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ATI Pharmacology Exam with Answers 2nd Set
Answers Marked With *
Urinary Incontinence and Benign Prostatic Hypertrophy (BPH)
1. Bethanechol (Urecholine) is a:
A. Peripherally acting muscle relaxant
B. Muscle paralytic agent
C. Muscarinic agonists used for urinary retention *
D. Centrally acting muscle relaxant
2. A nurse is caring for an 80 year-old female client who has a prescription for bethanechol (Urecholine) 50 mg PO three times a day. The nurse should recognize that all except for which one of the following findings is a clinical manifestation of extreme muscarinic stimulation of the parasympathetic nervous system?
D. Hypertension *
3. A nurse in a provider’s office is reviewing the health care record of an 82-year old woman who reported urinary incontinence and asked about a prescription for oxybutynin (Ditropan). This drug is a muscarinic antagonist and inhibits muscarinic receptors of the detrusor muscle of the bladder, which prevents contractions of the bladder and the urge to void. The nurse should recognize that oxybutynin has anticholinergic effects and is contraindicated in the presence of all except for which of the following conditions?
B. Myasthenia gravis
C. Paralytic ileus
D. Depression *
4. Pharmacological intervention for patients with urge incontinence include:
B. Olterodine (Detrol) *
C. Doxazosin (Cardura)
D. Finasteride (Proscar)
5. A client, Mrs. Jones, age 70, has begun taking an anticholinergic medication, Tylenol PM with Benadryl for insomnia. The nurse should make it a priority to assess for which unintended manifestations?
A. Tachycardia and hypertension
B. Urinary retention, hesitancy, and constipation *
C. Pain resembling the pattern associated with cholecystitis
D. Pain resembling renal colic
6. Finasteride (Proscar, Propecia) and dutasteride (Avodart) are helpful in the treatment of BPH because of their effect on
A. Bladder contractility
B. Prostate size *
C. Bladder pressure
D. Activity at select bladder receptor sites
7. Tamsulosin (Flovent) is helpful in the treatment of BPH because of its effect on
A. Activity at select bladder receptor sites *
B. Bladder pressure
C. Bladder contractility
D. Prostate size
8. Mr. Houser has come to the clinic asking for medication for his erectile dysfunction. Which of the following medications for erectile dysfunction treatment has the longest half-life?
A. Sildenafil (Viagra)
B. Avanafil (Stendra)
C. Tadalafil (Cialis) *
D. Vardenafil (Levitra)
9. When taking a PDE-5 inhibitor, concomitant use of which medication must be avoided?
C. ACE inhibitors
D. Nitrates *
10. Which of the following drugs is an alpha1 adrenergic blocker that causes venous and arterial dilation, smooth muscle relaxation of the prostatic capsule and is used to treat benign prostatic hyperplasia (BPH)?
A. Terazosin (Hytrin) *
B. Captopril (Capoten)
C. Losartan (Cozaar)
D. Clonidine (Catapres)
Non-Steroidal Anti-inflammatory Drugs (NSAIDS)
11. When taking a nonsteroidal anti-inflammatory drug, the client should take the medication:
A. Before bedtime
B. With food, a full glass of milk, or antacids *
C. One hour before meals
D. Four hours before bedtime
12. To decrease the risk of ulcer formation, NSAIDS should be prescribed with another drug such as all EXCEPT FOR which one of the following?
A. Misoprostol (Cytotec)
B. Omeprazole (Prilosec)
C. Ranitidine (Zantac)
D. Warfarin (Coumadin) *
13. A nurse is teaching a client who has a new prescription for ergotamine (Ergomar) to treat migraine headaches. The nurse should instruct the client to stop taking the medication and notify the provider for all EXCEPT for which one of the following reasons?
A. Muscle pain
B. Visual disturbances *
C. Positive home pregnancy test
D. Numbness and tingling in fingers
14. Mrs. Gray is taking baby aspirin each day. She thinks she took an overdose of the aspirin. What would be the signs?
D. Tinnitus *
15. Mr. Jackson, age 80 (above) became severely depressed and took an overdose of acetaminophen. What drug would he get IV in the ICU as an antidote?
