ATI RN
ATI Pharmacology Practice B Questions
Question 1 of 5
The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. The nurse knows that the factor that most influences the decision about which route to use is the patient's
Correct Answer: D
Rationale: In patients with heart failure, diminished circulation is a significant concern. The intravenous (IV) route is preferred over the intramuscular (IM) route because it ensures rapid and reliable drug delivery, especially in patients with compromised cardiac output. IM injections rely on adequate blood flow for absorption, which may be impaired in heart failure due to poor circulation. Altered biliary function, increased glomerular filtration, and reduced liver metabolism are less relevant to the choice of administration route in this context. Therefore, diminished circulation is the primary factor influencing the decision to use the IV route.
Question 2 of 5
Which of the following drugs is likely to increase the plasma lithium concentration if co-prescribed to a patient on chronic lithium therapy?
Correct Answer: B
Rationale: Lithium levels rise with drugs reducing renal clearance or altering metabolism. St John's wort induces CYP enzymes, potentially lowering lithium (not renally metabolized). Ibuprofen, an NSAID, reduces renal lithium excretion by inhibiting prostaglandins, increasing plasma levels, a well-known interaction. Phenytoin induces metabolism but doesn't affect lithium's renal clearance. Haloperidol and sertraline have minimal pharmacokinetic impact on lithium. Ibuprofen's effect necessitates monitoring, as elevated lithium risks toxicity (e.g., tremor, confusion), critical in bipolar management.
Question 3 of 5
GTN has its major effect on effort angina by:
Correct Answer: C
Rationale: Glyceryl trinitrate (GTN) relieves effort angina primarily by reducing preload (venodilation) and afterload (arterial dilation), decreasing myocardial oxygen demand, a true and major mechanism. It doesn't primarily reduce coronary vasospasm (more relevant in variant angina), nor significantly affect the renin-angiotensin system in this context. While it causes some coronary vasodilation, this is secondary to systemic effects on demand reduction. It doesn't cause systemic vasoconstriction (opposite effect). The preload/afterload reduction is the cornerstone of GTN's efficacy in stable angina, improving oxygen supply-demand balance, a critical concept in ischemic heart disease management.
Question 4 of 5
The drug that will most likely be used for treatment of erectile dysfunction (ED) is
Correct Answer: D
Rationale: Sildenafil (Viagra), a phosphodiesterase-5 inhibitor, enhances penile blood flow by increasing cyclic GMP, directly treating erectile dysfunction (ED) and is the standard first-line therapy. Leuprolide, a GnRH agonist, suppresses testosterone for prostate cancer, potentially worsening ED. Finasteride, for benign prostatic hyperplasia (BPH), reduces prostate size but may cause ED as a side effect, not treat it. Tamsulosin, an alpha-blocker for BPH, improves urinary flow but isn't indicated for ED and can lower blood pressure. Sildenafil's targeted action on vascular mechanisms in ED distinguishes it, offering rapid efficacy and a well-established safety profile for this condition.
Question 5 of 5
The nurse administers medications by various routes of delivery. The nurse recognizes which route of administration as requiring higher dosages of drugs to achieve a therapeutic effect?
Correct Answer: B
Rationale: Oral drugs face first-pass metabolism in the liver, reducing bioavailability, so higher doses are needed for therapeutic effect compared to IV (100% bioavailability), sublingual (bypasses liver), or rectal (partial bypass). Oral route's loss to metabolism drives dosage needs, a pharmacokinetic distinction.