ATI RN
Quizlet ATI Pharmacology Final Questions
Question 1 of 5
A patient was prescribed sertraline (Zoloft) for the treatment of depression and anxiety. The patient's spouse calls the clinic and reports the patient is increasingly moody and seems 'disconnected with life.' What is the best response by the nurse?
Correct Answer: B
Rationale: Sertraline, an SSRI, carries a black box warning for increased suicidal risk, particularly early in treatment, as it can paradoxically worsen mood or detachment in some patients. The spouse's report of moodiness and disconnection suggests possible suicidal ideation or adverse effects, necessitating urgent in-person assessment to evaluate safety and adjust treatment. Giving diphenhydramine is inappropriate, as it addresses neither depression nor the drug's effects and could mask symptoms. Holding medication without assessment risks untreated depression or withdrawal effects. Doubling the dose could exacerbate the issue, increasing risk. The nurse's priority is patient safety, requiring immediate evaluation by a professional, making choice B the most responsible and evidence-based response.
Question 2 of 5
When reviewing the health history of a patient, the nurse will note that a potential contraindication to potassium supplements exists if the patient has which problem?
Correct Answer: C
Rationale: Patients with renal disease may have difficulty excreting potassium properly. If a patient with renal disease takes potassium supplements, it can lead to hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can be dangerous and may result in cardiac dysrhythmias and other serious complications. Therefore, patients with renal disease should avoid potassium supplements unless directed otherwise by their healthcare provider.
Question 3 of 5
A 28-year-old woman is admitted with suspected urinary sepsis (temperature 40.2°C, BP 84/50, pulse 128). She had a massive haemorrhage following the birth of her only child when she was aged 24; since then she has had no periods. Her partner says that she has been progressively listless and depressed for at least two years. There is left loin tenderness and she has no pubic or axillary hair. Which of the following would be most appropriate?
Correct Answer: B
Rationale: Sepsis (fever, hypotension) with post-partum hemorrhage history, amenorrhea, fatigue, and hair loss suggest Sheehan's syndrome (pituitary necrosis) causing adrenal insufficiency. Oral amoxicillin is inadequate for septic shock. IV hydrocortisone treats acute adrenal crisis, stabilizing BP and stress response, most appropriate here alongside antibiotics. Pelvic exam doesn't address urgency. Gonadotrophins or triiodothyronine target secondary issues, not immediate crisis. Hydrocortisone's rapid action is life-saving, addressing cortisol deficiency in this emergency.
Question 4 of 5
A hospital nurse is taking imipramine for a phobic anxiety disorder, and her patient is being treated with chlorpromazine for a psychotic disorder. Which of the following adverse effects is likely to occur in both of these individuals?
Correct Answer: C
Rationale: Imipramine (TCA) and chlorpromazine (antipsychotic) share anticholinergic and alpha-adrenergic blocking properties. Orthostatic hypotension arises from alpha-1 receptor blockade, causing vasodilation and blood pressure drops upon standing, a common effect in both drugs, impacting patients and users alike. Excessive salivation and pupillary constriction (miosis) are cholinergic effects, opposite to their anticholinergic actions (dry mouth, mydriasis). Seizure threshold decreases with both, but this isn't an ‘adverse effect' per se—it's a risk. Weight loss isn't typical; TCAs and antipsychotics often cause gain. The shared alpha-blockade mechanism makes orthostatic hypotension a frequent, clinically significant side effect in both individuals, requiring caution in mobility and monitoring.
Question 5 of 5
A 24-year-old woman medical student with a history of depression presents to the emergency department with tachycardia and shallow breathing. After her initial presentation, she begins to become confused and has a seizure. An ECG is performed and shows QT prolongation. An arterial blood gas shows metabolic acidosis. She has been taking antidepressants for a couple of years, but her depression is worsening. She had a test yesterday and told her mother that she felt she did poorly. There is concern that she has overdosed on her medication. What is the most appropriate treatment?
Correct Answer: D
Rationale: TCA overdose (QT prolongation, seizures, acidosis) requires sodium bicarbonate . It corrects acidosis and stabilizes cardiac membranes. Ammonium chloride worsens acidosis. Atropine and Flumazenil are irrelevant. N-acetylcysteine (E) is for acetaminophen. Bicarbonate addresses her acute toxicity.