ATI RN
ATI RN Pharmacology Online Practice 2019 A Questions
Question 1 of 5
Regarding inhaled anaesthetics:
Correct Answer: C
Rationale: Nitrous oxide has a high minimum alveolar concentration (MAC >100%), not low, due to low potency, so that's false. Halogenated agents (e.g., isoflurane) have higher brain:blood coefficients, reflecting solubility, making that false. They reduce mean arterial pressure (MAP) proportional to alveolar concentration via vasodilation, a true statement. Nitrous oxide does decrease tidal volume and increase respiratory rate, true. They don't reduce cerebral metabolic rate via blood flow alone but directly. MAP reduction is a key hemodynamic effect, guiding anesthetic depth monitoring.
Question 2 of 5
The nursing instructor prepares to teach student nurses about how mean effective doses of medications are related to clinical practice. As a result of the instruction, what is the best understanding of the student nurses?
Correct Answer: D
Rationale: Mean effective dose (ED50) affects 50% of a population, but individuals vary-some need more or less due to metabolism, weight, or genetics, a clinical reality. Severe side effects aren't 50%-that's toxicity. Ethnic differences influence response, but dose variation is broader. No effect in 50% misreads ED50. Dose adjustment reflects individual pharmacokinetics, key to practice.
Question 3 of 5
The patient is receiving the benzodiazepine clonazepam (Klonopin) for the treatment of panic attacks. What is an important medication outcome for this patient as it relates to safety?
Correct Answer: D
Rationale: Clonazepam, a benzo, risks withdrawal (e.g., seizures) if stopped abruptly-patients knowing this ensures safe taper, per safety. Stevens-Johnson isn't linked-rash is rare. No diet restrictions apply (unlike MAOIs). Blood work isn't routine for benzos. Abrupt cessation's danger is key, protecting against rebound.
Question 4 of 5
A 6-year-old boy presents to his pediatrician for followup of recurrent hay fever and asthma. He usually has two to three attacks per week. For symptom control, he uses an albuterol inhaler, but his parents would like to try something more. They would like him to take something that would lessen the amount of attacks he has. Although corticosteroids would probably work best for prophylaxis, they are contraindicated in children. Which of the following drugs would decrease the amount of asthma attacks by preventing an arachidonic acid derivative from binding to its receptor?
Correct Answer: D
Rationale: Asthma attacks in this case are driven by inflammation, often mediated by leukotrienes, which are arachidonic acid derivatives. The goal is to reduce the frequency of attacks by targeting this pathway. Aspirin inhibits cyclooxygenase (COX), reducing prostaglandins but not leukotrienes, and may even worsen asthma in some patients. Celecoxib is a selective COX-2 inhibitor, also irrelevant to leukotrienes. Ipratropium is an anticholinergic bronchodilator, effective for acute symptom relief but not prophylaxis via arachidonic acid pathways. Montelukast is a leukotriene receptor antagonist, directly preventing leukotrienes from binding to their receptors, thus reducing inflammation and attack frequency. Zileuton (E), while a leukotriene synthesis inhibitor, isn't the best choice here as the question specifies receptor binding prevention, not synthesis inhibition. Montelukast aligns perfectly with the mechanism described, making it the correct answer.
Question 5 of 5
A 66-year-old man with a history of recurrent pulmonary infections and hypertension is managed with ethacrynic acid, which controls his hypertension well. He is often hospitalized and placed on gentamicin for his recurrent pulmonary infections. Which of the following adverse effects must the treating physician be keenly aware of?
Correct Answer: B
Rationale: Gentamicin, an aminoglycoside, risks ototoxicity-hearing loss , especially with repeated use. Ethacrynic acid, a loop diuretic, also has ototoxicity potential, compounding risk. Dizziness , nausea , vertigo , and vomiting (E) occur but are less specific. Monitoring hearing is critical in this scenario.