ATI RN
ATI Capstone Pharmacology Assessment 2 Questions
Question 1 of 5
For the patient who is taking nalbuphine, what should the nurse do? (Select all that apply.)
Correct Answer: D
Rationale: Nalbuphine is an opioid agonist-antagonist used for pain management. Like other opioids, it can cause respiratory depression, so monitoring respirations is critical. Bradycardia is another potential side effect that patients should report. Administering nalbuphine undiluted is not standard practice, as it can increase the risk of adverse reactions. Excessive urine output is not associated with nalbuphine use. Therefore, the nurse should focus on monitoring respirations and educating the patient to report bradycardia.
Question 2 of 5
Estimation of plasma/serum drug concentrations are most useful in optimizing the therapeutic dose required of:
Correct Answer: D
Rationale: Plasma concentration monitoring optimizes drugs with narrow therapeutic indices or variable pharmacokinetics. Warfarin uses INR, not plasma levels, for anticoagulation control. Omeprazole, a proton pump inhibitor, relies on symptom relief, not levels. Salbutamol, a bronchodilator, is titrated by response, not plasma monitoring. Olanzapine's dosing is guided by efficacy and side effects, not routine levels. Ciclosporin, an immunosuppressant, requires plasma monitoring (e.g., 100-400 ng/mL) due to its narrow therapeutic range, interindividual variability, and risk of toxicity or rejection in transplant patients. This ensures efficacy while minimizing nephrotoxicity, a cornerstone of therapeutic drug monitoring.
Question 3 of 5
Heparin:
Correct Answer: D
Rationale: Heparin is an anticoagulant that enhances the activity of antithrombin III, a natural inhibitor of thrombin and factor Xa, to prevent clotting. The statement that it inhibits clotting by decreasing antithrombin III effects is false, as heparin actually potentiates antithrombin III, making this the incorrect option. Its oral bioavailability is negligible (not 20-30%), as it's a large polysaccharide requiring parenteral administration (e.g., IV or subcutaneous), so this is false. Heparin is highly plasma protein-bound, not low, contradicting that option. The correct statement, replaced in the fourth slot, is that heparin binds to antithrombin III, causing a conformational change that accelerates its anticoagulant effect. This mechanism is fundamental to its clinical use in thrombosis prevention, distinguishing it from oral anticoagulants like warfarin.
Question 4 of 5
The nurse plans medication education for a client who receives a prescription for sildenafil (Viagra). What will the best plan by the nurse include?
Correct Answer: C
Rationale: Sildenafil (Viagra), a phosphodiesterase-5 inhibitor for erectile dysfunction, has a recommended dosing limit of one pill per 24 hours to prevent overdose risks like prolonged erections or cardiovascular strain, making this a critical safety instruction. Grapefruit juice actually increases sildenafil levels by inhibiting metabolism, not decreasing effects, which could heighten side effects. Timing is optimal at 1 hour before sex, with effectiveness possible up to 4 hours, not 6, ensuring accurate expectations. Taking it on an empty stomach enhances absorption, as food-especially high-fat meals-delays onset, contrary to the food suggestion. The 24-hour limit is foundational for safe use, balancing efficacy with minimizing adverse effects like headache or hypotension, and aligns with standard prescribing guidelines, making it the priority in client education.
Question 5 of 5
The nurse is conducting medication education for patients with hypertension. The focus of the education is on enhancing the absorption of their medications. The nurse determines that learning has occurred when the patients make which statement?
Correct Answer: D
Rationale: Food can affect drug absorption (e.g., calcium in dairy binding antihypertensives), so caution with meals enhances efficacy, showing learning. Expired drugs lose potency, risking failure. Storage matters-heat/light degrade drugs. Dairy avoidance is specific, not broad enough. General food caution reflects pharmacokinetic awareness, key for hypertension management.