ATI RN
ATI RN Pharmacology Online Practice 2023 A Questions
Question 1 of 5
Which drug in the following list has an analgesic effect which is not mediated wholly or partly by binding to opioid receptors?
Correct Answer: D
Rationale: Analgesics often act via opioid receptors. Codeine, a weak mu-opioid agonist, relieves mild pain. Tramadol combines mu agonism with serotonin/norepinephrine reuptake inhibition. Dextropropoxyphene is a mu agonist, buprenorphine a partial agonist. Nefopam's analgesia involves monoamine reuptake inhibition and possibly NMDA antagonism, not opioid receptors, distinguishing it. This non-opioid mechanism suits patients intolerant to opioids, offering an alternative in pain management.
Question 2 of 5
A male patient with blood type AB, Rh factor positive needs a blood transfusion. The Transfusion Service (blood bank) sends type O, Rh factor negative blood to the unit for the nurse to infuse into this patient. The nurse knows that:
Correct Answer: C
Rationale: Type O, Rh-negative blood is considered the universal donor blood and is compatible with all blood types, including AB-positive. This makes it a safe choice in emergencies or when the patient's blood type is unknown. Premedication with diphenhydramine and acetaminophen is not necessary for compatibility but may be used to prevent allergic reactions or fever. Therefore, the nurse can confidently administer this blood product.
Question 3 of 5
A client calls the nurse help-line and says, 'My friend and I have been swimming and drinking beer all day and he took a couple of swigs of Robitussin DM (dextromethorphan) about 15 minutes ago. Now he is acting funny and seeing things.' What should the nurse consider when formulating a response?
Correct Answer: D
Rationale: Dextromethorphan (DM), a cough suppressant, can cause dizziness, hallucinations, and confusion, especially with alcohol, which amplifies CNS depression . Dialysis isn't standard for DM overdose; it's not an opioid , though it acts centrally; and addiction isn't the acute issue. The nurse considers dizziness as a key adverse effect, worsened by beer, guiding a response to seek medical help.
Question 4 of 5
Which of the following statements regarding colloid administration does the nurse identify as being true?
Correct Answer: A
Rationale: Colloids, such as albumin and synthetic colloids like hydroxyethyl starch, do not enhance the oxygen-carrying capacity of the blood. They can help to increase the intravascular volume in cases of hypovolemia by osmotically drawing fluid into the intravascular space. This can help improve tissue perfusion by increasing blood pressure. Colloids do not have a direct effect on oxygen-carrying capacity or coagulation properties. Dextran therapy can cause adverse effects like anaphylaxis or renal failure, but it is not a general contraindication for all colloid administration in the treatment of hypovolemia.
Question 5 of 5
A 24-year-old G1P0 woman arrives at the hospital in labor at 39 weeks gestation. She denies an epidural, stating her desire to give birth naturally. After 5 h of labor, the baby has begun its descent through the birth canal when the patient requests pain relief. Which of the following opioids would be best to administer?
Correct Answer: A
Rationale: Labor pain relief without epidural favors Butorphanol , a mixed opioid agonist-antagonist. It provides analgesia with less respiratory depression risk to the fetus than Codeine , Methadone , or Morphine (E). Dextromethorphan is a cough suppressant. Butorphanol's safety profile suits late labor, minimizing neonatal impact.