ATI RN
ATI Capstone Pharmacology Assessment 2 Questions
Question 1 of 5
Select all the early manifestations of lithium
Correct Answer: A
Rationale: Nausea is one of the early manifestations of lithium toxicity. It is important to monitor for this symptom in patients taking lithium to detect toxicity early and prevent more serious complications. Hypotension and renal failure are more severe manifestations of lithium toxicity that occur at later stages. Muscle weakness is not typically associated with early lithium toxicity.
Question 2 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 3 of 5
Which of the following is a potassium-sparing diuretic?
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that works by blocking the effects of aldosterone in the distal tubules of the kidney, leading to increased excretion of sodium and water while retaining potassium. This class of diuretics helps to conserve potassium, making them suitable for patients at risk of hypokalemia. In contrast, furosemide, hydrochlorothiazide, and bumetanide are loop diuretics, thiazide diuretics, and another loop diuretic, respectively, which all promote the loss of potassium along with sodium and water.
Question 4 of 5
Which assessment finding, by the nurse, is a priority concern when a client receives pseudoephedrine (Sudafed)?
Correct Answer: C
Rationale: Pseudoephedrine, an oral decongestant, stimulates alpha-adrenergic receptors, potentially causing cardiovascular effects like dysrhythmias due to its sympathomimetic action. An irregular heart rate of 82 is a priority concern, signaling possible arrhythmia, which could escalate to serious cardiac events, requiring immediate reporting. A mild fever or elevated respiratory rate could relate to the underlying condition (e.g., infection) rather than the drug. Dry mouth is a common, benign side effect. The nurse focuses on the irregular pulse as it aligns with pseudoephedrine's known risk of dysrhythmias, especially in susceptible patients, making choice C the most urgent finding to address.
Question 5 of 5
Estimation of plasma/serum drug concentrations are most useful in optimizing the therapeutic dose required of:
Correct Answer: D
Rationale: Plasma concentration monitoring optimizes drugs with narrow therapeutic indices or variable pharmacokinetics. Warfarin uses INR, not plasma levels, for anticoagulation control. Omeprazole, a proton pump inhibitor, relies on symptom relief, not levels. Salbutamol, a bronchodilator, is titrated by response, not plasma monitoring. Olanzapine's dosing is guided by efficacy and side effects, not routine levels. Ciclosporin, an immunosuppressant, requires plasma monitoring (e.g., 100-400 ng/mL) due to its narrow therapeutic range, interindividual variability, and risk of toxicity or rejection in transplant patients. This ensures efficacy while minimizing nephrotoxicity, a cornerstone of therapeutic drug monitoring.