ATI RN
Pharmacology Across the Lifespan ATI Questions
Question 1 of 5
Tolerance may be caused by desensitization, internalization or downregulation of receptors, requiring higher drug doses to maintain the same response. Tolerance also often results from enhanced drug elimination that alters the concentrations of drugs available to interact with receptor.
Correct Answer: A
Rationale: Step-by-step rationale for why Answer A is correct: 1. Desensitization, internalization, and downregulation of receptors can lead to tolerance by reducing the responsiveness of receptors to a drug. 2. Higher drug doses are needed to achieve the same effect due to decreased receptor sensitivity. 3. Enhanced drug elimination can reduce drug concentrations, requiring higher doses to achieve the desired response. 4. Therefore, the statement accurately describes the mechanisms of tolerance development. Summary: Choice A is correct because it accurately explains how desensitization, internalization, downregulation of receptors, and enhanced drug elimination can contribute to the development of tolerance. Choices B, C, and D are incorrect as they do not provide a comprehensive explanation of tolerance mechanisms.
Question 2 of 5
The NP at the immunization clinic is reviewing the list of patients who are scheduled to receive the varicella vaccination. The NP will cancel all of the following patients except:
Correct Answer: C
Rationale: The correct answer is C because having asthma does not contraindicate receiving the varicella vaccination. Asthma is not a contraindication for the varicella vaccine, so the NP should not cancel the appointment for the 8-year-old patient with asthma. All the other choices have contraindications to receiving the varicella vaccine. A: Neomycin allergy is a contraindication as the vaccine may contain neomycin. B: Gelatin allergy is a contraindication as the varicella vaccine may contain gelatin. D: Pregnancy is a contraindication as live vaccines like varicella are generally not recommended during pregnancy due to theoretical risks to the fetus.
Question 3 of 5
A patient with a history of moderate to severe headache pain associated with nausea and vomiting is diagnosed with migraines. Which medication would the NP prescribe initially?
Correct Answer: D
Rationale: The correct answer is D: Sumatriptan. Sumatriptan is a specific medication used for acute migraine treatment by targeting serotonin receptors to reduce inflammation and pain. It is the initial choice due to its efficacy in relieving migraine symptoms. Meperidine (A) and Butorphanol (B) are opioid analgesics with potential for abuse and not recommended for routine migraine treatment. Aspirin (C) is a non-specific pain reliever and may not provide adequate relief for migraines compared to specific migraine medications like Sumatriptan.
Question 4 of 5
A 38-year old female is seen in your office complaining of cold intolerance, fatigue, dry skin, weight gain, and heavy menstrual periods. Her physical exam showed a HR 58 bpm and a waxy sallow complexion and a firm goiter. Her TSH level is 34 Mu/L. What is the recommended treatment for this patient?
Correct Answer: C
Rationale: The correct answer is C: Initiate levothyroxine dose 0.1mg PO every morning and recheck her TSH in 6 weeks. Rationale: 1. The patient presents with symptoms of hypothyroidism (cold intolerance, fatigue, weight gain, heavy menstrual periods) and has elevated TSH levels, indicating primary hypothyroidism. 2. The recommended initial levothyroxine dose for adults with hypothyroidism is 1.6 mcg/kg/day, which translates to approximately 100 mcg (0.1mg) for a 60kg person. 3. Starting with a dose of 0.1mg PO every morning is appropriate to avoid rapid correction and potential adverse effects. 4. Rechecking TSH levels in 6 weeks allows for assessment of treatment response and adjustment of the levothyroxine dose if needed. Summary: A: Starting with 0.025 mg of levothyroxine is too low
Question 5 of 5
Primary hypothyroidism may be suspected in what scenario?
Correct Answer: B
Rationale: The correct answer is B: If TSH high. In primary hypothyroidism, the thyroid gland fails to produce enough thyroid hormones, leading to elevated TSH levels as the body tries to stimulate the thyroid to produce more hormones. A high TSH is indicative of the pituitary gland's response to low thyroid hormone levels. Choices A, C, and D do not align with the typical hormonal profile seen in primary hypothyroidism. A high TSH is the key marker for suspecting primary hypothyroidism.