ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
A 26-year-old man presents to the emergency department with severe right lower quadrant pain. Physical exam reveals rebound tenderness and decreased bowel sounds. An emergent appendectomy is performed. Postsurgically, he is given an NSAID along with morphine for pain control. Which of the following NSAIDs is commonly used as an adjunct to opioids postsurgically?
Correct Answer: D
Rationale: Post-appendectomy pain management often combines opioids like morphine with NSAIDs for synergy. Acetaminophen is an analgesic but not a true NSAID (lacks significant anti-inflammatory action). Celecoxib , a COX-2 inhibitor, is less common acutely due to cost and milder effect. Ibuprofen is effective but less potent parenterally. Ketorolac , a potent NSAID, is widely used postsurgically-available IV/IM, it reduces inflammation and pain, complementing morphine's central action. Naproxen (E) is oral, less ideal acutely. Ketorolac's rapid onset and efficacy in reducing opioid requirements make it standard. Its short-term use minimizes GI risks, aligning with surgical protocols, distinguishing it from other options for acute postoperative pain control.
Question 2 of 5
A 65-year-old man with end-stage renal disease because of diabetes recently underwent a renal transplant. He has been responding well to the transplant and his creatinine has stabilized around 2.1 mg/dL. He was placed on immunosuppressive therapy with muromonab. What is the mechanism of action of muromonab?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 5
A habitual user of a schedule-controlled drug abruptly stops using it. Within 8 h, she becomes anxious, starts to sweat, and gets severe abdominal pain with diarrhea. These symptoms intensify over the next 12 h, during which time she has a runny nose, is lacrimating, and has uncontrollable yawning and intensification of muscle cramping and jerking. Assuming that these are withdrawal symptoms in the patient due to her physical dependence, the drug most likely to be involved is
Correct Answer: D
Rationale: Meperidine, a synthetic opioid, causes physical dependence with chronic use. Abrupt cessation triggers classic opioid withdrawal: anxiety, sweating, abdominal pain, diarrhea (8-12 hours onset), escalating to rhinorrhea, lacrimation, yawning, and muscle cramps—matching the timeline and symptoms described. Alprazolam (benzodiazepine) withdrawal peaks later (days), with seizures and anxiety but less GI distress. Amphetamine withdrawal causes fatigue and depression, not this autonomic profile. Ethanol withdrawal includes tremors and seizures, typically 12-48 hours, differing from this rapid onset. Secobarbital (barbiturate) withdrawal resembles benzodiazepines, with delayed seizures. Meperidine's mu receptor agonism explains the dependence and acute, opioid-specific withdrawal syndrome, aligning perfectly with the patient's presentation.
Question 4 of 5
The patient has been depressed, and the physician plans to begin treatment with an antidepressant medication. In performing the initial assessment, what is the most important question for the nurse to ask?
Correct Answer: D
Rationale: Before starting antidepressants, assessing for suicidal ideation is critical because depression carries a high suicide risk, and some antidepressants, especially SSRIs, may initially increase this risk in vulnerable patients. This safety concern trumps other questions in urgency, as it directly impacts immediate care planning—potentially requiring closer monitoring or hospitalization. Alcohol use affects treatment efficacy but isn't the primary safety issue. Allergies are important for drug selection but secondary to life-threatening risks. Duration of depression informs chronicity, not acute danger. The nurse must prioritize identifying suicidal thoughts to ensure patient safety, aligning with psychiatric protocols and the therapeutic delay of antidepressants (2-6 weeks), making choice D the most essential question in this context.
Question 5 of 5
The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the priority assessment by the nurse include?
Correct Answer: A
Rationale: Imipramine, a tricyclic antidepressant, is cardiotoxic in overdose, causing dysrhythmias (e.g., widened QRS) due to sodium channel blockade. The priority assessment is cardiac status to detect life-threatening arrhythmias, guiding urgent interventions like sodium bicarbonate. Liver and renal effects are secondary in acute overdose. Neurological issues like seizures occur but are less immediately lethal than cardiac collapse. The nurse focuses on cardiac monitoring, aligning with toxicology priorities, making A the critical assessment.