ATI RN
ATI Proctored Exam Pharmacology Questions
Question 1 of 5
The client has MRSA and receives vancomycin (Vancocin) intravenously (IV). The nurse assesses an upper body rash and decreased urine output. What is the nurse's priority action?
Correct Answer: A
Rationale: Vancomycin is an antibiotic used to treat serious infections like MRSA, but it can cause significant adverse effects, including nephrotoxicity (kidney damage) and hypersensitivity reactions, such as rashes. The symptoms of an upper body rash and decreased urine output suggest a possible allergic reaction or renal impairment, both of which are potentially life-threatening if the drug continues to be administered. Holding the next dose prevents further exposure to the drug, which could exacerbate the reaction or damage, while notifying the physician ensures prompt medical evaluation and intervention. Obtaining an X-ray or urine specimen might provide additional data but doesn't address the immediate risk. Administering an antihistamine could mask symptoms without addressing the underlying issue, potentially delaying critical treatment. Thus, the priority is to stop the drug and seek physician guidance, making choice A the most appropriate action.
Question 2 of 5
A patient is taken to the trauma unit after a motorcycle accident. It is estimated that he has lost 30% of his blood volume and he is in hypovolemic shock. The nurse anticipates a transfusion with which blood product?
Correct Answer: A
Rationale: In the case of a hypovolemic shock due to significant blood loss, the primary concern is to restore the lost blood volume quickly. Packed Red Blood Cells (PRBCs) contain a high concentration of red blood cells and are used to replenish oxygen-carrying capacity in cases of hemorrhage. PRBCs are the most appropriate blood product in this scenario as they can effectively increase the oxygen-carrying capacity of the blood without overloading the patient with excess fluid volume like whole blood. Whole blood contains not only red blood cells but also plasma and other components, which may not be necessary for immediate volume resuscitation. Cryoprecipitate and Fresh Frozen Plasma (FFP) are usually indicated for specific coagulation factor deficiencies and are not the primary choice for treating hypovolemic shock. Thus, in this case, PRBCs are the most suitable blood product to address the acute blood loss and restore
Question 3 of 5
A 65-year-old man undergoes an orthopaedic procedure. He spends an hour in the recovery room before being returned to the ward. You are called to see him and on examination note that he is drowsy, has shallow breathing, a slow pulse and pinpoint pupils. The notes show an uneventful anaesthetic using an inhalational agent, muscle relaxant and fentanyl. In the recovery room he was breathing normally and was awake, but because of pain was initially given intravenous morphine and then intramuscular morphine before being returned to the ward. Your course of action is:
Correct Answer: D
Rationale: The patient shows opioid overdose signs (drowsiness, respiratory depression, bradycardia, miosis) from fentanyl and morphine. Calling the resuscitation team delays specific treatment unless unresponsive. Atropine treats bradycardia but not respiratory depression. Neostigmine reverses neuromuscular blockers, not opioids. Flumazenil reverses benzodiazepines. IV naloxone, an opioid antagonist, rapidly reverses these effects, restoring breathing and consciousness, the best immediate action. Its specificity and speed are vital in postoperative opioid toxicity, ensuring patient safety.
Question 4 of 5
A patient comes to the office with a chief complaint of hair loss and peeling skin. The nurse notes many vitamins and minerals are on the medication list. The patient reports using vitamins to treat liver disease. The patient's complaint may be caused by an excess of which vitamin or mineral?
Correct Answer: A
Rationale: Excessive vitamin A can cause hypervitaminosis A, leading to symptoms such as hair loss, peeling skin, and liver toxicity. Zinc (B), vitamin C (C), and vitamin D (D) are not typically associated with these symptoms. The nurse should assess the patient's vitamin A intake and advise moderation.
Question 5 of 5
Ester group of local anesthesia differs from the amide group in that :
Correct Answer: B
Rationale: The main difference between ester group local anesthetics and amide group local anesthetics lies in the way they are metabolized in the body. Esters are metabolized in the plasma by the enzyme pseudocholinesterase, while amides are metabolized in the liver. Pseudocholinesterase hydrolyzes esters into inactive metabolites, which are then excreted mainly by the kidneys. On the other hand, amides undergo hepatic metabolism by the cytochrome P450 enzyme system before being excreted by the kidneys. This key metabolic difference between esters and amides impacts their pharmacokinetics, including onset of action, duration of effect, and potential for allergic reactions.