ATI RN
ATI PN Pharmacology Proctored Exam 2023 Questions
Question 1 of 5
A client is prescribed omeprazole (Prilosec) for GERD. Which instruction should the nurse include?
Correct Answer: A
Rationale: Omeprazole, a PPI, reduces acid by inhibiting proton pumps, most effective before meals when acid production peaks, optimizing GERD relief. With antacids reduces efficacy'PPIs need acidic pH. Crushing destroys enteric coating. Bedtime-only misses daytime acid. Pre-meal dosing aligns with omeprazole's mechanism, critical in GERD where timing enhances healing, making A the key instruction.
Question 2 of 5
Age associated changes in pharmacokinetics include:
Correct Answer: A
Rationale: Aging reduces creatinine clearance in about two-thirds of individuals due to declining renal function, a true statement impacting drug excretion. Body fat increases, not decreases, with age, altering distribution of lipophilic drugs, so that's false. Total body water decreases, not increases, affecting hydrophilic drugs. Conjugation (phase II) is less affected than oxidation (phase I) by age, making that false. Absorption isn't significantly altered by age alone. Reduced renal clearance is a critical age-related change, necessitating dose adjustments for renally cleared drugs like digoxin.
Question 3 of 5
A woman with myoclonic seizures is well controlled with lamotrigine. She becomes pregnant and begins to have breakthrough seizures. What is most likely happening?
Correct Answer: C
Rationale: Pregnancy increases lamotrigine clearance via enhanced glucuronidation (UGT enzyme induction), lowering plasma concentrations and risking breakthrough seizures, as seen here. Worsening epilepsy is possible but less likely without prior progression. Increased concentrations would improve control, not worsen it. Loss of efficacy is unlikely if previously effective; pharmacokinetic changes are more plausible. Monitoring and dose adjustment during pregnancy, per epilepsy guidelines, address this common issue, making decreased concentrations the most likely cause.
Question 4 of 5
Three days after a patient's total colectomy and ileostomy, he has a nasogastric tube for continuous suction and a Foley catheter for continuous drainage. The night nurse reports a high output from the ileostomy. The patient's pulse is irregular, and he reports leg weakness. Based on this situation, the nurse would correctly suspect what type of imbalance?
Correct Answer: A
Rationale: The patient's symptoms of irregular pulse and leg weakness, along with high ileostomy output, suggest hypokalemia. High ileostomy output can lead to excessive loss of potassium, a key electrolyte responsible for muscle and nerve function. Hypokalemia can cause muscle weakness and cardiac arrhythmias, which align with the patient's symptoms. Hyperkalemia (B) would typically cause muscle cramps and cardiac abnormalities like peaked T-waves, not weakness. Hyponatremia (C) and hypercalcemia (D) do not typically present with these specific symptoms.
Question 5 of 5
The patient has been treated by the same physician for 2 years and has had insomnia the entire time. Many different medications have been tried with limited success. What should be the nurse's primary assessment at this time?
Correct Answer: A
Rationale: Persistent insomnia despite meds suggests a primary disorder like sleep apnea-e.g., obstructed breathing disrupts sleep-needing assessment (e.g., EEG), not just med failure. Selling meds lacks evidence. Addiction or personality disorders don't explain resistance. Sleep apnea fits chronicity, per sleep science.