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 older adult client has gastrointestinal bleeding. The client says to the nurse, 'I don't understand this. All I did was take ibuprofen (Advil) for my arthritis.' Which plan would be best as it relates to the nurse's education of this client?
Correct Answer: B
Rationale: Ibuprofen, an NSAID, can cause gastrointestinal bleeding by irritating the stomach lining, a risk higher in older adults. Substituting acetaminophen, which lacks this effect, reduces harm while managing pain, making it the best education plan. Topical drugs may not address systemic arthritis. Physician approval is wise but less specific than substitution. Pros/cons of ibuprofen inform but don't directly mitigate risk. Acetaminophen offers a safer alternative, directly addressing the bleeding issue.
Question 3 of 5
The student nurse asks the nursing instructor why drug plateaus occur with medications. What are the best responses by the nursing instructor?
Correct Answer: A
Rationale: Plateaus occur when receptors are saturated-max effect is reached (e.g., morphine), a pharmacodynamic limit. 100% relief isn't guaranteed-plateau is effect ceiling. Resistance (tolerance) builds over time, not instant. Losing efficacy implies degradation, not saturation. Receptor occupancy explains the plateau, a core concept.
Question 4 of 5
Which explanation best indicates why barbiturates are rarely used to treat anxiety and insomnia?
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 5 of 5
A 26-year-old man presents to the emergency department with severe right lower quadrant pain. Physical exam reveals rebound tenderness and decreased bowel sounds. An emergent appendectomy is performed. Postsurgically, he is given an NSAID along with morphine for pain control. Which of the following NSAIDs is commonly used as an adjunct to opioids postsurgically?
Correct Answer: D
Rationale: Post-appendectomy pain management often combines opioids like morphine with NSAIDs for synergy. Acetaminophen is an analgesic but not a true NSAID (lacks significant anti-inflammatory action). Celecoxib , a COX-2 inhibitor, is less common acutely due to cost and milder effect. Ibuprofen is effective but less potent parenterally. Ketorolac , a potent NSAID, is widely used postsurgically-available IV/IM, it reduces inflammation and pain, complementing morphine's central action. Naproxen (E) is oral, less ideal acutely. Ketorolac's rapid onset and efficacy in reducing opioid requirements make it standard. Its short-term use minimizes GI risks, aligning with surgical protocols, distinguishing it from other options for acute postoperative pain control.