ATI RN
ATI PN Pharmacology Proctored Exam 2023 Questions
Question 1 of 5
Three days after a patient's total colectomy and ileostomy, he has a nasogastric tube for continuous suction and a Foley catheter for continuous drainage. The night nurse reports a high output from the ileostomy. The patient's pulse is irregular, and he reports leg weakness. Based on this situation, the nurse would correctly suspect what type of imbalance?
Correct Answer: A
Rationale: The patient's symptoms of irregular pulse and leg weakness, along with high ileostomy output, suggest hypokalemia. High ileostomy output can lead to excessive loss of potassium, a key electrolyte responsible for muscle and nerve function. Hypokalemia can cause muscle weakness and cardiac arrhythmias, which align with the patient's symptoms. Hyperkalemia (B) would typically cause muscle cramps and cardiac abnormalities like peaked T-waves, not weakness. Hyponatremia (C) and hypercalcemia (D) do not typically present with these specific symptoms.
Question 2 of 5
Three days after a patient's total colectomy and ileostomy, he has a nasogastric tube for continuous suction and a Foley catheter for continuous drainage. The night nurse reports a high output from the ileostomy. The patient's pulse is irregular, and he reports leg weakness. Based on this situation, the nurse would correctly suspect what type of imbalance?
Correct Answer: A
Rationale: The patient's symptoms of irregular pulse and leg weakness, along with high ileostomy output, suggest hypokalemia. High ileostomy output can lead to excessive loss of potassium, a key electrolyte responsible for muscle and nerve function. Hypokalemia can cause muscle weakness and cardiac arrhythmias, which align with the patient's symptoms. Hyperkalemia (B) would typically cause muscle cramps and cardiac abnormalities like peaked T-waves, not weakness. Hyponatremia (C) and hypercalcemia (D) do not typically present with these specific symptoms.
Question 3 of 5
The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have
Correct Answer: D
Rationale: Infants have a higher percentage of total body water (approximately 75%) compared to adults. This difference affects the distribution and concentration of water-soluble drugs, often requiring adjustments in dosing to achieve therapeutic effects. Increased protein in circulation, lower fat composition, and more muscular body composition are not primary factors influencing drug therapy in infants. Therefore, the nurse must consider the higher water composition when calculating drug dosages for pediatric patients.
Question 4 of 5
In developing a plan of care for the patient, the nurse understands that the order for pegfilgrastim was prescribed for which reason?
Correct Answer: D
Rationale: Pegfilgrastim is a long-acting form of filgrastim, modified with polyethylene glycol (pegylated) to prolong its activity. It is administered once per chemotherapy cycle to stimulate white blood cell production and reduce the risk of neutropenia. Unlike filgrastim, which requires daily injections, pegfilgrastim's extended half-life allows for less frequent dosing. The nurse should educate the patient about the dosing schedule and monitor for side effects, such as bone pain.
Question 5 of 5
One hour after receiving intravenous morphine sulfate, a patient reports generalized itching. The nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will the nurse take?
Correct Answer: D
Rationale: The nurse should prepare an epinephrine injection in case of an anaphylactic reaction. While generalized itching is a common side effect of morphine, the presence of itching along with clear breath sounds and absence of rash may suggest a possible allergic reaction. Anaphylactic reactions can be life-threatening and may present with symptoms such as itching, respiratory distress, and cardiovascular collapse. Therefore, having epinephrine readily available is crucial in case an anaphylactic reaction occurs, as it is the treatment of choice for such a reaction.