ATI RN
Practice ATI B Exam Pharmacology Questions
Question 1 of 5
A patient who has been diagnosed with social anxiety disorder will begin taking venlafaxine(Effexor). The nurse who performs a medication and dietary history will be concerned about ingestion of which substance or drug?
Correct Answer: D
Rationale: St. John's wort is an herbal supplement known to interact with many medications, including venlafaxine (Effexor). It can reduce the effectiveness of venlafaxine by increasing its metabolism and clearance from the body, potentially leading to decreased therapeutic effects. Therefore, patients taking venlafaxine for social anxiety disorder should be advised to avoid St. John's wort to prevent any negative interactions and ensure the medication works effectively. It is essential for the nurse to inquire about the use of St. John's wort during the medication and dietary history assessment to prevent such interactions.
Question 2 of 5
The nurse is doing preconception counseling with a patient. The patient asks why she must take folic acid (folate) during pregnancy. What is the nurse's response?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 5
A male patient is undergoing chemotherapy may also be given the drug allopurinol (Zyloprim, Aloprim). Allopurinol inhibits the synthesis of uric acid. Concomitant administration of allopurinol prevents:
Correct Answer: B
Rationale: Allopurinol is primarily used to prevent gout and hyperuricemia, which are common side effects of chemotherapy. Chemotherapy often leads to the rapid destruction of cancer cells, releasing large amounts of uric acid into the bloodstream. This can cause hyperuricemia, leading to gout or kidney stones. Allopurinol works by inhibiting xanthine oxidase, an enzyme involved in uric acid production, thereby reducing uric acid levels. While myelosuppression and pancytopenia are concerns during chemotherapy, they are not directly addressed by allopurinol. Similarly, allopurinol does not inhibit cancer cell growth or replication.
Question 4 of 5
Enrique who is under chemotherapy has the following CBC results: WBC 5000/mm3, RBC platelet 10,000/mm3. Which of the following is he at risk for?
Correct Answer: B
Rationale: A platelet count of 10,000/mm3 is critically low and places Enrique at significant risk for bleeding. Platelets are essential for blood clotting, and levels below 20,000/mm3 can lead to spontaneous bleeding, such as nosebleeds, gum bleeding, or internal hemorrhage. While a WBC count of 5000/mm3 is within the normal range, reducing the risk of infection, the extremely low platelet count is the primary concern. Angina is unrelated to platelet counts. Therefore, bleeding is the most immediate risk for Enrique.
Question 5 of 5
An 80-year-old man is taking digoxin and warfarin because of longstanding atrial fibrillation. He has an indwelling urinary catheter in situ, whilst awaiting a prostatectomy. At his pre-operation assessment he has a ventricular rate of 120/minute. The house officer doubles his daily digoxin dose and the operation is delayed one week. One week later he returns with nausea, vomiting, diarrhoea, abdominal pain, confusion, delirium and visual disturbances. The most likely cause of his current symptoms is:
Correct Answer: D
Rationale: Symptoms (nausea, confusion, visual changes) suggest digoxin toxicity, common in the elderly with doubled doses. Digoxin's narrow therapeutic index (0.5-2 ng/mL) and renal clearance (impaired with age) increase risk. Viral infection lacks cardiac specificity here. Hyperkalemia (e.g., >5.5 mmol/L) isn't indicated without ECG changes. Warfarin's INR prolongation causes bleeding, not these symptoms. UTI fits the catheter but not delirium/visual issues. Digoxin toxicity, from overdose and accumulation, explains the presentation, requiring level checks and cessation.