ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
An asymptomatic 46-year-old Indian woman is found to have an elevated serum calcium (2.80 mmol/L, corrected) at a 'well-woman' screening clinic. Other chemistries are normal, in particular phosphate is 0.8 mmol/L (normal range 0.8-1.45), and parathormone (PTH) is 5.4 pmol/L (normal range <0.9-5.4). She has a sedentary occupation in a northern UK city. Which of the following would be most suitable management?
Correct Answer: D
Rationale: Mild hypercalcemia (2.80 mmol/L) with borderline PTH (5.4 pmol/L) suggests primary hyperparathyroidism (PHPT), common in asymptomatic women. Alfacalcidol treats hypocalcemia, not hypercalcemia. Sevelamer binds phosphate, irrelevant here. Teriparatide increases calcium, contraindicated. Surgical parathyroidectomy suits severe cases, but mild, asymptomatic PHPT (calcium <3.0 mmol/L) warrants watchful waiting with monitoring, most suitable to assess progression without immediate intervention. This conservative approach balances risks, especially in a sedentary northern climate lacking vitamin D excess.
Question 2 of 5
The patient has been depressed, and the physician plans to begin treatment with an antidepressant medication. In performing the initial assessment, what is the most important question for the nurse to ask?
Correct Answer: D
Rationale: Before starting antidepressants, assessing for suicidal ideation is critical because depression carries a high suicide risk, and some antidepressants, especially SSRIs, may initially increase this risk in vulnerable patients. This safety concern trumps other questions in urgency, as it directly impacts immediate care planning—potentially requiring closer monitoring or hospitalization. Alcohol use affects treatment efficacy but isn't the primary safety issue. Allergies are important for drug selection but secondary to life-threatening risks. Duration of depression informs chronicity, not acute danger. The nurse must prioritize identifying suicidal thoughts to ensure patient safety, aligning with psychiatric protocols and the therapeutic delay of antidepressants (2-6 weeks), making choice D the most essential question in this context.
Question 3 of 5
A nurse is providing instructions to a client receiving baclofen (Lioresal). Which of the following would be included in the teaching plan?
Correct Answer: D
Rationale: Baclofen is a muscle relaxant used to treat spasticity. Weakness is a potential side effect and should be reported to the physician, as it may indicate an adverse reaction or the need for dose adjustment. Limiting fluid intake is not typically recommended, and holding the medication due to diarrhea is not a standard instruction. While alcohol can enhance the sedative effects of baclofen, the primary concern is monitoring for weakness, which could impact the patient's safety and mobility.
Question 4 of 5
A 65-year-old man with end-stage renal disease because of diabetes recently underwent a renal transplant. He has been responding well to the transplant and his creatinine has stabilized around 2.1 mg/dL. He was placed on immunosuppressive therapy with muromonab. What is the mechanism of action of muromonab?
Correct Answer: A
Rationale: Muromonab (OKT3) prevents transplant rejection by binding CD3 on T cells . This depletes and inactivates T cells. FK-binding , IL-2 receptor , mTOR , and calcineurin (E) are other drugs' mechanisms. CD3 targeting ensures immunosuppression in this patient.
Question 5 of 5
A client who is receiving edrophonium chloride suddenly is complaining of abdominal cramps and the nurse observes the client is experiencing increased perspiration and salivation. The nurse makes sure the availability of which of the following?
Correct Answer: C
Rationale: Edrophonium chloride is a medication used to diagnose myasthenia gravis, a condition characterized by muscle weakness. When a client receiving edrophonium chloride suddenly experiences symptoms like abdominal cramps, increased perspiration, and salivation, these are suggestive of cholinergic crisis, which is an overdose of acetylcholinesterase inhibitors like edrophonium. Atropine sulfate is an anticholinergic medication used to counteract the effects of excessive acetylcholine in the body, hence it is essential to have it readily available to manage cholinergic crisis in this client. Levodopa, methylphenidate hydrochloride, and carbamazepine are not indicated for managing cholinergic crisis.