ATI RN
ATI RN Pharmacology 2023 Proctored Exam Questions
Question 1 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.
Question 2 of 5
Mannitol (Osmitrol), an osmotic diuretic, is contraindicated to which conditions? Select all that apply.
Correct Answer: B
Rationale: 1. Narrow-angle glaucoma: Mannitol can exacerbate narrow-angle glaucoma by causing an increase in intraocular pressure. Therefore, it is contraindicated in patients with this condition.
Question 3 of 5
A patient is hypokalemic and will be receiving IV potassium. The patient is not on a heart monitor. How should the nurse administer the potassium replacement?
Correct Answer: C
Rationale: When administering IV potassium to a hypokalemic patient who is not on a heart monitor, it's important to ensure a controlled rate of infusion to prevent dangerous cardiac arrhythmias. The recommended maximum rate for IV potassium replacement in this scenario is typically no more than 20 mEq/hour. Faster administration rates can increase the risk of hyperkalemia and potentially lead to serious cardiac complications. Monitoring the patient closely for signs of hyperkalemia such as ECG changes or muscle weakness is also crucial during potassium replacement therapy.
Question 4 of 5
Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
Correct Answer: D
Rationale: Furosemide (Lasix) is a loop diuretic that helps the body to remove excess salt and water, which can be useful in conditions like congestive heart failure, liver disease, or kidney disorders. The correct statement by the nurse is to "Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes." This instruction is important because diuretics like furosemide can cause changes in blood pressure, leading to dizziness and fainting when standing up quickly. By changing positions slowly, the patient can minimize the risk of experiencing these symptoms.
Question 5 of 5
When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?
Correct Answer: B
Rationale: Grapefruit juice can interact with antilipemic medications, specifically statins, causing increased drug levels in the bloodstream. This can lead to a higher risk of side effects and adverse reactions. Therefore, patients on antilipemic therapy should be cautious about consuming grapefruit juice to prevent potential drug interactions.