ATI RN
ATI PN Pharmacology Proctored Exam 2023 Questions
Question 1 of 5
A patient with a creatinine clearance of 20 mL/min is admitted to the medical-surgical unit. The patient is in need of rapid diuresis. Which class of diuretic does the nurse anticipate administering?
Correct Answer: D
Rationale: A patient with a creatinine clearance of 20 mL/min indicates impaired kidney function or renal insufficiency. Loop diuretics are the preferred choice for patients with reduced kidney function because they act on the loop of Henle in the nephron, which is independent of creatinine clearance. They are effective for rapid diuresis even in patients with significantly reduced renal function. Loop diuretics, such as furosemide, are commonly used in patients with acute or chronic kidney disease to promote diuresis and manage fluid overload. Thiazides are not as effective in patients with low glomerular filtration rates, and osmotic diuretics may not be appropriate for rapid diuresis in this scenario. Potassium-sparing diuretics are not typically used for rapid diuresis but rather for maintaining potassium balance in cases where patients are at risk for hypokalemia.
Question 2 of 5
A woman with myoclonic seizures is well controlled with lamotrigine. She becomes pregnant and begins to have breakthrough seizures. What is most likely happening?
Correct Answer: C
Rationale: Pregnancy increases lamotrigine clearance via enhanced glucuronidation (UGT enzyme induction), lowering plasma concentrations and risking breakthrough seizures, as seen here. Worsening epilepsy is possible but less likely without prior progression. Increased concentrations would improve control, not worsen it. Loss of efficacy is unlikely if previously effective; pharmacokinetic changes are more plausible. Monitoring and dose adjustment during pregnancy, per epilepsy guidelines, address this common issue, making decreased concentrations the most likely cause.
Question 3 of 5
The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have
Correct Answer: D
Rationale: Infants have a higher percentage of total body water (approximately 75%) compared to adults. This difference affects the distribution and concentration of water-soluble drugs, often requiring adjustments in dosing to achieve therapeutic effects. Increased protein in circulation, lower fat composition, and more muscular body composition are not primary factors influencing drug therapy in infants. Therefore, the nurse must consider the higher water composition when calculating drug dosages for pediatric patients.
Question 4 of 5
It is defined as the fraction of drug absorbed by the body
Correct Answer: A
Rationale: Bioavailability is defined as the fraction of drug that reaches systemic circulation in an unchanged form after administration. It is a crucial pharmacokinetic parameter that reflects the amount and rate of drug absorption. Bioavailability can be influenced by various factors such as the route of administration, drug formulation, and first-pass metabolism. Monitoring bioavailability is important in determining the efficacy and dosage requirements of a drug.
Question 5 of 5
A client has been using sildenafil (Viagra) for several months. Which client reports would the nurse interpret as an adverse effect of this medication?
Correct Answer: A
Rationale: Sildenafil (Viagra) commonly causes nasal congestion due to vasodilation affecting nasal blood vessels, a frequent adverse effect tied to its mechanism. Earache isn't a recognized side effect-sildenafil targets vascular smooth muscle, not auditory systems. Blurry vision occurs from PDE-6 inhibition in the retina, another known issue. Priapism, a sustained erection, is a rare but serious risk requiring urgent care. Nasal congestion stands out as a typical, manageable effect, reflecting sildenafil's systemic vasodilatory impact, distinct from less common visual or emergent issues, and aligns with patient reports needing monitoring.