ATI RN
ATI RN Pharmacology Online Practice 2019 A Questions
Question 1 of 5
A prenatal patient tells the nurse that she is not taking vitamins because she heard that vitamins may cause damage to the fetus if she becomes pregnant. What is the nurse's best response?
Correct Answer: C
Rationale: While vitamins are generally beneficial during pregnancy, excessive doses (megadoses) can be harmful, especially in the first trimester. The nurse should emphasize the importance of taking vitamins at recommended levels and avoiding excessive supplementation. Taking extra vitamins (B) is not advised, and doses above the RDA (D) should be avoided unless prescribed.
Question 2 of 5
A 6-year-old boy presents to his pediatrician for followup of recurrent hay fever and asthma. He usually has two to three attacks per week. For symptom control, he uses an albuterol inhaler, but his parents would like to try something more. They would like him to take something that would lessen the amount of attacks he has. Although corticosteroids would probably work best for prophylaxis, they are contraindicated in children. Which of the following drugs would decrease the amount of asthma attacks by preventing an arachidonic acid derivative from binding to its receptor?
Correct Answer: D
Rationale: Asthma attacks in this case are driven by inflammation, often mediated by leukotrienes, which are arachidonic acid derivatives. The goal is to reduce the frequency of attacks by targeting this pathway. Aspirin inhibits cyclooxygenase (COX), reducing prostaglandins but not leukotrienes, and may even worsen asthma in some patients. Celecoxib is a selective COX-2 inhibitor, also irrelevant to leukotrienes. Ipratropium is an anticholinergic bronchodilator, effective for acute symptom relief but not prophylaxis via arachidonic acid pathways. Montelukast is a leukotriene receptor antagonist, directly preventing leukotrienes from binding to their receptors, thus reducing inflammation and attack frequency. Zileuton (E), while a leukotriene synthesis inhibitor, isn't the best choice here as the question specifies receptor binding prevention, not synthesis inhibition. Montelukast aligns perfectly with the mechanism described, making it the correct answer.
Question 3 of 5
The patient is receiving the benzodiazepine clonazepam (Klonopin) for the treatment of panic attacks. What is an important medication outcome for this patient as it relates to safety?
Correct Answer: D
Rationale: Clonazepam, a benzo, risks withdrawal (e.g., seizures) if stopped abruptly-patients knowing this ensures safe taper, per safety. Stevens-Johnson isn't linked-rash is rare. No diet restrictions apply (unlike MAOIs). Blood work isn't routine for benzos. Abrupt cessation's danger is key, protecting against rebound.
Question 4 of 5
Which of the following drugs is most effective in converting a patient with atrial fibrillation into sinus rhythm?
Correct Answer: B
Rationale: Converting atrial fibrillation (AF) to sinus rhythm requires cardioversion or antiarrhythmics. Digoxin controls rate, not rhythm, ineffective for conversion. Atenolol, a beta-blocker, and diltiazem, a calcium channel blocker, manage rate, not rhythm restoration. Lidocaine treats ventricular arrhythmias. Amiodarone, a class III antiarrhythmic, prolongs repolarization, effectively converting AF to sinus rhythm, especially in acute settings, outperforming others. Its broad-spectrum action is key in AF management, balancing efficacy and safety.
Question 5 of 5
A patient™s blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious.
Correct Answer: B
Rationale: In a patient with a hypertensive emergency, rapid and effective blood pressure reduction is crucial to prevent organ damage. The recommendation for IV administration of antihypertensive medications in this scenario is to titrate the medication to achieve a safe reduction in blood pressure, generally targeting a decrease in mean arterial pressure by no more than 25% within the first hour. The specific medication and infusion rate are dependent on the patient's clinical status and individual factors. Therefore, the maximum dose and duration of infusion must be tailored to the patient's response, with close monitoring by healthcare providers. Hence, determining a fixed time for the maximum dose of the drug to be infused is not appropriate in this critical care scenario.