ATI PN Pharmacology Proctored

Exam Review | 240 Questions and

Answers with Rationale | Rated A |

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1) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with

a partial-thickness burn, which has cultured positive for gram-negative bacteria. The

nurse is reinforcing information to the client about the medication. Which statement

made by the client indicates a lack of understanding about the treatments?

1. "The medication is an antibacterial."

2. "The medication will help heal the burn."

3. "The medication will permanently stain my skin."

4. "The medication should be applied directly to the wound."

Rationale:

Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against

gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to

assist in healing. It does not stain the skin.

2) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an

antineoplastic medication. During the infusion, the client complains of pain at the

insertion site. During an inspection of the site, the nurse notes redness and swelling and

that the rate of infusion of the medication has slowed. The nurse should take which

appropriate action?

1. Notify the registered nurse.

2. Administer pain medication to reduce the discomfort.

3. Apply ice and maintain the infusion rate, as prescribed.

4. Elevate the extremity of the IV site, and slow the infusion.

Rationale:

When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care

must be taken to prevent the medication from escaping into the tissues surrounding the injection

site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of

extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If

extravasation occurs, the registered nurse needs to be notified; he or she will then contact the

health care provider.

3) The client with squamous cell carcinoma of the larynx is receiving bleomycin

intravenously. The nurse caring for the client anticipates that which diagnostic study will

be prescribed?

1. Echocardiography

2. Electrocardiography

3. Cervical radiography

4. Pulmonary function studies

Rationale:

Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial

pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with

hematological, hepatic, and renal function tests need to be monitored. The nurse needs to

monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The

medication needs to be discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and

3 are unrelated to the specific use of this medication.

4) The client with acute myelocytic leukemia is being treated with busulfan (Myleran).

Which laboratory value would the nurse specifically monitor during treatment with this

medication?

1. Clotting time

2. Uric acid level

3. Potassium level

4. Blood glucose level

Rationale:

Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can produce uric

acid nephropathy, renal stones, and acute renal failure. Options 1, 3, and 4 are not specifically

related to this medication.

5) The client with small cell lung cancer is being treated with etoposide (VePesid). The

nurse who is assisting in caring for the client during its administration understands that

which side effect is specifically associated with this medication?

1. Alopecia

2. Chest pain

3. Pulmonary fibrosis

4. Orthostatic hypotension

Rationale:

A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is

monitored during the infusion. Hair loss occurs with nearly all the antineoplastic medications.

Chest pain and pulmonary fibrosis are unrelated to this medication.

6) The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic

medication. When implementing the plan, the nurse tells the client:

1. To take aspirin (acetylsalicylic acid) as needed for headache

2. Drink beverages containing alcohol in moderate amounts each evening

3. Consult with health care providers (HCPs) before receiving immunizations

4. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair

Rationale:

Because antineoplastic medications lower the resistance of the body, clients must be informed

not to receive immunizations without a HCP's approval. Clients also need to avoid contact with

individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and 

aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to

minimize the risk of toxicity and side effects.

7) The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse

monitors the client, knowing that which of the following indicates a side effect specific to

this medication?

1. Diarrhea

2. Hair loss

3. Chest pain

4. Numbness and tingling in the fingers and toes

Rationale:

A side effect specific to vincristine is peripheral neuropathy, which occurs in almost every client.

Peripheral neuropathy can be manifested as numbness and tingling in the fingers and toes.

Depression of the Achilles tendon reflex may be the first clinical sign indicating peripheral

neuropathy. Constipation rather than diarrhea is most likely to occur with this medication,

although diarrhea may occur occasionally. Hair loss occurs with nearly all the antineoplastic

medications. Chest pain is unrelated to this medication.

8) The nurse is reviewing the history and physical examination of a client who will be

receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the

registered nurse regarding the administration of the medication if which of the following

is documented in the client's history?

1. Pancreatitis

2. Diabetes mellitus

3. Myocardial infarction

4. Chronic obstructive pulmonary disease

Rationale:

Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or if the client

has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function

tests should be performed before therapy begins and when a week or more has elapsed between

administration of the doses. The client needs to be monitored for signs of pancreatitis, which

include nausea, vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are

not contraindicated with this medication.

9) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse

understands that the primary action of this medication is to:

1. Increase DNA and RNA synthesis.

2. Promote the biosynthesis of nucleic acids.

3. Increase estrogen concentration and estrogen response.

4. Compete with estradiol for binding to estrogen in tissues containing high concentrations

of receptors. .

Rationale:

Tamoxifen is an antineoplastic medication that competes with estradiol for binding to estrogen in

tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast

carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer

following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.