ATI Pharmacology Proctored Exam, Test Bank

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

3. Calcitonin (Miacalcin)

Rationale:

The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium

gluconate and calcium chloride are medications used for 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 calcium concentration.

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

4. Orange juice

Rationale:

Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer

the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the

iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple

juice.

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

1. Tinnitus

Rationale:

Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms 

include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not

associated with salicylism.

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

4. At least 30 minutes before exposure to the sun

Rationale:

Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they

can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.

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. Informing the client that this is normal

Rationale:

Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat

burns to reduce bacteria present in avascular tissues. The client should be informed that the medication

will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4

are incorrect

6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the 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

1.Hyperventilation

Rationale:

Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion 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. An elevated blood pressure may be

expected from the pain that occurs with a burn injury. 

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

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 been evaluated. Options 1,

3, and 4 do not need to be monitored specifically during this treatment.

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)

1. Vitamin A

Rationale:

Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin

toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued

before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.

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