ATI RN
ATI RN Pharmacology 2023 Questions
Question 1 of 5
Which of the following does NOT describe a local anesthetic drug:
Correct Answer: D
Rationale: Local anesthetic drugs typically contain an aromatic residue linked to an amine group, giving them a weak base property. They are usually soluble in water when converted into soluble salts, most commonly in the form of hydrochlorides. Additionally, local anesthetics are classified based on their chemical structure, with the key component being an ester or amide linkage. Therefore, choice D, which suggests an acidic group in the structure of a local anesthetic drug, is not accurate.
Question 2 of 5
A 38-year-old man with hypertension experiences a first ever attack of acute pain, redness and tenderness in the left first metatarsophalangeal joint ('podagra'). His medication is furosemide, calcium carbonate and irbesartan. Serum uric acid is 0.78 mmol/L (upper limit of normal for men 0.48 mmol/L). Which of the following is most appropriate pharmacotherapy?
Correct Answer: D
Rationale: Acute gout (podagra) requires rapid inflammation relief. Paracetamol offers analgesia but no anti-inflammatory effect, inadequate here. Aspirin, at low doses, retains uric acid, worsening gout; at high doses, it's uricosuric but not ideal acutely. Probenecid lowers uric acid long-term, not for acute attacks. Allopurinol prevents gout but can precipitate attacks if started now. Diclofenac, an NSAID, reduces inflammation and pain fast, the most appropriate acute treatment. Its efficacy targets gout's pathophysiology, critical for symptom control.
Question 3 of 5
The nurse administers IV furosemide (Lasix) to a client with heart failure. Which finding indicates a therapeutic effect?
Correct Answer: A
Rationale: Furosemide reduces fluid overload in heart failure by diuresis, decreasing edema , a direct therapeutic sign. BP may drop, not rise. Heart rate isn't primary'preload reduction matters. Thirst is a side effect. Edema reduction aligns with furosemide's action, critical in heart failure where congestion drives symptoms, making A the key finding.
Question 4 of 5
Which one of the following is characteristic of both phenytoin and carbamazepine?
Correct Answer: D
Rationale: Phenytoin and carbamazepine are antiepileptic drugs with a shared mechanism: they stabilize neuronal membranes by preventing sodium influx through fast sodium channels, reducing excitability and controlling seizures, particularly in partial and tonic-clonic types. Both induce hepatic cytochrome P450 enzymes, accelerating metabolism of other drugs, not inhibiting it. Phenytoin exhibits zero-order elimination at high doses due to enzyme saturation, while carbamazepine follows first-order kinetics, so this isn't a shared trait. They reduce the efficacy of oral contraceptives by inducing their metabolism, not enhancing them. Safety in pregnancy is questionable, with both linked to teratogenicity (e.g., fetal hydantoin syndrome). The sodium channel blockade is the fundamental property uniting their therapeutic effects, making it the key characteristic they share, critical to their role in epilepsy management.
Question 5 of 5
A 17-year-old man presents to the emergency department with a persistent cough and nasal congestion. He has been taking various prescription cough and cold medicines but did not know their names. A urine drug screen is positive for amphetamines. When confronted with this information, he vehemently denies amphetamine use. What is the best explanation?
Correct Answer: B
Rationale: Positive amphetamine screen with cough/cold medicine use suggests a false positive from ephedrine . Ephedrine, in decongestants, cross-reacts with amphetamine assays. Codeine and marijuana don't. Lying or sample mix-up (E) are less likely given his denial and context. This common false positive explains the discrepancy.