The nurse is performing a health history on a patient who is ordered to begin therapy with valproic

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ATI Pharmacology Practice A Questions

Question 1 of 5

The nurse is performing a health history on a patient who is ordered to begin therapy with valproic

Correct Answer: D

Rationale: Valproic acid is known to have potential hepatotoxicity, meaning it can damage the liver. Therefore, if a patient already has liver disease, it can increase the risk of further liver damage when taking valproic acid. The nurse needs to be particularly cautious when a patient with pre-existing liver disease is prescribed this medication, as close monitoring of liver function tests will be necessary to detect any signs of liver damage early on. It is important to assess and consider the patient's liver condition before initiating valproic acid therapy to prevent potential adverse effects.

Question 2 of 5

The nurse has a patient demonstrate self-administration of eyedrops. Place the steps in the order in which the patient will perform them.

Correct Answer: B

Rationale: The correct order for self-administering eyedrops is: 1. Wash hands (g). 2. Remove the cap (d). 3. Gently shake the bottle to evenly distribute the drug (b). 4. Tilt the head backward and look upward (e). 5. Pull the lower lid away from the eye so that a pouch is formed (a). 6. Place the dropper just above the pouch without touching the tip to the eye or finger (f). 7. Gently squeeze one drop of medicine into the pouch (h). 8. Press a finger against the inner corner of the eye for 2 to 3 minutes (c). This sequence ensures proper administration and minimizes the risk of contamination or systemic absorption.

Question 3 of 5

A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse?

Correct Answer: C

Rationale: When a patient reports a drug allergy, it is essential for the nurse to gather specific information about the nature of the reaction. Asking, 'What type of reaction did you have when you took penicillin?' allows the nurse to determine whether the reaction was a true allergy (e.g., anaphylaxis) or a side effect (e.g., gastrointestinal upset). This information is critical for guiding treatment decisions and avoiding potentially life-threatening situations. Dismissing the allergy or making assumptions about its relevance based on the patient's age is inappropriate and could compromise patient safety. Therefore, the nurse's priority is to assess the details of the allergic reaction.

Question 4 of 5

The most serious adverse effect of tricyclic antidepressant (TCA) overdose is:

Correct Answer: B

Rationale: Tricyclic antidepressants (TCAs) are associated with a high risk of toxicity in overdose, with cardiac arrhythmias being the most serious and life-threatening complication. TCAs can block sodium channels in the heart, leading to prolonged QRS intervals, ventricular tachycardia, and even cardiac arrest. Hyperpyrexia, seizures, and metabolic acidosis can also occur, but cardiac arrhythmias are the primary concern due to their potential to cause sudden death. Immediate medical intervention is required to manage TCA overdose, including cardiac monitoring and administration of sodium bicarbonate.

Question 5 of 5

Which of the following drugs need not be avoided or only used at a reduced dose in renal failure?

Correct Answer: A

Rationale: Renal failure alters drug clearance, requiring dose adjustments or avoidance. Prednisolone, a glucocorticoid, is metabolized hepatically to prednisone, with minimal renal excretion, making it safe without adjustment in renal failure. Netilmicin, an aminoglycoside, is renally cleared, risking ototoxicity if not reduced. Metformin, cleared renally, risks lactic acidosis in renal impairment, often avoided. Methotrexate, renally excreted, accumulates in failure, causing toxicity (e.g., marrow suppression). Tinzaparin, a low molecular weight heparin, requires adjustment due to renal clearance. Prednisolone's hepatic handling makes it the exception, safe for use in renal dysfunction without modification.

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