ATI RN
Pharmacology Test Bank Questions
Question 1 of 5
The most common dose-limiting toxicity of chemotherapy is:
Correct Answer: C
Rationale: Myelosuppression, the suppression of bone marrow activity, is the most common dose-limiting toxicity of chemotherapy. It leads to reduced production of blood cells, including white blood cells, red blood cells, and platelets, increasing the risk of infections, anemia, and bleeding. While nausea, vomiting, and mucositis are significant side effects, they can often be managed with supportive care. Myelosuppression, however, can be life-threatening and frequently requires dose adjustments or delays in treatment. Bloody stools are less common and typically not the primary dose-limiting factor.
Question 2 of 5
A 78-year-old man is admitted with deterioration of chronic heart failure. He is house-bound and has had three similar admissions in the past nine months. There is a history of ischaemic heart disease. His medication comprises furosemide, ramipril in full dose, valsartan, spironolactone, simvastatin and aspirin. He is dyspnoeic on minimal exertion, looks unwell, pulse 100/min regular, BP 90/70 mmHg, jugular venous pressure (JVP) is at 4 cm, gallop rhythm, chest clear, pretibial oedema. ECG shows sinus rhythm, an old inferior infarct and poor anterior R wave progression. Serum urea 15 mmol/L, creatinine 90 μmol/L, Na+ 140, K+ 4.6. Which of the following would be most appropriate?
Correct Answer: C
Rationale: Chronic heart failure (CHF) decompensation needs optimization. Morphine relieves acute dyspnea but not chronic management here. Hydralazine/isosorbide reduces afterload/preload, useful in advanced CHF, but less immediate. Carvedilol, a beta-blocker, risks decompensation with low BP. Metolazone, a potent diuretic, aids fluid overload but overlaps with furosemide. Digoxin improves contractility and rate control in sinus rhythm CHF, reducing hospitalizations, most appropriate given his recurrent admissions and stable renal function. Its inotropic benefit stabilizes this patient, enhancing quality of life.
Question 3 of 5
Regarding glucocorticoids:
Correct Answer: A
Rationale: Cortisol is indeed the primary human glucocorticoid, a true statement regulating metabolism and stress. Normal cortisol secretion is ~10-20 mg/day, not 100 mg, so that's false. ACTH suppression occurs rapidly (hours), true. Cortisol absence heightens catecholamine sensitivity, true, as in Addison's disease. Leukocyte/macrophage inhibition is a glucocorticoid action, not its absence. Cortisol's role as the major glucocorticoid underpins its therapeutic mimicry (e.g., hydrocortisone) in adrenal insufficiency.
Question 4 of 5
The nurse is assessing a client and notes that he is receiving finasteride (Proscar). The client denies having any history of a significant prostate disorder. What is the best assessment question for the nurse to ask at this time?
Correct Answer: A
Rationale: Finasteride, a 5-alpha reductase inhibitor, is used as Proscar for benign prostatic hyperplasia (BPH) and as Propecia for male pattern baldness, reducing dihydrotestosterone to promote hair growth. Without prostate issues, baldness is a likely reason for its use. Erectile dysfunction isn't treated by finasteride-it may cause it-making that irrelevant. Stomach ulcers and hypertension aren't linked to finasteride's androgen-targeted action. Asking about baldness probes a condition tied to its alternative use, clarifying the prescription's purpose and guiding the nurse's understanding of the client's therapy.
Question 5 of 5
The patient receives antibiotics for a serious infection. The patient asks the nurse, 'Why don't you just give me more of that drug to cure this infection faster?' What is the best response by the nurse?
Correct Answer: D
Rationale: Antibiotics have a maximum dose beyond which efficacy plateaus-more risks toxicity (e.g., ototoxicity), not faster cure, a pharmacodynamic limit. Checking with the doctor delays a clear answer. Interactions aren't the sole issue-toxicity is. Time-based increase lacks basis. Maximum dose explains efficacy ceiling, educating safely.