ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
A nurse is providing instructions to a client receiving baclofen (Lioresal). Which of the following would be included in the teaching plan?
Correct Answer: D
Rationale: Baclofen is a muscle relaxant used to treat spasticity. Weakness is a potential side effect and should be reported to the physician, as it may indicate an adverse reaction or the need for dose adjustment. Limiting fluid intake is not typically recommended, and holding the medication due to diarrhea is not a standard instruction. While alcohol can enhance the sedative effects of baclofen, the primary concern is monitoring for weakness, which could impact the patient's safety and mobility.
Question 2 of 5
An asymptomatic 46-year-old Indian woman is found to have an elevated serum calcium (2.80 mmol/L, corrected) at a 'well-woman' screening clinic. Other chemistries are normal, in particular phosphate is 0.8 mmol/L (normal range 0.8-1.45), and parathormone (PTH) is 5.4 pmol/L (normal range <0.9-5.4). She has a sedentary occupation in a northern UK city. Which of the following would be most suitable management?
Correct Answer: D
Rationale: Mild hypercalcemia (2.80 mmol/L) with borderline PTH (5.4 pmol/L) suggests primary hyperparathyroidism (PHPT), common in asymptomatic women. Alfacalcidol treats hypocalcemia, not hypercalcemia. Sevelamer binds phosphate, irrelevant here. Teriparatide increases calcium, contraindicated. Surgical parathyroidectomy suits severe cases, but mild, asymptomatic PHPT (calcium <3.0 mmol/L) warrants watchful waiting with monitoring, most suitable to assess progression without immediate intervention. This conservative approach balances risks, especially in a sedentary northern climate lacking vitamin D excess.
Question 3 of 5
Drugs with no significant effect on anticoagulant therapy include:
Correct Answer: D
Rationale: Amiodarone inhibits warfarin metabolism, increasing INR, so it affects anticoagulation. Disulfiram also potentiates warfarin via CYP inhibition, enhancing effect. Fluconazole similarly boosts warfarin levels, a significant interaction. Benzodiazepines have no major effect on anticoagulant therapy, a true statement, as they're metabolized differently. Metronidazole, like fluconazole, increases warfarin effect. Benzodiazepines' lack of interaction makes them safer in this context, a key consideration in polypharmacy.
Question 4 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 5 of 5
The student nurse asks the nursing instructor why drug plateaus occur with medications. What are the best responses by the nursing instructor?
Correct Answer: A
Rationale: Plateaus occur when receptors are saturated-max effect is reached (e.g., morphine), a pharmacodynamic limit. 100% relief isn't guaranteed-plateau is effect ceiling. Resistance (tolerance) builds over time, not instant. Losing efficacy implies degradation, not saturation. Receptor occupancy explains the plateau, a core concept.