ATI RN
ATI RN Pharmacology 2023 Proctored Exam Questions
Question 1 of 5
When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?
Correct Answer: B
Rationale: Grapefruit juice can interact with antilipemic medications, specifically statins, causing increased drug levels in the bloodstream. This can lead to a higher risk of side effects and adverse reactions. Therefore, patients on antilipemic therapy should be cautious about consuming grapefruit juice to prevent potential drug interactions.
Question 2 of 5
An 80-year-old man is taking digoxin and warfarin because of longstanding atrial fibrillation. He has an indwelling urinary catheter in situ, whilst awaiting a prostatectomy. At his pre-operation assessment he has a ventricular rate of 120/minute. The house officer doubles his daily digoxin dose and the operation is delayed one week. One week later he returns with nausea, vomiting, diarrhoea, abdominal pain, confusion, delirium and visual disturbances. The most likely cause of his current symptoms is:
Correct Answer: D
Rationale: Symptoms (nausea, confusion, visual changes) suggest digoxin toxicity, common in the elderly with doubled doses. Digoxin's narrow therapeutic index (0.5-2 ng/mL) and renal clearance (impaired with age) increase risk. Viral infection lacks cardiac specificity here. Hyperkalemia (e.g., >5.5 mmol/L) isn't indicated without ECG changes. Warfarin's INR prolongation causes bleeding, not these symptoms. UTI fits the catheter but not delirium/visual issues. Digoxin toxicity, from overdose and accumulation, explains the presentation, requiring level checks and cessation.
Question 3 of 5
A male patient is undergoing chemotherapy may also be given the drug allopurinol (Zyloprim, Aloprim). Allopurinol inhibits the synthesis of uric acid. Concomitant administration of allopurinol prevents:
Correct Answer: B
Rationale: Allopurinol is primarily used to prevent gout and hyperuricemia, which are common side effects of chemotherapy. Chemotherapy often leads to the rapid destruction of cancer cells, releasing large amounts of uric acid into the bloodstream. This can cause hyperuricemia, leading to gout or kidney stones. Allopurinol works by inhibiting xanthine oxidase, an enzyme involved in uric acid production, thereby reducing uric acid levels. While myelosuppression and pancytopenia are concerns during chemotherapy, they are not directly addressed by allopurinol. Similarly, allopurinol does not inhibit cancer cell growth or replication.
Question 4 of 5
A 6-year-old boy is brought to his primary care physician with a history of hay fever and asthma. He usually has two to three attacks per week. For symptom control, he uses an albuterol inhaler, but his parents would like to try something more. They would like him to take something that would lessen the amount of attacks he has. Although corticosteroids would probably work best for prophylaxis, they are contraindicated in children. He is instead given montelukast. How does montelukast work?
Correct Answer: A
Rationale: Montelukast prevents asthma attacks by blocking leukotriene receptors . Leukotrienes drive inflammation; montelukast reduces this, complementing albuterol's acute relief. Muscarinic blockade is ipratropium's action. COX inhibition (C, D) is NSAIDs'. Lipoxygenase inhibition (E) is zileuton's. Montelukast's specificity suits prophylaxis in this child.
Question 5 of 5
Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
Correct Answer: D
Rationale: Furosemide (Lasix) is a loop diuretic that helps the body to remove excess salt and water, which can be useful in conditions like congestive heart failure, liver disease, or kidney disorders. The correct statement by the nurse is to "Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes." This instruction is important because diuretics like furosemide can cause changes in blood pressure, leading to dizziness and fainting when standing up quickly. By changing positions slowly, the patient can minimize the risk of experiencing these symptoms.