ATI-P ATI Pharmacology - Set 2 - Part 1

Correct Answer: Increased urine output

Furosemide blocks sodium, chloride, and water reabsorption in the loop of Henle, producing rapid diuresis. The nurse should expect increased urine output, which mobilizes excess fluid and relieves the client's pulmonary edema. Option b is incorrect because loss of appetite is not how this loop diuretic works. Reduced appetite belongs to other drug pictures, such as early digoxin toxicity, and signals a problem rather than the fluid removal furosemide is meant to achieve. Option c is incorrect because a slowed resting respiratory rate is not a direct drug action. Breathing eases only indirectly once diuresis clears the lungs, so urine output, not respiratory rate, is the response the nurse measures first. Option d is incorrect because warm, flushed skin suggests vasodilation or a reaction, neither of which furosemide produces. The diuretic pulls fluid through the kidney, so the change the nurse anticipates appears in the client's urine, not the skin.

Correct Answer: Eat foods such as bananas and potatoes

Loop diuretics waste potassium and can cause hypokalemia. Eating potassium-rich foods such as bananas, potatoes, dried fruits, and citrus helps replace the potassium lost in the urine and protects the client from this adverse effect. Option a is incorrect because restricting fluids does not guard potassium and could worsen the dehydration furosemide already promotes. The concern here is an electrolyte the drug excretes, which is corrected through diet, not by cutting back on what the client drinks. Option b is incorrect because a bedtime dose is wrong because furosemide causes nocturia that disrupts sleep; it is given early in the day. More importantly, dose timing does nothing to replace potassium, which is the point of this teaching. Option d is incorrect because dairy foods supply calcium, not the potassium furosemide depletes, and there is no reason to avoid them. The instruction that prevents hypokalemia points the client toward potassium sources rather than steering them away fro

Correct Answer: Muscle weakness and leg cramps

Hypokalemia from furosemide produces muscle weakness, leg cramps, fatigue, and nausea, and it can trigger dangerous dysrhythmias. The nurse should report weakness and cramping so potassium can be checked and replaced before cardiac effects develop. Option a is incorrect because a pink tinge to urine points toward bleeding, not a potassium problem; triamterene, a different diuretic, can turn urine bluish. Low potassium shows itself through muscle and cardiac signs rather than through any change in urine color. Option c is incorrect because increased salivation reflects cholinergic activity and has no link to potassium balance. Hypokalemia instead drains muscle strength and threatens the heart, so weakness and cramps, not extra saliva, are what prompt the nurse to call the provider. Option d is incorrect because constricted pupils stem from drug effects on the eye, not from a falling potassium level. The reportable picture of hypokalemia centers on skeletal muscle complaints and rhythm d

Correct Answer: An elevated potassium level

Spironolactone blocks aldosterone, so the kidney retains potassium while excreting sodium and water. This can raise potassium to dangerous levels, so the nurse should report an elevated potassium level and watch for weakness and dysrhythmias. Option a is incorrect because a low potassium level fits the loop and thiazide diuretics, which waste potassium. Spironolactone works in the opposite direction by sparing potassium, so hypokalemia would not be the adverse effect the nurse expects from this drug. Option b is incorrect because a drop in blood glucose is unrelated to this potassium-sparing diuretic. Thiazide and loop diuretics tend to raise glucose, but spironolactone's defining danger is potassium accumulation, not any shift in the client's blood sugar. Option c is incorrect because increased urine output is the goal of diuretic therapy, not an adverse effect to report. The finding that signals harm with spironolactone is potassium climbing too high, which calls for monito

Correct Answer: I will avoid salt substitutes that contain potassium

Spironolactone retains potassium, so adding potassium raises the risk of hyperkalemia. Avoiding salt substitutes that contain potassium shows the client understands how to prevent a dangerous rise in potassium while taking this drug. Option a is incorrect because reaching for a salt substitute is unsafe here because most are potassium based and would stack potassium on top of what spironolactone already spares. This statement reflects the opposite of correct teaching and would prompt the nurse to clarify. Option c is incorrect because a daily potassium supplement is contraindicated with this drug; supplements belong with potassium-wasting diuretics instead. Adding potassium to a potassium-sparing diuretic invites hyperkalemia, so this statement signals a misunderstanding rather than mastery. Option d is incorrect because loading up on oranges and bananas pushes potassium intake higher, which the client on spironolactone should limit. These foods are encouraged with loop diuretics, but

