ATI RN
ATI Capstone Pharmacology Assessment 2 Questions
Question 1 of 5
A patient undergoing chemotherapy for breast cancer asks why she is not receiving trastuzumab like her sister. Which response by the nurse is correct?
Correct Answer: D
Rationale: Trastuzumab is a targeted therapy used specifically for HER2-positive breast cancer. If the patient's cancer cells do not overexpress the HER2 receptor, trastuzumab will not be effective. The decision to use targeted therapy is based on the molecular characteristics of the tumor, not the patient's age, insurance coverage, or estrogen receptor status. The nurse should explain that targeted therapies are tailored to the specific biology of the cancer, and trastuzumab is only appropriate for HER2-positive tumors.
Question 2 of 5
For the patient who is taking nalbuphine, what should the nurse do? (Select all that apply.)
Correct Answer: D
Rationale: Nalbuphine is an opioid agonist-antagonist used for pain management. Like other opioids, it can cause respiratory depression, so monitoring respirations is critical. Bradycardia is another potential side effect that patients should report. Administering nalbuphine undiluted is not standard practice, as it can increase the risk of adverse reactions. Excessive urine output is not associated with nalbuphine use. Therefore, the nurse should focus on monitoring respirations and educating the patient to report bradycardia.
Question 3 of 5
The most serious adverse effect of Alprostadil (Prostin VR pediatric injection) administration in neonates is:
Correct Answer: B
Rationale: Apnea is the most serious adverse effect of alprostadil in neonates, requiring close monitoring and respiratory support. Alprostadil is used to maintain ductus arteriosus patency in congenital heart defects, but its use carries significant risks. Bleeding, hypotension, and fever are also possible but are less critical than apnea.
Question 4 of 5
Estimation of plasma/serum drug concentrations are most useful in optimizing the therapeutic dose required of:
Correct Answer: D
Rationale: Plasma concentration monitoring optimizes drugs with narrow therapeutic indices or variable pharmacokinetics. Warfarin uses INR, not plasma levels, for anticoagulation control. Omeprazole, a proton pump inhibitor, relies on symptom relief, not levels. Salbutamol, a bronchodilator, is titrated by response, not plasma monitoring. Olanzapine's dosing is guided by efficacy and side effects, not routine levels. Ciclosporin, an immunosuppressant, requires plasma monitoring (e.g., 100-400 ng/mL) due to its narrow therapeutic range, interindividual variability, and risk of toxicity or rejection in transplant patients. This ensures efficacy while minimizing nephrotoxicity, a cornerstone of therapeutic drug monitoring.
Question 5 of 5
Heparin:
Correct Answer: D
Rationale: Heparin is an anticoagulant that enhances the activity of antithrombin III, a natural inhibitor of thrombin and factor Xa, to prevent clotting. The statement that it inhibits clotting by decreasing antithrombin III effects is false, as heparin actually potentiates antithrombin III, making this the incorrect option. Its oral bioavailability is negligible (not 20-30%), as it's a large polysaccharide requiring parenteral administration (e.g., IV or subcutaneous), so this is false. Heparin is highly plasma protein-bound, not low, contradicting that option. The correct statement, replaced in the fourth slot, is that heparin binds to antithrombin III, causing a conformational change that accelerates its anticoagulant effect. This mechanism is fundamental to its clinical use in thrombosis prevention, distinguishing it from oral anticoagulants like warfarin.