ATI RN
ATI Pharmacology Practice B 2023 Questions
Question 1 of 5
The nurse is preparing to administer phenytoin (Dilantin) to a patient who has a seizure disorder. The nurse notes that the last random serum drug level was 18 mcg/mL. What action Will the nurse take?
Correct Answer: B
Rationale: A random serum phenytoin level of 18 mcg/mL is above the therapeutic range (usually 10-20 mcg/mL) and may indicate that the patient is at risk for toxicity. The nurse should contact the provider to discuss decreasing the phenytoin dose in order to prevent potential toxic effects such as ataxia, nystagmus, and confusion. Administering the current dose without addressing the elevated serum level could increase the risk of toxicity. Monitoring closely for toxicity (Choice D) is appropriate after the dosage adjustment is discussed with the provider. Reporting drug toxicity to the providers (Choice E) may be necessary if toxicity symptoms develop or if the provider does not respond to the recommendation to decrease the dose.
Question 2 of 5
A 29-year-old woman has a positive pregnancy test. She presents to her primary care physician for confirmation. She has a history of recurrent urinary tract infections, headaches, seizure disorder, and pulmonary embolus. Her current medications include acetaminophen, ciprofloxacin, warfarin, valproic acid, and methotrexate. Which of the following medications could be maintained at its current dose during her pregnancy?
Correct Answer: A
Rationale: Pregnancy limits medication safety. Acetaminophen is safe, used for pain with minimal fetal risk. Ciprofloxacin risks cartilage damage. Methotrexate and Valproic acid are teratogenic. Warfarin (E) causes fetal bleeding. Acetaminophen's profile suits her needs.
Question 3 of 5
The following drugs undergo significant enterohepatic circulation:
Correct Answer: A
Rationale: Oestrogens undergo enterohepatic circulation as they are conjugated in the liver, excreted in bile, and reabsorbed in the intestine, prolonging their action.
Question 4 of 5
Two days after admission, the nurse is reviewing laboratory results of the patient. Which is the most common electrolyte finding resulting from the administration of furosemide (Lasix)?
Correct Answer: C
Rationale: Furosemide (Lasix) is a loop diuretic commonly used to treat conditions such as edema and hypertension by increasing urine output. One of the most common electrolyte imbalances associated with the use of furosemide is hypokalemia, which is a low level of potassium in the blood. This occurs because furosemide increases the excretion of potassium in the urine by inhibiting its reabsorption in the kidneys. Hypokalemia can lead to various symptoms such as muscle weakness, cramps, and cardiac arrhythmias, making it important for healthcare providers to monitor potassium levels closely in patients receiving furosemide.
Question 5 of 5
A 19-year-old man attempts suicide after failing all of his college courses. He goes home and takes more than 90 digoxin tablets (0.25 mg each), ingesting them about 3 h prior to presentation at the emergency department. He is brought to the hospital by his brother. Vital signs are as follows: pulse is 50 beats/minute, and the electrocardiogram indicates third-degree heart block. Serum electrolytes are normal. Which of the following is the most important therapy to initiate in this patient?
Correct Answer: B
Rationale: Digoxin overdose (bradycardia, heart block) requires digoxin immune Fab , binding free digoxin to reverse toxicity. Amiodarone and lidocaine treat arrhythmias but not the cause. Potassium and verapamil (E) worsen hyperkalemia or block. Fab is urgent here.