ATI RN
Pharmacology Assessment 1 ATI Capstone Questions
Question 1 of 5
A 39-year-old man with chronic allergic rhinitis and nasal congestion takes an over-the-counter nasal spray containing oxymetazoline. Over the next few days, he has significant improvement in his symptoms. Which of the following is the most likely mechanism of action of this agent?
Correct Answer: C
Rationale: Oxymetazoline treats nasal congestion in allergic rhinitis by acting as an α-adrenergic agonist. Option , increased nasal blood flow, is incorrect-vasoconstriction reduces flow. Option , increased arterial pressure, doesn't directly relieve congestion. Option , receptor stimulation on nasal vasculature, is correct-oxymetazoline stimulates α-receptors, causing vasoconstriction, shrinking swollen mucosa, and improving airflow. Option , transmembrane conductance change, is unrelated to its action. Option (E), understimulation, contradicts its agonist role. This vasoconstrictive effect rapidly alleviates congestion, explaining the symptom improvement. Unlike antihistamines or steroids, oxymetazoline targets vascular tone, not inflammation or histamine, making it ideal for quick relief in rhinitis. Prolonged use risks rebound congestion, but the question focuses on initial efficacy, where receptor-mediated vasoconstriction is key.
Question 2 of 5
You have been monitoring a 62-year-old man who is a retired small business owner over the past year and have noted a slowly changing intraocular pressure bilaterally. You have started him on physostigmine to treat his open-angle glaucoma. How does physostigmine affect intraocular pressure?
Correct Answer: C
Rationale: Physostigmine, a cholinesterase inhibitor, lowers IOP in glaucoma by increasing aqueous outflow . It contracts the ciliary muscle, opening the trabecular meshwork. Secretion or synthesis reduction isn't its mechanism. Raising pressure (D, E) contradicts its use. This aids drainage in open-angle glaucoma.
Question 3 of 5
A 29-year-old male patient is being treated with an antidepressant drug, and his mood is improving. However, he complains of feeling 'jittery' and agitated at times, and if he takes his medication in the afternoon he finds it difficult to get to sleep at night. He seems to have lost weight during the 6 months that he has been taking the drug. He has been warned not to take other drugs without consultation because severe reactions have occurred with opioid analgesics including meperidine. This patient is probably taking
Correct Answer: C
Rationale: Paroxetine, an SSRI, treats depression by inhibiting serotonin reuptake, often improving mood. Its side effects include agitation and insomnia (especially if taken late), due to serotonin's stimulating effects, and weight loss can occur initially, unlike TCAs which cause gain. A critical clue is the warning against opioids like meperidine: SSRIs can cause serotonin syndrome when combined with MAOIs or other serotonergic drugs, though meperidine's risk is notable in polypharmacy. Alprazolam, a benzodiazepine, sedates rather than agitates. Chlorpromazine, an antipsychotic, causes sedation and weight gain. Amitriptyline, a TCA, is sedating and linked to weight gain, not loss. Trazodone promotes sleep. Paroxetine's profile—activation, insomnia, weight loss, and drug interaction risks—matches the patient's experience.
Question 4 of 5
Which drug is most likely to be ordered for the client with herpes simplex virus?
Correct Answer: A
Rationale: Herpes simplex virus (HSV) is a viral infection requiring antiviral therapy, and acyclovir (Zovirax) is the gold-standard treatment due to its specific action against herpesviruses. It inhibits viral DNA replication, reducing symptom duration and severity, making it the most likely choice (A). Zidovudine targets HIV, a retrovirus, not HSV, and is irrelevant here. Nystatin is an antifungal, ineffective against viruses. Metronidazole treats bacterial and protozoal infections, not viral ones. Acyclovir's specificity and efficacy for HSV, supported by clinical guidelines, make it the priority drug. The nurse must recognize this distinction to ensure appropriate therapy, as misidentification could delay recovery or worsen outcomes. Choice A stands out as the only antiviral tailored to HSV's pathophysiology, ensuring targeted treatment.
Question 5 of 5
A patient has taken two doses of interferon Alfa-2b (Intron-A). He comes to the clinic today with the following complaints. Which symptoms would the nurse identify as common adverse effects of this therapy?
Correct Answer: A
Rationale: Interferon Alfa-2b, used for hepatitis or cancer, commonly causes flu-like symptoms—dizziness , fatigue , and anorexia —due to its immune-modulating effects. Dizziness reflects CNS impact, often early in therapy, while fatigue and appetite loss stem from systemic inflammation. An itchy rash might suggest hypersensitivity but is less frequent than these systemic effects. The nurse identifies dizziness as a common adverse effect (correct answers: 1, 3, 4), distinguishing it from severe reactions requiring intervention. This aligns with interferon's side effect profile, where patients often report such symptoms within days of starting, necessitating education on management (e.g., rest, hydration). Choice A is a key identifier among expected effects, ensuring appropriate monitoring.