Download B261 Pathophysiology and Pharmacology in Nursing Practice ATI

B261 Pathophysiology and Pharmacology in Nursing Practice
ATI Testing Study Guide
1. A nurse is caring for a client with glaucoma who is given mannitol (Osmitrol). What is a
serious adverse event with this drug?
2. What does sucralfate (Carafate) do?
3. What are the common adverse effects to morphine? What are its dangerous adverse effects?
4. How do you administer mixed types of insulin in a single syringe?
5. Are there types of insulin that you would not mix together?
6. What are the serious adverse effects associated with acetazolamide (Diamox sequels) that
should be reported to the healthcare provider?
7. What are the medications commonly used to treat tuberculosis? Why does a TB patient need
to take multiple medications at the same time?
8. What is an important radiological test to monitor for any patient taking long term
glucocorticoids? What is this test trying to detect?
9. Prioritizing care: Which of these medications should be held and the provider contacted in at
patient with this assessment?
Assessment: Lungs are clear, pain is a “2”, K+ is 2.8, B/P 120/76
Medications: furosemide (Lasix), celecoxib (Celebrex), atenolol (Tenormin).
1
10. Which of these medications should not be taken during pregnancy?
Medications: acetominophen (Tylenol), docusate sodium (Colace), Regular Insulin,
Levothyroxine (Synthroid), Doxycycline
Why should this medication be avoided?
11. What is a serious adverse effect of enalapril (Vasotec) that may be particularly dangerous for
the patient with heart disease?
12. What are the respiratory symptoms of acute salicylate (Aspirin) poisoning?
13. What medication is given to the patient on warfarin (Coumadin) who starts to bleed?
14. What medication is given to the patient on heparin who starts to bleed?
15. What are the signs of magnesium toxicity when it is given for pre-eclampsia in pregnancy?
16. What are the side effects of tamoxifen, used for breast cancer treatment?
17. What is the emergency drug used to treat a diazepam (Valium) overdose?
18. What is propylthiouracil (PTU) used for? How do you know if propylthiouracil (PTU) is
effective (patient symptoms)?
19. What medication for pain should be avoided in the patient taking fluoxetine (Prozac) and
why?
20. What are the possible adverse effects of benztropine (Cogentin) on the heart rate?
21. Which of the following medications is a rescue inhaler for PRN use in the treatment of
asthma? Albuterol Serevent or Advair.
2
22. Patients taking metronidazole (Flagyl) should be advised to avoid what?
23. Urticaria, dyspnea, anxiety, and hypertension after a new antibiotic is started are early signs
of what? In an emergency setting, what will be given?
24. Patients who take iron (Feosal) should be instructed to take it (select one):
On an empty stomach
With food
 With antacids
25. Patients who have GI upset with tetracycline can be instructed to _____________.
26. How do you know if Synthroid is effective? What is a normal TSH level?
27. How do you instruct a patient to take ergotamine or sumatriptan (Imitrex) for migraine
headaches?
28. Patients who start taking phenytoin (Dilantin) should be advised to tell their dentist because
of _______________________.
29. Signs of digoxin (Lanoxin) toxicity include bradycardia and this effect on the vision
_______________________ .
30. Ceftazidime (Fortaz), cephalexin (Keflex) or any cephalosporin is a risk factor for cross
sensitivity with what other common antibiotic?
31. What are the signs of an allergic reaction?
32. What is the clinical indication for taking indomethacin (Indocin)?
3
33. Priority of care: An order is written for morphine (MSO4) IV Q2hours prn pain. In a patient
who has just come out of the recovery room and reports his pain as an “8”, what is your first
action?
34. When do you decide to withhold an ordered dose of Hydromorphone (Dilaudid) in a postoperative patient?
35. Why do you use a spacer for fluticasone (Flovent) inhaler treatment? (Hint: it’s the same
reason that you rinse and flush the mouth).
36. Over-the-counter (OTC) decongestants are sympathomimetic and can constrict blood vessels.
This has what action on B/P? What is an OTC decongestant commonly used?
37. Side effects of oxybutynin (Ditropan) include _________, __________, and __________ .
38. Serious adverse events associated with methotrexate (Rheumatrex, Trexall) can include
fever. Why is this?
39. The most serious adverse event of donepezil (Aricept) other than bradycardia is what? Why
can this occur?
40. What medication is given for candidiasis infection?
41. An intended action of baclofen (Lioresal) in spinal cord injury is what?
42. Why is a patient withdrawing from alcohol given chlordiazepoxide (Librium)?
43. MATH: Amoxicillin syrup 250 mg PO BID is ordered. It comes in 200 mg /5 mL bottles.
How much will be given in mL per dosage? (round off to the nearest tenth)?
4
44. What is a neuromuscular adverse effects of haloperidol (Haldol) that is characterized by a
continuous need to be moving around?
45. What are some of the possible adverse effects of metoclopramide (Reglan)?
46. What is the therapeutic indication for Salmeterol (Serevent)?
47. Epoetin (Procrit) is used to treat anemia by raising hemoglobin. If the hemoglobin rises too
quickly, what adverse effects can occur?
