ATI RN
ATI Pharmacology Practice A 2023 Questions
Question 1 of 5
A patient has had recent mechanical heart valve surgery and is receiving anticoagulant therapy. While monitoring the patient™s laboratory work, the nurse interprets that the patient™s international normalized ratio (INR) level of 3 indicates that:
Correct Answer: B
Rationale: An international normalized ratio (INR) level of 3 is within the recommended therapeutic range for patients on anticoagulant therapy, particularly those with mechanical heart valve surgery. The target INR range for patients with mechanical heart valves is typically between 2.5 to 3.5. An INR of 3 indicates that the patient™s warfarin dose is at the appropriate therapeutic levels to prevent blood clots while minimizing the risk of bleeding complications. It is essential to closely monitor and adjust the patient's warfarin dose based on their INR levels to maintain a balance between preventing clot formation and avoiding excessive bleeding.
Question 2 of 5
Which of the following agents if taken in overdose by a depressed patient is most likely to result in a fatal outcome?
Correct Answer: A
Rationale: Overdose fatality depends on toxicity and mechanism. Amitriptyline, a tricyclic antidepressant (TCA), blocks sodium channels and muscarinic receptors, causing lethal arrhythmias, seizures, and anticholinergic effects (LD50 ~13 mg/kg), making it highly fatal. Fluoxetine, fluvoxamine, paroxetine, and citalopram, all SSRIs, primarily cause serotonin syndrome or seizures, but lethality is lower (e.g., citalopram's QT risk is less immediate). TCAs' cardiotoxicity far exceeds SSRIs', driving amitriptyline's higher fatality rate, a critical factor in prescribing for depression with suicide risk.
Question 3 of 5
A neighbor tells nurse Maureen he has to have surgery and is reluctant to have any blood product transfusions because of a fear of contracting an infection. He asks the nurse what are his options. The nurse teaches the person that the safest blood product is:
Correct Answer: C
Rationale: An autologous blood product is the safest option for the neighbor who is reluctant to have blood transfusions due to a fear of contracting an infection. Autologous blood is blood that is donated by the patient themselves prior to surgery. This type of blood product eliminates the risk of transmitting infections from other donors, as the blood comes from the patient's own body. It is considered the safest option for those concerned about infection transmission during blood transfusions.
Question 4 of 5
A 24-year-old sexually active woman presents to her primary care physician with vaginal itching and a greenish, frothy vaginal discharge. Her boyfriend is asymptomatic. She is prescribed metronidazole for Trichomonas vaginalis. Which of the following should be told to avoid while taking metronidazole?
Correct Answer: A
Rationale: Metronidazole treats Trichomonas vaginalis, and alcohol must be avoided. It inhibits aldehyde dehydrogenase, causing a disulfiram-like reaction (nausea, flushing). Aspirin , caffeine , grapefruit juice , and machinery (E) lack this interaction. This precaution prevents severe discomfort, ensuring treatment adherence.
Question 5 of 5
The nurse is caring for a patient who is receiving warfarin (Coumadin) and notes bruising and petechiae on the patient™s extremities. The nurse will request an order for which laboratory test?
Correct Answer: B
Rationale: The nurse should request an order for a platelet level to assess the patient's platelet count. Warfarin (Coumadin) is an anticoagulant medication that works by interfering with the blood clotting process. Bruising and petechiae may be signs of decreased platelet count or impaired platelet function. Monitoring the platelet level will help determine if the patient's symptoms are related to thrombocytopenia (low platelet count). While the International Normalized Ratio (INR) is commonly used to monitor the effects of warfarin therapy, in this case, the presence of bruising and petechiae suggest a need to assess platelet levels specifically. PT and aPTT tests assess the clotting function of factors produced by the liver and are not directly related to platelet count. Vitamin K level may be tested in cases of suspected vitamin K deficiency, but it would not directly help in assessing