ATI RN
ATI Pharmacology Practice B Questions
Question 1 of 9
Which of the following drugs is likely to increase the plasma lithium concentration if co-prescribed to a patient on chronic lithium therapy?
Correct Answer: B
Rationale: Lithium levels rise with drugs reducing renal clearance or altering metabolism. St John's wort induces CYP enzymes, potentially lowering lithium (not renally metabolized). Ibuprofen, an NSAID, reduces renal lithium excretion by inhibiting prostaglandins, increasing plasma levels, a well-known interaction. Phenytoin induces metabolism but doesn't affect lithium's renal clearance. Haloperidol and sertraline have minimal pharmacokinetic impact on lithium. Ibuprofen's effect necessitates monitoring, as elevated lithium risks toxicity (e.g., tremor, confusion), critical in bipolar management.
Question 2 of 9
The physician prescribes fluticasone (Flonase) for the client. The nurse would hold the drug and contact the physician with which assessment finding?
Correct Answer: B
Rationale: Fluticasone, Category C, requires caution in pregnancy , prompting physician consultation due to fetal risk uncertainty. Diabetes , glaucoma , and hypertension aren't immediate holds. B ensures safety, making it the key finding.
Question 3 of 9
The patient tells the nurse he worries about everything all day, feels confused, restless, and just can't stop worrying. What is the best response by the nurse?
Correct Answer: A
Rationale: Persistent worry, confusion, and restlessness suggest generalized anxiety disorder (GAD)-relaxation techniques (e.g., breathing) help manage, a practical response. Social anxiety ties to specific triggers, not all-day worry. PTSD needs trauma history, not indicated. Panic disorder features acute attacks, not constant worry. GAD diagnosis with techniques fits symptoms, per psychiatry.
Question 4 of 9
A patient calls the clinic office saying that the cholestyramine (Questran) powder he started yesterday clumps and sticks to the glass when he tries to mix it. The nurse will suggest what method for mixing this medication for administration?
Correct Answer: C
Rationale: Cholestyramine (Questran) is a bile acid sequestrant used to lower cholesterol levels in the blood. To prevent clumping and sticking to the glass when mixing the powder, the nurse will suggest mixing the powder with food or fruit, or at least 4 to 6 ounces of fluid. This method helps to evenly disperse the powder and prevent clumping, making it easier for the patient to consume the medication. Mixing the powder with a carbonated soda drink (choice A) may not be suitable as the effervescence of the soda could affect the medication's stability. Adding the powder to any liquid and stirring vigorously (choice B) may not dissolve the powder effectively. Taking the powder dry on a spoon followed by a glass of water (choice E) may be difficult for the patient to swallow and may not distribute the medication evenly. Mixing with food or fluid provides a more palatable and effective method for administering Questr
Question 5 of 9
The client takes a bisphosphonate for osteoporosis. Which assessment is best in determining the effectiveness of the medication?
Correct Answer: C
Rationale: Bisphosphonates (e.g., alendronate) halt bone loss-bone density scans measure improvement, per efficacy standard. Calcium levels don't reflect bone strength. Fractures or pain absence helps but isn't direct-density shows progress, per treatment.
Question 6 of 9
A 53-year-old man with chronic neuropathic back pain and depression is managed with amitriptyline. He has recently complained of urinary frequency and was given a prescription for Ditropan. He now complains of acute abdominal pain and is unable to pass flatus or bowel movement. What is the most likely explanation of this finding?
Correct Answer: C
Rationale: Amitriptyline and Ditropan (oxybutynin), both anticholinergics, risk paralytic ileus , stopping GI motility, causing pain and obstruction. Hepatitis , pancreatitis , overdose , and normalcy (E) don't fit. Combined anticholinergic effects explain this acute issue.
Question 7 of 9
A 33-year-old female is brought to the emergency department by her mother. The patient had a sudden onset of fever and her temperature is now 40°C (104°F). She has no sick contacts. The mother mentions that she is on a medication for schizophrenia but could not remember the name. A complete blood count shows 250 neutrophils per microliter. Which of the following medications is she likely taking?
Correct Answer: A
Rationale: Fever and severe neutropenia (250 neutrophils/μL) in a schizophrenic patient suggest clozapine . Clozapine causes agranulocytosis, a rare but serious side effect requiring monitoring. Olanzapine , Quetiapine , Risperidone , and Haloperidol (E) rarely cause this. Clozapine's risk explains the acute presentation, necessitating immediate cessation.
Question 8 of 9
While on pentamidine (Pentam) infusion therapy. The nurse must anticipate doing which of the following?
Correct Answer: B
Rationale: Pentamidine (Pentam) infusion therapy is associated with potential ocular toxicities, including retinal damage. Therefore, the nurse must closely monitor the client for signs and symptoms of retinal damage during the therapy. These may include changes in visual acuity, blurred vision, floaters, or any other visual disturbances. Timely detection of retinal damage is crucial for preventing further complications and ensuring appropriate management.
Question 9 of 9
Which of the following is used to calculate the loading dose of a drug required to reach an initial target blood concentration
Correct Answer: D
Rationale: The loading dose of a drug required to reach an initial target blood concentration is based on the volume of distribution (Vd) of the drug. The volume of distribution represents the theoretical volume that would be necessary to contain the total amount of the administered drug at the same concentration as in the blood plasma. The loading dose is calculated by multiplying the target blood concentration by the volume of distribution of the drug. This initial dose helps to rapidly achieve the desired drug concentration in the body, especially when a drug has a long half-life or when steady-state levels need to be reached more quickly. Understanding the volume of distribution of a drug is crucial in dosage calculation to ensure therapeutic efficacy and avoid potential toxicity.