ATI Capstone Pharmacology Assessment 1

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A client with an artificial heart valve is prescribed warfarin therapy. Which of the following laboratory values should the nurse monitor to assess the therapeutic effect of warfarin?

  • A. Hemoglobin (Hgb)
  • B. Prothrombin time (PT)
  • C. Bleeding time
  • D. Activated partial thromboplastin time (aPTT)
Correct Answer: B

Rationale: The correct answer is B: Prothrombin time (PT). Warfarin is an anticoagulant medication that works by inhibiting the clotting factors dependent on vitamin K, such as factors II, VII, IX, and X. The prothrombin time (PT) measures the extrinsic pathway and is used to monitor the therapeutic effects of warfarin therapy. Monitoring PT helps assess the time it takes for the blood to clot, ensuring that the anticoagulant effect is within the desired range. Choices A, C, and D are incorrect because hemoglobin (Hgb) measures the amount of hemoglobin in the blood, bleeding time assesses the time it takes for bleeding to stop, and activated partial thromboplastin time (aPTT) is used to monitor heparin therapy, not warfarin therapy.

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A healthcare provider is preparing to administer heparin sodium to a client with deep vein thrombosis (DVT). Which of the following laboratory values should the provider monitor during therapy?

  • A. INR
  • B. Serum creatinine
  • C. aPTT
  • D. Bilirubin
Correct Answer: C

Rationale: The correct answer is C: aPTT. The healthcare provider should monitor the activated partial thromboplastin time (aPTT) value during heparin therapy to assess the client's coagulation status. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure that the client is within the therapeutic range to prevent bleeding or clotting issues. INR (Choice A) is used to monitor warfarin therapy, not heparin. Serum creatinine (Choice B) is not directly related to monitoring heparin therapy. Bilirubin (Choice D) is related to liver function, not heparin therapy.

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.

A nurse is reviewing a client's medication regimen. Which of the following medications places the client at increased risk for digoxin toxicity?

  • A. Calcium channel blockers
  • B. Potassium-sparing diuretics
  • C. Beta blockers
  • D. Loop diuretics
Correct Answer: D

Rationale: The correct answer is D, Loop diuretics. Loop diuretics can lead to hypokalemia, which increases the risk for digoxin toxicity. Loop diuretics cause potassium loss, and hypokalemia can potentiate the toxic effects of digoxin. Choices A, B, and C are incorrect because calcium channel blockers, potassium-sparing diuretics, and beta blockers do not directly increase the risk of digoxin toxicity.

A nurse is caring for a client receiving theophylline for chronic obstructive pulmonary disease (COPD). Which of the following client findings indicates the need for immediate intervention?

  • A. Productive cough
  • B. Drowsiness
  • C. Vomiting
  • D. Polyuria
Correct Answer: D

Rationale: Polyuria is a sign of theophylline toxicity and requires immediate intervention. Theophylline toxicity can lead to serious complications, and polyuria is a concerning symptom that indicates the need for urgent medical attention. Productive cough, drowsiness, and vomiting are common side effects of theophylline but are not typically indicative of immediate life-threatening issues like polyuria in the context of theophylline toxicity.

A nurse is caring for a client taking ciprofloxacin for an infection. Which of the following adverse effects should the nurse include in the client education?

  • A. Constipation
  • B. Tendon rupture
  • C. Dry mouth
  • D. Nasal congestion
Correct Answer: B

Rationale: The correct answer is B: Tendon rupture. Ciprofloxacin belongs to the fluoroquinolone class of antibiotics, which is associated with the adverse effect of tendon rupture. Tendon rupture is a severe but rare side effect that can occur with the use of ciprofloxacin. Educating the client about this potential adverse effect is crucial to promote awareness and early recognition of symptoms, such as tendon pain, swelling, or inflammation. Choices A, C, and D are not typically associated with ciprofloxacin use and are less relevant for client education in this scenario.

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