ATI-P ATI Pharmacology - Set 3 - Part 2

Correct Answer: Glucose tablets

Acarbose blocks the breakdown of sucrose in the gut, so table sugar will not raise blood glucose effectively. The nurse treats hypoglycemia with glucose itself, such as glucose tablets, which does not require that enzyme. Option a is incorrect because table sugar is sucrose, which acarbose prevents the body from breaking down into absorbable glucose. Dissolving it in water does not bypass the block, so it fails to correct the low blood sugar quickly. Option c is incorrect because milk with honey relies partly on sucrose and lactose, whose breakdown acarbose impairs. This choice would act too slowly, so it is less reliable than pure glucose for a client taking acarbose. Option d is incorrect because granulated sucrose is exactly the sugar acarbose blocks from being digested. Giving sucrose to an acarbose-treated client will not raise glucose promptly, which is why glucose is the correct treatment.

Correct Answer: It can hide a fast heartbeat and tremors.

Beta blockers blunt the sympathetic warning signs of hypoglycemia, such as a fast heartbeat and tremors. The nurse teaches the client to rely on blood glucose monitoring rather than these masked symptoms. Option a is incorrect because beta blockers do not prevent hypoglycemia; they only hide some of its early signs. Telling the client low blood sugar cannot occur creates a dangerous false sense of security. Option b is incorrect. Because beta blockers mask warning signs, glucose monitoring becomes more important, not less. Saying monitoring is unnecessary removes the very safeguard the client needs while on these drugs. Option d is incorrect because beta blockers dampen rather than strengthen the shakiness of hypoglycemia. This option reverses the true effect, since the drug blunts the tremor that would otherwise warn the client.

Correct Answer: Take it about thirty minutes before breakfast.

Glipizide stimulates insulin release, so it is taken about thirty minutes before breakfast to match insulin with the meal. The nurse also teaches the client to withhold the dose if a meal will be missed. Option b is incorrect because taking glipizide two hours after lunch separates the drug from the meal it should support. This timing misses the goal of having insulin available as food is digested. Option c is incorrect because a bedtime schedule does not align glipizide with food, raising the risk of low blood sugar overnight. The drug should precede the morning meal, so a nighttime dose is incorrect timing. Option d is incorrect because glipizide is taken on a regular schedule before a meal, not only when glucose is high. Using it as a reactive dose ignores how the medication is meant to control blood sugar.

Correct Answer: A rapid heart rate and tremors

Too much levothyroxine produces signs of hyperthyroidism, such as a rapid heart rate, tremors, and heat intolerance. The nurse reports these findings, which indicate the dose may be too high. Option a is incorrect because a slow heart rate and constipation reflect low thyroid activity, indicating the client may need more medication. These are undertreatment findings, not evidence that the dose is excessive. Option b is incorrect because cold intolerance and fatigue are signs of an underactive thyroid, meaning the dose may be too low rather than too high. They reflect undertreatment, not the overmedication the question asks about. Option c is incorrect because weight gain and dry skin are hypothyroid findings that suggest insufficient hormone replacement. Because they point to too little thyroid hormone rather than too much, they are the opposite of the overmedication signs in question.

Correct Answer: Take it on an empty stomach before breakfast.

Levothyroxine absorbs best on an empty stomach, so it is taken about thirty to sixty minutes before breakfast. The nurse teaches this timing to ensure consistent absorption of the thyroid hormone. Option b is incorrect because taking levothyroxine with a large evening meal reduces absorption, since food interferes with the drug. The recommended schedule is before breakfast on an empty stomach, not with an evening meal. Option c is incorrect because calcium supplements bind levothyroxine and lower its absorption, so they should be separated by several hours. Taking them together undermines the dose rather than supporting it, which is exactly what this instruction would cause. Option d is incorrect because antacids reduce levothyroxine absorption and must be spaced several hours apart from it. Taking an antacid along with the dose decreases the amount of hormone absorbed, so this instruction works against effective therapy.

