ATI RN
ATI Pharmocology Exam Fletcher NRSG 106 Questions
Extract:
Question 1 of 5
During a routine appointment, a patient with a history of seizures is found to have a phenytoin level of 23 mcg/mL. What concern will the nurse have, if any?
Correct Answer: A
Rationale: The correct answer is A. A phenytoin level of 23 mcg/mL is above the therapeutic range (10-20 mcg/mL) and indicates toxicity.
To address this, the dosage should be reduced to prevent adverse effects such as ataxia and nystagmus.
Choice B is incorrect because a high phenytoin level does not guarantee seizure control, and adding another antiepileptic drug may increase the risk of adverse effects.
Choice C is incorrect as a high phenytoin level does not necessarily mean an increased risk of seizures, but rather toxicity.
Choice D is incorrect because a phenytoin level of 23 mcg/mL is above the therapeutic range, indicating toxicity rather than efficacy.
Question 2 of 5
A nurse is preparing to administer methylnaltrexone 12 mg subcutaneously to a client who has opioid-induced constipation. Available is methylnaltrexone 8 mg/0.4 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: A
Rationale:
To calculate the amount of methylnaltrexone needed, divide the desired dose (12 mg) by the available concentration (8 mg/0.4 mL): 12 mg ÷ 8 mg/0.4 mL = 1.5 mL. The answer must be rounded to the nearest tenth, making it 1.5 mL, which is equivalent to 0.5 mL.
Therefore, the nurse should administer 0.6 mL.
Choices B, C, and D are incorrect as they do not reflect the correct calculation.
Choice E, F, and G are not applicable.
Question 3 of 5
A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice for the treatment of this condition?
Correct Answer: A
Rationale:
Rationale: Midazolam is the drug of choice for treating status epilepticus due to its rapid onset and short duration of action, making it effective in quickly terminating seizures. It acts as a potent sedative and anticonvulsant by enhancing the inhibitory effects of GABA in the brain. Carbamazepine (
B) is used for long-term seizure management, not for acute seizure control. Diazepam (
C) is effective but less preferred due to its longer duration of action. Valproic acid (
D) is also effective but has a slower onset compared to midazolam in the acute setting.
Question 4 of 5
A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that the least little thing bothers him now. Which is the correct explanation for this problem?
Correct Answer: C
Rationale: The correct answer is C. Phenobarbital is known to cause deprivation of REM sleep, leading to an inability to cope with normal stress. This can manifest as increased tension and irritability in the patient. This explanation aligns with the patient's reported symptoms of feeling tense and easily bothered. Options A, B, and D are incorrect. Adverse effects of phenobarbital typically subside with continued use, so stopping the drug immediately is not warranted. The drug does not cause an increase in REM sleep or result in nightmares, as suggested in options D. The correct explanation lies in the drug's impact on REM sleep and its association with increased stress sensitivity.
Question 5 of 5
When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to anesthesia?
Correct Answer: C
Rationale:
Rationale: The 82-year-old patient undergoing gallbladder removal is at higher risk due to age-related physiological changes. Elderly patients have decreased organ function, altered drug metabolism, and increased sensitivity to anesthesia, leading to potential complications. Option A is less likely to have altered response due to youth. Option B's surgery is not as invasive as gallbladder removal. Option D's smoking history is relevant but not as significant as age-related changes in option C.