The patient has been receiving escitalopram (Lexapro) for treatment of obsessive-compulsive disorder. Unknown to the nurse, the patient has also been self-medicating with St. John's wort. The patient comes to the office with symptoms of hyperthermia and diaphoresis. Which statement best describes the result of the nurse's assessment?

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ATI RN Pharmacology 2023 Proctored Exam Questions

Question 1 of 5

The patient has been receiving escitalopram (Lexapro) for treatment of obsessive-compulsive disorder. Unknown to the nurse, the patient has also been self-medicating with St. John's wort. The patient comes to the office with symptoms of hyperthermia and diaphoresis. Which statement best describes the result of the nurse's assessment?

Correct Answer: D

Rationale: Escitalopram and St. John's wort, both serotonin boosters, risk serotonin syndrome-hyperthermia, diaphoresis-per pharmacology. St. John's toxicity alone (e.g., photosensitivity) doesn't fit. They're not safe together-interaction is known. Withdrawal lacks agitation context. Serotonin excess explains symptoms, a critical finding.

Question 2 of 5

Prior to administering medications, the student nurse reviews the therapeutic index. Which statement best describes the student's understanding of therapeutic index?

Correct Answer: B

Rationale: Therapeutic index (TI), the ratio of toxic to effective dose, gauges safety-wide TI means safer dosing, helping the student assess if doses are within safe limits. Best drug choice is clinical, not TI-based. Interactions aren't TI-specific. Monitoring needs tie to narrow TI drugs (e.g., lithium), but safety is broader. TI ensures safe dosing, a key review point.

Question 3 of 5

A 6-year-old boy is brought to his primary care physician with a history of hay fever and asthma. He usually has two to three attacks per week. For symptom control, he uses an albuterol inhaler, but his parents would like to try something more. They would like him to take something that would lessen the amount of attacks he has. Although corticosteroids would probably work best for prophylaxis, they are contraindicated in children. He is instead given montelukast. How does montelukast work?

Correct Answer: A

Rationale: Montelukast prevents asthma attacks by blocking leukotriene receptors . Leukotrienes drive inflammation; montelukast reduces this, complementing albuterol's acute relief. Muscarinic blockade is ipratropium's action. COX inhibition (C, D) is NSAIDs'. Lipoxygenase inhibition (E) is zileuton's. Montelukast's specificity suits prophylaxis in this child.

Question 4 of 5

When administering the drug lithium, name one important side effect to watch for:

Correct Answer: B

Rationale: One important side effect to watch for when administering the drug lithium is seizures. Lithium is commonly used to treat bipolar disorder, but it can lower the seizure threshold and increase the risk of seizures in some patients. It is crucial to monitor individuals taking lithium for any signs of seizures or seizure activity and to promptly address any such occurrences. Regular monitoring of lithium levels and adjusting the dosage as necessary can help minimize the risk of seizures in patients receiving this medication.

Question 5 of 5

A patient says, 'I have such bad seasonal allergies. Is there anything I can take to keep them from happening?' What information should the nurse provide?

Correct Answer: C

Rationale: Preventing seasonal allergies involves blocking histamine (antihistamines, choice A), reducing inflammation (corticosteroids, choice B), or stabilizing mast cells . Mast cell stabilizers (e.g., cromolyn) prevent histamine release, a proactive approach. Decongestants relieve symptoms, not prevent. Choice C highlights a preventive mechanism, key for allergy management education.

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