ATI Pharmacology Proctored Test Bank
1. 1) A nurse is caring for a client with
hyperparathyroidism and notes that the
client's serum calcium level is 13 mg/dL.
Which medication should the nurse prepare
to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D
2. 2.) Oral iron supplements are prescribed for
a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to
administer the iron with which best food
item?
1. Milk
2. Water
3. Apple juice
4. Orange juice
3. 3.) Salicylic acid is prescribed for a client
with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of
the following would indicate the presence
of systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
4. 4.) The camp nurse asks the children
preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the
children that chemical sunscreens are most
effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to
the sun
5. 5.) Mafenide acetate (Sulfamylon) is
prescribed for the client with a burn injury.
When applying the medication, the client
complains of local discomfort and burning.
Which of the following is the most
appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed
to the burn site
3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia.Calciumgluconateandcalciumchloridearemedicationsusedfor the
treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calciumconcentration.
4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be
instructedtoadminister themedication witha citrus fruit or ajuice thatis high in
vitaminC. Milkmay affectabsorptionoftheiron.Waterwill notassistinabsorption.
Orange juice contains a greater amount of vitamin C than apple juice.
1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)
canresult.Symptoms includetinnitus, dizziness, hyperpnea,andpsychological
disturbances. Constipation and diarrhea are not associated with salicylism.
4. Atleast 30 minutes beforeexposure to thesun
Rationale:
Sunscreens are most effective when applied at least 30 minutes beforeexposure to
thesun so thatthey can penetrate theskin. All sunscreens shouldbereappliedafter
swimming or sweating.
3. Informing the clientthat this is normal
Rationale:
Mafenideacetateisbacteriostatic forgram-negativeandgram-positiveorganisms
and is used totreatburns toreducebacteriapresentinavascular tissues. Theclient
shouldbeinformedthatthemedication will cause local discomfort andburningand
that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
6. 6.) The burn client is receiving treatments of
topical mafenide acetate (Sulfamylon)tothe
site of injury. The nurse monitors the client,
knowing that which of the following indicates
that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site
7. 7.) Isotretinoin is prescribed for a client with
severe acne. Before the administration of this
medication, the nurse anticipates that which
laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count
8. 8.) A client with severe acne is seen in the
clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the
client's medication record and would contact
the (HCP) if the client is taking which
medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
9. 9.) The nurse is applying a topical
corticosteroid to a client with eczema. The
nurse would monitor for the potential for
increased systemic absorption of the
medication if the medication were being
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands
10. 10.) The clinic nurse is performing an
admission assessment on a client. The nurse
notes that the client is taking azelaic acid
(Azelex). Because of the medication
prescription, the nurse would suspect that the
client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex
1. Hyperventilation
Rationale:
Mafenideacetateis acarbonicanhydraseinhibitor andcansuppress renalexcretion
of acid, thereby causing acidosis. Clients receiving this treatment should be
monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the
medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local
rather than systemic effects. Anelevatedblood pressuremay beexpectedfromthe
pain that occurs with a burn injury.
2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has beenevaluated. Options 1, 3, and 4 do not needtobemonitored
specifically during this treatment.
1. Vitamin A
Rationale:
IsotretinoinisametaboliteofvitaminAandcanproducegeneralizedintensification
of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements shouldbediscontinuedbeforeisotretinointherapy.Options2,3,and4
are not contraindicated with the use of isotretinoin.
2. Axilla
Rationale:
Topicalcorticosteroids canbeabsorbedintothesystemic circulation.Absorptionis
higher from regions where the skin is especially permeable (scalp, axilla, face,
eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
poor (back, palms, soles).
1. Acne
Rationale:
Azelaic acid is a topical medication used to treatmild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and
decreasing theproliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
11. 11.) The health care provider has prescribed silver
sulfadiazine (Silvadene) for the client with a partialthickness burn, which has cultured positive for gramnegative 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."
12. 12.) 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 painmedication toreduce the
discomfort.
3. Apply ice and maintain the infusion rate, as
prescribed.
4. Elevate the extremity of the IV site, and slow the
infusion.
13. 13.) 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
14. 14.) 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
3. "The medication will permanently stainmy skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum
ofactivity againstgram-negativebacteria, gram-positivebacteria, and
yeast. It is applied directly to the wound to assist in healing. It does not
stain the skin.
1. Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are
administeredviaIV,greatcaremustbetakentopreventthemedicationfrom
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
decreasedinfusionrate. Ifextravasationoccurs,theregisterednurseneeds
to be notified; he or she will then contact the health care provider.
