ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
A 52-year-old man with organic impotence is in the preoperative holding area before surgery. He is given intravenous vancomycin over 20 min and begins to develop fever, chills, and redness at the injection site. What is the most appropriate course of action for the physician to take?
Correct Answer: D
Rationale: Vancomycin's rapid infusion causes red man syndrome (fever, chills, redness) is discontinue . Anticholinesterase is irrelevant. Corticosteroids treat severe reactions, not initial step. Intubation is excessive. Slowing infusion (E) is preventive, not reactive. Stopping vancomycin halts histamine release, resolving symptoms.
Question 2 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 3 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 4 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.
Question 5 of 5
A client with diabetes is prescribed metformin (Glucophage). Which instruction should the nurse include in the teaching plan?
Correct Answer: A
Rationale: Metformin lowers blood glucose by reducing hepatic production and improving insulin sensitivity, best taken with meals to minimize GI upset (e.g., nausea), a common side effect, while aligning with food intake for glycemic control. Reporting muscle pain relates to rare lactic acidosis, not a primary instruction unless symptomatic. Avoiding carbohydrates is incorrect'diabetes management balances carbs, not eliminates them. Bedtime-only dosing ignores twice-daily norms. Taking it with meals enhances tolerance and efficacy, critical for adherence in type 2 diabetes, where metformin is first-line. This instruction reflects its pharmacokinetics and practical use, making A the key teaching point.