ATI Custom ASN Pharm NSG 1540 Final Exam Winter

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Free ATI Custom ASN Pharm NSG 1540 Final Exam Winter Questions

1. A nurse is administering furosemide to a client who has heart failure and a serum potassium level of 3.0 mEq/L (Normal range 3.5 mEq/L– 5.0 mEq/L). Which action should the nurse take?
  • Administer the medication with food to reduce gastrointestinal upset.

  • Hold the medication and notify the provider of the potassium level.

  • Encourage the client to increase fluid intake before giving the medication.

  • Administer the medication as prescribed and recheck potassium after the dose.

Explanation

Explanation
Correct Answer: B) Hold the medication and notify the provider of the potassium level.
Furosemide is a loop diuretic that causes significant potassium wasting through the kidneys. The client's potassium level of 3.0 mEq/L is already below the normal range of 3.5–5.0 mEq/L, indicating hypokalemia. Administering furosemide in this situation would further deplete potassium levels, placing the client at serious risk for life-threatening cardiac dysrhythmias. The nurse must hold the medication and notify the provider immediately so potassium replacement can be initiated before the diuretic is administered.
2. A nurse is evaluating the effectiveness of carbidopa-levodopa in a client who has Parkinson's Disease. Which manifestation should indicate the medication is effective?
  • Improved motor function

  • Decreased heart rate

  • Improved visual acuity

  • Increased blood pressure

Explanation

Explanation
Correct Answer: A) Improved motor function
Carbidopa-levodopa is the primary treatment for Parkinson's Disease. It works by replenishing dopamine in the brain, which directly improves motor symptoms such as tremors, rigidity, bradykinesia, and postural instability. Improved motor function is therefore the expected therapeutic outcome indicating the medication is working. Decreased heart rate, improved visual acuity, and increased blood pressure are not therapeutic goals of carbidopa-levodopa and do not reflect its effectiveness in managing Parkinson's Disease.
3. A nurse is teaching a client who has tuberculosis and is starting rifampin. Which instruction should the nurse give about this medication?
  • "This medication can turn your urine and tears an orange color."

  • "You may take this medication with antacids for stomach comfort."

  • "You should stop taking the medication if your appetite increases."

  • "This medication can cause weight gain and swelling."

Explanation

Explanation
Correct Answer: A) "This medication can turn your urine and tears an orange color."
Rifampin causes a harmless but alarming side effect of turning body fluids — including urine, tears, sweat, and saliva — an orange-red color. Clients must be educated about this expected effect to prevent unnecessary concern and to avoid discontinuing the medication. Rifampin should not be taken with antacids as they reduce its absorption. Increased appetite is not a reason to stop the medication; rather, hepatotoxicity symptoms such as jaundice or dark urine should prompt discontinuation. Weight gain and swelling are not associated adverse effects of rifampin.
4. A nurse at an ophthalmology clinic is providing teaching to a client who has open-angle glaucoma and a new prescription for timolol eye drops. Which of the following instructions should the nurse provide?
  • The medication is to be applied when the client is experiencing eye pain.

  • The medication should be applied on a regular schedule for the rest of the client's life.

  • The medication will be used until the client's intraocular pressure returns to normal.

  • The medication is to be used for approximately 10 days, followed by a gradual tapering off.

Explanation

Explanation
Correct Answer: B) The medication should be applied on a regular schedule for the rest of the client's life.
Open-angle glaucoma is a chronic, lifelong condition that requires ongoing management to prevent progressive optic nerve damage and vision loss. Timolol, a beta-blocker eye drop, works by reducing intraocular pressure and must be used consistently on a regular schedule indefinitely. It is not a PRN (as-needed) medication for eye pain, it is not discontinued once intraocular pressure normalizes, and it does not follow a short-term tapering course.
5. A nurse is caring for a client who has been prescribed sertraline. When evaluating effectiveness of the medication, which statement from the client indicates that the medication is effective?
  • "I still feel sad the majority of the time, but I'm sleeping a little better."

  • "I've been having more vivid dreams and occasional headaches."

  • "I stopped taking the medication last week because I felt fine."

  • "I've started enjoying my morning walks again and feel more hopeful."

