PN Pharmacology 2023

ATI PN Pharmacology 2023

Total Questions : 45

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Question 1: View

A nurse is preparing to administer vaccines to an 11-year-old child who is up to date on immunizations. Which of the following vaccines should the nurse plan to administer?

Explanation

D. The Quadrivalent human papillomavirus (HPV) vaccine is recommended for both males and females to protect against certain strains of HPV that can lead to cervical cancer, genital warts, and other HPV- related cancers. It is typically administered in a series of doses starting around 11-12 years of age.
A. Hepatitis B vaccine is typically administered at birth, followed by a series of doses at 1-2 months and 6-18 months of age. By the age of 11, the child would have completed the series if they were up to date on immunizations. Therefore, it is unlikely that the child would need another dose of the Hepatitis B vaccine at this age.
B. Rotavirus vaccine is usually administered in infancy, with the first dose given around 2 months of age and the last dose by 8 months of age. By the age of 11, the child would have completed the series if they were up to date on immunizations. So, administering the Rotavirus vaccine to an 11-year-old who is up to date on immunizations is unnecessary.
C. The Pneumococcal conjugate vaccine protects against infections caused by the bacterium Streptococcus pneumoniae, such as pneumonia and meningitis. It is typically administered in infancy, with a booster dose recommended at around 12-15 months of age. However, the CDC recommends a single revaccination dose of Pneumococcal conjugate vaccine for children aged 6 through 18 years who are at high risk of infection. If the child falls into this category, the nurse should plan to administer the vaccine.


Question 2: View
Exhibits

Click to highlight the instructions the nurse should reinforce to the client. Prescribed

Medication Albuterol

Nursing Instructions

"Take your albuterol when you are having difficulty breathing."

"Hold your breath for 20 seconds when taking your albuterol."

Salmeterol

"Take the salmeterol 5 minutes before the albuterol when you need both medications."

“Take the salmeterol 2 times each day."

Fluticasone

"Rinse out your mouth after taking the fluticasone."

Take the fluticasone as needed for an asthma attack."

Explanation

Albuterol belongs to a class of medications known as beta-adrenergic agonists, specifically beta-2 selective agonists. When inhaled, albuterol binds to beta-2 adrenergic receptors located on the smooth muscle cells lining the airways in the lungs. Activation of these receptors leads to relaxation of the smooth muscles surrounding the bronchial tubes, causing them to widen (bronchodilation). By dilating the airways, albuterol helps to reduce airway resistance and increase airflow into and out of the lungs, making it easier to breathe during an asthma attack.

One should hold breath for 5 to 10 seconds after inhalation of the puff.

Salmeterol is a long-acting beta-adrenergic agonist (LABA) bronchodilator commonly used for the maintenance treatment of asthma and chronic obstructive pulmonary disease (COPD). Salmeterol is usually prescribed for twice-daily dosing.

One should wait for 2 minutes between two puffs.

Fluticasone is a corticosteroid medication that is inhaled into the lungs to reduce inflammation in the airways. If these particles remain in the mouth, they can increase the risk of developing oral thrush, which is a fungal infection caused by Candida albicans. Rinsing the mouth with water after using the inhaler helps to remove any residual medication particles, reducing the risk of oral thrush.


Question 3: View

A nurse is caring for a client who is taking allopurinol. Which of the following laboratory findings indicates the medication has been effective?

Explanation

B. Allopurinol is primarily prescribed to lower uric acid levels in the blood. It achieves this by inhibiting the enzyme xanthine oxidase, which is involved in the production of uric acid. Lowering uric acid levels helps prevent the formation of uric acid crystals, which can lead to gout attacks or kidney stones.
A. Triglycerides are a type of fat found in the blood. Allopurinol is not directly involved in lowering triglyceride levels. Medications that are typically used to lower triglycerides include statins, fibrates, niacin, and omega-3 fatty acids.
C. Albumin is a protein found in the blood, and its levels can be affected by various factors such as liver or kidney function. Allopurinol is not known to directly influence albumin levels. Therefore, an increase in albumin would not be a laboratory finding indicative of the effectiveness of allopurinol.
D. Potassium levels in the blood can be influenced by medications, diet, kidney function, and other factors. Allopurinol is not typically associated with increasing potassium levels. In fact, certain medications used to treat gout, such as thiazide diuretics, can lead to increased potassium levels.


Question 4: View

A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?

Explanation

A. Renal function typically declines with age, leading to a decrease in glomerular filtration rate (GFR) and renal blood flow. As a result, medications may be excreted more slowly from the body, leading to an increased risk of drug accumulation and potential toxicity. Adjustments in medication dosages or dosing intervals may be necessary to account for this age-related change.
B. Brain receptors do not change significantly. However, older adults may require lower doses to achieve the same therapeutic effect due to reduced receptor sensitivity.
C. Gastric emptying tends to slow down with age rather than increase. Delayed gastric emptying can affect the absorption of orally administered medications, leading to unpredictable drug levels and potentially reduced efficacy.
D. Hepatic function generally decreases with age, leading to a decline in the metabolic capacity of the liver. This can result in slower drug metabolism and clearance, prolonging the duration of action of medications and increasing the risk of adverse effects.


