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?

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Pharmacology Final ATI 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 cardiotoxic in overdose, causing dysrhythmias (e.g., widened QRS) due to sodium channel blockade. The priority assessment is cardiac status to detect life-threatening arrhythmias, guiding urgent interventions like sodium bicarbonate. Liver and renal effects are secondary in acute overdose. Neurological issues like seizures occur but are less immediately lethal than cardiac collapse. The nurse focuses on cardiac monitoring, aligning with toxicology priorities, making A the critical assessment.

Question 2 of 5

A client with myasthenia gravis frequently complains of weakness and fatigue. The physician plans to identify whether the client is responding to an overdose of the medication or a worsening of the disease. A tensilon test is performed. Which of the following would indicate that the client is experiencing an overdose of the medication?

Correct Answer: A

Rationale: In a Tensilon test, edrophonium chloride is administered to differentiate between myasthenic crisis (worsening of the disease) and cholinergic crisis (overdose of medication). A temporary worsening of symptoms, such as increased weakness, indicates a cholinergic crisis due to an overdose of anticholinesterase medications. Improvement suggests myasthenic crisis, while no change is inconclusive. Muscle spasms are not specific to an overdose. Therefore, worsening symptoms indicate an overdose.

Question 3 of 5

A patient is receiving TPN at home. The visiting nurse assists the family with the care plan, which includes changing the TPN solution and tubing. What is the recommended initial frequency for changing the tubing?

Correct Answer: A

Rationale: TPN tubing should be changed every 24 hours to prevent infection and maintain sterility. Longer intervals (B, C, D) increase the risk of bacterial contamination and sepsis.

Question 4 of 5

A patient on diuretic therapy calls the clinic because he™s had the flu, with terrible vomiting and

Correct Answer: B

Rationale: The correct statement by the nurse is, "It™s important to try to stay on your prescribed medication. Try to take it with sips of water." It is important to continue taking diuretic therapy as prescribed, even if the patient has been vomiting. Taking the medication with small sips of water can help ensure hydration and absorption of the medication. Discontinuing the diuretic abruptly can lead to fluid retention and exacerbation of the patient's condition. It's best to ensure proper hydration and medication adherence while also seeking proper medical advice if needed.

Question 5 of 5

Which explanation best indicates why barbiturates are rarely used to treat anxiety and insomnia?

Correct Answer: D

Rationale: Barbiturates (e.g., phenobarbital) cause serious adverse effects-respiratory depression, dependence-limiting use versus safer options like benzos, per pharmacology. Cost isn't higher. Allergies aren't notable. They're effective but risky. Side effects drive rarity, a safety shift.

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