ATI RN
ATI RN Pharmacology 2023 Proctored Exam Questions
Question 1 of 5
A 4-year-old boy is brought to the emergency department who was found drinking antifreeze while the father was working on their car. A primary component of antifreeze is ethylene glycol, an alcohol converted to toxic metabolites by the liver enzyme alcohol dehydrogenase. To prevent toxicity, the physician could administer ethanol, which would compete with ethylene glycol for the enzyme. In order to avoid administering ethanol to this patient, the physician could instead give which of the following drugs that would also prevent metabolism of ethylene glycol?
Correct Answer: C
Rationale: Ethylene glycol toxicity requires blocking alcohol dehydrogenase. Fomepizole inhibits this enzyme, preventing toxic metabolite formation. Bicarbonate treats acidosis, not metabolism. Disulfiram blocks aldehyde dehydrogenase. Furosemide and Methanol (E) are irrelevant. Fomepizole's specificity avoids ethanol's risks in a child, ensuring safe detoxification.
Question 2 of 5
The patient has been receiving escitalopram (Lexapro) for treatment of obsessive-compulsive disorder. Unknown to the nurse, the patient has also been self-medicating with St. John's wort. The patient comes to the office with symptoms of hyperthermia and diaphoresis. Which statement best describes the result of the nurse's assessment?
Correct Answer: D
Rationale: Escitalopram and St. John's wort, both serotonin boosters, risk serotonin syndrome-hyperthermia, diaphoresis-per pharmacology. St. John's toxicity alone (e.g., photosensitivity) doesn't fit. They're not safe together-interaction is known. Withdrawal lacks agitation context. Serotonin excess explains symptoms, a critical finding.
Question 3 of 5
Select all when taking Iron Supplements.
Correct Answer: A
Rationale: A. It is recommended to take iron supplements one hour before or two hours after a meal because food can interfere with the absorption of iron. By taking it on an empty stomach or away from meals, the body can absorb the iron more effectively.
Question 4 of 5
A 6-year-old boy is brought to his primary care physician with a history of hay fever and asthma. He usually has two to three attacks per week. For symptom control, he uses an albuterol inhaler, but his parents would like to try something more. They would like him to take something that would lessen the amount of attacks he has. Although corticosteroids would probably work best for prophylaxis, they are contraindicated in children. He is instead given montelukast. How does montelukast work?
Correct Answer: A
Rationale: Montelukast prevents asthma attacks by blocking leukotriene receptors . Leukotrienes drive inflammation; montelukast reduces this, complementing albuterol's acute relief. Muscarinic blockade is ipratropium's action. COX inhibition (C, D) is NSAIDs'. Lipoxygenase inhibition (E) is zileuton's. Montelukast's specificity suits prophylaxis in this child.
Question 5 of 5
Regarding phenytoin, all the following are true EXCEPT:
Correct Answer: B
Rationale: Phenytoin's oral bioavailability varies due to formulation and absorption, a true statement. It's highly plasma protein-bound (~90%), not poorly, making that false and the exception. Hepatic enzyme inducers (e.g., rifampicin) enhance its metabolism, true. At higher doses, its elimination shifts to zero-order due to saturated metabolism, true. Half-life ranges from 12-36 hours, also true. High protein binding affects free drug levels, critical for therapeutic monitoring, especially in hypoalbuminemia.