ATI RN
ATI Capstone Pharmacology Pre-Assessment Quiz Questions
Question 1 of 9
The nurse is caring for a patient receiving IV heparin therapy for treatment of a pulmonary embolus. The patient is being converted to warfarin (Coumadin) therapy. The following questions relate nursing considerations when caring for this patient. Nursing considerations for conversion of IV heparin to oral warfarin (Coumadin) therapy will include
Correct Answer: B
Rationale: When converting a patient from IV heparin to oral warfarin (Coumadin) therapy, it is important to overlap the two therapies for at least 5 days. This is because warfarin takes time to reach its full anticoagulant effect, and the patient needs to be adequately anticoagulated during this transition period to prevent the risk of thrombosis. The INR should be closely monitored, and the IV heparin should be stopped once the INR is in the therapeutic range. Simply discontinuing IV heparin and starting oral warfarin immediately could result in a period of inadequate anticoagulation, which could be dangerous for the patient, especially when transitioning from treatment for a pulmonary embolus.
Question 2 of 9
A patient is scheduled to receive high-dose cyclophosphamide via an intravenous infusion as treatment for cancer. Which will be most important for the nurse to include when teaching the patient about cyclophosphamide?
Correct Answer: B
Rationale: Cyclophosphamide can cause hemorrhagic cystitis, a serious side effect resulting from the irritation of the bladder lining by its metabolites. To prevent this, patients must maintain high fluid intake (at least 2 liters per day) to dilute the urine and flush out the bladder. While emptying the bladder regularly is important, it is secondary to ensuring adequate hydration. Limiting fluid intake is contraindicated, as it increases the risk of bladder toxicity. An indwelling urinary catheter is not routinely required unless the patient has urinary retention.
Question 3 of 9
The nurse receives a stat order to administer 50% dextrose solution intravenously to a 1-year-old child with hypoglycemia. How should this drug best be prepared for safe administration to the child?
Correct Answer: C
Rationale: Administering 50% dextrose solution directly to a 1-year-old child is unsafe due to the risk of hyperosmolar injury to veins and tissues. Diluting it 1:1 with sterile water reduces the concentration to 25%, making it safer for pediatric administration. Using a filter needle (A) or tuberculin syringe (B) is not necessary for this preparation. Shaking the solution (D) is inappropriate and could introduce air bubbles.
Question 4 of 9
The primary beneficial action of epinephrine when performing root end surgery is which of the following?
Correct Answer: C
Rationale: Epinephrine primarily acts on beta1 adrenergic receptors in the alveolar mucosa during root end surgery. This results in vasoconstriction, which reduces bleeding in the surgical field by constricting blood vessels. With decreased bleeding, the surgical site becomes clearer, allowing for better visualization and manipulation during the procedure. Additionally, epinephrine may also prolong the duration of anesthesia by reducing systemic uptake of the local anesthetic solution, thus enhancing its effect locally.
Question 5 of 9
Which of the following is a potassium-sparing diuretic?
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, which means that it helps the body get rid of excess sodium and water while retaining potassium. This is accomplished by blocking the action of aldosterone, a hormone that normally causes the kidneys to retain sodium and water and excrete potassium. Potassium-sparing diuretics like spironolactone are often used in conjunction with other diuretics to prevent potassium loss and maintain electrolyte balance. In contrast, options A, C, and D (Furosemide, Hydrochlorothiazide, Bumetanide) are loop diuretics or thiazide diuretics which promote the excretion of both sodium and potassium.
Question 6 of 9
The nurse is monitoring for adverse effects in a patient who is receiving an amiodarone
Correct Answer: A
Rationale: Adverse effects of amiodarone include QT prolongation and gray coloring of the skin on the face, arms, and neck.
Question 7 of 9
The patient is discharged home and returns to the emergency department 4 days later. The patient is admitted to the ICU with acute decompensated HF with dyspnea at rest. The nurse anticipates administration of which medication?
Correct Answer: D
Rationale: Nesiritide, also known as Natrecor, is a medication commonly used in the treatment of acute decompensated heart failure (ADHF) with dyspnea at rest. It is a recombinant form of B-type natriuretic peptide (BNP) which helps to improve cardiac function and alleviate symptoms of heart failure, such as dyspnea. Nesiritide works by promoting vasodilation and increasing diuresis, which can help reduce the workload on the heart and improve cardiac output. Therefore, in the case of a patient with acute decompensated heart failure and dyspnea at rest, the nurse would anticipate the administration of Nesiritide to help improve the patient's condition.
Question 8 of 9
For the patient receiving periodic morphine via intravenous push, which of the following findings would be of utmost concern to the nurse?
Correct Answer: C
Rationale: Morphine is an opioid analgesic that can cause respiratory depression as a serious side effect. Decreased respirations are a critical finding because they indicate that the patient may not be receiving adequate oxygenation, which can lead to hypoxia, brain damage, or even death. Increased temperature, decreased bowel sounds, and increased red blood cell count are less concerning in this context. Nurses must monitor respiratory rates closely in patients receiving morphine and be prepared to intervene with naloxone if respiratory depression occurs.
Question 9 of 9
What is the therapeutic use of levothyroxine?
Correct Answer: C
Rationale: Levothyroxine is a synthetic form of the thyroid hormone thyroxine and is commonly used for the treatment of hypothyroidism. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone to meet the body's needs, leading to various symptoms such as fatigue, weight gain, cold intolerance, and depression. By providing exogenous levothyroxine, the medication helps restore normal thyroid hormone levels in the body, thereby alleviating the symptoms of hypothyroidism and restoring normal hormonal balance. It is important to monitor thyroid hormone levels regularly when on levothyroxine therapy to ensure optimal dosing and maintenance of normal thyroid function.