Virtual ATI Pharmacology Pre Assessment -Nurselytic

Correct Answer: B

Rationale: The Drug Enforcement Administration (DE
A) is the agency responsible for enforcing the control of drugs considered to have a potential for abuse in the United States. It is the primary federal agency involved in combating drug trafficking and the illegal distribution of controlled substances. The DEA works to regulate and enforce the Controlled Substances Act, which classifies drugs into different schedules based on their accepted medical use and potential for abuse and addiction. This agency plays a crucial role in preventing the diversion and misuse of controlled substances, as well as ensuring public safety and health.

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

Correct Answer: A

Rationale: When a patient is on Warfarin therapy, the two primary tests that need to be monitored are the Prothrombin Time (PT) and the International Normalized Ratio (INR). Warfarin works by inhibiting the activity of Vitamin K-dependent clotting factors, and both PT and INR are measures of the extrinsic pathway of coagulation, which is primarily affected by Warfarin. PT measures the time it takes for blood to clot, while INR is a standardized calculation based on the PT value to monitor the effectiveness and safety of Warfarin therapy. Monitoring these tests helps ensure that the patient's blood is not too thick (increased risk of clotting) or too thin (increased risk of bleeding) while on Warfarin.

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.

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.