ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
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 2 of 5
A nurse is providing instructions to a client receiving baclofen (Lioresal). Which of the following would be included in the teaching plan?
Correct Answer: D
Rationale: Baclofen is a muscle relaxant used to treat spasticity. Weakness is a potential side effect and should be reported to the physician, as it may indicate an adverse reaction or the need for dose adjustment. Limiting fluid intake is not typically recommended, and holding the medication due to diarrhea is not a standard instruction. While alcohol can enhance the sedative effects of baclofen, the primary concern is monitoring for weakness, which could impact the patient's safety and mobility.
Question 3 of 5
A client with myasthenia gravis frequently complains of weakness and fatigue. The physician plans to identify whether the client is responding to an overdose of the medication or a worsening of the disease. A tensilon test is performed. Which of the following would indicate that the client is experiencing an overdose of the medication?
Correct Answer: A
Rationale: In a Tensilon test, edrophonium chloride is administered to differentiate between myasthenic crisis (worsening of the disease) and cholinergic crisis (overdose of medication). A temporary worsening of symptoms, such as increased weakness, indicates a cholinergic crisis due to an overdose of anticholinesterase medications. Improvement suggests myasthenic crisis, while no change is inconclusive. Muscle spasms are not specific to an overdose. Therefore, worsening symptoms indicate an overdose.
Question 4 of 5
An asymptomatic 46-year-old Indian woman is found to have an elevated serum calcium (2.80 mmol/L, corrected) at a 'well-woman' screening clinic. Other chemistries are normal, in particular phosphate is 0.8 mmol/L (normal range 0.8-1.45), and parathormone (PTH) is 5.4 pmol/L (normal range <0.9-5.4). She has a sedentary occupation in a northern UK city. Which of the following would be most suitable management?
Correct Answer: D
Rationale: Mild hypercalcemia (2.80 mmol/L) with borderline PTH (5.4 pmol/L) suggests primary hyperparathyroidism (PHPT), common in asymptomatic women. Alfacalcidol treats hypocalcemia, not hypercalcemia. Sevelamer binds phosphate, irrelevant here. Teriparatide increases calcium, contraindicated. Surgical parathyroidectomy suits severe cases, but mild, asymptomatic PHPT (calcium <3.0 mmol/L) warrants watchful waiting with monitoring, most suitable to assess progression without immediate intervention. This conservative approach balances risks, especially in a sedentary northern climate lacking vitamin D excess.
Question 5 of 5
Drugs with no significant effect on anticoagulant therapy include:
Correct Answer: D
Rationale: Amiodarone inhibits warfarin metabolism, increasing INR, so it affects anticoagulation. Disulfiram also potentiates warfarin via CYP inhibition, enhancing effect. Fluconazole similarly boosts warfarin levels, a significant interaction. Benzodiazepines have no major effect on anticoagulant therapy, a true statement, as they're metabolized differently. Metronidazole, like fluconazole, increases warfarin effect. Benzodiazepines' lack of interaction makes them safer in this context, a key consideration in polypharmacy.