ATI LPN
ATI LPN Pharmacology Exam I Questions
Extract:
Question 1 of 5
The patient's insurance company refuses to pay for the brand name formulation of a prescribed drug. Which formulation of the drug will the patient receive instead?
Correct Answer: B
Rationale: Trade names are brand-specific; insurance denial of the brand rules this out, as it's the costly formulation they won't cover for the patient. Generic drugs, bioequivalent to brands, cost less; insurance favors them, ensuring the same active ingredient and efficacy at a lower price point. Chemical names describe molecular structure, not a formulation; they're not dispensed as drugs, making this irrelevant to insurance or pharmacy. Proprietary is synonymous with brand; if insurance denies the brand, this option is also excluded, leaving generic as the viable substitute.
Question 2 of 5
The nurse is to administer the patient's next dose of vancomycin at 9:30 a.m. What time will the nurse draw the patient's blood to check the trough vancomycin level?
Correct Answer: B
Rationale: Drawing at 8:30 a.m., 60 minutes before, is too early; trough levels, taken just before the next dose, reflect minimum concentration, and this timing risks inaccurate results. At 9:00 a.m., 30 minutes before the 9:30 a.m. dose, the trough level accurately measures the lowest vancomycin concentration, ensuring therapeutic monitoring aligns with pharmacokinetics. Drawing at 10:00 a.m., after the dose, measures a post-infusion level, not the trough; this timing misses the minimum concentration critical for dosing adjustments. At 10:30 a.m., well after the dose, blood reflects peak or random levels, not the trough, skewing data needed to assess vancomycin's therapeutic efficacy and safety.
Question 3 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.
Question 4 of 5
After the nurse hands a client a medication, the client says, 'What is this red tablet for? I have always taken a yellow pill.' What is the most appropriate action for the nurse to take?
Correct Answer: A
Rationale: Withholding and rechecking ensures safety; a color change signals a potential error, and verifying the MAR against orders prevents administering the wrong drug. Assuming a change is risky; without confirmation, administering an unverified drug could harm the patient if it's not the intended prescription. Administering then checking later endangers the patient; a wrong drug could cause adverse effects, and delayed verification violates safety protocols. Describing and giving without verification is unsafe; the red tablet may not match the order, risking incorrect treatment or allergic reactions.
Question 5 of 5
Using the label, what is the trade name of the medication? (No label provided; assuming Zestril from prior context.)
Correct Answer: B
Rationale: Lisinopril is the generic name; trade names are branded, and this doesn't fit the question's focus on the manufacturer's marketed title. Zestril is the trade name for lisinopril; it's trademarked by the manufacturer, aligning with the question's request for the branded medication name. Acetaminophen is a generic, not a trade name here; it's unrelated to Zestril's class (ACE inhibitor), making it an incorrect option. Morphine is a generic opioid; it doesn't match Zestril's antihypertensive role or trade name status, ruling it out entirely.