ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
The student nurse asks the nursing instructor why drug plateaus occur with medications. What are the best responses by the nursing instructor?
Correct Answer: A
Rationale: Plateaus occur when receptors are saturated-max effect is reached (e.g., morphine), a pharmacodynamic limit. 100% relief isn't guaranteed-plateau is effect ceiling. Resistance (tolerance) builds over time, not instant. Losing efficacy implies degradation, not saturation. Receptor occupancy explains the plateau, a core concept.
Question 2 of 5
A 26-year-old man presents to the emergency department with severe right lower quadrant pain. Physical exam reveals rebound tenderness and decreased bowel sounds. An emergent appendectomy is performed. Postsurgically, he is given an NSAID along with morphine for pain control. Which of the following NSAIDs is commonly used as an adjunct to opioids postsurgically?
Correct Answer: D
Rationale: Post-appendectomy pain management often combines opioids like morphine with NSAIDs for synergy. Acetaminophen is an analgesic but not a true NSAID (lacks significant anti-inflammatory action). Celecoxib , a COX-2 inhibitor, is less common acutely due to cost and milder effect. Ibuprofen is effective but less potent parenterally. Ketorolac , a potent NSAID, is widely used postsurgically-available IV/IM, it reduces inflammation and pain, complementing morphine's central action. Naproxen (E) is oral, less ideal acutely. Ketorolac's rapid onset and efficacy in reducing opioid requirements make it standard. Its short-term use minimizes GI risks, aligning with surgical protocols, distinguishing it from other options for acute postoperative pain control.
Question 3 of 5
A 52-year-old man with organic impotence is in the preoperative holding area before surgery. He is given intravenous vancomycin over 20 min and begins to develop fever, chills, and redness at the injection site. What is the most appropriate course of action for the physician to take?
Correct Answer: D
Rationale: Vancomycin's rapid infusion causes red man syndrome (fever, chills, redness) is discontinue . Anticholinesterase is irrelevant. Corticosteroids treat severe reactions, not initial step. Intubation is excessive. Slowing infusion (E) is preventive, not reactive. Stopping vancomycin halts histamine release, resolving symptoms.
Question 4 of 5
A 65-year-old man with end-stage renal disease because of diabetes recently underwent a renal transplant. He has been responding well to the transplant and his creatinine has stabilized around 2.1 mg/dL. He was placed on immunosuppressive therapy with muromonab. What is the mechanism of action of muromonab?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 5 of 5
A habitual user of a schedule-controlled drug abruptly stops using it. Within 8 h, she becomes anxious, starts to sweat, and gets severe abdominal pain with diarrhea. These symptoms intensify over the next 12 h, during which time she has a runny nose, is lacrimating, and has uncontrollable yawning and intensification of muscle cramping and jerking. Assuming that these are withdrawal symptoms in the patient due to her physical dependence, the drug most likely to be involved is
Correct Answer: D
Rationale: Meperidine, a synthetic opioid, causes physical dependence with chronic use. Abrupt cessation triggers classic opioid withdrawal: anxiety, sweating, abdominal pain, diarrhea (8-12 hours onset), escalating to rhinorrhea, lacrimation, yawning, and muscle cramps—matching the timeline and symptoms described. Alprazolam (benzodiazepine) withdrawal peaks later (days), with seizures and anxiety but less GI distress. Amphetamine withdrawal causes fatigue and depression, not this autonomic profile. Ethanol withdrawal includes tremors and seizures, typically 12-48 hours, differing from this rapid onset. Secobarbital (barbiturate) withdrawal resembles benzodiazepines, with delayed seizures. Meperidine's mu receptor agonism explains the dependence and acute, opioid-specific withdrawal syndrome, aligning perfectly with the patient's presentation.