ATI RN PHARMACOLOGY PROCTORED NEWEST 2024 EXAM 3 LATEST NEWEST 2024 WITH UPDATED QUESTIONS AND DETAILED CORRECT ANSWERS WITH RATIONALES (ALREADY GRADED A+)

ATI RN PHARMACOLOGY PROCTORED
NEWEST 2024 EXAM 3 LATEST NEWEST
2024 WITH UPDATED QUESTIONS AND
DETAILED CORRECT ANSWERS WITH
RATIONALES (ALREADY GRADED A+)
A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For
which of the following types of insulin should the nurse tell the clients to expect a peak
effect 1-5 hrs after administration?
A. Insulin glargine
B. NPH insulin
C. Regular insulin
D. Insulin lispro - ANSWER-C
Insulin glargine (long-acting) doesn't have a peak effect time. NPH insulin has a peak
effect around 6-14 hrs. Regular insulin has a peak effect around 1-5 hrs. Insulin lispro
has a peak effect around 30 min - 2.5 hrs.
A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus.
Which of the following laboratory tests should the nurse plan to monitor?
A. WBC
B. Amylase
C. Platelet count
D. Liver function tests - ANSWER-D
Infection is not an adverse effect of acarbose. Sitagliptin and Exenatide can cause rare
pancreatitis so check amylase and lipase if client reports uncontrolled abdominal pain,
but not associated with acarbose. Acarbose doesn't effect platelet levels but can cause
iron deficiency anemia so monitor hemoglobin. Acarbose can cause liver toxicity when
taken long-term so monitor liver function.
A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting
repaglinide. Which of the following statements by the client indicates understanding of
the administration of this medication?
A. "I'll take this medication after I eat."
B. "I'll take this medicine 30 minutes before I eat."
C. "I'll take this medicine just before I go to bed."
D. "I'll take this medication at least 1 hour before I eat." - ANSWER-B
This med peaks within 1 hr, taking it after meals wouldn't be effective helping client
process the carbs consumed during the meal. This med causes a rapid, short-lived
release of insulin; client should take it 30 mins before meal so that insulin is available
when food is digested. This med is only effective for 4 hrs, taking it at bed wouldn't help
manage mealtime carb intake. With the rapid onset the risk of hypoglycemia would be
high if taken an hour before eating.
A nurse is providing teaching for a client who has a new prescription for metformin.
Which of the following findings should the nurse instruct the client to report as an
adverse effect of metformin?
A. Somnolence
B. Constipation
C. Fluid retention
D. Weight gain - ANSWER-A
Somnolence can indicate lactic acidosis, a very serious adverse effect of metformin.
Diarrhea, not constipation is an adverse effect of metformin. Fluid retention is an
adverse effect of pioglitazone. Anorexia and weight loss, not weight gain are adverse
effects of metformin.
A nurse is providing teaching to a client who has a prescription for pramlintide for type 1
diabetes mellitus. Which of the following should the nurse include in the teaching?
(select all that apply.)
A. "Take oral medications 30 minutes before injection."
B. "Use upper arms as preferred injection sites."
C. "Mix pramlintide with the breakfast dose of insulin."
D. "Inject pramlintide just before a meal."
E. "Discard open vials after 28 days." - ANSWER-D, E
A nurse is planning care for a client who is receiving furosemide IV for peripheral
edema. Which following interventions should the nurse include in the plan of care?
(select all that apply.)
A. Assess for tinnitus.
B. Report urine output 50 ml/hr.
C. Monitor blood potassium levels.
D. Elevate the head of the bed slowly before ambulation.
E. Recommend eating a banana daily. - ANSWER-A, C, D, E
An adverse effect of furosemide is ototoxicity, manifestations of tinnitus should be
reported to provider. A urine output of 50 ml/hr is expected, less than 30 ml/hr is a sign
of dehydration and should be reported to provider. A decrease in blood potassium levels
is an adverse effect of furosemide. Slowly elevate the head of the bed to prevent client
from developing orthostatic hypotension which is a manifestation of hypovolemia. A
banana is high in potassium and will prevent hypokalemia.
A nurse is providing information to a client who has a new prescription for
hydrochlorothiazide. Which of the following information should the nurse include?
A. Take the medication with food.
B. Plan to take the medication at bedtime.
C. Expect increased swelling of the ankles.
D. Fluid intake should be limited in the morning. - ANSWER-A
The client should take hydrochlorothiazide with or after meals to prevent GI upset. The
client should take hydrochlorothiazide in the morning or no later than 1400, and not at
bedtime, to prevent nocturia. The client should expect decreased swelling of the ankles.
The client should maintain an adequate fluid intake (1,500 ml) throughout the day
unless contraindicated.
A nurse is monitoring a client who is receiving spironolactone. Which of the following
findings should the nurse report to the provider?
A. Blood sodium 144 mEq/L
B. Urine output 120 ml in 4 hr
C. Blood potassium 5.2 mEq/L
D. Blood pressure 140/90 mmHg - ANSWER-C
Blood sodium, urine output, and blood pressure are all within expected reference
ranges. Blood potassium of 5.2 mEq/L indicates hyperkalemia; because spironolactone
causes potassium retention, withold the medication and notify the provider.
A nurse is caring for a client who has increased intracranial pressure and is receiving
mannitol. Which of the following findings should the nurse report to the provider?
A. Blood glucose 150 mg/dL
B. Urine output 40 ml/hr
C. Dyspnea
D. Bilateral equal pupil size - ANSWER-C
Blood glucose, urine output, and pupil size are all within expected reference ranges.
Dyspnea is a manifestation of HF, an adverse effect of mannitol. Stop the medication
and notify the provider.
A nurse is planning care for a client who has a new prescription for torsemide. The
nurse should plan to monitor for which of the following conditions as potential adverse
reactions of this medication? (select all that apply.)
A. Respiratory acidosis
B. Hypokalemia
C. Hypotension
D. Ototoxicity
E. Ventricular dysrhythmias - ANSWER-B, C, D, E
Monitor for metabolic acidosis not respiratory acidosis. Monitor for hypokalemia,
hypotension, ototoxicity (because it is a loop diuretic), and ventricular dysrhythmias
(which is a manifestation of hypokalemia, an adverse effect of torsemide.)
Oral meds should be taken 1 hr before or 2 hrs after injections. Thigh and abdomen are
preferred injection sites. Pramlintide shouldn't be mixed with insulin. It is important to eat
a meal after injection to prevent hypoglycemia. Unused med in the open vial should be
discarded after 28 days.