ATI RN
Quizlet Pharmacology ATI Questions
Question 1 of 5
What is an adverse reaction to Montelukast? (select all that apply)
Correct Answer: B
Rationale: A. Stroke is not typically associated with an adverse reaction to Montelukast. The most common adverse reactions include neuropsychiatric events such as mood changes, suicidal thoughts/behaviors, and allergic reactions affecting the skin and mucous membranes.
Question 2 of 5
A 37-year-old man is found to have hypercholesterolemia during a routine checkup. The physician prescribes lovastatin and counsels the patient to make healthy dietary and lifestyle changes to keep his cholesterol under control. Two weeks later, he returns complaining of severe muscle pain, possibly caused by his lovastatin therapy. He insists that he is taking the medication exactly as prescribed, but the physician knows that lovastatin is metabolized by the cytochrome P450 3A4. What else may he be using that would explain his condition?
Correct Answer: B
Rationale: Lovastatin's myopathy (muscle pain) suggests a CYP3A4 interaction. Grapefruit juice inhibits CYP3A4, increasing lovastatin levels, causing toxicity. Barbiturates , Griseofulvin , and Phenytoin induce CYP3A4, reducing levels. St. John's wort (E) also induces. Grapefruit juice fits the timeline and mechanism, explaining the adverse effect.
Question 3 of 5
A client is prescribed propranolol (Inderal) for migraines. Which statement by the client indicates a need for further teaching?
Correct Answer: B
Rationale: Propranolol, a beta-blocker, prevents migraines but requires consistent use'stopping if migraines cease risks rebound, showing a teaching gap. Pulse checking monitors bradycardia. Tiredness and orthostasis are expected. Abrupt cessation can worsen migraines, critical in prophylaxis where steady-state matters, making B the statement needing correction.
Question 4 of 5
Lorazepam can be safely used as a preanesthetic medication in a patient undergoing liver transplantation without fear of excessive CNS depression because the drug is
Correct Answer: C
Rationale: Lorazepam is a benzodiazepine commonly used as a preanesthetic medication due to its anxiolytic and sedative properties. In patients undergoing liver transplantation, where hepatic function is compromised, drugs that rely on liver metabolism could accumulate and cause excessive central nervous system depression. Lorazepam's key advantage lies in its pharmacokinetic profile: it undergoes glucuronidation, a conjugation process that occurs outside the liver, primarily in the kidneys. This extrahepatic metabolism ensures that its clearance is less affected by liver dysfunction, reducing the risk of prolonged or excessive sedation. Unlike other benzodiazepines that depend heavily on hepatic cytochrome P450 enzymes, lorazepam's metabolism is more predictable in such patients, making it a safer choice. Excretion in unchanged form or secretion into the GI tract does not apply, and while it is anxiolytic, it does have CNS depressant effects, ruling out other options. Naloxone reverses opioids, not benzodiazepines.
Question 5 of 5
Which condition does the nurse identify as a late manifestation of hypokalemia?
Correct Answer: C
Rationale: Palpitations are a late manifestation of hypokalemia. Hypokalemia is a condition characterized by low levels of potassium in the blood, which can affect the heart's ability to function properly. Palpitations, or irregular heartbeat, can occur as a result of the heart's increased sensitivity to adrenaline due to low potassium levels. Other early manifestations of hypokalemia include muscle weakness, which is a result of potassium's role in muscle contraction, hypotension (low blood pressure), and lethargy.