Correct Answer: Report the findings promptly as possible agranulocytosis.

Sore throat and fever can be early signs of agranulocytosis, a serious drop in white blood cells caused by methimazole. The nurse reports these findings promptly so blood counts can be checked and treatment adjusted. Option a is incorrect because sore throat and fever are not expected effects to be reassured away; they may signal a dangerous loss of infection-fighting cells. Dismissing them could delay recognition of agranulocytosis. Option b is incorrect because encouraging fluids and waiting a week could allow a severe infection to progress if agranulocytosis is developing. These findings call for prompt reporting and evaluation of blood counts, not a delayed recheck that risks harm. Option c is incorrect because doubling the dose would increase exposure to the very drug suspected of suppressing white blood cells. This action is unsafe and ignores the urgent need to evaluate for agranulocytosis.

Correct Answer: Keep your distance and limit close contact time.

The client and their secretions remain radioactive until the iodine decays, so keeping distance from others and limiting close contact reduces radiation exposure to family members. This is core radiation safety teaching. Option a is incorrect because preparing meals for others increases their exposure to the client's radioactive secretions. The client should avoid food preparation for others during this period, so this instruction is unsafe. Option b is incorrect because sharing utensils spreads radioactive saliva to household members and increases their exposure. The client should not share utensils, so this instruction directly conflicts with the radiation precautions needed after radioactive iodine. Option d is incorrect because fluids should be increased, not restricted, to help the body clear the radioactive iodine. Restricting fluids works against elimination, so it is the opposite of the correct advice.

Correct Answer: Plan to administer a supplemental dose of hydrocortisone.

The stress of surgery can trigger an acute adrenal crisis in a client with Addison disease, which is life-threatening. The priority is planning a supplemental hydrocortisone dose to prevent this crisis during the added stress. Option a is incorrect because inserting a urinary catheter may be appropriate perioperatively but does not address the immediate life-threatening risk. Preventing adrenal crisis with a steroid dose takes priority over this routine task. Option c is incorrect because teaching coughing and deep breathing is useful but not urgent compared with preventing a crisis. The client's greatest danger is adrenal insufficiency, so the supplemental steroid comes first. Option d is incorrect because collecting a detailed history is helpful but does not protect the client from the surgical stress response. The priority action is the steroid dose, which prevents a potentially fatal adrenal crisis.

Correct Answer: Edema and a low potassium level

Fludrocortisone promotes sodium and water retention and potassium loss. The nurse identifies edema and a low potassium level as adverse effects and monitors weight, blood pressure, and potassium. Option b is incorrect because the drug lowers potassium rather than raising it, so a slow heart rate from a high potassium level does not fit. Its expected electrolyte effect is potassium loss, not retention. Option c is incorrect because fludrocortisone causes water retention and weight gain, not increased urine output with weight loss. These findings contradict its sodium- and water-retaining effect, so they are not the adverse effects to expect. Option d is incorrect because fludrocortisone causes fluid retention and a rise in blood pressure, so weight loss and low blood pressure are the opposite of its effects. These findings do not match its mineralocorticoid action.

Correct Answer: A decrease in the large urine output

Desmopressin acts like antidiuretic hormone to promote water reabsorption in the kidneys. The expected therapeutic effect is a reduction of the excessive urine output toward a normal volume in diabetes insipidus. Option a is incorrect because desmopressin treats a water balance problem, not blood glucose, despite the word diabetes in the condition name. A change in blood sugar is unrelated to this hormone's action. Option c is incorrect because a rise in body temperature is not an effect of desmopressin. Because the drug works on water handling in the kidneys, a change in temperature does not reflect its therapeutic response or signal that it is working. Option d is incorrect because a faster heart rate is not the goal of desmopressin therapy. Effectiveness is judged by reduced urine output, so a pulse change does not indicate the drug is working.