Correct Answer: General muscle weakness

Hydrochlorothiazide wastes potassium, and hypokalemia produces general muscle weakness, fatigue, leg cramps, and nausea. The nurse should teach the client to report weakness so the provider can evaluate and replace potassium before cardiac problems arise. Option b is incorrect because a bluish tinge to urine is associated with triamterene, a potassium-sparing diuretic, and is harmless. It is not a feature of low potassium, which announces itself through muscle and cardiac symptoms rather than a change in urine color. Option c is incorrect because ringing in the ears warns of ototoxicity from loop diuretics; thiazides carry no hearing risk. Low potassium does not affect the ears, so the client should instead watch for weakness and cramps as the signal to call the provider. Option d is incorrect because a metallic or altered taste links to captopril, an ACE inhibitor, not to a potassium deficit. Hypokalemia is recognized through weakness and muscle cramps, so taste changes are not what t

Correct Answer: Severe renal impairment

Thiazide diuretics work only when kidney function is intact, so they are contraindicated in severe renal impairment because they become ineffective. The nurse should recognize this finding and anticipate that the provider will select a different diuretic. Option a is incorrect because seasonal allergies do not interfere with thiazide therapy and are not a contraindication. The factor that blocks this drug from working is poor kidney function, since the thiazide must reach an intact nephron to produce diuresis. Option b is incorrect because mild hypertension is actually an indication for hydrochlorothiazide, which is often a first-choice agent for it. Rather than a reason to withhold the drug, this finding is exactly the condition the medication is prescribed to treat. Option d is incorrect because a history of osteoporosis is not a contraindication; thiazides promote calcium reabsorption and may even help protect bone. The condition that rules this drug out is severe renal impairment,

Correct Answer: A low potassium level

Furosemide wastes potassium, and a low potassium level sensitizes the heart to digoxin, greatly increasing the risk of toxic dysrhythmias. The nurse should report hypokalemia first so potassium can be replaced before digoxin toxicity develops. Option a is incorrect because an increase in urine output is the intended effect of furosemide and is not the priority concern. While diuresis contributes to potassium loss, it is the resulting low potassium, not the urine output itself, that endangers a client on digoxin. Option c is incorrect because a mild headache may accompany diuretic therapy but does not raise digoxin toxicity risk and is not the first finding to report. The link between these two drugs is potassium, so the low potassium level outranks a minor headache. Option d is incorrect because dry mouth signals fluid loss and warrants attention, yet it does not predispose the client to digoxin toxicity. The dangerous interaction here runs through potassium, making hypokalemia the fin

Correct Answer: A decrease in intracranial pressure

Mannitol is an osmotic diuretic that raises serum osmolality and pulls fluid out of brain tissue into the bloodstream. The nurse should identify a decrease in intracranial pressure as the therapeutic effect of this medication. Option a is incorrect because a rise in blood pressure is not the goal of mannitol, which is given to reduce pressure inside the skull or eye. The drug shifts fluid for that purpose, so cerebral pressure is what the nurse expects to improve. Option b is incorrect because increased appetite has nothing to do with this osmotic diuretic. Mannitol works by drawing water along an osmotic gradient to lower intracranial or intraocular pressure, so its benefit is measured in pressure readings, not in hunger. Option d is incorrect because a slower heart rate is not a direct effect of mannitol. The drug acts by osmosis to remove fluid from swollen tissue, and the response the nurse looks for is falling intracranial pressure rather than a change in pulse.

Correct Answer: Stop the infusion

Dyspnea, crackles, and distended neck veins indicate fluid overload and pulmonary edema, a serious mannitol complication. The nurse should first stop the infusion to prevent further fluid from entering the vascular space, then notify the provider. Option b is incorrect because increasing the rate would force even more fluid into an already overloaded circulation, intensifying the pulmonary edema. The safe first action is to halt the drug, because speeding it up directly worsens the very problem the client is showing. Option c is incorrect because lying the client flat would worsen breathing and increase venous return to an overwhelmed heart. The priority is to stop the offending infusion; positioning may follow, but it does not address the source of the fluid overload. Option d is incorrect because offering oral fluids adds volume to a client who already has too much, deepening the overload. The first and most protective step is to discontinue the mannitol, since continued or added flu

