ATI RN
Pharmacology Final ATI Questions
Question 1 of 5
Which explanation best indicates why barbiturates are rarely used to treat anxiety and insomnia?
Correct Answer: D
Rationale: In the context of pharmacology, the correct answer is D) They produce many serious adverse effects. Barbiturates, while effective in treating anxiety and insomnia, are associated with a high risk of serious adverse effects such as respiratory depression, dependence, tolerance, and overdose. These risks outweigh their benefits, making them less favorable in the treatment of anxiety and insomnia. Option A) They have a greater associated cost is incorrect because the cost is not a primary factor in why barbiturates are rarely used for anxiety and insomnia. Option B) They have a high risk of producing an allergic response is also incorrect as the main concern with barbiturates lies in their serious adverse effects rather than allergic reactions. Option C) They are seldom effective is not the best explanation as barbiturates can be effective, but their side effect profile limits their use. Educationally, it is crucial for healthcare professionals to understand the rationale behind the choice of medications for specific conditions. By knowing the risks and benefits of different drug classes, they can make informed decisions that prioritize patient safety and well-being. In this case, understanding why barbiturates are not commonly used for anxiety and insomnia helps professionals choose safer and more effective alternatives for their patients.
Question 2 of 5
A 52-year-old man with organic impotence is in the preoperative holding area before surgery. He is given intravenous vancomycin over 20 min and begins to develop fever, chills, and redness at the injection site. What is the most appropriate course of action for the physician to take?
Correct Answer: D
Rationale: Vancomycin's rapid infusion causes red man syndrome (fever, chills, redness) is discontinue . Anticholinesterase is irrelevant. Corticosteroids treat severe reactions, not initial step. Intubation is excessive. Slowing infusion (E) is preventive, not reactive. Stopping vancomycin halts histamine release, resolving symptoms.
Question 3 of 5
A 65-year-old man with end-stage renal disease because of diabetes recently underwent a renal transplant. He has been responding well to the transplant and his creatinine has stabilized around 2.1 mg/dL. He was placed on immunosuppressive therapy with muromonab. What is the mechanism of action of muromonab?
Correct Answer: A
Rationale: The correct answer is A) Binds to CD3 on T cells. Muromonab, also known as OKT3, is a monoclonal antibody that targets and binds to the CD3 receptor on T cells. By binding to CD3, muromonab inhibits the function of T cells, specifically blocking T cell activation and proliferation. This mechanism of action is crucial in the context of organ transplantation to prevent T cell-mediated rejection of the transplant. Option B) Binds to FK-binding protein is incorrect because this mechanism refers to drugs like tacrolimus and cyclosporine, which act by inhibiting calcineurin and preventing the production of interleukin-2 (IL-2). Option C) Binds to IL-2 receptors on T cells is incorrect because muromonab does not directly target IL-2 receptors but rather binds to CD3 to block T cell activation, subsequently affecting IL-2 production. Option D) Binds to mTOR is incorrect because this mechanism refers to drugs like sirolimus and everolimus, which inhibit the mTOR pathway involved in cell growth and proliferation, but it is not the mechanism of action of muromonab. Understanding the mechanism of action of immunosuppressive drugs like muromonab is essential for healthcare professionals involved in the care of transplant patients. Knowing how these medications work can help in optimizing therapy, managing side effects, and ultimately improving patient outcomes.
Question 4 of 5
A habitual user of a schedule-controlled drug abruptly stops using it. Within 8 h, she becomes anxious, starts to sweat, and gets severe abdominal pain with diarrhea. These symptoms intensify over the next 12 h, during which time she has a runny nose, is lacrimating, and has uncontrollable yawning and intensification of muscle cramping and jerking. Assuming that these are withdrawal symptoms in the patient due to her physical dependence, the drug most likely to be involved is
Correct Answer: D
Rationale: Meperidine, a synthetic opioid, causes physical dependence with chronic use. Abrupt cessation triggers classic opioid withdrawal: anxiety, sweating, abdominal pain, diarrhea (8-12 hours onset), escalating to rhinorrhea, lacrimation, yawning, and muscle cramps—matching the timeline and symptoms described. Alprazolam (benzodiazepine) withdrawal peaks later (days), with seizures and anxiety but less GI distress. Amphetamine withdrawal causes fatigue and depression, not this autonomic profile. Ethanol withdrawal includes tremors and seizures, typically 12-48 hours, differing from this rapid onset. Secobarbital (barbiturate) withdrawal resembles benzodiazepines, with delayed seizures. Meperidine's mu receptor agonism explains the dependence and acute, opioid-specific withdrawal syndrome, aligning perfectly with the patient's presentation.
Question 5 of 5
The patient has been depressed, and the physician plans to begin treatment with an antidepressant medication. In performing the initial assessment, what is the most important question for the nurse to ask?
Correct Answer: D
Rationale: Before starting antidepressants, assessing for suicidal ideation is critical because depression carries a high suicide risk, and some antidepressants, especially SSRIs, may initially increase this risk in vulnerable patients. This safety concern trumps other questions in urgency, as it directly impacts immediate care planning—potentially requiring closer monitoring or hospitalization. Alcohol use affects treatment efficacy but isn't the primary safety issue. Allergies are important for drug selection but secondary to life-threatening risks. Duration of depression informs chronicity, not acute danger. The nurse must prioritize identifying suicidal thoughts to ensure patient safety, aligning with psychiatric protocols and the therapeutic delay of antidepressants (2-6 weeks), making choice D the most essential question in this context.