ATI RN
ATI Pharmacology Book Questions
Question 1 of 5
Chris asks the nurse whether all donor blood products are cross-matched with the recipient to prevent a transfusion reaction. Which of the following always require cross-matching?
Correct Answer: D
Rationale: Packed red blood cells (PRBCs) always require cross-matching with the recipient to prevent a transfusion reaction. Cross-matching is crucial for PRBCs because they contain red blood cells with antigens on their surface that may react with antibodies in the recipient's plasma, potentially causing a transfusion reaction. Cross-matching involves testing the compatibility of donor red blood cells with the recipient's plasma to ensure a safe transfusion. Other blood products like granulocytes, platelets, and plasma do not contain red blood cells and, therefore, do not require cross-matching.
Question 2 of 5
Which of the following drugs is more likely to cause hyperkalaemia than hypokalaemia in a patient with diabetes and estimated glomerular filtration rate (eGFR) within the 'normal' reference range?
Correct Answer: D
Rationale: Hyperkalemia involves elevated potassium, hypokalemia reduced levels. Amphotericin causes hypokalemia via renal potassium wasting, not hyperkalemia. Prednisolone, a glucocorticoid, promotes potassium excretion, risking hypokalemia. Low molecular weight heparin (LMWH) rarely affects potassium directly with normal eGFR. Salmeterol, a beta-agonist, can shift potassium intracellularly, causing hypokalemia. Insulin, in diabetes management, drives potassium into cells with glucose, potentially causing hyperkalemia if renal excretion is impaired, though less common with normal eGFR. However, its potassium-shifting effect makes hyperkalemia more likely than hypokalemia compared to others, especially in acute settings, a key consideration in diabetic care.
Question 3 of 5
The patient is complaining of a severe headache. The physician orders aspirin. Which action by the nurse will result in the fastest relief of the patient's headache?
Correct Answer: D
Rationale: Aspirin on an empty stomach absorbs fastest, speeding headache relief by avoiding food delays-fatty meals like peanut butter slow gastric emptying, reducing onset. Alkaline foods may alter pH but don't hasten absorption significantly. Enteric-coated forms delay release for GI protection, not speed. Empty stomach delivery maximizes bioavailability quickly, aligning with pain relief urgency.
Question 4 of 5
A client is prescribed methotrexate (Rheumatrex) for rheumatoid arthritis. Which teaching point should the nurse emphasize?
Correct Answer: A
Rationale: Methotrexate, a DMARD, treats RA but risks renal toxicity from crystal formation. Drinking plenty of water ensures excretion, reducing this risk, a critical teaching point. Milk doesn't help'absorption is unaffected. Green leafy vegetables increase folate, which methotrexate depletes, but supplementation is controlled. Stopping if better risks flare-ups. Hydration aligns with methotrexate's pharmacokinetics, vital in RA where long-term safety matters, making A the priority to emphasize for renal protection.
Question 5 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 works by inhibiting both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. COX-1 is responsible for producing prostaglandins that help maintain the stomach lining, promote blood clotting, and support kidney function. When COX-1 is inhibited by aspirin, it interferes with the protective mechanisms of the stomach lining, leading to increased risk of gastrointestinal irritation, ulcers, and bleeding. This is why aspirin is known to cause gastrointestinal upset, including symptoms like stomach pain, heartburn, nausea, and even ulcers in some cases.