ATI Capstone Pharmacology Assessment 1

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A client is receiving magnesium sulfate for the management of preeclampsia. Which of the following client assessments should the nurse monitor to prevent complications of therapy?

  • A. Bowel sounds
  • B. Deep tendon reflexes
  • C. Oxygen saturation
  • D. Fluid balance
Correct Answer: B

Rationale: The correct answer is deep tendon reflexes. Monitoring deep tendon reflexes is crucial to assess for magnesium toxicity during therapy for preeclampsia. Magnesium sulfate can lead to neuromuscular blockade, reflected by decreased or absent deep tendon reflexes. Assessing bowel sounds (choice A) is important for gastrointestinal function but is not directly related to magnesium sulfate therapy. Oxygen saturation (choice C) is vital for respiratory status but is not specifically linked to magnesium sulfate administration. Fluid balance (choice D) is essential but does not directly correlate with monitoring for complications of magnesium sulfate therapy in the context of preeclampsia.

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A client is prescribed digoxin 0.125 mg daily for heart failure. Which of the following client reports should concern the nurse as a sign of digoxin toxicity?

  • A. Increased appetite
  • B. Visual disturbances
  • C. Weight gain
  • D. Constipation
Correct Answer: B

Rationale: Visual disturbances such as blurred vision or seeing halos around lights are common signs of digoxin toxicity. Increased appetite, weight gain, and constipation are not typically associated with digoxin toxicity. Weight gain could be a sign of worsening heart failure rather than digoxin toxicity. Increased appetite and constipation are not specific signs of digoxin toxicity and are less likely to be related.

A client is prescribed HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?

  • A. Liver function tests
  • B. Renal function tests
  • C. Visual acuity screening
  • D. Hearing screenings
Correct Answer: A

Rationale: The correct answer is A: Liver function tests. Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity, making it essential to monitor liver function tests regularly. Choices B, C, and D are incorrect because atorvastatin primarily affects the liver, not the kidneys, vision, or hearing.

A client is prescribed spironolactone. Which of the following findings would indicate an adverse effect of this medication?

  • A. Hyperkalemia
  • B. Hypokalemia
  • C. Hyponatremia
  • D. Hypernatremia
Correct Answer: A

Rationale: Hyperkalemia is the correct answer as it is an adverse effect associated with spironolactone, a potassium-sparing diuretic. Spironolactone works by blocking the aldosterone receptor in the distal convoluted tubule, leading to decreased potassium excretion and potential hyperkalemia. Hypokalemia (choice B) and hyponatremia (choice C) are not typically associated with spironolactone use. Hypernatremia (choice D) is also an unlikely finding with spironolactone.

A nurse is preparing to administer nitroglycerin ointment to a client. Which of the following actions should the nurse take?

  • A. Apply the ointment to the client's hairless chest
  • B. Rub the ointment gently into the skin
  • C. Cover the applied ointment with a transparent dressing
  • D. Massage the ointment into the skin
Correct Answer: A

Rationale: The correct action is to apply the nitroglycerin ointment to a hairless area of the client's chest, back, or upper arms. This allows for better absorption of the medication. Choice B is incorrect because rubbing the ointment gently into the skin may be appropriate, but the primary action is to ensure application on a hairless area. Choice C is incorrect as covering the ointment with a transparent dressing is not a standard practice for nitroglycerin ointment administration. Choice D is incorrect because massaging the ointment into the skin is not recommended, as it can alter absorption rates.

A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not associated with this therapy?

  • A. Tolerance
  • B. Orthostatic hypotension
  • C. Headache
  • D. Productive cough
Correct Answer: D

Rationale: The correct answer is D: Productive cough. Nitroglycerin therapy can lead to adverse effects such as tolerance, orthostatic hypotension, and headache. However, it is not known to cause a productive cough. Tolerance may develop over time, requiring dose adjustments. Orthostatic hypotension can occur due to vasodilation effects, leading to a sudden drop in blood pressure when changing positions. Headache is a common side effect due to vasodilation of cranial blood vessels. Productive cough is not a recognized adverse effect associated with transdermal nitroglycerin therapy.

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