Explanation

Explanation
Correct Answer: D) "I've started enjoying my morning walks again and feel more hopeful."
Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat depression and anxiety disorders. Effectiveness is indicated by an improvement in mood, increased interest in previously enjoyed activities (reduced anhedonia), and an overall sense of hopefulness — all of which are reflected in this statement. Continued persistent sadness suggests the medication is not yet fully effective. Vivid dreams and headaches are common side effects, not indicators of effectiveness. Stopping the medication abruptly is dangerous and can cause discontinuation syndrome and relapse, indicating a need for further patient education.
6. A nurse is reviewing medications with a client who has chronic diarrhea. Which over-the-counter medication slows intestinal motility to reduce the frequency of stools?
  • Loperamide

  • Docusate sodium

  • Bisacodyl

  • Magnesium hydroxide

Explanation

Explanation
Loperamide (Imodium) is an antidiarrheal medication that works by binding to opioid receptors in the intestinal wall, slowing peristalsis and intestinal motility, which reduces stool frequency and increases stool consistency. Docusate sodium is a stool softener used for constipation. Bisacodyl is a stimulant laxative that increases intestinal motility, promoting bowel movements. Magnesium hydroxide is an osmotic laxative that draws water into the intestine to promote elimination — all three of the latter options would worsen diarrhea, not treat it.
7. A nurse is evaluating the effectiveness of estradiol therapy for a client who is menopausal. Which finding should the nurse identify as an expected outcome of the medication?
  • The client has an increase in vaginal bleeding and clotting.

  • The client reports an increase in breast tenderness and swelling.

  • The client reports a reduction in hot flashes and night sweats.

  • The client has a decrease in serum potassium levels.

Explanation

Explanation
Correct Answer: C) The client reports a reduction in hot flashes and night sweats.
Estradiol is an estrogen hormone replacement therapy used to manage menopausal symptoms. Its primary therapeutic goal is to alleviate vasomotor symptoms such as hot flashes and night sweats, which result from declining estrogen levels during menopause. A reduction in these symptoms confirms the medication is effective. Increased vaginal bleeding and clotting are adverse effects requiring immediate reporting. Breast tenderness and swelling are side effects, not therapeutic outcomes. Changes in serum potassium are not an expected outcome of estradiol therapy.
8. A nurse is caring for a client who is experiencing nausea and has a prescription for metoclopramide. The client asks the nurse how this medication will help their symptoms. Which of the following responses should the nurse provide?
  • "It numbs the lining of your stomach so you don't feel nauseated."

  • "It works by decreasing the acid in your stomach to prevent irritation."

  • "It coats your stomach to protect it from foods that may cause nausea."

  • "It helps reduce your nausea by improving how quickly your stomach empties."

Explanation

Explanation
Metoclopramide is a prokinetic agent that works by blocking dopamine receptors in the chemoreceptor trigger zone and enhancing gastric motility, accelerating gastric emptying. This reduces nausea and vomiting by moving stomach contents into the small intestine more quickly, preventing the buildup that triggers nausea. It does not numb the stomach lining, reduce acid production, or coat the stomach — those mechanisms belong to local anesthetics, antacids/PPIs, and sucralfate respectively.
9. A client who has hypertension is prescribed losartan. Which action should the nurse take to ensure the medication's effectiveness?
  • Advise the client to take the medication on an empty stomach.

  • Instruct the client to avoid potassium-rich foods.

  • Suggest the client monitor blood glucose levels regularly.

  • Encourage the client to increase sodium intake.

Explanation

Explanation
Losartan is an angiotensin II receptor blocker (ARB) that lowers blood pressure by blocking the effects of angiotensin II, which also causes potassium retention. Because losartan increases serum potassium levels, clients should be advised to avoid excessive intake of potassium-rich foods such as bananas, oranges, and potatoes to prevent hyperkalemia. Losartan can be taken with or without food, so empty stomach administration is not required. Monitoring blood glucose is not relevant to losartan therapy. Increasing sodium intake would counteract the antihypertensive effects of the medication.
10. A nurse is caring for a client who presents with wheezing, shortness of breath, and increased work of breathing due to an asthma exacerbation. The provider prescribes albuterol (Proventil). The nurse understands that albuterol is used to treat which condition in this client?
  • Acute bronchospasm

  • Dyspnea on exertion

  • Nasal congestion

  • Acute allergies

Explanation

Explanation
Correct Answer: A) Acute bronchospasm
Albuterol is a short-acting beta-2 adrenergic agonist (SABA) that works by relaxing the smooth muscles of the airways, causing bronchodilation. It is the first-line rescue medication specifically used to treat acute bronchospasm in asthma exacerbations, rapidly relieving wheezing, chest tightness, and shortness of breath. It does not treat dyspnea on exertion as a standalone condition, nasal congestion, or acute allergic reactions, as these require different classes of medications such as antihistamines or epinephrine.

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