ATI RN
ATI Pharmacology Made Easy 4.0 The Hematologic System Questions
Question 1 of 5
The patient has bipolar disorder and is in a manic phase. The physician prescribes lithium (Eskalith). The patient's current lithium level is 0.4. What will the nurse expect to assess in this patient?
Correct Answer: B
Rationale: Lithium's therapeutic range is 0.6-1.2 mEq/L-0.4 is subtherapeutic, so mania (hyperactivity, pressured speech) persists, per pharmacokinetics. Baseline calm needs higher levels. Depression isn't current. Manic decrease requires therapeutic dosing. Low level predicts ongoing mania, per assessment.
Question 2 of 5
A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?
Correct Answer: A
Rationale: Option E is the correct answer. When a patient with type II diabetes is taking a beta blocker, it's important to monitor blood glucose levels regularly for possible changes in glucose levels. Beta blockers can mask the symptoms of hypoglycemia, such as tremors and rapid heartbeat, which can make it harder for patients to recognize when their blood sugar is too low. On the other hand, beta blockers can also potentially lead to hyperglycemia as they can blunt the body's response to hypoglycemia by inhibiting the release of counter-regulatory hormones like epinephrine. Therefore, monitoring blood glucose levels is crucial in such patients to prevent complications related to blood sugar fluctuations.
Question 3 of 5
A 17-year-old client is taking phenytoin (Dilantin) for the treatment of seizures. Phenytoin blood level reveals to be 25 mcg/ml. Which of the following symptoms would be expected as a result of the laboratory result?
Correct Answer: D
Rationale: A phenytoin level of 25 mcg/ml is above the therapeutic range (10-20 mcg/ml) and can cause toxicity symptoms such as nystagmus, ataxia, and confusion. Hyperactivity and tremors are not typical signs of phenytoin toxicity. Therefore, nystagmus is the expected symptom.
Question 4 of 5
Peripheral adverse effects of levodopa, including nausea, hypotension, and cardiac arrhythmias, can be diminished by including which of the following drugs in the therapy?
Correct Answer: C
Rationale: Levodopa's peripheral conversion to dopamine by dopa decarboxylase causes nausea (via chemoreceptor trigger zone stimulation), hypotension, and arrhythmias. Carbidopa, a peripheral dopa decarboxylase inhibitor, prevents this conversion outside the CNS, reducing these side effects while increasing levodopa's brain availability. Amantadine, an NMDA antagonist, boosts dopamine release but doesn't address peripheral metabolism. Ropinirole, a dopamine agonist, bypasses levodopa but doesn't mitigate its effects. Tolcapone, a COMT inhibitor, prolongs levodopa's action but can increase peripheral dopamine if used alone, worsening side effects. Carbidopa's specific blockade of peripheral decarboxylation directly counters these adverse effects, making it the essential adjunct in levodopa therapy.
Question 5 of 5
Which statement about ARBs does the nurse identify as being true?
Correct Answer: A
Rationale: Angiotensin II Receptor Blockers (ARBs) are less likely to cause cough compared to ACE inhibitors. However, one of the notable adverse effects associated with ARBs is hyperkalemia. ARBs can lead to an increase in potassium levels in the blood more so than ACE inhibitors. Therefore, the nurse should recognize that hyperkalemia is more likely to occur with ARBs than when using ACE inhibitors.