ATI RN
Virtual ATI Pharmacology Pre Assessment Questions
Question 1 of 5
The patient is prescribed an ACE inhibitor. What primary mechanism of ACE inhibitors will the nurse understand as the therapeutic action?
Correct Answer: C
Rationale: ACE inhibitors work by inhibiting the enzyme angiotensin-converting enzyme (ACE) in the renin-angiotensin-aldosterone system (RAAS). By inhibiting ACE, the conversion of angiotensin I to angiotensin II is blocked. Angiotensin II is a potent vasoconstrictor and also stimulates the release of aldosterone from the adrenal glands. Aldosterone is a hormone that acts on the kidneys to increase reabsorption of sodium and water, leading to increased blood volume and pressure. By inhibiting aldosterone secretion, ACE inhibitors reduce blood volume and lower blood pressure, making them effective in treating hypertension and heart failure.
Question 2 of 5
A patient is in the intensive care unit because of an acute myocardial infarction. He is experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of choice for this dysrhythmia?
Correct Answer: C
Rationale: Amiodarone is the drug of choice for treating severe ventricular dysrhythmias, such as those experienced by the patient in the intensive care unit with acute myocardial infarction. It is a class III antiarrhythmic medication that works by prolonging the action potential duration and refractory period, thereby helping to stabilize the electrical activity of the heart. Amiodarone is effective in treating various types of ventricular dysrhythmias, including ventricular tachycardia and ventricular fibrillation, making it a suitable choice in this scenario. Diltiazem and verapamil are calcium channel blockers primarily used for supraventricular arrhythmias and are not the first-line treatment for severe ventricular dysrhythmias. Adenosine is used for terminating supraventricular tachycardias, not ventricular dysrhythmias. Amiodarone
Question 3 of 5
Which patient is the best candidate to receive nesiritide therapy?
Correct Answer: D
Rationale: Nesiritide is a synthetic form of brain natriuretic peptide (BNP) that is used for the treatment of acutely decompensated heart failure (HF) in patients who have dyspnea at rest. It works by vasodilating veins and arteries, leading to decreased preload and afterload, thus improving the symptoms of HF such as dyspnea and edema. Nesiritide is typically reserved for patients who are hospitalized with acute decompensated HF and severe symptoms like dyspnea at rest. Patients needing initial treatment for HF or those with atrial fibrillation may not necessarily benefit from nesiritide therapy. Patients with reduced cardiac output may benefit from other therapies aimed at improving cardiac function rather than nesiritide alone.
Question 4 of 5
A patient is in the intensive care unit and receiving an infusion of milrinone (Primacor) for severe
Correct Answer: D
Rationale: Milrinone and furosemide are two medications that are known to interact when mixed together in the same intravenous line. Milrinone is a phosphodiesterase inhibitor that works to increase cardiac contractility and output, while furosemide is a loop diuretic used to promote diuresis. When mixed together, the pH level of the solution can become altered, leading to potential precipitation or inactivation of one or both drugs.
Question 5 of 5
Which drug goes through extensive first-pass hepatic metabolism?
Correct Answer: C
Rationale: Propranolol is the drug that undergoes extensive first-pass hepatic metabolism. First-pass metabolism refers to the metabolism of a drug by the liver before it enters the systemic circulation. In the case of propranolol, a significant portion of the drug is metabolized by the liver before reaching the systemic circulation, leading to reduced bioavailability. This is why propranolol is often given in higher doses to achieve the desired therapeutic effect. Heparin, insulin, nitroglycerine, and warfarin do not undergo significant first-pass metabolism by the liver.