Review ATI Pharmacology NRSG 106 Fletcher Exam

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ATI Pharmacology NRSG 106 Fletcher Exam

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Total Questions : 46

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Question 1:

A nurse is providing teaching for a client who has diabetes and a new prescription for insulin glargine. Which of the following instructions should the nurse provide regarding this type of insulin?

A. Insulin glargine has a duration of 6 to 10 hr. B. Insulin glargine has a duration of 3 to 6 hr. C. Insulin glargine has a duration of 16 to 24 hr. D. Insulin glargine has a duration of 18 to 24 hr.

Answer and Explanation

Choice A:

This is incorrect because insulin glargine has a longer duration than 6 to 10 hr. Insulin glargine is a long-acting insulin that provides a steady and continuous level of insulin in the blood. It is usually given once daily at the same time.

Choice B:

This is incorrect because insulin glargine has a longer duration than 3 to 6 hr. Insulin glargine is not a short-acting or rapid-acting insulin that peaks quickly and lasts for a few hours. It is a long-acting insulin that does not have a peak and lasts for up to 24 hr.

Choice C:

This is incorrect because insulin glargine has a longer duration than 16 to 24 hr. Insulin glargine is a long-acting insulin that can last for up to 24 hr, but not more than that. It is not an ultra-long-acting insulin that can last for more than 24 hr.

Choice D:

This is correct because insulin glargine has a duration of 18 to 24 hr. Insulin glargine is a long-acting insulin that provides a steady and continuous level of insulin in the blood. It is usually given once daily at the same time.

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Question 2:

A gardener needs a decongestant because of seasonal allergy problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants?

A. Immediate onset B. Absence of rebound congestion C. Shorter duration D. More potent effect

Answer and Explanation

Choice A:

This is incorrect because orally administered decongestants do not have an immediate onset. They take longer to act than nasal sprays because they have to be absorbed through the gastrointestinal tract. Nasal sprays act directly on the nasal mucosa and have a faster onset.

Choice B:

This is correct because orally administered decongestants do not cause rebound congestion. Rebound congestion is a condition in which the nasal passages become more swollen and congested after the effect of the nasal spray wears off. This can lead to overuse and dependence on the nasal spray. Orally administered decongestants do not have this effect because they act systemically and not locally.

Choice C:

This is incorrect because orally administered decongestants do not have a shorter duration. They have a longer duration than nasal sprays because they are metabolized more slowly by the liver. Nasal sprays have a shorter duration because they are eliminated more quickly by the nasal mucosa.

Choice D:

This is incorrect because orally administered decongestants are not more potent than nasal sprays. They have a similar potency, but they have a different mechanism of action. Orally administered decongestants act on the alpha-adrenergic receptors in the blood vessels, causing vasoconstriction and reducing congestion. Nasal sprays act on the beta-adrenergic receptors in the bronchial smooth muscle, causing bronchodilation and improving airflow.

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Question 3:

A patient who has been on long-term corticosteroid therapy has had surgery to correct an abdominal hernia. The nurse keeps in mind that which potential effect of this medication may have the most impact on the patient's recovery?

A. Hypotension B. Muscle weakness C. Osteoporosis D. Delayed wound healing

Answer and Explanation

Choice A:

This is incorrect because hypotension is not a common effect of long-term corticosteroid therapy. Corticosteroids can cause fluid retention and sodium retention, which can lead to hypertension, not hypotension.

Choice B:

This is incorrect because muscle weakness is not the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can cause muscle wasting and loss of muscle mass, which can affect the patient's mobility and strength, but not as much as delayed wound healing.

Choice C:

This is incorrect because osteoporosis is not the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can cause bone loss and increased risk of fractures, which can affect the patient's bone health and stability, but not as much as delayed wound healing.

Choice D:

This is correct because delayed wound healing is the most impactful effect of long-term corticosteroid therapy on the patient's recovery. Corticosteroids can impair the inflammatory response and the immune system, which can slow down the healing process and increase the risk of infection. This can affect the patient's recovery time and quality.

