ATI RN
Quizlet ATI Pharmacology Final Questions
Question 1 of 5
A 60-year-old man with agitation is hospitalized on the medicine service for hyponatremia. He is being treated with intravenous fluids and haloperidol. He develops new onset of tremors and difficulty with ambulation and gait disturbance. What is the most likely explanation for these findings?
Correct Answer: A
Rationale: The patient's new tremors, ambulation issues, and gait disturbance during hospitalization for hyponatremia suggest a drug-related cause. Haloperidol, an antipsychotic, is known for extrapyramidal symptoms (EPS)-tremors, rigidity, and gait problems-making iatrogenic the correct answer. Infection lacks supporting fever or systemic signs. Neoplastic process is unlikely without prior hints. Viral encephalitis would involve fever, altered mentation beyond agitation, and CSF findings, none present. Haloperidol's dopamine D2 blockade in the nigrostriatal pathway induces EPS, especially in older patients, aligning with the timeline and symptoms. This iatrogenic effect is a common adverse reaction, distinguishing it from unrelated pathologies in this context.
Question 2 of 5
A 24-year-old woman medical student with a history of depression presents to the emergency department with tachycardia and shallow breathing. After her initial presentation, she begins to become confused and has a seizure. An ECG is performed and shows QT prolongation. An arterial blood gas shows metabolic acidosis. She has been taking antidepressants for a couple of years, but her depression is worsening. She had a test yesterday and told her mother that she felt she did poorly. There is concern that she has overdosed on her medication. What is the most appropriate treatment?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 5
A hospital nurse is taking imipramine for a phobic anxiety disorder, and her patient is being treated with chlorpromazine for a psychotic disorder. Which of the following adverse effects is likely to occur in both of these individuals?
Correct Answer: C
Rationale: Imipramine (TCA) and chlorpromazine (antipsychotic) share anticholinergic and alpha-adrenergic blocking properties. Orthostatic hypotension arises from alpha-1 receptor blockade, causing vasodilation and blood pressure drops upon standing, a common effect in both drugs, impacting patients and users alike. Excessive salivation and pupillary constriction (miosis) are cholinergic effects, opposite to their anticholinergic actions (dry mouth, mydriasis). Seizure threshold decreases with both, but this isn't an ‘adverse effect' per se—it's a risk. Weight loss isn't typical; TCAs and antipsychotics often cause gain. The shared alpha-blockade mechanism makes orthostatic hypotension a frequent, clinically significant side effect in both individuals, requiring caution in mobility and monitoring.
Question 4 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, an SSRI, carries a black box warning for increased suicidal risk, particularly early in treatment, as it can paradoxically worsen mood or detachment in some patients. The spouse's report of moodiness and disconnection suggests possible suicidal ideation or adverse effects, necessitating urgent in-person assessment to evaluate safety and adjust treatment. Giving diphenhydramine is inappropriate, as it addresses neither depression nor the drug's effects and could mask symptoms. Holding medication without assessment risks untreated depression or withdrawal effects. Doubling the dose could exacerbate the issue, increasing risk. The nurse's priority is patient safety, requiring immediate evaluation by a professional, making choice B the most responsible and evidence-based response.
Question 5 of 5
The physician has prescribed sertraline (Zoloft) for the patient who is anxious and depressed. The patient calls the nurse to report that he has experienced delayed ejaculation since being on this medication. What is the best response by the nurse?
Correct Answer: A
Rationale: Sertraline, an SSRI, often causes sexual dysfunction like delayed ejaculation due to serotonin elevation. Reporting this to the doctor allows dose adjustment or switching (e.g., to bupropion), addressing quality of life. Choice B minimizes the issue, risking noncompliance. Choice C assumes suicide risk without basis. Choice D falsely promises resolution. A advocates for the patient, ensuring tailored care, making it the best response.