ATI RN
ATI Capstone Pharmacology Assessment 2 Questions
Question 1 of 5
A 21-year-old male has recently begun pimozide therapy for Tourette disorder. His parents bring him to the emergency department. They describe that he has been having 'different-appearing tics' than before, such as prolonged contraction of the facial muscles. While being examined, he experiences opisthotonos (type of extrapyramidal spasm of the body in which the head and heels are bent backward and the body is bowed forward). Which of the following drugs would be beneficial in reducing these symptoms?
Correct Answer: A
Rationale: Pimozide, a D2 antagonist for
Tourette's, can cause acute dystonia (prolonged muscle contractions, opisthotonos) as an extrapyramidal symptom due to dopamine blockade. Benztropine, an anticholinergic, restores dopamine-acetylcholine balance in the basal ganglia, rapidly relieving dystonia by reducing cholinergic overactivity. Bromocriptine, a dopamine agonist, might theoretically help but isn't standard for acute EPS. Lithium treats bipolar disorder, not EPS. Prochlorperazine, an antipsychotic, worsens dystonia. Risperidone adds D2 blockade. Benztropine's proven efficacy in acute dystonia, per clinical guidelines, makes it the best intervention here.
Question 2 of 5
The nurse is caring for a patient receiving IV heparin therapy for treatment of a pulmonary embolus. The patient is being converted to warfarin (Coumadin) therapy. The following questions relate nursing considerations when caring for this patient. Nursing considerations for conversion of IV heparin to oral warfarin (Coumadin) therapy will include
Correct Answer: B
Rationale: When converting a patient from IV heparin to oral warfarin (Coumadin) therapy, overlapping therapy of both medications for at least 5 days is typically recommended. This overlap ensures that the patient's blood remains appropriately anticoagulated during the transition period. The effectiveness of warfarin is delayed and it takes time for the INR to reach the therapeutic range; therefore, it is important to continue the IV heparin until the INR is within the desired range. Monitoring the INR is essential to adjust the dosages of warfarin accordingly and to ensure that the patient is receiving adequate anticoagulation therapy.
Question 3 of 5
A 19-year-old man who is a known heroin addict is brought to the emergency department because of an apparent overdose. The reason why addicts enjoy heroin is because of its conversion to which of the following substances?
Correct Answer: C
Rationale: Heroin's appeal comes from its metabolism to morphine , which activates μ-opioid receptors for euphoria. Dopamine , epinephrine , norepinephrine , and serotonin (E) aren't direct products. Morphine's potency drives addiction in this overdose case.
Question 4 of 5
A patient with a new prescription for a HMG-CoA (statin) drug is instructed to take the
Correct Answer: D
Rationale: The nurse's best response is D: "This timeframe correlates better with the natural diurnal rhythm of cholesterol production." This explanation is accurate and helps the patient understand the rationale behind the timing of taking the HMG-CoA (statin) drug. Cholesterol production in the body typically follows a natural diurnal rhythm, with cholesterol synthesis peaking during the night. By taking the statin medication in the evening, it aligns with the body's cholesterol production pattern, making it more effective in reducing cholesterol levels. This explanation supports the patient's understanding of the importance of timing in maximizing the medication's effectiveness.
Question 5 of 5
Upon preparing to administer activated charcoal by mouth to treat a patient who took an overdose of aspirin and several unknown drugs, the nurse notes that the patient has become very somnolent and eyes open only to a noxious stimulus. Which action by the nurse is most appropriate at this point?
Correct Answer: A
Rationale: The patient's decreased level of consciousness (somnolence and only responding to noxious stimuli) indicates a potential deterioration in their condition, possibly due to the overdose. Activated charcoal is contraindicated in patients with an altered mental status due to the risk of aspiration. The nurse should immediately consult the nurse practitioner to reassess the patient's condition and determine the appropriate intervention, such as securing the airway or considering alternative treatments.