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Question 4:

A patient is taking guaifenesin as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching?

A. Report symptoms that last longer than 2 days. B. Report clear-colored sputum to the prescriber. C. Avoid driving a car or operating heavy machinery because of the sedating effects. D. Increase fluid intake to help loosen and liquefy secretions.

Answer and Explanation

Choice A:

This is incorrect because reporting symptoms that last longer than 2 days is not specific to guaifenesin. This is a general instruction for any patient with a sinus infection, regardless of the medication they are taking.

Choice B:

This is incorrect because reporting clear-colored sputum to the prescriber is not necessary. Clear-colored sputum indicates that the infection is improving and the mucus is thinning. This is a desired effect of guaifenesin, not a problem that needs to be reported.

Choice C:

This is incorrect because guaifenesin does not have sedating effects. Guaifenesin is an expectorant that helps to break up and expel mucus from the respiratory tract. It does not cause drowsiness or impair the ability to drive or operate machinery.

Choice D:

This is correct because increasing fluid intake is an important instruction for a patient taking guaifenesin. Fluids help to hydrate the body and thin the mucus, making it easier to cough up and clear the sinuses. Fluids also help to prevent dehydration and dryness of the mucous membranes.

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Question 5:

A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching?

A. "I should take my flu vaccine within one week of starting this medication." B. "I should eat more bananas while taking this medication." C. "I should take aspirin for minor aches and pains while taking this medication." D. "I can expect a sore throat for the first week after starting this medication."

Answer and Explanation

Choice A:

This is incorrect because the client should avoid live vaccines while taking prednisone, as it can suppress the immune system and increase the risk of infection.

Choice B:

This is correct because prednisone can cause hypokalemia (low potassium levels) and bananas are a good source of potassium. The client should monitor their potassium levels and eat foods rich in potassium while taking prednisone.

Choice C:

This is incorrect because the client should avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin while taking prednisone, as they can increase the risk of gastrointestinal bleeding and ulceration.

Choice D:

This is incorrect because a sore throat is not a common side effect of prednisone. However, the client should report any signs of infection, such as fever, sore throat, or cough, to the provider, as prednisone can mask the symptoms of infection.

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Question 6:

A nurse is teaching a client how to draw up regular insulin and NPH insulin in the same syringe. Which of the following instructions should the nurse include?

A. Inject air into the regular insulin first. B. Shake the NPH insulin until it is well mixed. C. Draw up the NPH insulin into the syringe first. D. Discard regular insulin that appears cloudy.

Answer and Explanation

Choice A:

This is correct because the nurse should inject air into the regular insulin vial first, then into the NPH insulin vial, before drawing up the regular insulin. This prevents contamination of the regular insulin with the NPH insulin.

Choice B:

This is incorrect because the nurse should not shake the NPH insulin vial, but rather roll it gently between the palms to mix it. Shaking can cause bubbles and affect the accuracy of the dose.

Choice C:

This is incorrect because the nurse should draw up the regular insulin into the syringe first, then the NPH insulin. This prevents mixing of the NPH insulin with the regular insulin in the vial.

Choice D:

This is incorrect because the nurse should not discard regular insulin that appears cloudy, but rather clear it by drawing up and injecting air into the vial. Regular insulin is normally clear and NPH insulin is normally cloudy.

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Question 7:

A nurse is providing teaching to a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse instruct the client to report to the provider? (Select all that apply.)

A. Drowsiness B. Tachycardia C. Jaw pain D. Dizziness E. Esophageal erosion

Answer and Explanation

Choice A:

This is incorrect because drowsiness is not a common or serious adverse effect of alendronate. However, the client should avoid driving or operating machinery if they experience drowsiness.

Choice B:

This is incorrect because tachycardia is not a common or serious adverse effect of alendronate. However, the client should monitor their pulse and blood pressure regularly and report any abnormal changes to the provider.

