ATI RN
ATI RN Pharmacology 2023 Proctored Exam Questions
Question 1 of 5
A male patient is undergoing chemotherapy may also be given the drug allopurinol (Zyloprim, Aloprim). Allopurinol inhibits the synthesis of uric acid. Concomitant administration of allopurinol prevents:
Correct Answer: B
Rationale: Allopurinol is primarily used to prevent gout and hyperuricemia, which are common side effects of chemotherapy. Chemotherapy often leads to the rapid destruction of cancer cells, releasing large amounts of uric acid into the bloodstream. This can cause hyperuricemia, leading to gout or kidney stones. Allopurinol works by inhibiting xanthine oxidase, an enzyme involved in uric acid production, thereby reducing uric acid levels. While myelosuppression and pancytopenia are concerns during chemotherapy, they are not directly addressed by allopurinol. Similarly, allopurinol does not inhibit cancer cell growth or replication.
Question 2 of 5
What's the normal range for therapeutic serum digoxin levels?
Correct Answer: A
Rationale: The normal range for therapeutic serum digoxin levels is typically considered to be 0.5-2 ng/mL. This range is where the drug digoxin effectively treats heart conditions such as atrial fibrillation and heart failure without causing toxicity. Levels below 0.5 ng/mL may be subtherapeutic, while levels above 2 ng/mL can lead to digoxin toxicity, characterized by symptoms like nausea, vomiting, visual disturbances, and cardiac arrhythmias. Regular monitoring of serum digoxin levels is essential to ensure the drug is being used safely and effectively.
Question 3 of 5
The nurse is caring for a patient who is receiving an adrenergic blocking agent. While writing the care plan for this patient what nursing diagnoses would be most appropriate concerning comfort?
Correct Answer: A
Rationale: All four options would be appropriate nursing diagnoses for a patient receiving an adrenergic blocking agent. However, acute pain would be the only nursing diagnosis related to the patient’s comfort level. The nurse should address pain management as a priority to improve the patient’s quality of life and adherence to treatment.
Question 4 of 5
Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student's understanding of therapeutic index?
Correct Answer: B
Rationale: Therapeutic index (TI), the ratio of toxic to effective dose, gauges safety-wide TI means safer dosing, helping the student assess if doses are within safe limits. Best drug choice is clinical, not TI-based. Interactions aren't TI-specific. Monitoring needs tie to narrow TI drugs (e.g., lithium), but safety is broader. TI ensures safe dosing, a key review point.
Question 5 of 5
A patient comes to the ER with a painful stab wound. The ER resident administers pentazocine for the pain. Soon after administration the patient experiences sweating, restlessness, and an increase in pain sensations. What is the most likely explanation for his symptoms?
Correct Answer: B
Rationale: Pentazocine, a mixed opioid agonist-antagonist, acts as a kappa receptor agonist and a partial mu receptor agonist, providing analgesia in opioid-naive patients. However, in a heroin addict with high mu receptor tolerance, pentazocine's partial antagonism at mu receptors can displace full agonists like heroin, precipitating withdrawal symptoms—sweating, restlessness, and heightened pain perception. Tolerance to pentazocine itself wouldn't typically increase pain; it would reduce efficacy. Pentazocine is an effective analgesic in appropriate contexts, so ineffectiveness isn't the issue. Incorrect dosing might alter efficacy or toxicity but wouldn't specifically cause this withdrawal-like reaction. The patient's history of heroin use explains this response, as pentazocine's antagonist properties disrupt the opioid equilibrium, unmasking withdrawal in a dependent individual.