ATI RN
ATI Pharmacology Proctored Exam 2019
1. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?
- A. Administer subcutaneously in a large muscle mass to prevent injury.
- B. Ensure that the medication is kept at room temperature until just prior to administration.
- C. Invert vial gently to mix well before withdrawing dose.
- D. Discard vial after removing one dose of the medication.
Correct answer: D
Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.
2. A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal low T3 and T4 levels and elevated TSH levels. Which of the following is the most likely diagnosis?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Euthyroid sick syndrome
- D. Subclinical hyperthyroidism
Correct answer: B
Rationale: The scenario describes a 45-year-old woman with fatigue, weight gain, cold intolerance, low T3 and T4 levels, and elevated TSH levels, which are indicative of hypothyroidism. In hypothyroidism, there is decreased production of thyroid hormones (T3 and T4) leading to elevated TSH levels as the pituitary gland tries to stimulate the thyroid gland to produce more hormones. Therefore, the correct answer is hypothyroidism (Choice B). Choice A, Hyperthyroidism, is incorrect as the patient's symptoms and thyroid function tests point towards decreased thyroid hormone levels, which is characteristic of hypothyroidism, not hyperthyroidism. Choice C, Euthyroid sick syndrome, is incorrect because this condition typically presents with normal to low T3 and T4 levels in the setting of non-thyroid illness, unlike the elevated TSH levels observed in this case. Choice D, Subclinical hyperthyroidism, is also incorrect as the patient has low T3 and T4 levels, which is not consistent with hyperthyroidism, whether clinical or subclinical.
3. What does a QRS Complex represent in an ECG reading?
- A. Atrial depolarization
- B. Ventricular repolarization
- C. Ventricular depolarization
- D. End of ventricular depolarization
Correct answer: C: Ventricular depolarization
Rationale: The QRS Complex in an ECG reading represents ventricular depolarization, which is the process of the heart's ventricles preparing to contract by changing the electrical charge in the cell, hence choice 'C' is the correct answer. Choice 'A' is incorrect because atrial depolarization is represented by the P wave in an ECG reading, not the QRS Complex. Choice 'B' is incorrect as ventricular repolarization is depicted by the T wave, not the QRS Complex. Finally, choice 'D' is also incorrect because the QRS Complex is not the end of ventricular depolarization, but the process itself.
4. What is the major effect of filgrastim (Neupogen) in a patient with chronic renal failure?
- A. Decreases neutropenia related to chemotherapy
- B. Decreases white blood cells related to infection
- C. Decreases growth of blood vessels due to ischemia
- D. Decreases platelet count related to bleeding
Correct answer: A
Rationale: The major effect of filgrastim (Neupogen) is to stimulate the production of neutrophils, thereby decreasing neutropenia in patients undergoing chemotherapy. This medication helps the bone marrow produce more white blood cells, specifically neutrophils, to reduce the risk of infections associated with low neutrophil counts. Choices B, C, and D are incorrect because filgrastim does not decrease white blood cells related to infection, growth of blood vessels, or platelet count related to bleeding.
5. A nurse is providing dietary teaching for a client who has a burn injury and adheres to a vegan diet. The nurse should recommend which of the following foods as the best source of protein to promote wound healing?
- A. One cup of brown rice
- B. One cup of orange juice
- C. One cup of pureed avocado
- D. One cup of lentils
Correct answer: One cup of lentils
Rationale: Lentils are an excellent source of plant-based protein, essential for wound healing in a vegan diet. Brown rice, orange juice, and pureed avocado are not protein-rich foods like lentils and would not provide sufficient protein for wound healing in this scenario.
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