ATI RN
Practice ATI B Exam Pharmacology Questions
Question 1 of 5
The nurse is caring for a patient who is receiving an adrenergic blocking agent. While writing the care plan for this patient what nursing diagnoses would be most appropriate concerning comfort?
Correct Answer: A
Rationale: All four options would be appropriate nursing diagnoses for a patient receiving an adrenergic blocking agent. However, acute pain would be the only nursing diagnosis related to the patient’s comfort level. The nurse should address pain management as a priority to improve the patient’s quality of life and adherence to treatment.
Question 2 of 5
A male patient is undergoing chemotherapy may also be given the drug allopurinol (Zyloprim, Aloprim). Allopurinol inhibits the synthesis of uric acid. Concomitant administration of allopurinol prevents:
Correct Answer: B
Rationale: Allopurinol is primarily used to prevent gout and hyperuricemia, which are common side effects of chemotherapy. Chemotherapy often leads to the rapid destruction of cancer cells, releasing large amounts of uric acid into the bloodstream. This can cause hyperuricemia, leading to gout or kidney stones. Allopurinol works by inhibiting xanthine oxidase, an enzyme involved in uric acid production, thereby reducing uric acid levels. While myelosuppression and pancytopenia are concerns during chemotherapy, they are not directly addressed by allopurinol. Similarly, allopurinol does not inhibit cancer cell growth or replication.
Question 3 of 5
Enrique who is under chemotherapy has the following CBC results: WBC 5000/mm3, RBC platelet 10,000/mm3. Which of the following is he at risk for?
Correct Answer: B
Rationale: A platelet count of 10,000/mm3 is critically low and places Enrique at significant risk for bleeding. Platelets are essential for blood clotting, and levels below 20,000/mm3 can lead to spontaneous bleeding, such as nosebleeds, gum bleeding, or internal hemorrhage. While a WBC count of 5000/mm3 is within the normal range, reducing the risk of infection, the extremely low platelet count is the primary concern. Angina is unrelated to platelet counts. Therefore, bleeding is the most immediate risk for Enrique.
Question 4 of 5
An 80-year-old man is taking digoxin and warfarin because of longstanding atrial fibrillation. He has an indwelling urinary catheter in situ, whilst awaiting a prostatectomy. At his pre-operation assessment he has a ventricular rate of 120/minute. The house officer doubles his daily digoxin dose and the operation is delayed one week. One week later he returns with nausea, vomiting, diarrhoea, abdominal pain, confusion, delirium and visual disturbances. The most likely cause of his current symptoms is:
Correct Answer: D
Rationale: Symptoms (nausea, confusion, visual changes) suggest digoxin toxicity, common in the elderly with doubled doses. Digoxin's narrow therapeutic index (0.5-2 ng/mL) and renal clearance (impaired with age) increase risk. Viral infection lacks cardiac specificity here. Hyperkalemia (e.g., >5.5 mmol/L) isn't indicated without ECG changes. Warfarin's INR prolongation causes bleeding, not these symptoms. UTI fits the catheter but not delirium/visual issues. Digoxin toxicity, from overdose and accumulation, explains the presentation, requiring level checks and cessation.
Question 5 of 5
Regarding phenytoin, all the following are true EXCEPT:
Correct Answer: B
Rationale: Phenytoin's oral bioavailability varies due to formulation and absorption, a true statement. It's highly plasma protein-bound (~90%), not poorly, making that false and the exception. Hepatic enzyme inducers (e.g., rifampicin) enhance its metabolism, true. At higher doses, its elimination shifts to zero-order due to saturated metabolism, true. Half-life ranges from 12-36 hours, also true. High protein binding affects free drug levels, critical for therapeutic monitoring, especially in hypoalbuminemia.