ATI RN
ATI Proctored Exam Pharmacology Questions
Question 1 of 5
Ester group of local anesthesia differs from the amide group in that :
Correct Answer: B
Rationale: The main difference between ester group local anesthetics and amide group local anesthetics lies in the way they are metabolized in the body. Esters are metabolized in the plasma by the enzyme pseudocholinesterase, while amides are metabolized in the liver. Pseudocholinesterase hydrolyzes esters into inactive metabolites, which are then excreted mainly by the kidneys. On the other hand, amides undergo hepatic metabolism by the cytochrome P450 enzyme system before being excreted by the kidneys. This key metabolic difference between esters and amides impacts their pharmacokinetics, including onset of action, duration of effect, and potential for allergic reactions.
Question 2 of 5
A client is prescribed docusate sodium (Colace) for constipation. Which statement by the client indicates understanding?
Correct Answer: B
Rationale: Docusate, a stool softener, prevents straining by drawing water into stool. Drinking more water enhances this, showing understanding. It works in 1-3 days, not hours or immediately . Milk isn't needed. Hydration aligns with docusate's mechanism, key in constipation where moisture matters, making B the correct statement.
Question 3 of 5
The patient is receiving zolpidem (Ambien) for treatment of short-term insomnia. What is the primary safety concern of the nurse when the patient takes this medication?
Correct Answer: A
Rationale: Zolpidem, a sedative-hypnotic, causes dizziness and daytime sedation-fall risks, especially if not sleeping fully, per safety data. Nausea and diarrhea occur but aren't primary. Sleepwalking is rare, notable but less common. Sedation drives monitoring, a key concern.
Question 4 of 5
Ester group of local anesthesia differs from the amide group in that :
Correct Answer: B
Rationale: The main difference between ester group local anesthetics and amide group local anesthetics lies in the way they are metabolized in the body. Esters are metabolized in the plasma by the enzyme pseudocholinesterase, while amides are metabolized in the liver. Pseudocholinesterase hydrolyzes esters into inactive metabolites, which are then excreted mainly by the kidneys. On the other hand, amides undergo hepatic metabolism by the cytochrome P450 enzyme system before being excreted by the kidneys. This key metabolic difference between esters and amides impacts their pharmacokinetics, including onset of action, duration of effect, and potential for allergic reactions.
Question 5 of 5
A 65-year-old man undergoes an orthopaedic procedure. He spends an hour in the recovery room before being returned to the ward. You are called to see him and on examination note that he is drowsy, has shallow breathing, a slow pulse and pinpoint pupils. The notes show an uneventful anaesthetic using an inhalational agent, muscle relaxant and fentanyl. In the recovery room he was breathing normally and was awake, but because of pain was initially given intravenous morphine and then intramuscular morphine before being returned to the ward. Your course of action is:
Correct Answer: D
Rationale: The patient shows opioid overdose signs (drowsiness, respiratory depression, bradycardia, miosis) from fentanyl and morphine. Calling the resuscitation team delays specific treatment unless unresponsive. Atropine treats bradycardia but not respiratory depression. Neostigmine reverses neuromuscular blockers, not opioids. Flumazenil reverses benzodiazepines. IV naloxone, an opioid antagonist, rapidly reverses these effects, restoring breathing and consciousness, the best immediate action. Its specificity and speed are vital in postoperative opioid toxicity, ensuring patient safety.