Correct Answer: Water intoxication

A pounding headache and drowsiness during desmopressin therapy suggest water intoxication from too much water retention. The nurse reduces fluid intake, uses the smallest effective dose, and notifies the provider. Option a is incorrect because dehydration produces thirst, dry mucous membranes, and concentrated urine, not headache from excess fluid. Desmopressin causes water retention, so dehydration is the opposite of what these findings suggest. Option b is incorrect because a low calcium level causes muscle cramps and tingling, not headache and drowsiness from fluid retention. The clinical picture points to water intoxication rather than a calcium disturbance. Option c is incorrect because a high blood sugar level is unrelated to desmopressin, which acts on water balance rather than glucose. The headache and drowsiness here reflect fluid overload from water retention, not a problem with the client's blood sugar.

Correct Answer: A high blood sugar level

Somatropin decreases glucose use, which can raise blood glucose. In a client who has diabetes, the nurse monitors for a high blood sugar level and watches for increased thirst, hunger, and urination. Option b is incorrect because somatropin is not associated with a drop in potassium. Its metabolic effect raises glucose rather than shifting potassium, so a low potassium level is not the adverse effect to monitor. Option c is incorrect because a slow heart rate is not a recognized effect of somatropin. The relevant concern in a client who has diabetes is a rising blood sugar level, not a change in pulse, so this finding does not apply. Option d is incorrect because a low body temperature does not result from somatropin. Because the growth hormone affects glucose and body growth, a drop in temperature is not an expected adverse effect and would not be the focus of monitoring.

Correct Answer: Chest pain and tightness

Vasopressin causes vasoconstriction, which can reduce blood flow to the heart and produce chest pain. The nurse reports chest pain and tightness promptly, as these may signal myocardial ischemia, and monitors the heart. Option a is incorrect because a mild headache that resolves is not the serious concern with vasopressin, though significant headache can suggest fluid problems. The reportable danger here is chest pain from reduced coronary blood flow. Option b is incorrect because a decrease in thirst is not a serious adverse effect requiring urgent reporting. The critical concern with vasopressin is cardiac, specifically chest pain from coronary vasoconstriction, which is far more dangerous than a change in thirst. Option c is incorrect because increased urine output would actually suggest the drug is not retaining water as expected, but it is not the dangerous adverse effect. The serious finding to report is chest pain signaling heart involvement.

Correct Answer: Cold intolerance and weight gain

Methimazole blocks thyroid hormone production, so overmedication produces hypothyroid signs such as cold intolerance and weight gain. The nurse expects these findings when the antithyroid dose is too high. Option a is incorrect because heat intolerance and weight loss are hyperthyroid signs seen with too much levothyroxine, not too much methimazole. They reflect excess hormone, which is the opposite of an antithyroid overdose. Option c is incorrect because a racing heartbeat and shaking point to an overactive thyroid, the pattern expected if the levothyroxine dose runs too high. Methimazole lowers hormone output, so it would calm these findings, not produce them. Option d is incorrect because nervousness and sweating are classic signs of too much circulating thyroid hormone, as in levothyroxine excess. Because methimazole suppresses hormone production, an overdose of it would bring sluggish, hypothyroid features instead.

Correct Answer: Consume a fast-acting source of carbohydrate.

A conscious client with low blood sugar should take a fast-acting carbohydrate, such as fruit juice or glucose tablets, to raise glucose quickly. The nurse teaches this prompt action to relieve hypoglycemia. Option a is incorrect because lying down and waiting allows the blood sugar to fall further and risks loss of consciousness. Hypoglycemia needs active treatment with a fast-acting carbohydrate, not passive waiting, so this action could endanger the client. Option b is incorrect because taking insulin would lower the blood sugar even further and deepen the hypoglycemia. This action is the exact opposite of what a client with low blood sugar needs, making it a dangerous choice in this situation. Option d is incorrect because plain water contains no carbohydrate and will not raise the blood sugar at all. Because the client needs a fast-acting sugar source to recover, water does nothing to treat the hypoglycemia the client is experiencing.

