ATI RN
ATI RN Pharmacology 2023 Proctored Exam Questions
Question 1 of 5
Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student's understanding of therapeutic index?
Correct Answer: B
Rationale: Therapeutic index (TI), the ratio of toxic to effective dose, gauges safety-wide TI means safer dosing, helping the student assess if doses are within safe limits. Best drug choice is clinical, not TI-based. Interactions aren't TI-specific. Monitoring needs tie to narrow TI drugs (e.g., lithium), but safety is broader. TI ensures safe dosing, a key review point.
Question 2 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, has a dosing limit of one pill per 24 hours to avoid risks like prolonged erections or hypotension, a key safety point for education. Grapefruit juice increases sildenafil levels by inhibiting metabolism, not decreasing effects, risking intensified side effects. It's optimally taken 1 hour before sex, effective up to 4 hours-not 6-setting realistic timing expectations. Food, especially high-fat meals, delays absorption, so it's best on an empty stomach. The 24-hour limit ensures safe use, balancing efficacy with minimizing adverse effects, aligning with prescribing standards and making it the priority in client teaching.
Question 3 of 5
A patient comes to the ER with a painful stab wound. The ER resident administers pentazocine for the pain. Soon after administration the patient experiences sweating, restlessness, and an increase in pain sensations. What is the most likely explanation for his symptoms?
Correct Answer: B
Rationale: Pentazocine, a mixed opioid agonist-antagonist, acts as a kappa receptor agonist and a partial mu receptor agonist, providing analgesia in opioid-naive patients. However, in a heroin addict with high mu receptor tolerance, pentazocine's partial antagonism at mu receptors can displace full agonists like heroin, precipitating withdrawal symptoms—sweating, restlessness, and heightened pain perception. Tolerance to pentazocine itself wouldn't typically increase pain; it would reduce efficacy. Pentazocine is an effective analgesic in appropriate contexts, so ineffectiveness isn't the issue. Incorrect dosing might alter efficacy or toxicity but wouldn't specifically cause this withdrawal-like reaction. The patient's history of heroin use explains this response, as pentazocine's antagonist properties disrupt the opioid equilibrium, unmasking withdrawal in a dependent individual.
Question 4 of 5
In the case of an intramuscular injection of a drug:
Correct Answer: D
Rationale: Exercise increases blood flow to muscles, enhancing absorption of intramuscularly injected drugs.
Question 5 of 5
A patient who has been diagnosed with social anxiety disorder will begin taking venlafaxine(Effexor). The nurse who performs a medication and dietary history will be concerned about ingestion of which substance or drug?
Correct Answer: D
Rationale: St. John's wort is an herbal supplement known to interact with many medications, including venlafaxine (Effexor). It can reduce the effectiveness of venlafaxine by increasing its metabolism and clearance from the body, potentially leading to decreased therapeutic effects. Therefore, patients taking venlafaxine for social anxiety disorder should be advised to avoid St. John's wort to prevent any negative interactions and ensure the medication works effectively. It is essential for the nurse to inquire about the use of St. John's wort during the medication and dietary history assessment to prevent such interactions.