ATI RN
ATI Pharmacology Practice B 2023 Questions
Question 1 of 5
A 19-year-old man attempts suicide after failing all of his college courses. He goes home and takes more than 90 digoxin tablets (0.25 mg each), ingesting them about 3 h prior to presentation at the emergency department. He is brought to the hospital by his brother. Vital signs are as follows: pulse is 50 beats/minute, and the electrocardiogram indicates third-degree heart block. Serum electrolytes are normal. Which of the following is the most important therapy to initiate in this patient?
Correct Answer: B
Rationale: Digoxin overdose (bradycardia, heart block) requires digoxin immune Fab , binding free digoxin to reverse toxicity. Amiodarone and lidocaine treat arrhythmias but not the cause. Potassium and verapamil (E) worsen hyperkalemia or block. Fab is urgent here.
Question 2 of 5
The client takes diphenhydramine (Benadryl) but forgets to tell the physician about this drug when a monoamine oxidase inhibitor (MAOI) drug is prescribed for depression. What will the best assessment by the nurse reveal?
Correct Answer: D
Rationale: Diphenhydramine with MAOIs risks hypertensive crisis due to norepinephrine excess, a life-threatening interaction. Depression , seizures , and allergy control are secondary. D prioritizes urgent assessment, making it the best focus.
Question 3 of 5
Warfarin:
Correct Answer: C
Rationale: Warfarin is highly bioavailable (near 100%), so 90% is close and true. It doesn't inactivate vitamin K but inhibits vitamin K epoxide reductase, reducing clotting factor synthesis, making that false. It can paradoxically cause venous thrombosis (e.g., skin necrosis) early in therapy due to protein C depletion, a true statement. Initial loading is typically 5-10 mg, not 0.5 mg, so that's false. Metronidazole increases its effect via metabolism inhibition, not bactericidal action. The thrombosis risk is a rare but serious side effect, highlighting the need for bridging with heparin during initiation.
Question 4 of 5
A client with bipolar disorder is prescribed lithium carbonate. Which symptom should the nurse teach the client to report?
Correct Answer: C
Rationale: Lithium stabilizes mood but risks toxicity (e.g., >1.5 mEq/L), causing tremors , a neurologic sign needing reporting to adjust dosing or check levels. Thirst and weight gain are common, manageable. Nausea occurs but is less urgent unless severe. Tremors indicate potential overdose, critical in bipolar disorder where narrow therapeutic range demands vigilance, making C the key symptom to report.
Question 5 of 5
Which of the following is least likely to have an adverse drug interaction with phenelzine (a monoamine oxidase (MAO) inhibitor)?
Correct Answer: D
Rationale: Phenelzine, an MAOI, risks hypertensive crisis or serotonin syndrome with drugs increasing monoamines. Levodopa raises catecholamines, risking hypertension with MAOIs. Ropinirole, a dopamine agonist, may enhance monoamine effects, potentially hazardous. Tolcapone, a COMT inhibitor, increases levodopa levels, amplifying MAOI risks. Pseudoephedrine, a sympathomimetic, causes severe hypertension. Propofol, an anesthetic, acts via GABA without monoamine interaction, making it least likely to cause adverse effects with phenelzine. Its safety profile here is key for procedural use in MAOI patients.