Correct Answer: Withhold the metformin around the time of the procedure.

Iodine-containing contrast can combine with metformin to cause acute kidney injury. The nurse plans to withhold metformin around the time of the procedure and resume it later once kidney function is confirmed normal. Option a is incorrect because continuing metformin through the procedure leaves the client exposed to the kidney injury risk the contrast creates. The safe plan is to hold the drug, not continue it. Option b is incorrect because doubling the dose increases drug levels and the danger of kidney injury and lactic acidosis. Far from being safe, this action worsens the very risk the iodine contrast interaction already poses to the client. Option c is incorrect because giving metformin with the contrast dye combines the two agents most likely to harm the kidneys together. The correct plan separates them by withholding the metformin, not pairing them.

Correct Answer: Swelling of the ankles and weight gain

Pioglitazone can cause fluid retention, which may worsen or trigger heart failure. The nurse reports swelling of the ankles and weight gain, since these findings suggest fluid overload that requires evaluation. Option a is incorrect because a bitter taste is not a recognized effect of pioglitazone and is not the reportable concern. The serious risk with this drug is fluid retention, not a change in taste. Option b is incorrect because increased thirst points more toward high blood sugar than to pioglitazone's main hazard. The finding that truly requires reporting is fluid retention shown by ankle edema and weight gain, which can signal heart failure. Option d is incorrect because mild dry skin is not the concerning effect of pioglitazone. The drug's signature risk is fluid retention and possible heart failure, so edema is what the nurse reports.

Correct Answer: This insulin has no pronounced peak.

Insulin glargine is long-acting, with no pronounced peak and a duration that covers most of a day. A statement reflecting its flat, long action shows the client understands how this insulin works. Option b is incorrect because insulin glargine does not have a strong peak; it releases steadily. Describing a sharp peak fits a different insulin, so this statement shows the client misunderstands its profile. Option c is incorrect because insulin glargine must never be mixed with other insulins, including regular insulin. Saying it can be combined in one syringe reflects a misunderstanding that could alter the action of both insulins and harm the client. Option d is incorrect because insulin glargine is given by the subcutaneous route only and is never given intravenously. Saying it should be given by the intravenous route is unsafe and clearly reflects a misunderstanding of how this insulin is used.

Correct Answer: Kava

Kava is known to cause liver injury, including severe liver failure, especially with chronic or high-dose use. The nurse reports kava as the supplement most likely responsible for the client's increased liver enzymes. Option a is incorrect because glucosamine is associated with mild stomach upset and a bleeding risk, not liver injury. It does not explain rising liver enzymes, so it is not the supplement to report here. Option b is incorrect because saw palmetto causes mild gastrointestinal effects and can affect a prostate blood test, but it is not linked to liver damage. It does not account for the elevated liver enzymes. Option d is incorrect because ginger root affects nausea, bleeding risk, and blood sugar, not the liver. It is not a recognized cause of increased liver enzymes, so kava remains the supplement of concern.

Correct Answer: It can reduce the effectiveness of your oral contraceptives.

St. John's wort can decrease the effectiveness of oral contraceptives, raising the risk of an unintended pregnancy. The nurse includes this information so the client can discuss reliable contraception with the provider. Option b is incorrect because st. John's wort weakens rather than strengthens oral contraceptives by lowering their effectiveness. Saying it strengthens them is the opposite of the true interaction and could give the client a false and risky sense of reassurance. Option c is incorrect because claiming the herb has no effect ignores a clinically important interaction. St. John's wort speeds the breakdown of the contraceptive hormones, which can lead to an unintended pregnancy if the client relies on the pill. Option d is incorrect because darkening of the stool is linked to iron, not St. John's wort. This option names an unrelated finding instead of the contraceptive interaction the client needs to know about.