A. Naloxane (Narcan)
B. Acetylcysteine (Mucomyst) *
C. Misoprostol (Cytotec)
D. Flumazenil (Romazicon)
16. All of the following are NSAIDS with COX-1 and COX-2 inhibition except for which one?
A. Ketorolac (Toradol)
B. Meloxicam (Mobic)
C. Indomethacin (Indocin)
D. Celecoxib (Celebrex) *
17. Mr. Keller, age 56, has kidney stones and has been taking an NSAID, ketorolac (Toradol), via intramuscular injections. Toradol is used to treat acute pain and is only for short-term use. It is not for extended periods use or for chronic pain. Since this drug interferes with platelet aggregation, you should check your patient for:
A. Blood in his urine
D. Bruising *
18. You are caring for Mr. Duke, age 60, who is diagnosed with salicylism. The patient would demonstrate all of the following findings EXCEPT FOR which one?
D. Diarrhea *
19. Mrs. Lambert is babysitting for one of her grandchildren, age 6, who has flu symptoms. The child has a fever and Mrs. Lambert looks in her cabinet for baby aspirin. Aspirin is contraindicated in children with viral illnesses because it can cause:
A. Reye’s Syndrome *
C. Gastro-intestinal bleeding
20. Mrs. Cameron became very depressed and took an overdose of aspirin. A nurse in an emergency department is performing an admission assessment for her, knowing that she may have severe aspirin toxicity. Which of the following findings should the nurse expect to find?
A. Cool, dry skin
B. Hyperventilation from metabolic acidosis *
21. You are taking a health history for a client, Mrs. Smith, age 71, who reports that she is taking aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?
A. Digoxin (Lanoxin)
B. Nitroglycerin (Nitro-Dur)
C. Warfarin (Coumadin) *
D. Metformin (Glucophage)
22. A nurse is caring for a 60 year-old client who has cancer and is taking a glucocorticoid as an adjuvant for pain control. The nurse should especially plan to monitor closely for all EXCEPT FOR which one of the following?
A. Serum glucose
B. Serum potassium level
C. Gastric bleeding
D. Sedation *
Anti-Hypertensive Drugs and Diuretics
Match the following diuretic drugs with the correct category and description:
A. Furosemide (Lasix)
B. Mannitol (Osmitrol)
C. Hydrochlorothiazide (Hydrodiuril)
D. Butamide (Bumex)
E. Spironolactone (Aldactone)
Fill in the blank with the letter, generic, and trade name of the correct drug
23. ___________B_______________ Osmotic diuretic that reduces intracranial pressure by raising serum osmolality and drawing fluid back into the vascular and extravascular space
24. ___________A_______________ Prototype medication for the class of High Ceiling Loop diuretics that work in the ascending loop of Henle to block reabsorption of sodium and chloride and to prevent reabsorption of water – used in emergencies, such as with pulmonary edema
25. ___________E_______________ Potassium-sparing diuretic that blocks the action of aldosterone, used for heart failure
26. ___________C______________ Thiazide diuretic that works in the early distal convoluted tubule, often used as the medication of first choice for essential hypertension and for edema of mild-to-moderate heart failure
27. ___________D______________ Loop diuretic that works in the ascending loop of Henle to block reabsorption of sodium and chloride and to prevent reabsorption of water – used in conditions not responsive to other diuretics, such as edema caused by liver disease
28. Mrs. Rodriguez, above, age 65, has just been started on Lasix. She is complaining of side effects. Which of the following is a side effect of furosemide (Lasix), a loop diuretic?
A. High potassium levels
C. Tinnitus *
29. A nurse is providing information to a client, Miss Drake, age 85, above, who has a new prescription for hydrochlorothiazide (Hydrodiuril). Which of the following information should the nurse include?
A. Take the medication at bedtime
B. Take the medication with food *
C. Expect increased swelling of the ankles
D. Limit fluid intake at night
30. A nurse is monitoring a client who is receiving spironolactone (Aldactone), a potassium-sparing diuretic. Which of the following findings should the nurse report to the provider?
