ATI RN
ATI Pharmacology Practice B Questions
Question 1 of 5
GTN has its major effect on effort angina by:
Correct Answer: C
Rationale: Glyceryl trinitrate (GTN) relieves effort angina primarily by reducing preload (venodilation) and afterload (arterial dilation), decreasing myocardial oxygen demand, a true and major mechanism. It doesn't primarily reduce coronary vasospasm (more relevant in variant angina), nor significantly affect the renin-angiotensin system in this context. While it causes some coronary vasodilation, this is secondary to systemic effects on demand reduction. It doesn't cause systemic vasoconstriction (opposite effect). The preload/afterload reduction is the cornerstone of GTN's efficacy in stable angina, improving oxygen supply-demand balance, a critical concept in ischemic heart disease management.
Question 2 of 5
The nurse administers medications by various routes of delivery. The nurse recognizes which route of administration as requiring higher dosages of drugs to achieve a therapeutic effect?
Correct Answer: B
Rationale: Oral drugs face first-pass metabolism in the liver, reducing bioavailability, so higher doses are needed for therapeutic effect compared to IV (100% bioavailability), sublingual (bypasses liver), or rectal (partial bypass). Oral route's loss to metabolism drives dosage needs, a pharmacokinetic distinction.
Question 3 of 5
The patient tells the nurse he worries about everything all day, feels confused, restless, and just can't stop worrying. What is the best response by the nurse?
Correct Answer: A
Rationale: Persistent worry, confusion, and restlessness suggest generalized anxiety disorder (GAD)-relaxation techniques (e.g., breathing) help manage, a practical response. Social anxiety ties to specific triggers, not all-day worry. PTSD needs trauma history, not indicated. Panic disorder features acute attacks, not constant worry. GAD diagnosis with techniques fits symptoms, per psychiatry.
Question 4 of 5
The client takes a bisphosphonate for osteoporosis. Which assessment is best in determining the effectiveness of the medication?
Correct Answer: C
Rationale: In assessing the effectiveness of bisphosphonate therapy for osteoporosis, a bone density scan (Option C) is the best option. Bone density scans provide quantitative measurements of bone mineral density, which directly reflects the strength and density of bones. Improvements in bone density indicate the positive impact of the medication on bone health. Option A, normal serum calcium levels, is not the most reliable indicator of bisphosphonate effectiveness because calcium levels can be influenced by various factors other than bone density. Option B, absence of fractures, while important, may not necessarily reflect changes in bone density. Fracture occurrence can also be influenced by factors such as falls or trauma. Option D, absence of bone pain, is subjective and may not always correlate with improvements in bone density. Pain can be influenced by various factors beyond bone health. Educationally, understanding the rationale behind monitoring bone density in osteoporosis treatment is crucial for healthcare providers. It emphasizes the importance of using objective measures to assess treatment efficacy and highlights the significance of bone health in managing osteoporosis effectively. Regular bone density monitoring can help track progress, adjust treatment plans, and ultimately improve patient outcomes.
Question 5 of 5
A 33-year-old female is brought to the emergency department by her mother. The patient had a sudden onset of fever and her temperature is now 40°C (104°F). She has no sick contacts. The mother mentions that she is on a medication for schizophrenia but could not remember the name. A complete blood count shows 250 neutrophils per microliter. Which of the following medications is she likely taking?
Correct Answer: A
Rationale: Fever and severe neutropenia (250 neutrophils/μL) in a schizophrenic patient suggest clozapine . Clozapine causes agranulocytosis, a rare but serious side effect requiring monitoring. Olanzapine , Quetiapine , Risperidone , and Haloperidol (E) rarely cause this. Clozapine's risk explains the acute presentation, necessitating immediate cessation.