ATI RN
ATI PN Pharmacology Proctored Exam 2023 Questions
Question 1 of 5
Age associated changes in pharmacokinetics include:
Correct Answer: A
Rationale: Aging reduces creatinine clearance in about two-thirds of individuals due to declining renal function, a true statement impacting drug excretion. Body fat increases, not decreases, with age, altering distribution of lipophilic drugs, so that's false. Total body water decreases, not increases, affecting hydrophilic drugs. Conjugation (phase II) is less affected than oxidation (phase I) by age, making that false. Absorption isn't significantly altered by age alone. Reduced renal clearance is a critical age-related change, necessitating dose adjustments for renally cleared drugs like digoxin.
Question 2 of 5
A patient reports having adverse effects with nicotinic acid (niacin). The nurse can suggest performing which action to minimize these undesirable effects?
Correct Answer: D
Rationale: Taking an aspirin tablet 30 minutes before taking nicotinic acid (niacin) can help minimize flushing and other adverse effects associated with nicotinic acid therapy. Aspirin can help to reduce the vasodilation effects caused by nicotinic acid, thereby decreasing the flushing reaction experienced by the patient. This strategy is commonly recommended to help patients tolerate nicotinic acid therapy better and improve medication adherence.
Question 3 of 5
A client is prescribed omeprazole (Prilosec) for GERD. Which instruction should the nurse include?
Correct Answer: A
Rationale: Omeprazole, a PPI, reduces acid by inhibiting proton pumps, most effective before meals when acid production peaks, optimizing GERD relief. With antacids reduces efficacy'PPIs need acidic pH. Crushing destroys enteric coating. Bedtime-only misses daytime acid. Pre-meal dosing aligns with omeprazole's mechanism, critical in GERD where timing enhances healing, making A the key instruction.
Question 4 of 5
One hour after receiving intravenous morphine sulfate, a patient reports generalized itching. The nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will the nurse take?
Correct Answer: D
Rationale: The nurse should prepare an epinephrine injection in case of an anaphylactic reaction. While generalized itching is a common side effect of morphine, the presence of itching along with clear breath sounds and absence of rash may suggest a possible allergic reaction. Anaphylactic reactions can be life-threatening and may present with symptoms such as itching, respiratory distress, and cardiovascular collapse. Therefore, having epinephrine readily available is crucial in case an anaphylactic reaction occurs, as it is the treatment of choice for such a reaction.
Question 5 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.