A. Serum sodium of 148 mEq/L
B. Urine output of 100 ml/hr
C. Increased potassium level *
D. Blood pressure of 130/90 mm Hg
31. What is the normal range for extracellular potassium in the body?
_____3.5__ to ____5.0 ___mEq/L
32. A client who has increased intracranial pressure is receiving mannitol (Osmitrol), an osmotic diuretic. This medication works by raising serum osmolality and drawing fluid back into the vascular and extravascular space, thereby possibly causing pulmonary edema. Which of the following findings should the nurse report to the provider?
A. Blood glucose of 150 mg/dL
B. Urine output of 40 mL.hr
C. Dyspnea *
33. A nurse is reviewing a client’s medication history and notes that the client is taking digoxin (Lanoxin), an antihypertensive medication, and NSAIDS. The client has a new prescription for torsemide (Demadex), a loop diuretic. The nurse should plan to monitor for all of the following medication interactions EXCEPT for which one?
A. Ventricular dysrhythmias
B. Low urine output
D. Hyperkalemia *
34. Avoid administering loop diuretics such as furosemide (Lasix) and bumetanide (Bumex) late in the day so as to prevent:
A. Nocturia *
35. A patient, Miss King, age 75, above, is taking hydrochlorothiazide (Hydrodiuril) for hypertension. You would want to warn the client to eat which of the following foods?
A. Foods high in protein, such as steak, salmon, and tofu
B. Foods high in carbohydrates, such as donuts, muffins, and waffles
C. Foods high in potassium such as bananas, cantaloupe, and white potatoes *
D. Foods high in sodium such as potato chips, hot dogs, and canned soups
36. The client has a new prescription for spironolactone (Aldactone) which is a potassium-sparing diuretic. Which of the following laboratory values should the nurse recognize as a reason to hold the morning dose of this medication and notify the provider?
A. Serum potassium of 3.5 mEq/L
B. Serum sodium of 148 mEq/L
C. Serum chloride of 106 mEq/L
D. Serum potassium of 5.2 mEq/L *
Match the following blood pressure drugs with the correct category and description:
A. Nitroprusside (Nitropress)
B. Losartan (Cozaar)
C. Captopril (Capoten
D. Amlodipine (Norvasc)
E. Prazosin (Minipress)
F. Methyldopa (Aldomet)
G. Metoprolol (Lopressor)
H. Propranolol (Inderal)
I. Diltiazem (Cardizem)
J. Clonidine (Catapress)
K. Nitroglycerin (Nitrostat IV)
37. ___________I_______________ Calcium channel blocker that is used for angina pectoris, hypertension, and cardiac dysrhythmias so is often given in the ER intravenously to block down supraventricular tachycardias
38. ___________B_______________ Angiotensin II receptor blocker (ARBs) used in hypertension and also to prevent heart failure after MI, stroke prevention, and delay of progression of diabetic nephropathy
39. ___________C_______________ Angiotensin-converting enzyme (ACE) inhibitor, often given to diabetics to prevent further kidney damage from hypertension and to help with nondiabetic nephropathy, due to their effect on dilation of the renal arteries. Have side effects that are not tolerable to some patients.
40. ___________D_______________ Calcium channel blocker that is used for angina pectoris and hypertension only, but not for cardiac dysrhythmias, so is frequently a first-line drug for new onset hypertension
41. ___________G_______________ Beta Adrenergic Blocker (Sympatholytic) that is cardioselective and only affects the Beta 1 (cardiac) receptors
42. ___________A_______________Medication given IV to reduce afterload with direct vasodilation to the arteries. This medication should not be administered in the same infusion as any other medication.
