ATI RN
Pharmacology Final ATI Questions
Question 1 of 9
In severe renal failure:
Correct Answer: D
Rationale: In severe renal failure, the clearance of digoxin is reduced, requiring smaller maintenance doses to avoid toxicity.
Question 2 of 9
If you are treating a patient that has renal failure, what type of pain medications should you avoid?
Correct Answer: B
Rationale: When treating a patient with renal failure, it is important to avoid NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) as pain medications. NSAIDs can worsen renal function and may cause further damage to the kidneys. They can also lead to complications such as fluid retention, elevated blood pressure, and electrolyte imbalances in patients with renal failure. Instead, other types of pain medications such as opioids and nonopioids (e.g., acetaminophen) may be considered for pain management in patients with renal failure. Short-acting analgesics should also be utilized cautiously in this population, considering the potential clearance and metabolism issues due to decreased renal function.
Question 3 of 9
In what patient is propranolol (Inderal) contraindicated?
Correct Answer: B
Rationale: Beta-adrenergic blocking agents are contraindicated in patients with bradycardia, heart failure, and heart block. The drug would not be contraindicated in the other patients. The nurse should assess the patient’s medical history and contraindications before administering propranolol to ensure safe and effective treatment.
Question 4 of 9
The student nurse asks the nursing instructor why drug plateaus occur with medications. What are the best responses by the nursing instructor?
Correct Answer: A
Rationale: Plateaus occur when receptors are saturated-max effect is reached (e.g., morphine), a pharmacodynamic limit. 100% relief isn't guaranteed-plateau is effect ceiling. Resistance (tolerance) builds over time, not instant. Losing efficacy implies degradation, not saturation. Receptor occupancy explains the plateau, a core concept.
Question 5 of 9
The nurse should teach a patient to take their own pulse with which medication? (Hint: if pulse is <60 or >100, the patient should contact their health care provider before taking the medication)
Correct Answer: A
Rationale: Digoxin is a medication commonly prescribed to patients with heart conditions, such as heart failure and certain types of irregular heartbeats. It primarily works by slowing down the heart rate and increasing the strength of the heart's contractions. This is why patients taking digoxin are typically taught to monitor their own pulse regularly to ensure it stays within a safe range.
Question 6 of 9
A patient on diuretic therapy calls the clinic because he™s had the flu, with terrible vomiting and
Correct Answer: B
Rationale: The correct statement by the nurse is, "It™s important to try to stay on your prescribed medication. Try to take it with sips of water." It is important to continue taking diuretic therapy as prescribed, even if the patient has been vomiting. Taking the medication with small sips of water can help ensure hydration and absorption of the medication. Discontinuing the diuretic abruptly can lead to fluid retention and exacerbation of the patient's condition. It's best to ensure proper hydration and medication adherence while also seeking proper medical advice if needed.
Question 7 of 9
A 74-year-old professional golfer has chest pain that occurs toward the end of his golfing games. He says the pain usually goes away after one or two sublingual nitroglycerin tablets and rest. What type of angina is he experiencing?
Correct Answer: D
Rationale: The 74-year-old professional golfer is likely experiencing Prinzmetal™s angina. This type of angina, also known as variant angina, typically occurs at rest and is due to coronary artery spasm, rather than the typical obstruction of blood flow seen in classic angina. The chest pain in Prinzmetal™s angina is often relieved by medications that dilate the blood vessels, such as nitroglycerin, as described by the patient. This distinguishes it from classic angina, which is typically triggered by exertion or emotional stress. Unstable angina, on the other hand, is characterized by chest pain that occurs unpredictably, even at rest and may signal an impending heart attack.
Question 8 of 9
The older adult client has gastrointestinal bleeding. The client says to the nurse, 'I don't understand this. All I did was take ibuprofen (Advil) for my arthritis.' Which plan would be best as it relates to the nurse's education of this client?
Correct Answer: B
Rationale: Ibuprofen, an NSAID, can cause gastrointestinal bleeding by irritating the stomach lining, a risk higher in older adults. Substituting acetaminophen, which lacks this effect, reduces harm while managing pain, making it the best education plan. Topical drugs may not address systemic arthritis. Physician approval is wise but less specific than substitution. Pros/cons of ibuprofen inform but don't directly mitigate risk. Acetaminophen offers a safer alternative, directly addressing the bleeding issue.
Question 9 of 9
A 26-year-old man presents to the emergency department with severe right lower quadrant pain. Physical exam reveals rebound tenderness and decreased bowel sounds. An emergent appendectomy is performed. Postsurgically, he is given an NSAID along with morphine for pain control. Which of the following NSAIDs is commonly used as an adjunct to opioids postsurgically?
Correct Answer: D
Rationale: Post-appendectomy pain management often combines opioids like morphine with NSAIDs for synergy. Acetaminophen is an analgesic but not a true NSAID (lacks significant anti-inflammatory action). Celecoxib , a COX-2 inhibitor, is less common acutely due to cost and milder effect. Ibuprofen is effective but less potent parenterally. Ketorolac , a potent NSAID, is widely used postsurgically-available IV/IM, it reduces inflammation and pain, complementing morphine's central action. Naproxen (E) is oral, less ideal acutely. Ketorolac's rapid onset and efficacy in reducing opioid requirements make it standard. Its short-term use minimizes GI risks, aligning with surgical protocols, distinguishing it from other options for acute postoperative pain control.