ATI RN
Pharmacology ATI Practice Exam 1 Questions
Question 1 of 5
A patient receiving erythropoietin-stimulating drug has the following laboratory values: hemoglobin, 12.8 mg/dL; platelet count, 148,000/mm2; white blood cell count, 4800/mm2. Which action is most appropriate for the nurse to implement?
Correct Answer: B
Rationale: The patient's hemoglobin level of 12.8 mg/dL is within the target range for erythropoietin therapy, which is typically 10-12 g/dL. The nurse should continue monitoring the patient and ensure that the hemoglobin does not exceed 12 g/dL, as higher levels can increase the risk of thromboembolic events. Administering additional erythropoietin is unnecessary and potentially harmful. Stopping the medication abruptly is not indicated unless directed by the healthcare provider. Colony-stimulating factors are used to increase white blood cell counts, not hemoglobin levels.
Question 2 of 5
While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the elderly patient because of which alterations in pharmacokinetics?
Correct Answer: C
Rationale: Elderly patients often experience decreased blood flow to the liver due to age-related changes, which can alter drug metabolism and increase the risk of adverse effects. Keeping a journal of adverse effects helps the patient and healthcare provider monitor and manage these effects effectively. Increased renal excretion, alkaline gastric pH, and reduced adipose tissue are less relevant to the need for monitoring adverse effects. Therefore, the nurse's intervention is most important due to altered liver metabolism in elderly patients.
Question 3 of 5
A male patient with blood type AB, Rh factor positive needs a blood transfusion. The Transfusion Service (blood bank) sends type O, Rh factor negative blood to the unit for the nurse to infuse into this patient. The nurse knows that:
Correct Answer: C
Rationale: Type O, Rh-negative blood is considered the universal donor blood and is compatible with all blood types, including AB-positive. This makes it a safe choice in emergencies or when the patient's blood type is unknown. Premedication with diphenhydramine and acetaminophen is not necessary for compatibility but may be used to prevent allergic reactions or fever. Therefore, the nurse can confidently administer this blood product.
Question 4 of 5
Which drug in the following list has an analgesic effect which is not mediated wholly or partly by binding to opioid receptors?
Correct Answer: D
Rationale: Analgesics often act via opioid receptors. Codeine, a weak mu-opioid agonist, relieves mild pain. Tramadol combines mu agonism with serotonin/norepinephrine reuptake inhibition. Dextropropoxyphene is a mu agonist, buprenorphine a partial agonist. Nefopam's analgesia involves monoamine reuptake inhibition and possibly NMDA antagonism, not opioid receptors, distinguishing it. This non-opioid mechanism suits patients intolerant to opioids, offering an alternative in pain management.
Question 5 of 5
The following drug may be used safely in pregnancy:
Correct Answer: B
Rationale: Carbamazepine carries teratogenic risks (e.g., neural tube defects), making it unsafe in pregnancy. Digoxin is safe, used for fetal arrhythmias or maternal heart conditions, with no major congenital risks, a true statement. Streptomycin causes ototoxicity in the fetus, and methotrexate, a folate antagonist, is highly teratogenic, both unsafe. Propylthiouracil is also safe but not listed here correctly per the key. Digoxin's safety profile in pregnancy makes it a preferred option for cardiac issues, balancing maternal and fetal needs.