43. ___________H_______________ Beta Adrenergic Blocker (Sympatholytic) that is nonselective and affects the Beta1 and Beta2 (pulmonary) receptors, so would avoided in a patient with asthma
44. ____________J_______________ Centrally acting alpha2 agonist used in hypertension and also in management of withdrawal symptoms from alcohol
45. ____________K_______________ Medication given IV to reduce preload and thereby decrease blood pressure during emergencies
46. ____________E______________ Alpha Adrenergic Blocker (Sympatholytic) that has selective alpha 1 blockade resulting in venous and arterial dilation and also smooth muscle relaxation of the prostatic capsule and bladder neck (so can be used for benign prostatic hypertrophy, BPH)
47. ___________F______________ Centrally acting alpha2 agonist that works in the central nervous system to decrease sympathetic outflow to the heart and peripheral vascular system for treatment of hypertensive emergencies and in pregnancy induced hypertension (PIH)
48. Before a client, Mr. Frank, age 75, above, receives metoprolol (Lopressor) for hypertension, the nurse should ask the client about a history of which of the following?
A. Bronchospasm *
C. Peripheral vascular disease
D. Myasthenia gravis
Match the following blood pressure drugs with their main side effects:
A. Losartan (Cozaar)
B. Enalopril (Vasotec)
C. Nifedipine (Adalat)
D. Doxazosin mesylate (Cardura)
E. Labetalol (Normodyne)
F. Atenolol (Tenormin)
G. Clonidine (Catapress)
Write in the letter, generic, and trade name of the correct drug:
49. ____________G_______________ A centrally acting alpha 2 agonists that causes drowsiness (as in photo above), dry mouth, rebound hypertension (not for diabetics or major depression) and not for long-term management of hypertension
50. ____________B_______________ An ACE inhibitor that causes dry cough, as in the photo above, hyperkalemia, and angioedema with swelling of tongue
51. ___________E________________ A nonselective (Beta 1 and Beta 2) adrenergic blocker that causes inhibition of glycogenolysis and bronchoconstriction, so avoided in diabetics and asthmatics (above)
52. ____________C______________ A calcium channel blocker that can cause adverse effects of reflex tachycardia, orthostatic hypotension, bradycardia, and peripheral edema (swelling of feet especially, as in above photo). Also, consuming grapefruit juice can lead to toxicity.
53. __________A_______________ An ARB that can cause angioedema, as in the photo above and fetal injury (swelling of tongue)
54. _________F________________ A cardioselective (Beta 1) blocker that can cause bradycardia and decreased cardiac output (Decrease in exercise tolerance – not tolerated well)
55. _________D________________ An alpha adrenergic blocker that can cause first dose orthostatic hypotension as in the photo above
56. The nurse just administered a dose of hydralazine (Apresoline) intravenously to a client. After the initial dose, which of the following assessments is the priority?
A. Cardiac rhythm
B. Oxygen saturation
C. Blood pressure *
D. Respiratory rate
57. Which of the following foods are highest in potassium?
A. Dried apricots, avocados, and spinach *
B. Grits, bread, and oatmeal
C. Cheese, cream, and milk
D. Chicken, sardines, and shrimp
58. A nurse is assigned to the care of client who will be starting drug therapy with amlodipine (Norvasc) for chronic stable angina and hypertension. The nurse should include which appropriate information in the teaching plan?
A. This drug has also been recommended for relief of migraine headaches
B. Dizziness may occur if rising from a sitting position too rapidly *
C. Report urinary retention if it occurs
D. Call the prescriber if the respiratory rate slows excessively
59. A client taking atenolol (Tenormin) for hypertension tells the nurse, “Since I have been taking that medication I feel so tired.” The nurse formulates which most appropriate nursing diagnosis?
A. Risk for injury *
B. Increased cardiac output
C. Ineffective health maintenance
D. Self-care deficit
60. What classification is the drug, enalapril (Vasotec)?
A. Angiotensin II receptor blocker (ARB)
B. Calcium channel blocker
C. Centrally acting alpha2 agonist
D. Angiotensin-converting enzyme (ACE) inhibitor *
61. Mr. James is in heart failure and is on diuretics, digoxin, and medications to lower his blood pressure. Which of the following of his medications DO NOT cause hyperkalemia?
