ATI RN
Pharmacology ATI Test Bank Questions
Question 1 of 5
A patient has been on TPN for 1 month, and there is an order to discontinue TPN tomorrow. The nurse contacts the health care provider because sudden interruption of TPN therapy may cause which condition?
Correct Answer: D
Rationale: The correct answer is D) Hypoglycemia. When a patient has been on Total Parenteral Nutrition (TPN) for an extended period and it is suddenly discontinued, there is a risk of hypoglycemia due to the abrupt cessation of the continuous glucose infusion provided by the TPN. TPN provides essential nutrients, including glucose, directly into the bloodstream, maintaining the patient's blood glucose levels. Therefore, stopping TPN abruptly can lead to a rapid drop in blood glucose levels, resulting in hypoglycemia. Option A) Dehydration is incorrect because TPN provides both fluids and nutrients, so discontinuing it would not directly lead to dehydration. Option B) Tremors is incorrect because sudden discontinuation of TPN is not typically associated with tremors. Option C) Urinary retention is incorrect as it is not a direct consequence of stopping TPN therapy abruptly and is more related to issues with the urinary system rather than TPN therapy. Educationally, it is crucial for healthcare providers to understand the potential complications of discontinuing TPN abruptly to ensure patient safety. Monitoring and managing blood glucose levels carefully during and after TPN therapy are essential to prevent hypoglycemia in these patients. This question highlights the importance of gradual tapering or transition to alternative nutrition support to prevent adverse effects when discontinuing TPN.
Question 2 of 5
Epinephrine is administered to a female patient. The nurse should expect this agent to rapidly affect:
Correct Answer: A
Rationale: Epinephrine is a potent agonist of adrenergic receptors, which are part of the sympathetic nervous system. It rapidly affects alpha and beta-adrenergic receptors, leading to increased heart rate, vasoconstriction, and bronchodilation. Muscarinic and cholinergic receptors are part of the parasympathetic nervous system and are not directly activated by epinephrine. Nicotinic receptors are found in the neuromuscular junction and autonomic ganglia but are not the primary target of epinephrine. The rapid action of epinephrine makes it a critical drug in emergencies such as anaphylaxis.
Question 3 of 5
A client with osteoporosis is asking the nurse regarding the use of Salmon calcitonin (Miacalcin) nasal spray. The nurse tells the client to do the following, except?
Correct Answer: B
Rationale: Repeating the dose if the spray is not felt is incorrect and can lead to overdose. The delivery system is designed for 30 doses, and unused solution should be discarded. Miacalcin is typically administered as one spray daily in one nostril. Vitamin D supplementation may be recommended to support bone health, but it is not a direct instruction for using Miacalcin.
Question 4 of 5
Methylergonovine (Methergine) is prescribed to a patient who is having postpartum bleeding. Prior to giving the medication, the nurse contacts the physician who prescribed the medication if which of the following condition is documented in the patient’s chart?
Correct Answer: C
Rationale: Methylergonovine (Methergine) is contraindicated in patients with ischemic heart disease because it can cause vasoconstriction, increasing the risk of myocardial infarction or other cardiac complications. Hypotension is not a contraindication, and uterine atony is the indication for the medication. Acute gastroenteritis is unrelated to the use of methylergonovine. Therefore, ischemic heart disease is the condition that requires the nurse to contact the physician.
Question 5 of 5
A 62-year-old woman with type 2 diabetes, hypertension, renal impairment (creatinine 146 μmol/L) and mild congestive cardiac failure has poor diabetic control (HbA1c = 10.5 per cent), despite treatment with maximum doses of a sulfonylurea. Her body mass index (BMI) is 26. Which of the following would be most appropriate pharmacotherapy?
Correct Answer: A
Rationale: Poor glycemic control (HbA1c 10.5%) despite max sulfonylurea in type 2 diabetes with renal impairment and CHF needs escalation. Insulin replaces sulfonylurea, offering precise control without renal clearance issues, most appropriate here. Rosiglitazone risks fluid retention, worsening CHF. Bisoprolol, a beta-blocker, and rimonabant (withdrawn) don't address glycemia. Metformin is contraindicated with creatinine 146 μmol/L (eGFR <30-45) due to lactic acidosis risk. Insulin's flexibility and safety in this complex case optimize outcomes, critical for reducing complications.