ATI RN
Pharmacology Final ATI Questions
Question 1 of 9
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 9
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.
Question 3 of 9
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 9
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 5 of 9
A client with diabetes is prescribed metformin (Glucophage). Which instruction should the nurse include in the teaching plan?
Correct Answer: A
Rationale: Metformin lowers blood glucose by reducing hepatic production and improving insulin sensitivity, best taken with meals to minimize GI upset (e.g., nausea), a common side effect, while aligning with food intake for glycemic control. Reporting muscle pain relates to rare lactic acidosis, not a primary instruction unless symptomatic. Avoiding carbohydrates is incorrect'diabetes management balances carbs, not eliminates them. Bedtime-only dosing ignores twice-daily norms. Taking it with meals enhances tolerance and efficacy, critical for adherence in type 2 diabetes, where metformin is first-line. This instruction reflects its pharmacokinetics and practical use, making A the key teaching point.
Question 6 of 9
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 7 of 9
When administering the medication Spironolactone, when is the best time to administer it?
Correct Answer: D
Rationale: The best time to administer Spironolactone is in the morning. This is because Spironolactone is a diuretic that can increase urination, and taking it in the morning can help prevent disrupting the sleep cycle by decreasing the need to urinate during the night. Additionally, taking Spironolactone in the morning allows for better management of any potential electrolyte imbalances that may occur as a side effect of the medication, as healthcare providers are more readily available during daytime hours.
Question 8 of 9
A 74-year-old professional golfer has chest pain that occurs toward the end of his golfing games. He says the pain usually goes away after one or two sublingual nitroglycerin tablets and rest. What type of angina is he experiencing?
Correct Answer: D
Rationale: The 74-year-old professional golfer is likely experiencing Prinzmetal™s angina. This type of angina, also known as variant angina, typically occurs at rest and is due to coronary artery spasm, rather than the typical obstruction of blood flow seen in classic angina. The chest pain in Prinzmetal™s angina is often relieved by medications that dilate the blood vessels, such as nitroglycerin, as described by the patient. This distinguishes it from classic angina, which is typically triggered by exertion or emotional stress. Unstable angina, on the other hand, is characterized by chest pain that occurs unpredictably, even at rest and may signal an impending heart attack.
Question 9 of 9
A nurse is providing instructions to a client receiving baclofen (Lioresal). Which of the following would be included in the teaching plan?
Correct Answer: D
Rationale: Baclofen is a muscle relaxant used to treat spasticity. Weakness is a potential side effect and should be reported to the physician, as it may indicate an adverse reaction or the need for dose adjustment. Limiting fluid intake is not typically recommended, and holding the medication due to diarrhea is not a standard instruction. While alcohol can enhance the sedative effects of baclofen, the primary concern is monitoring for weakness, which could impact the patient's safety and mobility.