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ATI PHARMACOLOGY PROCTORED EXAM
1. A nurse is assessing a client who has a new prescription for chlorpromazine to treat
schizophrenia. The client has a mask-like facial expression and is experiencing involuntary
movements and tremors. Which of the following medications should the nurse anticipate
administering?
A. Amantadine.
B. Bupropion
C. Phenelzine
D. Hydroxyzine
Answer: A. Amantadine
Rationale:
Amantadine is commonly used to manage extrapyramidal symptoms (EPS) associated with
antipsychotic medications such as chlorpromazine. EPS include mask-like facial expressions,
tremors, and involuntary movements. Amantadine acts by increasing dopamine release and
blocking dopamine reuptake, thereby reducing EPS.
2. A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to
promote sleep. The nurse should plan to monitor the client for which of the following adverse
effects?
A. ecchymosis
B. decrease urine output.
C. increase blood pressure.
D. dizziness
Answer: D. dizziness
Rationale:
Zolpidem is a sedative-hypnotic medication used to treat insomnia by promoting sleep.
Dizziness is a common adverse effect, particularly in older adults, which increases the risk of
falls. Monitoring for dizziness allows for appropriate interventions to prevent falls and ensure
the safety of the client.
3. A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older
adult client who has Paget's disease of the bone. Which of the following actions should be the
nurse's priority?
A. Administer the medication to the client before breakfast in the morning.
B. Ambulate the client to a chair prior to administering the medication.
C. Give the medication to the client with water rather than milk.
D. Teach the client how to take the medication at home.
Answer: A. Administer the medication to the client before breakfast in the morning.
Rationale:
Alendronate, a bisphosphonate medication, is best absorbed on an empty stomach.
Administration before breakfast ensures optimal absorption. It's important to follow specific
administration instructions for bisphosphonates to maximize their effectiveness in treating
conditions like Paget's disease and osteoporosis.
4. A nurse is caring for a client who has a new prescription for ergotamine. The nurse should
recognize that ergotamine is administered to treat which of the following conditions?
A. Raynaud's phenomenon
B. Migraine headaches
C. Ulcerative colitis
D. Anemia
Answer: B. Migraine headaches
Rationale:
Ergotamine is a medication used to treat migraine headaches. It works by constricting blood
vessels in the brain, thereby reducing the pulsation and pain associated with migraines.
Ergotamine is often used when other migraine treatments have failed or are contraindicated.
5. A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of
the following medications should the nurse plan to administer?
A. Ibuprofen
B. Naproxen
C. Aspirin
D. Acetaminophen
Answer: D. Acetaminophen
Rationale:
Acetaminophen is the preferred analgesic for individuals with peptic ulcer disease as it has
minimal gastrointestinal side effects. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs)
such as ibuprofen, naproxen, and aspirin, acetaminophen does not increase the risk of
gastrointestinal bleeding or ulceration.
6. A nurse is providing teaching to a parent of a child who has asthma and a
new prescription for a cromolyn sodium metered dose inhaler. Which of the following
statements by the parent indicates the need for further teaching?
A. "I will give my child a dose as soon as wheezing starts."
B. My child should rinse out his mouth after using the inhaler."
C. "My child should exhale completely before placing the inhaler in his mouth."
D. "If my child has difficulty breathing in the dose, a spacer can be used."
Answer: A. "I will give my child a dose as soon as wheezing starts."
Rationale:
Cromolyn sodium is a mast cell stabilizer used for the prevention of asthma symptoms, not
for acute relief. It is not intended for use as a rescue medication to relieve wheezing. Instead,
it should be used regularly to prevent asthma attacks. Using it as soon as wheezing starts
would not provide immediate relief and may lead to inadequate asthma control.
7. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance.
The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3
and T4 level. The nurse should anticipate a prescription for which of the following
medications?
