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Rhenis Nursing

ATI Proctored Pharmacology 2026 Exam-4

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1 :
A nurse is caring for a client in an acute care setting. .

Day 1:

The client is being admitted to the acute care unit following complications with their total parenteral nutrition (TPN) at home. They have been receiving TPN for the last 4 weeks due to a malabsorption disorder; however, for the last 2 days, the TPN has not been infusing properly. Upon assessment, the client's lung sounds are clear throughout, bowel sounds are hypoactive in all 4 quadrants, and no edema is noted. The client is alert and oriented and answers questions appropriately.

Day 2:

Following the insertion of a new central venous catheter, the client has been receiving their TPN as ordered, with additional maintenance fluids to facilitate rehydration. Upon assessment, the client reports feeling dyspneic, has new onset 2+ pitting edema to the bilateral lower extremities. Bowel sounds are hypoactive. Upon auscultation, lung sounds are diminished with the presence of crackles. Jugular vein distention noted.

Day 1:

Temperature 37.5°C (99.5°F)

BP 125/88 mm Hg

Respiratory rate 18/min

Heart rate 88/min

SpO₂ 99% on room air

Weight 67.1 kg (148 lbs)

Day 2:

Temperature 37.4°C (99.3°F)

BP 160/98 mm Hg

Respiratory rate 24/min

Heart rate 124/min

SpO₂ 92% on room air

Weight 68.9 kg (152 lbs)

Day 1:

Potassium: 3.6 mEq/L (3.5 to 5mEq / L )

Calcium: 9.9 mg/dL (9 to 10.5mg / d * L )

Magnesium: 1.1 mEq/L (1.3 to 2.1mEq / L )

Sodium: 135 mEq/L (136 to 145mEq / L )

Blood glucose: 90 mg/dL (less than 200mg / d * L )

Day 2:

Potassium: 2.8 mEq/L (3.5 to 5mEq / L )

Calcium: 10.3 mg/dL (9 to 10.5mg / d * L )

Magnesium: 1.4 mEq/L (1.3 to 2.1mEq / L )

Sodium: 140 mEq/L (136 to 145mEq / L )

Blood glucose: 135 mg/dL (less than 200mg / d * L )

For each provider prescription, click to specify if the intervention is anticipated or contraindicated for this client.

Provider Prescription	Anticipated	Contraindicated
Labetalol 10 mg IV bolus x 1 dose
Bumetanide 0.5 mg/hr IV infusion
Oxygen at 2 L/min via simple face mask
Potassium 20 mEq intermittent IV bolus x 1 dose
Midodrine 10 mg PO every 8 hrs
Calcium gluconate 1 gram IV bolus x 1 dose
Metformin 500 mg PO twice daily

Hint : 🧭Match each prescription to the client's fluid status, blood pressure, oxygenation, and abnormal electrolyte findings.

Correct Answers

Labetalol 10 mg IV bolus x 1 dose [ Anticipated ]
Bumetanide 0.5 mg/hr IV infusion [ Anticipated ]
Oxygen at 2 L/min via simple face mask [ Contraindicated ]
Potassium 20 mEq intermittent IV bolus x 1 dose [ Anticipated ]
Midodrine 10 mg PO every 8 hrs [ Contraindicated ]
Calcium gluconate 1 gram IV bolus x 1 dose [ Contraindicated ]
Metformin 500 mg PO twice daily [ Contraindicated ]

Rationale :

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Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

1 :
A nurse is caring for a client in an acute care setting. .

Correct Answers

2 :
A nurse is caring for a patient on a medical-surgical unit.

Answer Options

3 :
The nurse is caring for a client in an outpatient clinic.

4 :
A nurse is planning care for a client who has a prescription for acetazolamide. Which of the following findings should the nurse plan to monitor for as an adverse effect of this medication?

5 :
A nurse is monitoring a client who is receiving warfarin and has an INR of 4 (0.8 to 1.1). Which of the following medications should the nurse plan to administer?

6 :
A nurse is preparing to administer diclofenac to a client who has chronic bursitis. Which of the following actions should the nurse take?

7 :
A nurse is caring for a client who has a prescription for acyclovir IV three times daily. Which of the following actions should the nurse take?

8 :
A nurse is caring for a client who has a new prescription for alendronate. Which of the following actions should the nurse take?

9 :
A nurse is caring for a client who has a prescription for penicillin V. Which of the following adverse effects is the priority for the nurse to monitor after the administration of the medication?

10 :
A nurse is assessing a client who has a positive Trousseau's sign. Which of the following medications should the nurse plan to administer?

1 : A nurse is caring for a client in an acute care setting. .

Correct Answers

2 : A nurse is caring for a patient on a medical-surgical unit.

Answer Options

3 : The nurse is caring for a client in an outpatient clinic.

4 : A nurse is planning care for a client who has a prescription for acetazolamide. Which of the following findings should the nurse plan to monitor for as an adverse effect of this medication?

5 : A nurse is monitoring a client who is receiving warfarin and has an INR of 4 (0.8 to 1.1). Which of the following medications should the nurse plan to administer?

6 : A nurse is preparing to administer diclofenac to a client who has chronic bursitis. Which of the following actions should the nurse take?

7 : A nurse is caring for a client who has a prescription for acyclovir IV three times daily. Which of the following actions should the nurse take?

8 : A nurse is caring for a client who has a new prescription for alendronate. Which of the following actions should the nurse take?

9 : A nurse is caring for a client who has a prescription for penicillin V. Which of the following adverse effects is the priority for the nurse to monitor after the administration of the medication?

10 : A nurse is assessing a client who has a positive Trousseau's sign. Which of the following medications should the nurse plan to administer?

1 :
A nurse is caring for a client in an acute care setting. .

2 :
A nurse is caring for a patient on a medical-surgical unit.

3 :
The nurse is caring for a client in an outpatient clinic.

4 :
A nurse is planning care for a client who has a prescription for acetazolamide. Which of the following findings should the nurse plan to monitor for as an adverse effect of this medication?

5 :
A nurse is monitoring a client who is receiving warfarin and has an INR of 4 (0.8 to 1.1). Which of the following medications should the nurse plan to administer?

6 :
A nurse is preparing to administer diclofenac to a client who has chronic bursitis. Which of the following actions should the nurse take?

7 :
A nurse is caring for a client who has a prescription for acyclovir IV three times daily. Which of the following actions should the nurse take?

8 :
A nurse is caring for a client who has a new prescription for alendronate. Which of the following actions should the nurse take?

9 :
A nurse is caring for a client who has a prescription for penicillin V. Which of the following adverse effects is the priority for the nurse to monitor after the administration of the medication?

10 :
A nurse is assessing a client who has a positive Trousseau's sign. Which of the following medications should the nurse plan to administer?