A 42-year-old woman with a 1-year history of rheumatoid arthritis comes to see her primary care physician complaining of worsening symptoms. She has been taking leflunomide. IL-1 and TNF-α are two key cytokines involved in the negative sequelae of rheumatoid arthritis. Which of the following drugs is a recombinant form of an endogenous IL-1 antagonist?

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ATI Intro to Pharmacology Quizlet Questions

Question 1 of 5

A 42-year-old woman with a 1-year history of rheumatoid arthritis comes to see her primary care physician complaining of worsening symptoms. She has been taking leflunomide. IL-1 and TNF-α are two key cytokines involved in the negative sequelae of rheumatoid arthritis. Which of the following drugs is a recombinant form of an endogenous IL-1 antagonist?

Correct Answer: B

Rationale: RA involves IL-1 and TNF-α driving inflammation. The question seeks a recombinant IL-1 antagonist. Abatacept inhibits T-cell costimulation, not IL-1. Anakinra , a recombinant IL-1 receptor antagonist (IL-1Ra), blocks IL-1 signaling, matching the description. Methotrexate slows cell proliferation, not an IL-1 antagonist. Hydroxychloroquine modulates immunity differently. Rituximab (E) targets B cells. Anakinra mimics natural IL-1Ra, reducing joint damage in RA when leflunomide fails, directly countering IL-1's effects, unlike broader or unrelated mechanisms of other options.

Question 2 of 5

A 48-year-old woman with obsessive-compulsive disorder presents to her primary care physician for evaluation. She states that her symptoms have worsened during the last 6 months and desires treatment. She has begun on sertraline. Which of the following precautions must be exercised by the physician?

Correct Answer: D

Rationale: Sertraline, an SSRI, risks suicidal tendencies , especially early in treatment for OCD. Hepatic carcinoma , volume overload , and antibiotic potentiation aren't concerns. FDA warnings highlight this risk, necessitating monitoring in this worsening case.

Question 3 of 5

Which one of the following CNS receptors is directly coupled to an ion channel so that the effects of its activation do not involve second messenger systems?

Correct Answer: A

Rationale: Nicotinic acetylcholine (N ACh) receptors are ligand-gated ion channels, directly opening to allow sodium and potassium flux upon acetylcholine binding, producing rapid effects without second messengers—key in neuromuscular transmission. Alpha-adrenergic (a NE) receptors couple to G-proteins, using second messengers like IP3 or cAMP. D2A dopamine receptors inhibit adenylate cyclase via Gi proteins, involving cAMP. Mu opioid receptors (µ) also use Gi proteins, reducing cAMP and opening potassium channels indirectly. 5HT2 serotonin receptors activate phospholipase C, generating IP3. The nicotinic receptor's direct ion channel linkage distinguishes it, enabling fast synaptic responses without the delay of intracellular signaling cascades.

Question 4 of 5

The nurse is managing the care of a group of patients with schizophrenia. The patients are receiving conventional antipsychotic medications. When assessing for anticholinergic side effects, which would the nurse immediately report to the physician?

Correct Answer: D

Rationale: Conventional antipsychotics like haloperidol have anticholinergic effects, including dry mouth, constipation, and urinary retention. Urinary retention is a medical emergency if severe, risking bladder damage or infection, requiring immediate physician reporting. Acute dystonia is an extrapyramidal side effect, not anticholinergic, though urgent. Severe headache could indicate various issues but isn't a typical anticholinergic effect. Hypertension isn't directly linked to anticholinergic action (hypotension is more common). The nurse prioritizes urinary retention due to its potential for rapid complications, aligning with anticholinergic pharmacology, making choice D the most critical to report.

Question 5 of 5

A patient was prescribed sertraline (Zoloft) for the treatment of depression and anxiety. The patient's spouse calls the clinic and reports the patient is increasingly moody and seems 'disconnected with life.' What is the best response by the nurse?

Correct Answer: B

Rationale: Sertraline carries a suicide risk warning, especially early on. Moodiness and disconnection suggest potential ideation, requiring urgent clinic assessment for safety. Diphenhydramine masks symptoms. Holding medication risks withdrawal. Doubling the dose could worsen effects. B ensures immediate evaluation, making it the best response.

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