ATI RN
ATI Pharmacology Proctored Exam 2019
1. A healthcare professional in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings is indicative of this condition?
- A. Insidious onset of painless loss of vision
- B. Gradual reduction in peripheral vision
- C. Severe pain around the eyes
- D. Intraocular pressure 12 mm Hg
Correct answer: C
Rationale: Severe pain around the eyes that radiates over the face is a classic symptom of acute angle-closure glaucoma. This intense pain is often associated with other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. Immediate medical attention is required to prevent permanent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more indicative of conditions like macular degeneration. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12 mm Hg is within the normal range and is not typical of angle-closure glaucoma.
2. A client has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?
- A. Orthostatic hypotension
- B. Hearing loss
- C. Gastrointestinal bleeding
- D. Weight loss
Correct answer: A
Rationale: Orthostatic hypotension is a known adverse effect of MAOIs, such as Phenelzine. It is characterized by a drop in blood pressure upon standing, which can lead to dizziness or fainting. Monitoring for orthostatic hypotension is crucial when administering MAOIs to prevent potential complications. Hearing loss (Choice B) is not a typical adverse effect associated with Phenelzine. Gastrointestinal bleeding (Choice C) is more commonly linked to NSAIDs or anticoagulants. Weight loss (Choice D) is not a typical adverse effect of Phenelzine and is more likely related to other factors such as appetite changes or metabolic issues.
3. A client has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?
- A. Crushing the medication might cause you to have a stomachache or indigestion.
- B. Crushing the medication is a good idea, and I can mix it in some ice cream for you.
- C. Crushing the medication would release all the medication at once, rather than over time.
- D. Crushing is unsafe, as it destroys the ingredients in the medication.
Correct answer: A
Rationale: Crushing an enteric-coated medication can cause it to break down in the stomach instead of the intestines, potentially leading to gastrointestinal distress like stomachache or indigestion. It is important to take enteric-coated medications whole to ensure they are properly absorbed in the intestines and to prevent irritation to the stomach.
4. When administering digoxin (Lanoxin) to a patient, the healthcare provider observes various signs and symptoms of an overdose. Which of the following should the healthcare provider give to reverse digoxin toxicity?
- A. Naloxone
- B. Vitamin K
- C. Digibind
- D. Flumazenil
Correct answer: C
Rationale: Digibind, also known as Digoxin immune Fab, is the specific antidote used to treat digoxin toxicity. It works by binding to digoxin in the body, forming a complex that can be excreted by the kidneys, thereby reversing the toxic effects of digoxin overdose. Naloxone is used for opioid overdoses, not digoxin toxicity. Vitamin K is used to reverse the effects of warfarin overdose. Flumazenil is used to reverse the effects of benzodiazepine overdose, not digoxin toxicity.
5. What is the appropriate medication to administer for a suspected opioid overdose in a patient who comes to the hospital?
- A. Exenatide
- B. Naloxone
- C. Heparin
- D. Tolvaptan
Correct answer: B
Rationale: The correct answer is B: Naloxone. Naloxone is the drug of choice for managing opioid overdoses as it competitively antagonizes opioid receptors, reversing the respiratory depression and sedation caused by opioids. It is crucial in the emergency treatment of opioid overdose to prevent fatal outcomes. Choices A, C, and D are incorrect. Exenatide is a medication used to treat diabetes, heparin is an anticoagulant, and tolvaptan is a diuretic. None of these medications are indicated for the management of opioid overdose.
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