ATI RN
Pharmacology ATI Final Questions
Question 1 of 5
The patient receives imipramine (Tofranil) as treatment for depression. He is admitted to the emergency department following an intentional overdose of this medication. What will the priority assessment by the nurse include?
Correct Answer: A
Rationale: Imipramine, a tricyclic antidepressant, is highly cardiotoxic in overdose, often causing fatal dysrhythmias due to sodium channel blockade, leading to widened QRS complexes and ventricular arrhythmias. The priority assessment must focus on cardiac status to detect life-threatening changes like tachycardia or arrhythmias, requiring immediate intervention such as sodium bicarbonate or cardioversion. Liver function and renal status may be affected long-term but aren't the acute priority in overdose. Neurological function , while impacted (e.g., seizures), is secondary to cardiac risks, as circulatory collapse poses the greatest immediate threat. The nurse's focus on cardiac monitoring aligns with toxicology protocols, ensuring rapid response to the most lethal complication, making choice A the critical assessment in this emergency scenario.
Question 2 of 5
A patient suffering from attention deficit hyperactivity disorder is placed on atomoxetine. A drug that has a similar mechanism of action to atomoxetine is
Correct Answer: D
Rationale: Atomoxetine treats ADHD by selectively inhibiting norepinephrine (NE) reuptake, increasing NE and dopamine in the prefrontal cortex to improve attention and impulse control, without stimulant properties. Methylphenidate blocks DA and NE reuptake but is a stimulant, differing in profile and abuse potential. Botulinum toxin affects neuromuscular junctions, unrelated to ADHD. Clonidine, an alpha-2 agonist, reduces NE release, calming hyperactivity but not via reuptake. Amitriptyline, a TCA, inhibits NE and 5HT reuptake, with broader effects and sedation, used off-label for ADHD in some cases. Its NE reuptake inhibition parallels atomoxetine's core mechanism, though it's less selective and not first-line. Among these, amitriptyline's shared NE focus makes it mechanistically closest.
Question 3 of 5
Rho(D) immune globulin (RhoGAM) is given to a pregnant woman after delivery and the nurse is giving information to the patient about the indication of the medication. The nurse determines that the patient understands the purpose of the medication if the patient tells that it will protect her baby from which of the following?
Correct Answer: D
Rationale: Rho(D) immune globulin (RhoGAM) is administered to Rh-negative mothers to prevent Rh incompatibility in future pregnancies. It works by preventing the mother's immune system from developing antibodies against Rh-positive fetal blood cells, which could harm subsequent Rh-positive babies. Pernicious anemia and German measles are unrelated to RhoGAM. The medication does not affect the baby's blood type but prevents the mother's immune response. Therefore, Rh incompatibility is the correct answer.
Question 4 of 5
A pregnant woman is experiencing hypertension. The nurse knows that which drug is commonly used for a pregnant patient who is experiencing hypertension?
Correct Answer: D
Rationale: Methyldopa is the preferred antihypertensive medication for pregnant women experiencing hypertension. It has been extensively studied and considered safe for both the mother and the fetus. Methyldopa has been shown to effectively lower blood pressure in pregnant women without causing harm to the developing fetus. Other antihypertensive medications, such as Enalapril (Vasote) and Hydrochlorothiazide (HydroDIURIL), are contraindicated during pregnancy as they can cause harm to the fetus. Mannitol (Osmitrol) is an osmotic diuretic primarily used for reducing intracranial pressure or treating cerebral edema, not for hypertension in pregnancy. Therefore, Methyldopa is the right choice for a pregnant patient with hypertension.
Question 5 of 5
The nurse is monitoring a post-renal transplantation client taking cyclosporine (Neoral). The nurse observes an elevation in one of the client's vital signs and the client is complaining of sweating and
Correct Answer: C
Rationale: Cyclosporine, a common immunosuppressive medication used in post-renal transplantation clients, can cause a range of adverse effects, including hypertension, nephrotoxicity, and electrolyte imbalances. One of the significant side effects of cyclosporine is causing an elevation in the pulse rate, also known as tachycardia. Tachycardia is a common side effect of cyclosporine due to its direct effects on the cardiovascular system. Therefore, in the context of a post-renal transplantation client taking cyclosporine, an elevation in pulse rate is the most likely vital sign to be increased. Sweatiness may be a response to the increased heart rate and may also be a side effect of cyclosporine. However, the primary vital sign affected by cyclosporine would be the pulse rate.