ATI RN
Pharmacology Final ATI Quizlet Questions
Question 1 of 5
A 57-year-old patient, living at home, has severe pain due to a metastatic carcinoma that is being managed with fentanyl, delivered transdermally from a patch. He should also be taking, or at least have on hand
Correct Answer: B
Rationale: Fentanyl, a potent opioid, effectively manages severe cancer pain via transdermal delivery, but constipation is a universal side effect due to mu receptor activation in the gut, reducing motility. Docusate, a stool softener, prevents and treats this by easing bowel movements, essential for patient comfort and compliance. Apomorphine, a dopamine agonist, treats Parkinson's off-periods, irrelevant here. Loperamide, an antidiarrheal, worsens constipation. Morphine duplicates fentanyl's action, unnecessary with a patch. Naloxone reverses overdose, useful in emergencies but not routine. Given fentanyl's chronic use, proactively managing constipation with docusate is critical, as it mitigates a predictable, distressing side effect without altering pain control.
Question 2 of 5
When the nurse is administering topical nitroglycerin ointment, which technique is correct?
Correct Answer: D
Rationale: The correct technique when administering topical nitroglycerin ointment is to remove the old ointment before applying the new ointment. This is to prevent any potential overdosing of the medication, as nitroglycerin can be rapidly absorbed through the skin. It is important to ensure that the previous application is fully removed before applying a new dose to prevent any accumulation of the medication.
Question 3 of 5
A 24-year-old beautician has a history of chronic fatigue since an attack of infectious mononucleosis when aged 20. Her fatigue has become progressively worse. Her periods are painful, heavy and irregular. Her BP is 116/62 (supine) and 92/52 (standing). Serum Na+ is 132, K+ 5.5, creatinine 60 μmol/L. Which of the following would be most appropriate management?
Correct Answer: D
Rationale: Fatigue, orthostatic hypotension (116/62 to 92/52), hyponatremia (Na+ 132), and hyperkalemia (K+ 5.5) post-mononucleosis suggest Addison's disease (adrenal insufficiency). Fludrocortisone treats mineralocorticoid deficiency but needs diagnosis first. CBT addresses fatigue psychologically, not endocrine causes. Aciclovir treats viral infections, irrelevant here. Tetracosactide (Synacthen) tests adrenal function, diagnosing Addison's by cortisol response, most appropriate to confirm before lifelong therapy. This diagnostic step ensures accurate management, critical in suspected adrenal failure.
Question 4 of 5
The nurse is giving instructions to a client receiving phenytoin (Dilantin). The nurse concludes that the client has a sufficient knowledge if the client states that:
Correct Answer: D
Rationale: Monitoring the serum phenytoin level is crucial when taking phenytoin (Dilantin) because phenytoin has a narrow therapeutic range. Having regular blood tests to check the drug levels ensures that the medication is within the effective range and helps prevent toxicity or ineffectiveness. This also allows healthcare providers to adjust the dosage if needed, based on the serum level results. It is an essential part of managing phenytoin therapy and ensuring its effectiveness while minimizing the risk of adverse reactions.
Question 5 of 5
The ability of epinephrine to cause hyperglycemia is due to;
Correct Answer: C
Rationale: The ability of epinephrine to cause hyperglycemia is primarily due to its effect on alpha adrenoreceptors in the pancreatic islets of Langerhans. Epinephrine, acting through these alpha adrenoreceptors, inhibits the release of insulin from beta cells in response to elevated blood glucose levels. This results in decreased uptake of glucose by cells, leading to increased blood glucose levels, ultimately causing hyperglycemia. Other effects of epinephrine, such as vasoconstriction and increased heart rate, also contribute to the overall stress response, but the inhibition of insulin release through alpha adrenoreceptors is the main mechanism responsible for its hyperglycemic effects.