A. Methimazole
B. Somatropin
C. Levothyroxine
D. Propylthiouracil
Answer: C. Levothyroxine
Rationale:
The client's symptoms and lab results indicate hypothyroidism, characterized by elevated
TSH and decreased T3 and T4 levels. Levothyroxine is a synthetic thyroid hormone
replacement used to treat hypothyroidism by supplementing deficient thyroid hormone levels.
8. A nurse is planning care for a client who has a seizure disorder and a new prescription for
valproic acid. Which of the following laboratory values should the nurse plan to monitor?
(Select all that apply)
A. PTT
B. Asparate aminotransferase (AST)
C. Alanine aminotransferase (ALT)
Answer: A. PTT, B. Asparate aminotransferase (AST), C. Alanine aminotransferase (ALT)
Rationale:
Valproic acid can affect liver function and may lead to hepatotoxicity. Therefore, monitoring
liver enzymes such as AST and ALT is essential to detect signs of liver damage. Additionally,
valproic acid can affect clotting factors, so monitoring prothrombin time (PTT) is necessary
to assess coagulation status.
9. A nurse is providing teaching to a client who has a new prescription for
hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following
instructions should the nurse include in the teaching?
A. "Take hydrochlorothiazide as needed for edema."
B. Check your weight once each week."
C. "Take the hydrochlorothiazide on an empty stomach."
D. "Take the hydrochlorothiazide in the morning."
Answer: D. "Take the hydrochlorothiazide in the morning."
Rationale:
Hydrochlorothiazide is a diuretic that increases urine production, so it's best taken in the
morning to avoid disrupting sleep with nighttime urination. Taking it earlier in the day also
helps prevent electrolyte imbalances that may occur if diuresis is more pronounced during
waking hours when fluid intake is higher.
10. A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to
an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should
the nurse administer per dose? (Round the answer to the nearest whole number)
Answer: 50 mg/1 mL = 250 mg/X mL 250/ 50 = 5
X = 5 mL
Rationale:
The nurse should administer 5 mL of amoxicillin suspension per dose to the older adult
client. This calculation is based on the desired dose of 250 mg and the concentration of the
suspension, which is 50 mg/mL. To determine the volume needed, the nurse uses the formula:
desired dose (250 mg) divided by concentration (50 mg/mL) equals the volume (X mL) to
administer. Therefore, 250 mg divided by 50 mg/mL equals 5 mL. Rounding to the nearest
whole number, the nurse should administer 5 mL per dose to ensure the client receives the
correct amount of medication. This calculation ensures accurate dosing and adherence to the
prescribed treatment regimen, promoting therapeutic effectiveness and minimizing the risk of
medication errors.
11. A nurse is providing teaching to a client who has gout and a new prescription for
allopurinol. The nurse should instruct the client to discontinue taking the medication for
which of the following adverse effects?
A. Nausea
B. Metallic taste
C. Fever
D. Drowsiness
Answer: C. Fever
Rationale:
Allopurinol is commonly used to treat gout by reducing the production of uric acid in the
body. One of the severe adverse effects of allopurinol is a hypersensitivity reaction, which
can manifest as fever. If the client experiences fever while taking allopurinol, it could indicate
a potentially life-threatening hypersensitivity reaction known as allopurinol hypersensitivity
syndrome. In such cases, immediate discontinuation of the medication is necessary.
12. A nurse is providing teaching to a client who has ulcerative colitis and a new prescription
for sulfasalazine. The nurse should instruct the client to monitor for which of the following
adverse effects of this medication?
A. Jaundice
B. Constipation
C. Oral candidiasis
D. Sedation
Answer: A. Jaundice
Rationale:
Sulfasalazine is commonly used to manage inflammatory bowel diseases such as ulcerative
colitis. One of the potential adverse effects of sulfasalazine is hepatotoxicity, which can
manifest as jaundice (yellowing of the skin and eyes) due to liver dysfunction. Monitoring for
signs of jaundice, such as yellow discoloration of the skin or sclera, is essential. If jaundice
occurs, the client should promptly report it to their healthcare provider for further evaluation
and possible discontinuation of the medication.
