ATI RN
Pharmacology ATI Proctored Exam 2023
1. 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.
2. A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?
- A. A headache indicates a serious allergic reaction to nitroglycerin.
- B. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
- C. Nitroglycerin does not cause a headache.
- D. The most common side effect of nitroglycerin is a headache.
Correct answer: D
Rationale: Nitroglycerin is known to cause headaches as a common side effect due to its vasodilatory properties. It dilates blood vessels, which can lead to headaches. While a headache can indicate other serious conditions, the most common association with nitroglycerin use is a headache. It is crucial for the nurse to recognize this side effect and provide appropriate education and support to the client.
3. When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?
- A. “Your chest pain should go away with one tablet.”
- B. “If your chest pain doesn’t go away after three tablets, call 911; you might be having a heart attack.”
- C. “If your chest pain doesn’t go away with one tablet, you can repeat the dose as many times as you need to.”
- D. “Be sure to call 911 before you take any tablets.”
Correct answer: B
Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.
4. What is the first type of medication prescribed to prevent angina pain for a client?
- A. Beta blockers
- B. Alpha blockers
- C. Calcium channel blockers
- D. Organic nitrates
Correct answer: A
Rationale: Beta blockers are the first-line medication prescribed to prevent angina pain. They work by reducing the heart rate and blood pressure, decreasing the heart's demand for oxygen. This helps in preventing angina attacks by improving blood flow to the heart. Alpha blockers, calcium channel blockers, and organic nitrates are also used in angina treatment but are typically considered after beta blockers.
5. How can the nurse best explain the difference between angina and a myocardial infarction to a client presenting with severe chest pain?
- A. “Angina usually resolves with rest, and is rarely fatal, while a myocardial infarction necessitates immediate treatment and can be life-threatening.”
- B. “There is a clear distinction between the two. You will receive treatment based on the diagnosis of a myocardial infarction.”
- C. “Both conditions result from a clot obstructing the coronary arteries. Angina occurs with the blockage of a small vessel, whereas a myocardial infarction occurs with a blockage of a large vessel.”
- D. “Angina may not cause as intense chest pain, whereas a myocardial infarction always presents with severe chest pain.”
Correct answer: A
Rationale: When educating a client about the differences between angina and a myocardial infarction, it is crucial to emphasize key distinguishing factors. Angina typically improves with rest and is not usually life-threatening, whereas a myocardial infarction requires urgent intervention as it can be life-threatening. This explanation helps the client understand the urgency and severity associated with a myocardial infarction compared to angina.
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