A. Enalapril (Vasotec)
B. Spironolactone (Aldactone)
C. Furosemide (Lasix) *
D. Amiloride (Midamor)
62. Which of the following drugs is an alpha1 adrenergic blocker (sympatholytic), so causes first-dose hypotension?
A. Clonidine (Catapres)
B. Methyldopa (Aldomet)
C. Metoprolol (Lopressor)
D. Prazosin (Minipress) *
63. Your patient is in hypovolemic shock and receiving an osmotic diuretic, mannitol (Osmitrol). This medication will help to prevent renal failure by continuing the flow of blood through the kidneys. As his nurse, you want to monitor and make sure that the urine output does not drop below a minimum of:
A. 10 mL/hr
B. 30 mL/hr *
C. 100 mL/hr
D. 150 mL/hr
64. Mr. Hunt, above, is on a new medication, Zestril. What is a side effect of lisinopril (Zestril) which is an angiotensin-converting enzyme (ACE) inhibitor?
B. Cough related to inhibition of kinase II *
C. Decreased libido
65. A client, Mr. Jones, who has hypertension, is taking captopril (Capoten), an angiotensin-converting enzyme (ACE) inhibitor. This drug blocks the production of angiotensin II, leading to retention of potassium by actions of the kidneys. Therefore, your client should not do which of the following?
A. Use salt substitutes that contain potassium *
B. Eat bananas
C. Drink orange juice
D. Eat raisins
66. Mrs. Nero has congestive heart failure (CHF) and is on spironolactone (Aldactone), a potassium-sparing diuretic. She knows that she should not eat foods high in sodium due to her CHF. Which of the following statements show that you need to intervene with further teaching?
A. I avoid eating hot dogs because they are high in sodium
B. I like to use a salt substitute on my food for seasoning *
C. I would never eat salted popcorn at the movie theater
D. Putting movie theater butter on my popcorn is not good for me
67. Mrs. Chimera, above, is having premature labor. Which of the following drugs can be used to suppress uterine contractions by blocking calcium channels?
A. Chlordiazepoxide (Librium)
B. Nifedipine (Adalat) *
C. Diazepam (Valium)
D. Cyclobenzaprine (Flexeril)
68. Mr. Dalasi is on digoxin (Lanoxin) 0.125 mg PO daily and also furosemide (Lasix) 20 mg PO daily. Which of the following show that he understands the consequences of taking these two drugs?
A. I am mostly concerned with eating a low sodium diet
B. Lasix makes me retain potassium, so I should eat low potassium foods
C. I will eat fruits and vegetables every day that have a high-potassium content in them *
D. I will make sure to drink plenty of milk and eat cheese so as to increase my potassium levels
69. Mrs. Tate, photo above, is 85 years old and in a nursing home. She is on a diuretic. You are worried that she might be dehydrated, so you would check for which of the following signs of dehydration?
A. Dry tongue and mucus membranes *
B. Heart rate of 80 bpm
C. Pale mucus membranes
D. Blood pressure of 110/70
70. Mr. Verona, age 76, above, is taking Verapamil (Calan). This drug has more than one action and is used to treat hypertension, cardiac rhythm disorders, and :
A. Peripheral vascular disease
B. Angina pain *
C. Peripheral edema
71. Mr. Brown, age 65, is on an antihypertensive medication, hydralazine (Apresoline) which is a vasodilator. His medication was changed to metoprolol (Lopressor). He will now be less likely to experience:
A. Tachycardia *
C. Sodium retention
72. You are in the intensive care unit treating Mrs. Orem, age 84 (above) who is recovering from pulmonary edema and congestive heart failure. She is receiving furosemide (Lasix) IV push. Later you would order a lab test to check the client for:
B. Hypokalemia *
73. Mrs. Graham is being discharged home on hydrochlorothiazide (Oretic) for hypertension. When performing discharge teaching, you know that the client understands side effects of this drug when she states,
A. This medication may make me retain sodium
B. I will need to drink more fluids than normal
C. This medication may cause a loss of potassium *
D. I may get swelling in my ankles when on this medication
74. Which of the following drugs is an alpha1 adrenergic blocker that causes venous and arterial dilation, smooth muscle relaxation of the prostatic capsule and is used to treat benign prostatic hyperplasia (BPH)?
E. Terazosin (Hytrin) *
F. Captopril (Capoten)
G. Losartan (Cozaar)
H. Clonidine (Catapres)
75. Mr. Katz, age 84 (above), has benign prostatic hyperplasia (BPH). He has been prescribed an α1-selective alpha blocker. Which of the following drugs may cause a first-dose orthostatic hypotension?
