ATI RN
Effects of Pharmacological Treatments on Clients Across a Lifespan Questions
Question 1 of 5
A 74-year-old man with bladder cancer and refractory depression is tried on a new agent to help his depression. Tranylcypromine is begun by his primary care physician. Which of the following adverse reactions may be expected in this patient?
Correct Answer: A
Rationale: The correct answer is A) Anxiety. Tranylcypromine is a monoamine oxidase inhibitor (MAOI) used to treat depression. MAOIs can lead to an increase in anxiety due to their mechanism of action on neurotransmitters like serotonin and norepinephrine. The inhibition of MAO can cause these neurotransmitters to accumulate, leading to increased stimulation which may manifest as anxiety in some patients. Option B) Hepatitis is incorrect because tranylcypromine is not known to cause liver toxicity or hepatitis as a common adverse reaction. Option C) Normalization of blood glucose levels is incorrect because tranylcypromine does not have a direct effect on blood glucose levels. Option D) Salivation is incorrect because tranylcypromine is not associated with changes in salivation as an adverse reaction. In an educational context, understanding the potential adverse reactions of pharmacological treatments is crucial for healthcare providers to make informed decisions and provide safe care to patients. Knowing the expected side effects of medications allows for early recognition and management of adverse reactions, improving patient outcomes and safety. It also highlights the importance of thorough assessment, monitoring, and patient education when initiating new pharmacological treatments, especially in vulnerable populations like older adults with multiple comorbidities.
Question 2 of 5
A 44-year-old man with multiple medical problems is placed on a carbonic anhydrase inhibitor which inhibits bicarbonate reabsorption and acts as a weak diuretic. This agent works at which of the following areas in the nephron?
Correct Answer: A
Rationale: The correct answer is A) Location 1, which refers to the proximal convoluted tubule of the nephron. Carbonic anhydrase inhibitors like acetazolamide work by inhibiting the enzyme carbonic anhydrase in the proximal convoluted tubule. This inhibition leads to decreased reabsorption of bicarbonate, resulting in a mild diuretic effect. Option B) Location 2, which is the loop of Henle, is incorrect because carbonic anhydrase inhibitors do not primarily act in this part of the nephron. Option C) Location 3, which is the distal convoluted tubule, is also incorrect as carbonic anhydrase inhibitors do not target this specific area for their mechanism of action. Option D) Location 4, which would be the collecting duct, is also an incorrect choice as carbonic anhydrase inhibitors primarily act in the proximal convoluted tubule. Understanding the specific location of action of pharmacological treatments on the nephron is crucial for healthcare professionals to predict the drug's effects on renal physiology and overall patient care. This knowledge aids in selecting appropriate medications, monitoring for potential side effects, and optimizing therapeutic outcomes for clients across the lifespan.
Question 3 of 5
An 83-year-old man has a 2-month history of akinesia, rigidity, and tremor. He has been taking a drug for the past 7 years to control severe behavioral and psychiatric symptoms associated with dementia, Alzheimer type. This adverse effect is most likely mediated through which of the following?
Correct Answer: B
Rationale: The symptoms (akinesia, rigidity, tremor) suggest drug-induced parkinsonism, a common side effect of antipsychotics used for behavioral symptoms in Alzheimer’s dementiThese drugs (e.g., haloperidol) exert antidopaminergic effects by blocking D2 receptors in the nigrostriatal pathway, mimicking Parkinson’s disease. Anticholinergic effects typically relieve parkinsonism, not cause it. GABA downregulation or upregulation (F) relates to sedation or seizures, not these motor symptoms. Norepinephrine or serotonin (E) reuptake inhibition is unrelated to parkinsonism.
Question 4 of 5
A 49-year-old man with hypertension comes to the physician for a follow-up examination. At his last visit 2 months ago, his serum total cholesterol concentration was 320 mg/dL. He then began a low-cholesterol diet. His blood pressure is 145/95 mm Hg. Physical examination shows no other abnormalities. Serum studies show a total cholesterol concentration of 310 mg/dL. Kidney and liver function test results are within normal limits. The most appropriate pharmacotherapy for this patient is a drug that has which of the following mechanisms of action?
Correct Answer: B
Rationale: Persistent hypercholesterolemia (310 mg/dL) despite diet indicates a need for a statin, which inhibits HMG-CoA reductase (E), reducing hepatic cholesterol synthesis and upregulating LDL receptors to lower serum cholesterol. PPAR activation is for fibrates (triglycerides), VLDL reduction for niacin, bile acid sequestration for resins, and cholesterol absorption inhibition for ezetimibe—statins are most effective for LDL here.
Question 5 of 5
A patient is about to receive a morning dose of digoxin and has an apical pulse of 53 beats/minute. Which of the following actions should the nurse do first?
Correct Answer: A
Rationale: Digoxin slows heart rate via vagal stimulation and AV node inhibition. A pulse of 53 beats/minute (bradycardia) is below the typical threshold (<60 bpm) for holding the dose, making the first action to prevent toxicity (e.g., arrhythmias). Notifying the charge nurse or provider follows, and administering risks harm. Note: Answer key says (c), but is the priority per nursing protocol.