ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
A patient is receiving TPN at home. The visiting nurse assists the family with the care plan, which includes changing the TPN solution and tubing. What is the recommended initial frequency for changing the tubing?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
A client with myasthenia gravis frequently complains of weakness and fatigue. The physician plans to identify whether the client is responding to an overdose of the medication or a worsening of the disease. A tensilon test is performed. Which of the following would indicate that the client is experiencing an overdose of the medication?
Correct Answer: A
Rationale: In a Tensilon test, edrophonium chloride is administered to differentiate between myasthenic crisis (worsening of the disease) and cholinergic crisis (overdose of medication). A temporary worsening of symptoms, such as increased weakness, indicates a cholinergic crisis due to an overdose of anticholinesterase medications. Improvement suggests myasthenic crisis, while no change is inconclusive. Muscle spasms are not specific to an overdose. Therefore, worsening symptoms indicate an overdose.
Question 3 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 4 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 5 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.