ATI RN
ATI Pharmacology Practice A Questions
Question 1 of 9
Which antipsychotic has the most sedative potential and is sometimes questionably used as a hypnotic agent in certain clinical settings?
Correct Answer: C
Rationale: Quetiapine, a second-generation antipsychotic, has strong histamine H1 antagonism, conferring potent sedation, especially at low doses. This property leads to off-label use as a hypnotic in insomnia, though controversial due to metabolic risks. Fluphenazine and haloperidol, high-potency first-generation drugs, lack sedation, focusing on D2 blockade. Thiothixene, mid-potency, has minimal sedative effects. Iloperidone is less sedating. Quetiapine's antihistaminic action, backed by clinical practice, makes it the most sedative antipsychotic, often leveraged for sleep despite primary indications.
Question 2 of 9
A 34-year-old man with seasonal allergic rhinitis that has been refractory to oral antihistamines is now placed on Singulair, a leukotriene receptor blocker, to see if this will improve symptoms. Important interactions with this medication include which of the following?
Correct Answer: C
Rationale: Singulair (montelukast) interacts with rifampin , a CYP3A4 inducer that reduces montelukast levels, decreasing efficacy. Ampicillin , chloramphenicol , and tetracycline lack significant interactions. Rifampin's effect is key in refractory rhinitis.
Question 3 of 9
Group of drugs which acts on amixed group of receptors:
Correct Answer: A
Rationale: Mixed agonist-antagonist drugs exhibit both agonistic and antagonistic properties at different receptor sites. These drugs can act as agonists at certain receptors while acting as antagonists at other receptors. This classification of drugs is distinct from pure agonists, pure antagonists, or partial agonists, as mixed agonist-antagonist drugs have a more complex mechanism of action. An example of a mixed agonist-antagonist drug is buprenorphine, which acts as a partial agonist at the mu opioid receptor and an antagonist at the kappa opioid receptor.
Question 4 of 9
A 23-year-old man is a driver who is involved in a motor vehicle accident. He is found to have a blood alcohol level of 850 mg/dL. Because of the way the body handles ethanol, the conventional 'half-life' to describe its metabolism does not apply. Which of the following drugs at therapeutic concentrations exhibits the same property?
Correct Answer: B
Rationale: Ethanol's zero-order metabolism (constant rate) differs from first-order half-life kinetics. Phenytoin shares this-saturating hepatic enzymes at therapeutic levels, making it correct. Ibuprofen , Simvastatin , Tolbutamide , and Valproic acid (E) follow first-order kinetics. Phenytoin's saturation mimics ethanol's fixed clearance, relevant to toxicology.
Question 5 of 9
A patient with a new prescription for a HMG-CoA (statin) drug is instructed to take the
Correct Answer: D
Rationale: The best response among the options provided is "This timeframe correlates better with the natural diurnal rhythm of cholesterol production." Statins work by inhibiting HMG-CoA reductase, an enzyme responsible for cholesterol production in the liver. Cholesterol synthesis follows a diurnal rhythm, with higher levels produced at night. Therefore, taking a statin medication in the evening aligns with the body's natural pattern of cholesterol synthesis, optimizing the drug's effectiveness. This explanation helps the patient understand the rationale behind the timing of taking the medication and promotes better adherence to the prescribed regimen.
Question 6 of 9
A patient is being discharged on anticoagulant therapy. The nurse will include in the patient- education conversation that it is important to avoid herbal products that contain which substance?
Correct Answer: B
Rationale: Ginkgo is the herbal product to avoid because it can interact with anticoagulant therapy and increase the risk of bleeding. Ginkgo has blood-thinning properties, which can further potentiate the anticoagulant effects of medications like warfarin, increasing the risk of bleeding complications. It's essential for patients on anticoagulant therapy to avoid herbal products containing ginkgo to prevent adverse effects and ensure the effectiveness of their prescribed medication.
Question 7 of 9
A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse?
Correct Answer: C
Rationale: When a patient reports a drug allergy, it is essential for the nurse to gather specific information about the nature of the reaction. Asking, 'What type of reaction did you have when you took penicillin?' allows the nurse to determine whether the reaction was a true allergy (e.g., anaphylaxis) or a side effect (e.g., gastrointestinal upset). This information is critical for guiding treatment decisions and avoiding potentially life-threatening situations. Dismissing the allergy or making assumptions about its relevance based on the patient's age is inappropriate and could compromise patient safety. Therefore, the nurse's priority is to assess the details of the allergic reaction.
Question 8 of 9
The nurse has a patient demonstrate self-administration of eyedrops. Place the steps in the order in which the patient will perform them.
Correct Answer: B
Rationale: The correct order for self-administering eyedrops is: 1. Wash hands (g). 2. Remove the cap (d). 3. Gently shake the bottle to evenly distribute the drug (b). 4. Tilt the head backward and look upward (e). 5. Pull the lower lid away from the eye so that a pouch is formed (a). 6. Place the dropper just above the pouch without touching the tip to the eye or finger (f). 7. Gently squeeze one drop of medicine into the pouch (h). 8. Press a finger against the inner corner of the eye for 2 to 3 minutes (c). This sequence ensures proper administration and minimizes the risk of contamination or systemic absorption.
Question 9 of 9
When taking Nitroglycerine (transdermal), you should have how many hours nitrate free each day?
Correct Answer: D
Rationale: When using Nitroglycerine transdermal patches, it is recommended to have a nitrate-free period of at least 10-12 hours each day to prevent the development of tolerance to the medication. Continuous exposure to nitrates can lead to a decrease in efficacy over time. By having a nitrate-free interval each day, the body has a chance to "reset" and maintain the effectiveness of the medication for angina control. It is crucial to follow this dosing schedule as directed by a healthcare provider to ensure optimal benefits and reduce the risk of tolerance.