ATI RN
Pharmacology Assessment 2 ATI Capstone Questions
Question 1 of 5
A 71-year-old man who has chronic back pain after falling from a first-floor apartment 25 years ago is managed with a morphine pump for his chronic pain. He also had a long history of chronic diarrhea that preceded his accident. The pump has been in place for 22 years. Which of the following effects will still likely be maintained by the device at this time?
Correct Answer: B
Rationale: Long-term morphine via pump sustains certain effects. Constipation persists-tolerance doesn't fully develop to GI μ-receptor effects, unlike analgesia , euphoria , or sedation (E). Pupil dilation is incorrect; morphine causes miosis. After 22 years, constipation remains a chronic issue, reflecting opioid pharmacology.
Question 2 of 5
A 26-year-old woman presents to her primary care physician complaining of seasonal allergies. She has done well without medications for some time but now has worsening of her symptoms. She is given a prescription for fexofenadine. Which of the following adverse effects must be considered in this patient?
Correct Answer: B
Rationale: Fexofenadine for allergies may cause headache , a frequent side effect of this non-sedating antihistamine. Flank pain , otitis , infection , and tinnitus (E) are rare. Headache monitoring ensures safe symptom relief.
Question 3 of 5
Which of the following antipsychotic agents is considered to be the most potent and, thus, have the highest risk of extrapyramidal symptoms?
Correct Answer: B
Rationale: Fluphenazine, a high-potency first-generation antipsychotic, strongly blocks D2 receptors, requiring lower doses for efficacy but increasing EPS risk (e.g., dystonia, parkinsonism) due to intense dopamine antagonism in the nigrostriatal pathway. Thioridazine and chlorpromazine, low-potency first-generation drugs, have weaker D2 affinity, causing more sedation and anticholinergic effects than EPS. Quetiapine, a second-generation antipsychotic, has low D2 potency and minimal EPS. Clozapine avoids EPS with broad receptor activity. Fluphenazine's potency, measured by dose equivalence and clinical data, correlates with its elevated EPS risk, distinguishing it here.
Question 4 of 5
The client receives diphenhydramine (Benadryl) to control allergic symptoms. Which common symptom does the nurse teach the client to report to the physician?
Correct Answer: D
Rationale: Diphenhydramine, a first-generation antihistamine, has anticholinergic effects, including urinary hesitancy , due to reduced bladder contractility. This can escalate to retention, a serious issue, especially in older adults or those with prostate issues, warranting physician reporting. Sedation is expected and manageable, not typically reported unless severe. Diarrhea isn't common; constipation is more likely. Projectile vomiting suggests a different pathology, not a typical antihistamine effect. The nurse teaches reporting urinary hesitancy as it's a significant anticholinergic complication requiring intervention, making choice D the priority symptom to monitor.
Question 5 of 5
The client tells the nurse that her symptoms have become worse since she has been using oxymetazoline (Afrin) for nasal congestion. What is the best assessment question for the nurse to ask?
Correct Answer: D
Rationale: Oxymetazoline causes rebound congestion if used beyond 3-5 days. Asking 'How long have you been using the medication?' identifies misuse, the likely cause of worsening symptoms. Bottle age , temperature , and other medications are secondary. D targets the root issue, making it the best question.