ATI RN
ATI RN Pharmacology Online Practice 2023 B Questions
Question 1 of 5
The patient has been prescribed dextromethorphan (Delsym). What medication information should the nurse provide?
Correct Answer: D
Rationale: Dextromethorphan with alcohol risks slurred speech . Smoking and timing are off. D ensures safety, making it key.
Question 2 of 5
A 78-year-old man is admitted with deterioration of chronic heart failure. He is house-bound and has had three similar admissions in the past nine months. There is a history of ischaemic heart disease. His medication comprises furosemide, ramipril in full dose, valsartan, spironolactone, simvastatin and aspirin. He is dyspnoeic on minimal exertion, looks unwell, pulse 100/min regular, BP 90/70 mmHg, jugular venous pressure (JVP) is at 4 cm, gallop rhythm, chest clear, pretibial oedema. ECG shows sinus rhythm, an old inferior infarct and poor anterior R wave progression. Serum urea 15 mmol/L, creatinine 90 μmol/L, Na+ 140, K+ 4.6. Which of the following would be most appropriate?
Correct Answer: C
Rationale: Chronic heart failure (CHF) decompensation needs optimization. Morphine relieves acute dyspnea but not chronic management here. Hydralazine/isosorbide reduces afterload/preload, useful in advanced CHF, but less immediate. Carvedilol, a beta-blocker, risks decompensation with low BP. Metolazone, a potent diuretic, aids fluid overload but overlaps with furosemide. Digoxin improves contractility and rate control in sinus rhythm CHF, reducing hospitalizations, most appropriate given his recurrent admissions and stable renal function. Its inotropic benefit stabilizes this patient, enhancing quality of life.
Question 3 of 5
Which of the following is the priority nursing diagnosis for a client undergoing chemotherapy?
Correct Answer: A
Rationale: Altered nutrition is often the priority nursing diagnosis for clients undergoing chemotherapy because the treatment can cause side effects such as nausea, vomiting, anorexia, and mucositis, leading to malnutrition and weight loss. Proper nutrition is essential for maintaining strength, supporting the immune system, and promoting recovery. While fear, anxiety, and decreased cardiac output are valid concerns, addressing nutritional deficits is critical to the client's overall well-being and ability to tolerate treatment.
Question 4 of 5
Regarding glucocorticoids:
Correct Answer: A
Rationale: Cortisol is indeed the primary human glucocorticoid, a true statement regulating metabolism and stress. Normal cortisol secretion is ~10-20 mg/day, not 100 mg, so that's false. ACTH suppression occurs rapidly (hours), true. Cortisol absence heightens catecholamine sensitivity, true, as in Addison's disease. Leukocyte/macrophage inhibition is a glucocorticoid action, not its absence. Cortisol's role as the major glucocorticoid underpins its therapeutic mimicry (e.g., hydrocortisone) in adrenal insufficiency.
Question 5 of 5
The most common dose-limiting toxicity of chemotherapy is:
Correct Answer: C
Rationale: Myelosuppression, the suppression of bone marrow activity, is the most common dose-limiting toxicity of chemotherapy. It leads to reduced production of blood cells, including white blood cells, red blood cells, and platelets, increasing the risk of infections, anemia, and bleeding. While nausea, vomiting, and mucositis are significant side effects, they can often be managed with supportive care. Myelosuppression, however, can be life-threatening and frequently requires dose adjustments or delays in treatment. Bloody stools are less common and typically not the primary dose-limiting factor.