ATI RN
Quizlet Pharmacology ATI Questions
Question 1 of 5
A 37-year-old man is found to have hypercholesterolemia during a routine checkup. The physician prescribes lovastatin and counsels the patient to make healthy dietary and lifestyle changes to keep his cholesterol under control. Two weeks later, he returns complaining of severe muscle pain, possibly caused by his lovastatin therapy. He insists that he is taking the medication exactly as prescribed, but the physician knows that lovastatin is metabolized by the cytochrome P450 3A4. What else may he be using that would explain his condition?
Correct Answer: B
Rationale: Lovastatin's myopathy (muscle pain) suggests a CYP3A4 interaction. Grapefruit juice inhibits CYP3A4, increasing lovastatin levels, causing toxicity. Barbiturates , Griseofulvin , and Phenytoin induce CYP3A4, reducing levels. St. John's wort (E) also induces. Grapefruit juice fits the timeline and mechanism, explaining the adverse effect.
Question 2 of 5
Lorazepam can be safely used as a preanesthetic medication in a patient undergoing liver transplantation without fear of excessive CNS depression because the drug is
Correct Answer: C
Rationale: Lorazepam is a benzodiazepine commonly used as a preanesthetic medication due to its anxiolytic and sedative properties. In patients undergoing liver transplantation, where hepatic function is compromised, drugs that rely on liver metabolism could accumulate and cause excessive central nervous system depression. Lorazepam's key advantage lies in its pharmacokinetic profile: it undergoes glucuronidation, a conjugation process that occurs outside the liver, primarily in the kidneys. This extrahepatic metabolism ensures that its clearance is less affected by liver dysfunction, reducing the risk of prolonged or excessive sedation. Unlike other benzodiazepines that depend heavily on hepatic cytochrome P450 enzymes, lorazepam's metabolism is more predictable in such patients, making it a safer choice. Excretion in unchanged form or secretion into the GI tract does not apply, and while it is anxiolytic, it does have CNS depressant effects, ruling out other options. Naloxone reverses opioids, not benzodiazepines.
Question 3 of 5
A patient with focal complex partial seizures has been treated for 6 months with carbamazepine but, recently, has been experiencing breakthrough seizures on a more frequent basis. You are considering adding a second drug to the antiseizure regimen. Which of the following drugs is least likely to have a pharmacokinetic interaction with carbamazepine?
Correct Answer: C
Rationale: Carbamazepine induces cytochrome P450 (e.g., CYP3A4), accelerating metabolism of drugs like topiramate, tiagabine, and lamotrigine, reducing their levels and complicating dosing. Levetiracetam, excreted renally with minimal hepatic metabolism, avoids P450 interactions, maintaining stable levels when added to carbamazepine. Zonisamide interacts via induction. Levetiracetam's lack of pharmacokinetic interference, per clinical pharmacology, makes it the safest adjunct, enhancing control without altering carbamazepine's efficacy.
Question 4 of 5
The client is prescribed a nasal decongestant spray. What information should the nurse include when educating the client about how to use this medication?
Correct Answer: D
Rationale: Nasal decongestant sprays (e.g., oxymetazoline) risk rebound congestion if used beyond 3-5 days, and excess drainage into the mouth should be spat out to avoid systemic effects (correct answers: 1, 3, 5). Blowing the nose clears passages, and limiting use prevents rebound, both key. Water isn't relevant. Choice D ensures safe administration, minimizing ingestion risks.
Question 5 of 5
A patient has been changed from a first generation H1 receptor antagonist to a second generation H1 receptor antagonist. The nurse evaluates that the patient understands the benefit of this change when which statement is made?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.