48. To avoid dizziness, patient education for verapamil (Calan) should include
_______________________________.
49. What labs are important to monitor in the patient taking atorvastatin (Lipitor) and why?
50. Oprelvekin (Neumega, Interleukin 11) is a thrombopoietic growth factor. What does it do for
patients receiving chemotherapy?
51. What is the effect of combining carbamazepine (Tegretol) with oral contraceptives?
52. What are the possible adverse effects of furosemide (Lasix)?
53. Amphotericin B (Fungazone) can be used to treat histoplasmosis. Serious adverse effects of
this drug include: ______________________________.
54. Bactrim DS has been associated with what serious autoimmune-mediated skin rash event?
How can this syndrome be recognized?
55. Urticaria with any antibiotic indicates: _____________________________.
5
56. Adverse effects of clindamycin (Cleocin) may include watery diarrhea. This is because
Cleocin may______________________________________________.
57. MATH: You have an IV of 0.9% normal saline that is to infuse 1 liter/8 hour. The drip factor
is 15 gtt/mL. What do you set the IV pump for in gtts/minute? (Round off to a whole number)
58. A patient who is taking valproic acid (Depakene, Depakote) and develops hepatic disease
may have skin that is __________.
59. A nurse gives regular insulin to a hospitalized patient. 2 hours later, the patient is nauseas
and lightheaded. What does the nurse do first?
60. Which of the following medications can cause tinnitus?
Nitrostat
aspirin
metoprolol Plavix
61. What are the adverse reaction to neostigmine prescribed for Myasthenia gravis?
62. Heparin is being used to treat DVT: What lab values suggest you should stop the medication?
Platelet count: _________________________________
INR level: ____________________________________
63. Patient education for phenazopyridine (Pyridium) should include telling the patient that his
or her urine will _________________.
64. MATH: Lidocaine infusion is ordered IV at 2 mg/minute. The drug comes in 2 grams per
500 mL. How fast do you set the IV in mL per hour?
65. Why is aspirin is contraindicated with warfarin (Coumadin)?
6
66. Why is acetominophen contraindicated with warfarin (Coumadin)?
67. Buproprion (Zyban) is a drug used to stop smoking. What effect can it have on sleep?
68. At what age should a child receive his or her first DTap vaccination?
69. A dietary goal of treatment for the child taking methylphenidate (Ritalin) for ADHD
treatment is to______________________________.
70. What are the desirable INR levels for a patient taking warfarin (Coumadin)?
71. What are the desirable aPTT levels for a patient taking Heparin?
72. Diet education for patients taking opioids for chronic pain should include
______________________________ .
73. Suspected opioid (morphine) excess includes decreased respirations and difficulty to arouse.
A priority care in the emergency setting is to give the medication ________________________.
74. Why does phenytoin (Dilantin) decrease the effectiveness of oral contraceptives?
75. How and when should risedronate (Actonel) for osteoporosis be taken?
76. Timolol (Timoptic) for glaucoma is a beta blocker and as such is can have what effect on
heart rate?
77. Parnate (tranylcypromine), an antidepressant medication that acts on monoamine oxidase can
cause what common side effect on blood pressure? What crisis effect does it trigger in the
presence of foods containing tyramine?
7
78. Mannitol (Osmitrol) is used for glaucoma emergencies in order to
___________________________________ .
79. What are some of the important patient education points for simvastatin (Zocor)?
80. What is the therapeutic range for serum digoxin levels?
81. What is isoniazid (INH) used for? What is the significance of yellowish skin tones in a client
taking isoniazid?
82. What lab tests might be affected by a glucocorticoid such as prednisone?
83. A safety measure used to prevent medication errors when receiving telephonic orders is
____________________________.
84. A patient is on furosemide (Lasix) and digoxin (Lanoxin). A K+ level comes back as 2.6.
What is the nurse’s priority action?
85. A patient on exenatide (Byetta) for Type II D develops abdominal pain. This could be an
indicator for what serious adverse event?
86. MATH: Gentamicin 2 mg/kg/day added to 100 mL of 0.9% sodium chloride is to be given in
two equal doses 12 hours apart. The patient weighs 132#. Gentamicin is available in 40 mg/mL
vials. How much of the available amount should be added to each 100 mL dose to give the
patient 2 mg/kg/day?
87. An older adult has a low grade temperature and is excreting green sputum. His only
medication is ranitidine (Zantac). What is the relationship between pneumonia in an older adult
and ranitidine (Zantac)?
8
88. What is the impact of live virus vaccines in a patient who is taking glucorticoids e.g.
prednisone?
89. What lab test is important to monitor in a patient who is taking Zidovudine (Retrovir)?
Why?
90. A patient taking nitroglycerin (Nitrobid) can have a lower  higher systolic BP.
91. What is an adverse reaction to an ACE inhibitor such as lisinopril (Zestril)?
92. Hydroxyuria (Droxia) is prescribed for sickle cell anemia. What are 3 significant lab tests to
be monitored for this drug that may indicate the need to hold a dose and notify the provider?
