ATI RN
Practice ATI B Exam Pharmacology Questions
Question 1 of 9
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 2 of 9
A patient comes to the ER with a painful stab wound. The ER resident administers pentazocine for the pain. Soon after administration the patient experiences sweating, restlessness, and an increase in pain sensations. What is the most likely explanation for his symptoms?
Correct Answer: B
Rationale: Pentazocine, a mixed opioid agonist-antagonist, acts as a kappa receptor agonist and a partial mu receptor agonist, providing analgesia in opioid-naive patients. However, in a heroin addict with high mu receptor tolerance, pentazocine's partial antagonism at mu receptors can displace full agonists like heroin, precipitating withdrawal symptoms—sweating, restlessness, and heightened pain perception. Tolerance to pentazocine itself wouldn't typically increase pain; it would reduce efficacy. Pentazocine is an effective analgesic in appropriate contexts, so ineffectiveness isn't the issue. Incorrect dosing might alter efficacy or toxicity but wouldn't specifically cause this withdrawal-like reaction. The patient's history of heroin use explains this response, as pentazocine's antagonist properties disrupt the opioid equilibrium, unmasking withdrawal in a dependent individual.
Question 3 of 9
A 6-year-old boy is brought to his primary care physician with a history of hay fever and asthma. He usually has two to three attacks per week. For symptom control, he uses an albuterol inhaler, but his parents would like to try something more. They would like him to take something that would lessen the amount of attacks he has. Although corticosteroids would probably work best for prophylaxis, they are contraindicated in children. He is instead given montelukast. How does montelukast work?
Correct Answer: A
Rationale: Montelukast prevents asthma attacks by blocking leukotriene receptors . Leukotrienes drive inflammation; montelukast reduces this, complementing albuterol's acute relief. Muscarinic blockade is ipratropium's action. COX inhibition (C, D) is NSAIDs'. Lipoxygenase inhibition (E) is zileuton's. Montelukast's specificity suits prophylaxis in this child.
Question 4 of 9
Discharge planning for the client prescribed tetracycline will include which instruction?
Correct Answer: C
Rationale: Tetracycline is a broad-spectrum antibiotic that can be rendered ineffective if taken with certain substances that interfere with its absorption. Dairy products, such as milk, contain calcium, which binds to tetracycline in the gastrointestinal tract, forming insoluble complexes that prevent the drug from being absorbed into the bloodstream. This interaction significantly reduces its therapeutic efficacy, making it crucial to instruct the client to avoid milk when taking the medication. Similarly, antacids (containing magnesium, aluminum, or calcium) and iron supplements also chelate tetracycline, decreasing its bioavailability, so choices A and B are incorrect and potentially harmful instructions. Reducing vitamin intake is unrelated to tetracycline's administration or efficacy, as vitamins do not typically interfere with its action unless specifically combined with minerals like iron or calcium. Therefore, the priority instruction is to avoid milk, ensuring the drug's effectiveness, which makes choice C the correct and most critical discharge teaching point.
Question 5 of 9
A patient who has been diagnosed with social anxiety disorder will begin taking venlafaxine(Effexor). The nurse who performs a medication and dietary history will be concerned about ingestion of which substance or drug?
Correct Answer: D
Rationale: St. John's wort is an herbal supplement known to interact with many medications, including venlafaxine (Effexor). It can reduce the effectiveness of venlafaxine by increasing its metabolism and clearance from the body, potentially leading to decreased therapeutic effects. Therefore, patients taking venlafaxine for social anxiety disorder should be advised to avoid St. John's wort to prevent any negative interactions and ensure the medication works effectively. It is essential for the nurse to inquire about the use of St. John's wort during the medication and dietary history assessment to prevent such interactions.
Question 6 of 9
Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student's understanding of therapeutic index?
Correct Answer: B
Rationale: Therapeutic index (TI), the ratio of toxic to effective dose, gauges safety-wide TI means safer dosing, helping the student assess if doses are within safe limits. Best drug choice is clinical, not TI-based. Interactions aren't TI-specific. Monitoring needs tie to narrow TI drugs (e.g., lithium), but safety is broader. TI ensures safe dosing, a key review point.
Question 7 of 9
If a patient is taking an ACE inhibitor, the nurse should monitor for signs of angioedema which include?
Correct Answer: B
Rationale: Angioedema is a potential adverse effect of ACE inhibitors. It is a serious condition involving swelling of the deeper layers of the skin and subcutaneous tissue, including the mucous membranes. Signs of angioedema can include swelling of the face, lips, tongue, or throat, which can lead to difficulty breathing (dyspnea) due to airway obstruction. It is important for the nurse to monitor for these signs and symptoms, as angioedema can be life-threatening and requires immediate medical attention. Vomiting, constipation, and epistaxis are not typical signs of angioedema associated with ACE inhibitors.
Question 8 of 9
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 9 of 9
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.