Correct Answer: A persistent dry cough

Captopril raises bradykinin levels, which commonly causes a persistent dry cough. The nurse should teach the client to report this cough, because the provider may discontinue the ACE inhibitor and switch the client to another agent. Option a is incorrect because improved energy is a welcome change, not an adverse effect to report. The hallmark bothersome effect the client must watch for with an ACE inhibitor is the nagging dry cough produced by rising bradykinin levels. Option b is incorrect because increased thirst is more typical of diuretic-related fluid loss than of captopril. The reportable effect tied specifically to this ACE inhibitor is the dry cough, so thirst is not the symptom the nurse highlights in this teaching. Option c is incorrect because a salt craving is not a recognized effect of captopril, and clients are actually advised to avoid potassium-based salt substitutes. The cough from bradykinin buildup is the classic complaint that should send the client to the provider

Correct Answer: A pregnancy in the second trimester

ACE inhibitors are contraindicated in the second and third trimesters because they cause fetal injury. The nurse should report a pregnancy before giving captopril so the provider can discontinue the drug and select a safer option. Option a is incorrect because seasonal allergies do not place this client at risk with captopril and would not delay the first dose. The finding that demands the provider's attention is the pregnancy, because the drug threatens the developing fetus in later trimesters. Option b is incorrect because a blood pressure in the expected range is not a reason to withhold an ACE inhibitor, which also treats heart failure and protects the kidneys. The truly alarming finding here is the pregnancy, which carries a known fetal danger. Option d is incorrect because well-controlled asthma is a concern with nonselective beta blockers, not with ACE inhibitors. The factor that must be reported before captopril is given is the pregnancy, since fetal harm is the reason thi

Correct Answer: Potassium level

Both captopril and spironolactone raise potassium, so using them together markedly increases the risk of hyperkalemia. The nurse should monitor the potassium level most closely and report an elevation, watching for weakness and dysrhythmias. Option a is incorrect because blood glucose is not the shared danger of these two drugs; neither characteristically drives glucose up or down. The overlap that makes this pairing risky is potassium retention, so the glucose level is not what the nurse prioritizes. Option c is incorrect because a falling white blood cell count can occur with captopril alone as rare neutropenia, but it is not what spironolactone adds to the picture. The combined and additive hazard here is potassium climbing too high, which directs monitoring. Option d is incorrect because the platelet count is unaffected by this combination, which does not impair clotting. Because each drug independently spares potassium, their joint effect threatens to produce hyperkalemia, making

Correct Answer: Swelling of the tongue and lips

Losartan can cause angioedema, a swelling of the tongue, lips, and throat that can block the airway. The nurse should instruct the client to report tongue and lip swelling immediately, because this reaction can become life-threatening. Option b is incorrect because a mild dry mouth is a minor effect linked more to other antihypertensives and does not threaten the airway. The reaction that demands immediate reporting with an ARB is angioedema, recognized by swelling of the tongue and lips. Option c is incorrect because occasional yawning is not a recognized adverse effect of losartan and poses no danger. The emergency the client must report at once is swelling of the mouth and throat, which can compromise breathing if angioedema progresses. Option d is incorrect because a small bruise is not characteristic of ARB therapy and is not the priority concern; bruising belongs to the bleeding picture of anticoagulants. With losartan, the emergency to watch for is rapid facial and airway swelli

Correct Answer: Reflex tachycardia

Nifedipine dilates arterioles, and the sudden drop in blood pressure triggers a reflex increase in heart rate. The nurse should monitor for reflex tachycardia, which a beta blocker can be added to control if it occurs. Option a is incorrect because a slow heart rate fits verapamil and diltiazem, which suppress the heart's conduction. Nifedipine acts mainly on vessels, so instead of slowing the heart it speeds it up through a reflex response to vasodilation. Option b is incorrect because constipation is a notable effect of verapamil rather than nifedipine. Because nifedipine works on arterioles and not strongly on the gut, the effect the nurse anticipates is a faster heart rate driven by the fall in blood pressure. Option c is incorrect because a dry cough belongs to ACE inhibitors through bradykinin buildup, not to calcium channel blockers. Nifedipine's vasodilation provokes a reflex rise in heart rate, which is the adverse effect the nurse watches for here.

