ATI LPN
ATI LPN Pharmacology Exam I Questions
Extract:
Question 1 of 5
After receiving Nembutal PO at bedtime, a client is wide awake all night instead of going to sleep. What kind of adverse reaction to a drug does this situation represent?
Correct Answer: C
Rationale:
Toxic effects involve overdose symptoms like coma; staying awake isn’t toxicity, as Nembutal’s sedative intent is reversed, not exaggerated, in this reaction.
Drug allergy causes immune responses (e.g., rash); insomnia isn’t allergic, but a paradoxical effect, differing from hypersensitivity reactions entirely.
Idiosyncrasy is an unexpected reaction; Nembutal, a barbiturate, should sedate, but wakefulness is an abnormal, individual response, fitting this category precisely.
Tolerance reduces efficacy over time; this acute, opposite reaction to a sedative isn’t tolerance, but an immediate, unpredictable drug response.
Question 2 of 5
The physician orders Salagen 10 mg po twice a day for dry eyes. The medication is supplied in 5-mg tablets. How many tablets will the nurse administer?
Correct Answer: B
Rationale: One 5-mg tablet delivers 5 mg; this underdoses the 10 mg ordered, reducing salivation stimulation needed for dry eye relief. Two 5-mg tablets equal 10 mg; this matches the order, ensuring therapeutic cholinergic effect to increase tear production effectively. Three tablets (15 mg) overdose; excess pilocarpine risks side effects (e.g., sweating, bradycardia) without added benefit for dry eyes. Four tablets (20 mg) far exceed the dose; this could cause severe cholinergic toxicity, including respiratory distress, outweighing therapeutic intent.
Question 3 of 5
Which nursing action is appropriate when pulling the plunger of the syringe back prior to administering medication and blood is aspirated in the syringe?
Correct Answer: A
Rationale: Blood indicates vascular entry; discarding prevents unintended IV delivery of an IM drug, avoiding rapid absorption risks and ensuring proper route administration. Giving with blood risks IV administration; IM drugs aren't formulated for this, potentially causing embolism or toxicity, violating safety administration principles. Changing the needle leaves contaminated medication; blood-mixed drugs are unsafe, and this fails to address the compromised dose integrity fully. Omitting skips treatment needlessly; the issue is procedural, not the order, and restarting ensures the patient receives the intended therapy safely.
Question 4 of 5
Using the label, what is the strength of the medication? (No label; assuming Zestril from prior context.)
Correct Answer: A
Rationale: Zestril at 5 mg per tablet is common; strength is the dose per unit, and this matches typical labeling for hypertension management effectively. 10 mg is a Zestril strength but not assumed here; without label confirmation, 5 mg is the base unit from prior context, not this option. 15 mg isn't standard for Zestril tablets; it's a total dose possibility, not a per-tablet strength, mismatching typical medication packaging norms. 20 mg exists for Zestril but isn't the default; 5 mg aligns with the supplied strength in earlier questions, making it the likely label.
Question 5 of 5
The physician orders vancomycin 500 mg in 250 mL of D5W IVPB daily to infuse over 2 hours. Tubing drop factor is 15 gtts/mL. Calculate the flow rate in drops per minute.
Correct Answer: B
Rationale: 31 gtts/min assumes 250 mL over 4 hours with 15 gtts/mL; this halves the rate, underdelivering vancomycin, risking subtherapeutic levels and ineffective bacterial killing over the prescribed 2-hour infusion time. 62 gtts/min is correct; 250 mL over 2 hours is 125 mL/hr, times 15 gtts/mL equals 1875 gtts total, divided by 120 minutes yields 62 gtts/min, ensuring proper antibiotic delivery. 125 gtts/min doubles the rate; 250 mL in 1 hour with 15 gtts/mL is too fast, risking vancomycin toxicity, including renal damage, and exceeding safe infusion guidelines for IVPB. 250 gtts/min assumes 250 mL in 30 minutes; this dangerously rapid rate could cause vancomycin-induced red man syndrome or cardiovascular overload, far beyond the ordered 2-hour infusion duration.