ATI RN
ATI Pharmacology Practice B Questions
Question 1 of 5
The nurse reviews the patient’s medication history. Based on the patient’s prolonged use of topical corticosteroids, which assessment will the nurse include? (Select all that apply.)
Correct Answer: B
Rationale: Prolonged use of topical corticosteroids can cause thinning of the skin (B) and purpura (D) due to decreased collagen production and increased fragility of blood vessels. Weight gain (A) is associated with systemic, not topical, corticosteroid use. Erythematous lesions (C) are not typically caused by topical corticosteroids.
Question 2 of 5
A child is admitted with a serious infection. After two days of antibiotics, he is severely neutropenic. The physician orders granulocyte transfusions for the next four days. The mother asks the nurse why? The nurse responds:
Correct Answer: D
Rationale: Granulocyte transfusions are used to temporarily increase the white blood cell count in severely neutropenic patients, particularly those with life-threatening infections. These transfusions provide functional granulocytes to help fight the infection while the patient's bone marrow recovers and begins producing its own white blood cells. This explanation is accurate and reassures the mother that the treatment is aimed at supporting the child's immune system during a critical period.
Question 3 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 4 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 5 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.