ATI RN
ATI Proctored Exam Pharmacology Questions
Question 1 of 5
Bisoprolol (Zebeta) would be the drug of choice for which patient with a diagnosis of hypertension?
Correct Answer: D
Rationale: Bisoprolol is the drug of choice for older adults. It is not associated with as many adverse effects in the elderly and regular dosing profiles can be used. This drug does not have an established pediatric dosage. Although the 37-year-old patient is an adult, there are additional choices for this patient, with a more favorable adverse effect profile. The nurse should consider age-related factors when selecting antihypertensive medications.
Question 2 of 5
The following are H1 receptor antagonist, except :
Correct Answer: D
Rationale: Terfenadine is a second-generation antihistamine, but it is not an H1 receptor antagonist like the other options listed. Terfenadine was once used for the treatment of allergic conditions, but it is known for its potential to cause cardiac side effects due to its interaction with other medications and prolongation of the QT interval. Consequently, terfenadine has been largely replaced by newer, safer antihistamines. The rest of the options listed (chlorpheniramine, promethazine, cimetidine, and diphenhydramine) are all H1 receptor antagonists commonly used to block the action of histamine and relieve symptoms of allergies.
Question 3 of 5
A 40-year-old man was given a drug that binds to a subunit of the GABA A receptor. When used at a high dose, the drug can open Cl- channels independent of GABA. What drug was the man given?
Correct Answer: C
Rationale: Phenobarbital, a barbiturate, binds to a distinct site on the GABA_A receptor, enhancing GABA's inhibitory effects by prolonging chloride channel opening. At high doses, it uniquely can directly open these channels without GABA, leading to profound CNS depression—useful in anesthesia or seizure control but risky due to overdose potential. Diazepam, a benzodiazepine, also acts on GABA_A receptors but only enhances GABA's effect, not independently opening channels, limiting its action to GABA availability. Ethanol affects GABA_A receptors indirectly and lacks this specific high-dose capability. Baclofen targets GABA_B receptors, influencing potassium channels, not chloride, and is unrelated to this mechanism. Dronabinol, a cannabinoid, has no GABA_A activity. Phenobarbital's ability to independently activate chloride channels at high doses distinguishes it, aligning with the scenario described and explaining its utility and risks in clinical settings.
Question 4 of 5
A patient who is taking aspirin for arthritis pain asks the nurse why it also causes gastrointestinal upset. The nurse understands that this is because aspirin:
Correct Answer: C
Rationale: Aspirin causes gastrointestinal upset because it inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. These enzymes are responsible for the production of prostaglandins, which are important in protecting the stomach lining. Inhibition of COX-1 reduces the production of protective prostaglandins that help maintain the integrity of the stomach lining, leading to irritation and potential damage, which can manifest as gastrointestinal upset. This is why patients taking aspirin may experience gastrointestinal side effects such as stomach pain, ulcers, or bleeding.
Question 5 of 5
A patient comes to the office with a chief complaint of hair loss and peeling skin. The nurse notes many vitamins and minerals are on the medication list. The patient reports using vitamins to treat liver disease. The patient's complaint may be caused by an excess of which vitamin or mineral?
Correct Answer: A
Rationale: Excessive vitamin A can cause hypervitaminosis A, leading to symptoms such as hair loss, peeling skin, and liver toxicity. Zinc (B), vitamin C (C), and vitamin D (D) are not typically associated with these symptoms. The nurse should assess the patient's vitamin A intake and advise moderation.