ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
A client with myasthenia gravis frequently complains of weakness and fatigue. The physician plans to identify whether the client is responding to an overdose of the medication or a worsening of the disease. A tensilon test is performed. Which of the following would indicate that the client is experiencing an overdose of the medication?
Correct Answer: A
Rationale: In a Tensilon test, edrophonium chloride is administered to differentiate between myasthenic crisis (worsening of the disease) and cholinergic crisis (overdose of medication). A temporary worsening of symptoms, such as increased weakness, indicates a cholinergic crisis due to an overdose of anticholinesterase medications. Improvement suggests myasthenic crisis, while no change is inconclusive. Muscle spasms are not specific to an overdose. Therefore, worsening symptoms indicate an overdose.
Question 2 of 5
The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the priority assessment by the nurse include?
Correct Answer: A
Rationale: Imipramine, a tricyclic antidepressant, is cardiotoxic in overdose, causing dysrhythmias (e.g., widened QRS) due to sodium channel blockade. The priority assessment is cardiac status to detect life-threatening arrhythmias, guiding urgent interventions like sodium bicarbonate. Liver and renal effects are secondary in acute overdose. Neurological issues like seizures occur but are less immediately lethal than cardiac collapse. The nurse focuses on cardiac monitoring, aligning with toxicology priorities, making A the critical assessment.
Question 3 of 5
The older adult client has gastrointestinal bleeding. The client says to the nurse, 'I don't understand this. All I did was take ibuprofen (Advil) for my arthritis.' Which plan would be best as it relates to the nurse's education of this client?
Correct Answer: B
Rationale: Ibuprofen, an NSAID, can cause gastrointestinal bleeding by irritating the stomach lining, a risk higher in older adults. Substituting acetaminophen, which lacks this effect, reduces harm while managing pain, making it the best education plan. Topical drugs may not address systemic arthritis. Physician approval is wise but less specific than substitution. Pros/cons of ibuprofen inform but don't directly mitigate risk. Acetaminophen offers a safer alternative, directly addressing the bleeding issue.
Question 4 of 5
The patient has been depressed, and the physician plans to begin treatment with an antidepressant medication. In performing the initial assessment, what is the most important question for the nurse to ask?
Correct Answer: D
Rationale: Before starting antidepressants, assessing for suicidal ideation is critical because depression carries a high suicide risk, and some antidepressants, especially SSRIs, may initially increase this risk in vulnerable patients. This safety concern trumps other questions in urgency, as it directly impacts immediate care planning—potentially requiring closer monitoring or hospitalization. Alcohol use affects treatment efficacy but isn't the primary safety issue. Allergies are important for drug selection but secondary to life-threatening risks. Duration of depression informs chronicity, not acute danger. The nurse must prioritize identifying suicidal thoughts to ensure patient safety, aligning with psychiatric protocols and the therapeutic delay of antidepressants (2-6 weeks), making choice D the most essential question in this context.
Question 5 of 5
Which of the following is not a phenylpropionic derivatives:
Correct Answer: D
Rationale: Mefenamic acid is not a phenylpropionic derivative. It is classified as a fenamate, structurally related to fenamic acid. The other options (A. ibuprofen, B. fenoprofen, C. naproxen) are all examples of phenylpropionic derivatives, commonly referred to as propionic acids. These drugs have similar chemical structures and mechanisms of action, making them a distinct group within the nonsteroidal anti-inflammatory drug (NSAID) class.