ATI RN
Pharmacology ATI Proctored Exam 2023
1. A client presents in the Emergency Department with chest pain. Which of the following conditions is least likely to cause chest pain?
- A. Arthritis
- B. Peptic ulcer disease
- C. Myocardial infarction
- D. Gastric reflux
Correct answer: A
Rationale: Arthritis is a condition primarily affecting the joints and is not known to cause chest pain. Peptic ulcer disease, myocardial infarction, and gastric reflux are conditions that can present with chest pain due to various reasons such as inflammation, ischemia, or reflux of stomach acid into the esophagus, respectively.
2. The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?
- A. “I will check my weight regularly for any gain or loss.”
- B. “I’ll make sure to take my high blood pressure medications.”
- C. “I am attending a smoking cessation class.”
- D. “As long as I exercise, stress at my job will not bother me.”
Correct answer: D
Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.
3. A client presents in the Emergency Department with a suspected MI. Which medication should NOT be given as soon as possible?
- A. Clopidogrel (Plavix)
- B. Morphine
- C. Aspirin (ASA)
- D. Metoprolol (Lopressor)
Correct answer: A
Rationale: In the setting of a suspected myocardial infarction (MI), the priority medications to administer as soon as possible include aspirin (ASA) and possibly morphine to manage pain and anxiety. Clopidogrel (Plavix) is not typically administered immediately in the emergency setting for MI management. Metoprolol (Lopressor) is indicated after aspirin administration and stabilization of the patient. Therefore, in this scenario, clopidogrel should NOT be given as a first-line medication for a suspected MI.
4. Why should the nitrate patch be off for 8 hours per day?
- A. “There is no reason to take the patch off each day.”
- B. “The patch can be addictive; leaving it off reduces the addiction.”
- C. “You should only leave the patch off for 15 minutes.”
- D. “Leaving the patch off for 8 hours per day helps to delay the development of tolerance.”
Correct answer: D
Rationale: Removing the nitrate patch for 8 hours each day is essential to prevent the body from developing tolerance to the medication. By allowing the body to have a drug-free period, the effectiveness of the medication is maintained over time. This practice helps in ensuring that the nitrate patch continues to provide its intended therapeutic effects without diminishing its efficacy. Therefore, it is important for the client to adhere to the prescribed schedule of removing the patch for 8 hours daily to optimize the treatment outcomes.
5. Why has an ACE inhibitor been prescribed following an MI?
- A. “This medication will lower your potassium level.”
- B. “ACE inhibitors have been found to reduce mortality following MI.”
- C. “ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI.”
- D. “This medication will treat your hypotension.”
Correct answer: B
Rationale: Following a myocardial infarction (MI), ACE inhibitors are commonly prescribed due to their proven benefit in reducing mortality and improving outcomes post-MI. These medications help by decreasing the workload of the heart, preventing remodeling of the heart chambers, and improving survival rates. While ACE inhibitors may have effects on potassium levels, the primary reason for their prescription post-MI is their mortality-reducing properties.
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