A. Doxazosin mesylate (Cardura) *
B. Captopril (Capoten)
C. Losartan (Cozaar)
D. Clonidine (Catapres)
76. Mr. Grant, above, is having alcohol withdrawal delirium with hallucinations of seeing rats, vomiting, tremors, seizures, increased temperature, and severe hypertension. Which of the following anti-hypertension medications is also used to bring down high blood pressure during withdrawal symptoms from alcohol and opioids?
A. Doxazosin mesylate (Cardura)
B. Captopril (Capoten)
C. Losartan (Cozaar)
D. Clonidine (Catapres) *
77. Which of the following drugs has many functions and is used to treat angina pectoris, hypertension, and also cardiac dysrhythmias such as atrial fibrillation and supraventricular ventricular tachycardia?
A. Amlodipine (Norvasc)
B. Nifedipine (Procardia)
C. Nicardipine (Cardene)
D. Diltiazem (Cardizem) *
78. Which of the following drugs is a centrally-acting vasodilator given IV drip and used in hypertensive crisis?
A. Esmolol HCL (Brevibloc)
B. Nicardipine (Cardene)
C. Nitroprusside (Nitropress) *
D. Amlodipine (Norvasc)
79. A nurse is reviewing the health record of a client who is starting propranolol (Inderal), a beta-blocker, to treat hypertension. Which of the following conditions is a contraindication for taking propranolol?
A. Asthma *
80. A nurse is teaching a client who is starting verapamil (Calan), a calcium channel blocker, to control hypertension. Calcium channel blockers slow down the gastro-intestinal system. Which of the following should the nurse include in the teaching?
A. Drink grapefruit juice daily to increase vitamin C intake
B. Withhold food for 1 hr after the medication is taken
C. Decrease the amount of calcium in the diet
D. Increase the amount of dietary fiber in the diet *
81. A nurse is caring for a client who is starting captopril (Capoten), an ace inhibitor, for hypertension. For which of the following adverse effects should the nurse monitor the client?
B. Neutropenia *
82. A nurse in an acute care facility is infusing IV nitroprusside for a client who is in hypertensive crisis. For which of the following adverse reactions should the nurse monitor this client?
A. Confusion and dizziness *
83. A nurse is planning to administer a first dose of captopril (Capoten) to a hospitalized client who has hypertension. All of the following medications EXCEPT for which one intensify early adverse effects of captopril?
A. Simvastin (Zocor) *
B. Clonidine (Catapres)
C. Liskiren (Tekturna)
D. Hydrochlorothiazide (HydroDIURIL)
84. A medication used to treat hypertension that is a direct renin inhibitor that can cause adverse effects of angioedema, hyperkalemia, and diarrhea is:
A. Clonidine (Catapres)
B. Aliskiren (Tekturna) *
C. Eplerenone (Inspra)
D. Valsartan (Diovan)
85. A nurse is caring for four clients who are each taking digoxin (Lanoxin). The client who is taking which of the following medications concurrently is a risk for digoxin toxicity?
A. Procainamide (Pronestyl) for premature ventricular contractions
B. Ranitidine (Zantac) for peptic ulcer disease
C. Phenytoin (Dilantin) for a seizure disorder
D. Amiodarone (Cardarone) for ventricular dysrhythmias *
86. A nurse, above, is administering digoxin. Which of the following is true?
A. Administer at different times each day
B. Instruct clients to observe for symptoms of hyperkalemia
C. Check the apical pulse rate and rhythm and record it before the administration of digoxin *
D. If a digoxin dose is missed, the next dose should be doubled
87. A nurse is providing teaching to a client, Mrs. Couture, who went to a fundraiser last night for President Obama. The client is taking digoxin (Lanoxin). She said that the president did not look quite right to her. Which of the following may indicate digoxin toxicity and should be reported to the provider?
A. Weakness, anorexia, diplopia (double vision),
[Solved] ATI Pharmacology Exam with Answers 2nd Set
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