ATI RN
ATI RN Pharmacology 2023 Proctored Exam Questions
Question 1 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.
Question 2 of 5
Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
Correct Answer: D
Rationale: Furosemide (Lasix) is a loop diuretic that helps the body to remove excess salt and water, which can be useful in conditions like congestive heart failure, liver disease, or kidney disorders. The correct statement by the nurse is to "Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes." This instruction is important because diuretics like furosemide can cause changes in blood pressure, leading to dizziness and fainting when standing up quickly. By changing positions slowly, the patient can minimize the risk of experiencing these symptoms.
Question 3 of 5
A patient says, 'I have such bad seasonal allergies. Is there anything I can take to keep them from happening?' What information should the nurse provide?
Correct Answer: C
Rationale: Preventing seasonal allergies involves blocking histamine (antihistamines, choice A), reducing inflammation (corticosteroids, choice B), or stabilizing mast cells . Mast cell stabilizers (e.g., cromolyn) prevent histamine release, a proactive approach. Decongestants relieve symptoms, not prevent. Choice C highlights a preventive mechanism, key for allergy management education.
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
It is a measure of drug activity in terms of the amount required to produce an effect.
Correct Answer: C
Rationale: Potency refers to the measure of drug activity in terms of the amount required to produce a particular effect. It is the strength or concentration of a drug that is needed to produce a specific effect. Potency is often expressed as the dose of a drug required to produce a certain response compared to a standard reference dose. It is an essential consideration in pharmacology as it helps determine the appropriate dosage needed for therapeutic effects and to avoid potential toxicity. Potency is distinct from efficacy, which is the ability of a drug to produce a desired effect regardless of the dose.