ATI RN
Pharmacology Final ATI Quizlet Questions
Question 1 of 5
A client with juvenile pilocytic astrocytoma who is receiving dexamethasone (Decadron) 4mg/IV every 6 hours to relieve symptoms of right arm weakness and headache. Which of the following assessments will concern the nurse most?
Correct Answer: C
Rationale: Dexamethasone (Decadron) is a corticosteroid used to reduce inflammation and edema in brain tumors. A client no longer recognizing family members indicates a potential worsening of neurological status, such as increased intracranial pressure or tumor progression, which is a critical concern. Elevated blood glucose and weight gain are common side effects of steroids but are less urgent. Persistent headaches are expected but less concerning than cognitive changes.
Therefore, cognitive decline is the most alarming assessment.
Question 2 of 5
Regarding first pass metabolism:
Correct Answer: A
Rationale: The extraction ratio (ER = hepatic clearance / liver blood flow) quantifies first-pass metabolism's impact on bioavailability (F = 1 - ER), a true statement. It doesn't directly affect volume of distribution, which is a distribution parameter, so that's false. Oral morphine's bioavailability is ~20-30%, not exactly 15%, but close, though false per key. Phenytoin's extraction ratio is low, not high, due to capacity-limited metabolism. Lidocaine's high first-pass effect prevents oral efficacy, true. The ER formula is foundational in pharmacokinetics, predicting oral drug availability.
Question 3 of 5
What is levothyroxine's pharmacologic classification?
Correct Answer: A
Rationale: Levothyroxine belongs to the pharmacologic classification of thyroid preparations. It is a synthetic form of the thyroid hormone thyroxine (T4) and is used to treat hypothyroidism by supplementing or replacing the body's own thyroid hormone. Levothyroxine works to normalize thyroid hormone levels in the body and help regulate metabolism. It is not a metabolic inhibitor, analgesic, or loop diuretic.
Question 4 of 5
The nurse is giving instructions to a client receiving phenytoin (Dilantin). The nurse concludes that the client has a sufficient knowledge if the client states that:
Correct Answer: D
Rationale: Monitoring the serum phenytoin level is crucial when taking phenytoin (Dilantin) because phenytoin has a narrow therapeutic range. Having regular blood tests to check the drug levels ensures that the medication is within the effective range and helps prevent toxicity or ineffectiveness. This also allows healthcare providers to adjust the dosage if needed, based on the serum level results. It is an essential part of managing phenytoin therapy and ensuring its effectiveness while minimizing the risk of adverse reactions.
Question 5 of 5
A patient arrives in the emergency department with severe chest pain. The patient reports that the pain has been occurring off and on for a week now. Which assessment finding would indicate the need for cautious use of nitrates and nitrites?
Correct Answer: A
Rationale: A blood pressure of 88/62 mm Hg indicates hypotension, which is a contraindication for nitrates and nitrites use. Nitrates and nitrites are vasodilators that can further lower blood pressure, potentially leading to severe hypotension and cardiovascular collapse in a patient with already low blood pressure.
Therefore, caution should be exercised in administering nitrates and nitrites to a patient with hypotension. In this case, the presence of severe chest pain may be indicative of a myocardial infarction, which would typically warrant the consideration of nitroglycerin (a nitrate) administration for chest pain relief. However, in the presence of hypotension, alternative treatment options may need to be considered first to stabilize the blood pressure before nitrate administration.