4. Pulmonary function studies
Rationale:
Bleomycinisanantineoplasticmedication(ChemotheraputicAgents)that
can cause interstitial pneumonitis, which can progress to pulmonary fibrosis.
Pulmonary functionstudies along with hematological, hepatic, andrenal
function tests need to be monitored. The nurse needs to monitor lung
sounds fordyspnea and crackles, which indicatepulmonary 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.
2. Uric acidlevel
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level.
Hyperuricemiacanproduceuricacidnephropathy,renalstones,andacute
renal failure. Options 1, 3, and 4 are not specifically related to this
medication.
15. 15.) 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
16. 16.) 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
17. 17.) 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
18. 18.) 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
4. Orthostatic hypotension
Rationale:
Asideeffectspecific toetoposide is orthostatic hypotension. Theclient'sblood
pressureis monitoredduring theinfusion. Hair loss occurs with nearly all the
antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to
this medication.
3. Consult with health care providers (HCPs) before receiving immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must
beinformed nottoreceiveimmunizations 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.
4. Numbnessandtinglinginthefingersandtoes
Rationale:
A side effect specific to vincristine is peripheral neuropathy, which occurs in
almost every client. Peripheralneuropathy can bemanifestedas numbness and
tingling in the fingers and toes. Depression ofthe Achilles tendon reflex may be
thefirst clinical sign indicatingperipheral neuropathy. Constipationrather than
diarrhea is most likely to occur with this medication, although diarrhea may occur
occasionally. Hair loss occurs with nearly allthe antineoplastic medications.
Chest pain is unrelated to this medication.
1. Pancreatitis
Rationale:
Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or
if the client has a history of pancreatitis. The medication impairs pancreatic
functionand pancreatic functiontests should be performedbeforetherapybegins
and whena weekor morehas elapsed betweenadministration ofthedoses. The
client needs to be monitored for signs of pancreatitis, which include nausea,
vomiting, andabdominalpain.Theconditions notedinoptions 2,3,and4 arenot
contraindicated with this medication.
19. 19.) 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.
20. 20.) The client with metastatic
breast cancer is receiving
tamoxifen. The nurse specifically
monitors which laboratory value
while the client is taking this
medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time
21. 21.) A nurse is assisting with caring
for a client with cancer who is
receiving cisplatin. Select the
adverse effects that the nurse
monitors for that are associated
with this medication. Select all
that apply.
1. Tinnitus
2. Ototoxicity
3. Hyperkalemia
4. Hypercalcemia
5. Nephrotoxicity
6. Hypomagnesemia
22. 22.) A nurse is caring for a client
after thyroidectomy and notes
that calcium gluconate is
prescribed for the client. The
nurse determines that this
medication has been prescribed
to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemictetany.
4. Stimulate the release of
parathyroid hormone.
4.Compete withestradiolforbindingtoestrogenintissues containinghigh concentrationsof
receptors.
Rationale:
Tamoxifenisanantineoplasticmedicationthat competeswithestradiolforbindingtoestrogen
intissues containing high concentrationsof receptors.Tamoxifenis usedtotreatmetastatic
breastcarcinoma in women and men. Tamoxifenis alsoeffective indelaying therecurrenceof
cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.
2. Calcium level
Rationale:
Tamoxifenmay increasecalcium, cholesterol,andtriglyceridelevels.Beforetheinitiationof
therapy, a complete blood count, platelet count, and serum calcium levels should be
assessed. These blood levels, along with cholesterol and triglyceride levels, should be
monitoredperiodicallyduringtherapy.Thenurseshouldassess forhypercalcemiawhilethe
clientis takingthis medication. Signs of hypercalcemia include increasedurinevolume,
excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and
flank pain.
1. Tinnitus
2. Ototoxicity
5. Nephrotoxicity
6. Hypomagnesemia
Rationale:
Cisplatinisanalkylatingmedication.Alkylatingmedications arecellcyclephase-nonspecific
medications thataffectthesynthesis ofDNAby causing thecross-linkingofDNAtoinhibit cell
reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia,
hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin
to reduce the potential for renaltoxicity.
3. Treat hypocalcemic tetany.
Rationale:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally
removedor injuredduringsurgery.Manifestationsdevelop 1 to7days after surgery. Iftheclient
develops numbness and tingling aroundthemouth, fingertips, or toes or muscle spasms or
twitching,thehealthcareprovider isnotifiedimmediately.Calciumgluconateshouldbekeptat
the bedside.
Version | 2021 |
Category | HESI |
Included files | |
Authors | qwivy.com |
Pages | 63 |
Language | English |
Comments | 0 |
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