Correct Answer: Increase fiber and fluids in your diet

Verapamil commonly causes constipation by slowing intestinal motility. The nurse should instruct the client to increase dietary fiber and fluids, which promote regular bowel movements and help manage this frequent adverse effect of the medication. Option a is incorrect because limiting fluids would worsen constipation, the very effect this teaching targets. Verapamil slows the bowel, so the client needs more fluid, not less, to keep stool moving and prevent the discomfort the drug tends to cause. Option b is incorrect because cutting fiber would make constipation worse rather than better. Because verapamil reduces intestinal motility, the client should add fiber to bulk and soften the stool, which is the opposite of decreasing it. Option d is incorrect because taking the drug on an empty stomach does not address constipation and is unrelated to bowel function. The instruction that manages verapamil's common GI effect is to boost fiber and fluids, which keep the bowel regular.

Correct Answer: A slow heart rate

Metoprolol slows the heart through beta-blockade, so it should be withheld when the pulse is already slow. The nurse should assess the heart rate and hold the dose for bradycardia, then notify the provider before giving the drug. Option b is incorrect because an elevated blood pressure is a reason to give metoprolol, not withhold it, since the drug treats hypertension. The finding that signals the nurse to hold the dose is a slow heart rate, which the beta blocker would lower further. Option c is incorrect because a mild headache is not a parameter for holding a beta blocker and does not reflect its cardiac action. The vital sign that must be checked first is the pulse, because metoprolol can drop an already slow rate dangerously. Option d is incorrect because increased urine output relates to diuretics, not to metoprolol, and is not a reason to withhold it. The nurse holds this beta blocker for bradycardia, so the heart rate, not urine output, guides the decision to give or hold.

Correct Answer: This drug can mask a fast heartbeat from hypoglycemia

Propranolol can mask the tachycardia that normally warns of hypoglycemia, so a client with diabetes may not feel the usual early signs. Recognizing that the drug can hide a racing heartbeat shows the client understands this important teaching. Option a is incorrect because propranolol does not characteristically raise blood sugar; the concern is that it conceals the warning signs of low blood sugar. This statement misstates the effect, so it would prompt the nurse to correct the client's understanding. Option b is incorrect because stopping a beta blocker abruptly can cause rebound excitation of the heart, so it must be tapered. Believing the drug can be quit at will is unsafe and signals that the client needs further teaching rather than understanding. Option c is incorrect because antihypertensives control blood pressure but do not cure hypertension, which requires ongoing therapy. Calling the drug a cure reflects a misunderstanding, so this statement does not show the client ha

Correct Answer: Metoprolol

Metoprolol is cardioselective, blocking mainly beta-one receptors in the heart while largely sparing the beta-two receptors in the lungs. The nurse should anticipate this agent because it is less likely to provoke bronchoconstriction in a client with asthma. Option a is incorrect because propranolol is nonselective and blocks beta-two receptors in the lungs, which can trigger bronchospasm. For a client with asthma it is contraindicated, so the nurse would expect a cardioselective drug rather than this one. Option c is incorrect because nadolol is also nonselective and carries the same risk of constricting the airways. Because it does not spare the lungs, it is a poor choice in asthma, unlike the beta-one selective agent the nurse anticipates. Option d is incorrect because carvedilol blocks both alpha and beta receptors, including beta-two in the lungs, so it can worsen asthma. The safer selection for this client is a cardioselective beta blocker that mainly affects the heart.

Correct Answer: Do not stop the medication abruptly

Stopping clonidine abruptly can cause severe rebound hypertension. The nurse should instruct the client not to discontinue the drug suddenly and to taper it only under the provider's direction to prevent a dangerous spike in blood pressure. Option a is incorrect because stopping the drug at the first dizziness could trigger rebound hypertension. Dizziness should be managed with safety measures and reported, but the central teaching is to avoid suddenly halting clonidine, which this option dangerously suggests. Option b is incorrect because clonidine is taken on a regular schedule to keep blood pressure controlled, not as needed for symptoms. Using it only occasionally would leave pressure uncontrolled and invites rebound effects, so this instruction is incorrect. Option c is incorrect because doubling a missed dose can cause excessive hypotension and sedation and is never advised. The instruction the nurse stresses is consistent use without abrupt discontinuation, not making up do