ATI RN
Intro to Pharmacology ATI Questions
Question 1 of 5
Ingestion of methanol in wood spirits would cause which of the following to happen?
Correct Answer: A
Rationale: Methanol, a toxic alcohol, is metabolized by alcohol dehydrogenase into formaldehyde, then by aldehyde dehydrogenase into formic acid, causing severe metabolic acidosis and blindness via optic nerve damage. This initial step—formation of formaldehyde—is the critical toxic event, distinguishing methanol poisoning from ethanol's safer metabolism. Nephrotoxicity isn't primary; formic acid affects mitochondria and eyes more. Hypotension and vomiting occur secondary to acidosis but aren't the defining process. Glycolic acid is a metabolite of ethylene glycol, not methanol. Methanol inhibits aldehyde dehydrogenase minimally; its danger lies in metabolite accumulation. Formaldehyde production initiates the cascade, making it the most direct and accurate consequence of methanol ingestion.
Question 2 of 5
The nurse is preparing to administer phenytoin (Dilantin) to a patient who has a seizure disorder. The nurse notes that the last random serum drug level was 18 mcg/mL. What action Will the nurse take?
Correct Answer: B
Rationale: The therapeutic range for phenytoin (Dilantin) is typically 10-20 mcg/mL. A level of 18 mcg/mL is at the upper end of the therapeutic range, and the patient may be at risk for toxicity, especially if symptoms are present. Therefore, the nurse should contact the provider to discuss potentially decreasing the phenytoin dose to avoid toxicity. Monitoring levels closely and reporting any signs of toxicity are also important actions, but the immediate action should be to address the potential for toxicity by discussing a dosage adjustment with the provider.
Question 3 of 5
An otherwise healthy 78-year-old man is found to have a blood pressure (BP) of 168/80 at a routine check, and similar pressures are confirmed on three separate occasions despite adhering to dietary advice. Investigations including an ECG and creatinine/electrolytes are normal. Which of the following is the most appropriate next step in management?
Correct Answer: D
Rationale: Systolic hypertension (168 mmHg) in the elderly increases cardiovascular risk, despite normal diastolic (80 mmHg). Echo isn't first-line without organ damage signs (normal ECG). Reassurance ignores systolic risk; treatment is indicated (>160 mmHg). Doxazosin, an alpha-blocker, is less preferred initially due to hypotension risk. Ramipril, an ACE inhibitor, is effective, but amlodipine, a calcium channel blocker, is most appropriate per guidelines (e.g., NICE) for isolated systolic hypertension in the elderly, offering vascular protection and tolerability. Its efficacy reduces stroke and MI risk, critical at this age.
Question 4 of 5
Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
Correct Answer: D
Rationale: The correct statement by the nurse is D. "Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes." This instruction is important for patients taking furosemide (Lasix) because this medication can cause changes in blood pressure, especially when changing positions quickly. By rising slowly, the patient can minimize the risk of dizziness or fainting. This precaution is crucial to ensure patient safety while taking furosemide.
Question 5 of 5
What serious adverse reaction can occur with the loop diuretic Furosemide?
Correct Answer: A
Rationale: Furosemide, a loop diuretic, can rarely lead to a serious adverse reaction known as Stevens-Johnson syndrome. Stevens-Johnson syndrome is a severe skin reaction that can be life-threatening and typically involves painful blistering and shedding of the skin. This reaction is considered a serious medical emergency and requires immediate medical attention. It is crucial to monitor for any signs of skin changes or reactions while using Furosemide and report them to a healthcare provider promptly.