93. The biggest danger of combining acetominophen with oxycodone/acetominophen (Percocet)
is _______________________.
94. Nitroglycerin (Nitrodur) transdermal patch should  should not be removed each evening
for a medication-free time of 12-14 hours before applying a new patch.
95. Given a choice, which of the following is a preferred medication for pain at an “8”?
Dilaudid
 Nubain
 Demerol
 Celebrex
96. A widened QRS complex >50% is a sign of ____________________ from procainamide
(Pronestyl). What priority action should be taken if this occurs?
97. A patient is receiving oxytocin (Pitocin) by continuous IV infusion. Fetal heart monitor
shows late heart rate decelerations. What action should be taken? Why?
9
98. What diet education should be done for a patient with a new prescription for captopril
(Capoten)?
99. MATH: Cefobid is ordered at 250 mg IM x1. It is reconstituted as a 1 gm vial of powdered
medication plus 2.8 mL of sterile water to make a 3 mL solution. How many mL should be
administered for a 250 mg dose?
100. What is the interaction between allopurinol (Zyloprim) and warfarin (Coumadin)?
101. Which medication should be held based on the following patient assessments?
 Heparin with an aPTT of 70 seconds
 Digoxin (Lanoxin) with a HR of 72
 Insulin with a FBS of 250
 Isosorbide (Monoket) with a BP of 82/60
102. How do you know if IV dopamine is effective when given for cardiogenic shock?
103. Which medication is an outpatient treatment for opioid addiction?
104. Which medication is an emergency treatment for opioid overdose?
105. What medication is administered to a patient who is in a cholinergic crisis (e.g. a
Myasthenia Gravis patient)?
107. Should a woman try to get pregnant while on chemotherapy? Why or why not?
108. Lactobaccillum acidophilus is used to _____________________________ .It may be used
following ___________________________ in children or in _______________ infections.
10
109.Why is tendonitis is a contraindication for ciprofloxacin (Cipro)?
110. What adverse reaction may occur when combining spironlactone (Aldactone) with enalapril
(Vasotec)?
111. How do you store and administer an Epi-pen?
112. What lab is important to check for an adverse event to cyclosporine (Sandimmune)? What
does this abnormal lab possibly indicate?
113. Common side effects of opioids like duragesic (Fentanyl) include ____________________.
Two treatments are ____________________ and _______________.
114. A patient taking spironlactone (Aldactone) complains of lethargy. What lab test should be
immediately checked?
115. What is the purpose of pegfilgrastim (Neulasta) in cancer patients?
116. What therapeutic effect does atenolol (Tenormin) have? What is the nursing assessment
associated with it?
117. A patient taking sumatriptan (Imitrex) complains of chest pain. This adverse reaction is due
to what mechanism of action of the drug?
118. Medications used to treat tuberculosis include ______________ and _______________.
119. A patient is started on prednisone and she gains 10 lbs in 4-days. What is this a sign of?
What nursing assessment should be performed?
11
120. An older adult who was started on gentamicin calls the office to report muffled hearing.
What priority action should the nurse take?
121. What are the early signs of hypoglycemia?
122. MATH: Cipro elixir is ordered to be given at 15 gm/kg Q12 hours for 10 days. The child
weighs 44 pounds. What is the mg per dose?
123. A patient has bilateral crackles in the lungs since starting the medication metoprolol
(Lopressor). What category of medication is this? What does this symptom possibly indicate?
124. When should oxytocin (Pitocin) be discontinued during labor?
125. What is the therapeutic value for INR in a patient taking warfarin (Coumadin)? What value
is considered too high?
126. A patient taking Trimethoprim/Sulfamethoxazole (Bactrim DS) is advised by the nurse to
increase his water intake significantly. Why?
127. A patient is given a new prescription for lithium (Lithobid). The nurse tells the patient to
avoid what over-the-counter pain medication?
128. MATH: 1500 mL of D5W is to infuse over 8 hours. How many mL/hour is this? (Answer
in whole numbers)
129. Patients who are taking warfarin (Coumadin) should be advised to watch for what sign of
GI bleeding?
130. Isotretinoin (Amnesteem) is prescribed for severe nodulocystic acne vulgaris in a 20-year
old college female student. What patient education should be done?
12
131. What labs should be monitored for a patient taking desmopressin (DDAVP) for diabetes
insipidus? (Try to come up with three lab tests).
131. An adverse effect of rosuvastin (Crestor) is myopathy. What are the signs of this? What is
the dangerous condition associated with myopathy?
132. Diphenoxylate/atropine (Lomotil) acts to ___________________________. What is a
nursing assessment to be done with a patient who is taking this medication on a regular basis?
133. A shellfish allergy increases a client’s risk for _____________________________ to
contrast dye or medium such as the type used in many radiological studies.
134. Anticholinergic drugs such as amitriptyline (Elavil) have what effect on the urological
system?
135. Anticholinergic drugs cause:  constipation  diarrhea
13
14