disease.Which of the following instructions should the nurse include?A. Increase intake of protein-rich foods.B. Expect muscle twitching to occur.C. Take this medication with food.D. Anticipate relief of manifestations in 24 hr.60. A nurse is preparing to administer a medication to a client who has absence seizures. The nurse shouldexpect to administer which of the following medications to the client? (Select all that apply.)A. PhenytoinB. EthosuximideC. GabapentinD. CarbamazepineE. Valproic acidF. Lamotrigine61. A nurse is reviewing a new prescription for oxcarbazepine with a client who has partial seizures. Which ofthe following instructions should the nurse include? (Select all that apply.)lOMoARcPSD|13445102

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A. "Use caution if given a prescription for a diuretic medication."B. "Consider using an alternate form of contraception if you are using oral contraceptives."C. "Chew gum to increase saliva production."D. "Avoid driving until you see how the medication affects you."E. "Notify your provider if you develop a skin rash."62. A nurse in the operating room is caring for a client who received a dose of succinylcholine. During theoperation, the client suddenly develops rigidity and a rise in body temperature. The nurse should expect aprescription for which of the following medications?A. NeostigmineB. NaloxoneC. DantroleneD. Vecuronium63. A nurse in the post-anesthesia care unit is caring for a client who is experiencing malignant hyperthermia.Which of the following actions should the nurse take? (Select all that apply.)A. Place a cooling blanket on the client.B. Administer oxygen at 100%.C. Administer iced 0.9% sodium chloride.D. Administer potassium chloride IV.E. Monitor core body temperature.64. A nurse is teaching a client who has a new prescription for baclofen to treat muscle spasms. Which of thefollowing statements by the client indicates an understanding of the teaching? (Select all that apply.)A. "I will stop taking this medication right away if I develop dizziness."B. "I know the doctor will gradually increase my dose of this medication for a while."C. "I should increase fiber to prevent constipation from this medication."D. "I won't be able to drink alcohol while I'm taking this medication."E. "I should take this medication on an empty stomach each morning."65. A nurse is reviewing the medical record of a client who reports urinary incontinence and asks about aprescription for oxybutynin. The nurse should recognize that oxybutynin is contraindicated in the presence ofwhich of the following conditions?A. BursitisB. SinusitisC. DepressionD. Glaucoma66. A nurse is assessing a client who has a prescription for bethanechol to treat urinary retention. The nurseshould identify that which of the following findings is a manifestation of muscarinic stimulation?A. Dry mouthB. HypertensionC. Excessive perspirationlOMoARcPSD|13445102

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D Fecal impaction67. A nurse is providing instructions to a client who has been experiencing insomnia and has a newprescription for temazepam. The nurse should inform the client that which of the following manifestationsare adverse effects of temazepam? (Select all that apply.)A. IncoordinationB. HypertensionC. PruritusD. Sleep drivingE. Amnesia68. A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client isoversedated. Which of the following medications should the nurse expect to administer to this client?A. KetamineB. NaltrexoneC. FlumazenilD. Fluvoxamine69. A nurse is teaching a client who has a new prescription for ramelteon. The nurse should instruct the clientto avoid which of the following foods at the time of medication administration?A. Baked potatoB. Fried chickenC. Whole-grain breadD. Citrus fruits70. A nurse is caring for a client who is to undergo a surgical procedure. Which of the following preexistingconditions can be a contraindication for the use of ketamine as an intravenous anesthetic?A. Peptic ulcer diseaseB. Breast cancerC. Diabetes mellitusD. Schizophrenia71. A nurse is providing instructions to a client who has a new prescription for zolpidem. Which of thefollowing instructions should the nurse include?A. "Notify the provider if you plan to become pregnant."B. "Take the medication 1hr before you plan to go to sleep."C. "Allow at least 6hr for sleep when taking zolpidem."D. "To increase the effectiveness of zolpidem, take it with a bedtime snack."72. A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension.The nurse should recognize which of the following conditions is a contraindication for taking propranolol?A. AsthmalOMoARcPSD|13445102

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