ATI RN
ATI Pharmacology Practice B 2023 Questions
Question 1 of 5
Which of the following drugs is most useful for the treatment of absence seizures?
Correct Answer: D
Rationale: Lamotrigine, a broad-spectrum antiepileptic, treats absence seizures by stabilizing sodium channels and inhibiting glutamate release, though less specific than ethosuximide.
Topiramate and levetiracetam manage multiple seizure types but aren't first-line for absence. Tiagabine, a GABA reuptake inhibitor, may worsen absence seizures. Zonisamide has broad efficacy but less absence focus. While ethosuximide is gold standard, lamotrigine's utility in absence, especially in mixed epilepsies, and clinical evidence make it the most useful here among options.
Question 2 of 5
A 13-year-old female presents with 3 months of easy bruisability and bone pain. Complete blood count shows extreme leukocytosis. She is diagnosed with ALL and begins a chemotherapy regimen. One of her chemotherapeutic drugs is cyclophosphamide. What should also be given to avoid a potentially serious side effect of cyclophosphamide?
Correct Answer: A
Rationale: Cyclophosphamide in ALL risks hemorrhagic cystitis from acrolein, a toxic metabolite. Mesna binds acrolein, preventing bladder damage. Methylene blue , N-acetylcysteine , Ibuprofen , and Succimer (E) don't address this. Mesna's specificity ensures safe chemotherapy, critical in this young patient.
Question 3 of 5
Enzymatic activity that changes a medication into a less active form is an example of
Correct Answer: C
Rationale: Enzymatic change to a less active form is metabolism, a pharmacokinetic process altering drugs for excretion, distinct from pharmacodynamics (drug effects), active transport (energy-driven movement), or diffusion (passive spread). Pharmacokinetics governs this transformation, key to drug handling.
Question 4 of 5
The nurse acknowledges that the first-line drug for treating this client's blood pressure might be which drug?
Correct Answer: C
Rationale: ACE inhibitors are considered a first-line drug for treating hypertension in many patients. They work by inhibiting the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor, leading to vasodilation and a decrease in blood pressure. ACE inhibitors are well tolerated and have been shown to reduce the risk of cardiovascular events and mortality in patients with hypertension. Other medication classes such as diuretics, alpha blockers, and alpha/beta blockers may also be used in the management of hypertension but ACE inhibitors are often preferred as a first-line therapy due to their efficacy, safety profile, and proven outcomes in hypertension management.
Question 5 of 5
The nurse is preparing to administer phenytoin (Dilantin) to a patient who has a seizure disorder. The nurse notes that the last random serum drug level was 18 mcg/mL. What action Will the nurse take?
Correct Answer: B
Rationale: A random serum phenytoin level of 18 mcg/mL is above the therapeutic range (usually 10-20 mcg/mL) and may indicate that the patient is at risk for toxicity. The nurse should contact the provider to discuss decreasing the phenytoin dose in order to prevent potential toxic effects such as ataxia, nystagmus, and confusion. Administering the current dose without addressing the elevated serum level could increase the risk of toxicity. Monitoring closely for toxicity (
Choice
D) is appropriate after the dosage adjustment is discussed with the provider. Reporting drug toxicity to the providers (
Choice E) may be necessary if toxicity symptoms develop or if the provider does not respond to the recommendation to decrease the dose.