Question 5: View

A nurse is collecting data from a client who has taken an overdose of oxycodone. Which of the following findings should the nurse expect?

Explanation

A. Opioid overdose typically results in central nervous system depression, which can lead to bradycardia (slow heart rate) rather than tachycardia. Bradycardia occurs due to decreased sympathetic nervous system activity.
B. Bradyppnea is a common finding in opioid overdose due to the depressive effect of opioids on the respiratory center in the brainstem. Opioids can suppress the drive to breathe, leading to shallow and rapid breathing, or even respiratory arrest in severe cases.
C. Sedation or drowsiness is a hallmark feature of opioid overdose. Oxycodone, like other opioids, acts on the central nervous system to produce analgesia and sedation. In cases of overdose, sedation may progress to unconsciousness and respiratory depression, which can be life-threatening.
D. Opioid overdose typically causes pinpoint (constricted) pupils rather than dilated pupils. The constriction of pupils, known as miosis, is a classic sign of opioid toxicity due to the suppression of the sympathetic nervous system.


Question 6: View

A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?

Explanation

A. Furosemide can decrease the renal clearance of lithium, leading to increased lithium levels in the blood. This can potentiate the toxic effects of lithium, such as neurotoxicity and cardiac toxicity. Therefore, concurrent use of furosemide and lithium is generally contraindicated, and caution is advised. The nurse should identify lithium carbonate as contraindicated in this scenario.
B. Albuterol is a bronchodilator commonly used to treat respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). There are no significant contraindications between albuterol and furosemide.
C. Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism. There are no significant contraindications between levothyroxine and furosemide.
D. Cetirizine is an antihistamine used to treat allergies and allergic reactions. There are no significant contraindications between cetirizine and furosemide. They are generally considered safe to use together.


Question 7: View

A nurse is reinforcing teaching about phenytoin with a client who had a tonic-clonic seizure. Which of the following information should the nurse include in the teaching?

Explanation

B. Phenytoin is associated with gingival hyperplasia, which is an overgrowth of gum tissue. It's essential for clients taking phenytoin to maintain good oral hygiene and receive regular dental check-ups to monitor for this side effect.
A. Phenytoin is not known to directly diminish potassium levels. However, it can cause a variety of electrolyte imbalances, including hyponatremia (low sodium levels) and hypocalcemia (low calcium levels), but not typically hypokalemia (low potassium levels).
C. Ginkgo biloba is an herbal supplement that does not interact with phenytoin.
D. Phenytoin can cause photosensitivity reactions in some individuals, leading to an increased risk of sunburn. However, teaching on gingival hyperplasia is more important.


Question 8: View

A nurse is reinforcing teaching with a client who has a prescription for sildenafil to treat erectile dysfunction. Which of the following statements by the client indicates an understanding of the teaching?

Explanation

B. Fatty foods can delay the absorption of sildenafil, potentially delaying its onset of action. While it's not necessary to completely avoid fatty foods, consuming a high-fat meal shortly before taking sildenafil may delay its effects. Therefore, it's advisable to avoid large, high-fat meals before taking sildenafil to optimize its effectiveness.
A. Sildenafil is typically taken on an as-needed basis, approximately 30 minutes to 1 hour before anticipated sexual activity. Taking sildenafil more than once a day is not recommended and can increase the risk of adverse effects and complications.
C. Sildenafil is a medication used to treat erectile dysfunction by improving blood flow to the penis, but it does not protect against sexually transmitted diseases (STDs).
D. Constipation is not a common side effect of sildenafil. Common side effects of sildenafil include headache, flushing, indigestion, nasal congestion, and dizziness. Constipation is not typically associated with sildenafil use.


Question 9: View

A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication?

Explanation

D. The expected therapeutic effect of montelukast is the reduction of bronchial inflammation. By blocking leukotriene receptors, montelukast helps to prevent the constriction of airway muscles, decrease mucus secretion, and reduce inflammation in the airways. This can lead to improved asthma control and symptom management.
A. Montelukast is not indicated for the treatment of gastric acid-related conditions such as gastroesophageal reflux disease (GERD) or peptic ulcers.
B. Montelukast is not typically associated with peripheral vasodilation. Its primary mechanism of action involves blocking the action of leukotrienes, which are inflammatory mediators involved in allergic and asthmatic reactions.
C. Montelukast does not affect white blood cell (WBC) count.


Question 10: View

A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take?

Explanation

A. When administering a TST, the nurse should select an injection site that is free of scar tissue and areas with excessive hair, veins, or visible lesions. The preferred site for TST administration is the volar aspect of the forearm, approximately 2-4 inches below the elbow.
B. After administering the TST, the nurse should not massage or manipulate the injection site. Massaging the site can cause irritation or spread the solution, leading to inaccurate results.
C. he TST is administered intradermally, typically with a 27-gauge needle. The needle should be inserted with the bevel facing upward at a 5-15-degree angle.
D. The standard dose of tuberculin solution (e.g., purified protein derivative, PPD) for a TST is 0.1 mL containing 5 tuberculin units (TU).


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