Choice C:

This is correct because jaw pain can indicate a rare but serious condition called osteonecrosis of the jaw, which is associated with alendronate use. The client should report any jaw pain, swelling, or infection to the provider immediately and avoid dental procedures while taking alendronate.

Choice D:

This is incorrect because dizziness is not a common or serious adverse effect of alendronate. However, the client should rise slowly from a lying or sitting position to prevent orthostatic hypotension and falls.

Choice E:

This is correct because esophageal erosion can occur if alendronate is not taken correctly. The client should take alendronate with a full glass of water, at least 30 minutes before any food or drink, and remain upright for at least 30 minutes after taking it. The client should report any difficulty swallowing, chest pain, or heartburn to the provider.

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Question 8:

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes mellitus. When mixing the two types of insulin, which of the following actions should the nurse take first?

A. Inject 20 units of air into the NPH insulin vial. B. Inject 10 units of air into the regular insulin vial. C. Replace the needle for withdrawal with a safety needle. D. Withdraw 10 units of insulin from the regular insulin vial.

Answer and Explanation

Choice A:

This is incorrect because the nurse should inject air into the NPH insulin vial after injecting air into the regular insulin vial. This prevents contamination of the regular insulin with the NPH insulin.

Choice B:

This is correct because the nurse should inject air into the regular insulin vial first, then into the NPH insulin vial, before withdrawing the regular insulin. This equalizes the pressure in the vials and facilitates the withdrawal of the insulin.

Choice C:

This is incorrect because the nurse should not replace the needle for withdrawal with a safety needle. The same needle should be used for injecting air and withdrawing insulin from both vials.

Choice D:

This is incorrect because the nurse should withdraw 10 units of insulin from the regular insulin vial after injecting air into both vials. This prevents mixing of the NPH insulin with the regular insulin in the vial.

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Question 9:

During a routine checkup, a patient states that she is unable to take the prescribed antihistamine because of one of its most common adverse effects. The nurse suspects that which adverse effect has been bothering this patient?

A. Constipation B. Abdominal cramps C. Drowsiness D. Decreased libido

Answer and Explanation

Choice A:

This is incorrect because constipation is not a common or serious adverse effect of antihistamines. However, the patient should increase their fluid and fiber intake and exercise regularly to prevent constipation.

Choice B:

This is incorrect because abdominal cramps are not a common or serious adverse effect of antihistamines. However, the patient should avoid spicy or fatty foods and take the antihistamine with food or milk to prevent stomach irritation.

Choice C:

This is correct because drowsiness is one of the most common and bothersome adverse effects of antihistamines. The patient should avoid driving or operating machinery if they experience drowsiness and take the antihistamine at bedtime.

Choice D:

This is incorrect because decreased libido is not a common or serious adverse effect of antihistamines. However, the patient should inform their provider if they experience any sexual dysfunction or mood changes while taking the antihistamine.

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Question 10:

During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased:

A. Incidence of nausea B. Levels of triglycerides C. Risk for thrombosis D. Tendency to bleed during menstruation

Answer and Explanation

Choice A:

This is incorrect because nausea is not a common or serious adverse effect of estrogen therapy. However, the patient should take the estrogen with food or milk to prevent stomach upset.

Choice B:

This is incorrect because triglycerides are not affected by estrogen therapy. However, the patient should monitor their cholesterol and blood pressure levels regularly and follow a healthy diet and exercise regimen.

Choice C:

This is correct because smoking and estrogen therapy are both risk factors for thrombosis, which is the formation of blood clots in the blood vessels. The patient should stop smoking and report any signs of thrombosis, such as leg pain, swelling, redness, or warmth, to the provider.

Choice D:

This is incorrect because bleeding during menstruation is not increased by estrogen therapy. However, the patient should report any abnormal vaginal bleeding, such as spotting, heavy bleeding, or prolonged bleeding, to the provider.

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