ATI RN
ATI Practice Exam Pharmacology The Endocrine System 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 20-year-old woman comes to the clinic for follow-up related to isotretinoin use. Which information from the iPLEDGE program will the nurse provide to the patient? (Select all that apply.)
Correct Answer: B
Rationale: The iPLEDGE program is a risk management program for isotretinoin to prevent fetal exposure. Patients must review iPLEDGE educational materials (B) and provide a negative pregnancy test before each monthly refill (C). Two methods of contraception are required, not one (A). Informed consent is required (D is incorrect). A 30-day, not 60-day, supply is prescribed (E is incorrect).
Question 3 of 5
A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statement?
Correct Answer: D
Rationale: Enteric-coated medications are designed to resist dissolution in the stomach and release the active ingredient in the intestines. Chewing or crushing the tablet can compromise the coating, leading to premature drug release and potential irritation of the stomach lining. Therefore, the nurse should instruct the patient to swallow the tablet whole without chewing. Taking the tablet with orange juice or avoiding other medications is not necessary, and crushing the tablet is contraindicated. Proper administration ensures the medication's effectiveness and minimizes the risk of adverse effects.
Question 4 of 5
A neighbor tells nurse Maureen he has to have surgery and is reluctant to have any blood product transfusions because of a fear of contracting an infection. He asks the nurse what are his options. The nurse teaches the person that the safest blood product is:
Correct Answer: C
Rationale: An autologous blood product is the safest option because it involves the patient donating their own blood before surgery, eliminating the risk of transfusion reactions or infections from donor blood. Allogeneic products come from other donors and carry a small risk of infection or incompatibility. Directed donations are from known donors but still carry some risks. Cross-matching ensures compatibility but does not eliminate infection risks. Therefore, autologous donation is the safest choice.
Question 5 of 5
Which of the following is least likely to have an adverse drug interaction with phenelzine (a monoamine oxidase (MAO) inhibitor)?
Correct Answer: D
Rationale: Phenelzine, an MAOI, risks hypertensive crisis or serotonin syndrome with drugs increasing monoamines. Levodopa raises catecholamines, risking hypertension with MAOIs. Ropinirole, a dopamine agonist, may enhance monoamine effects, potentially hazardous. Tolcapone, a COMT inhibitor, increases levodopa levels, amplifying MAOI risks. Pseudoephedrine, a sympathomimetic, causes severe hypertension. Propofol, an anesthetic, acts via GABA without monoamine interaction, making it least likely to cause adverse effects with phenelzine. Its safety profile here is key for procedural use in MAOI patients.