ATI RN
ATI Proctored Pharmacology 2023
1. What should you monitor when administering Clopidogrel to a patient?
- A. Signs of thrombotic thrombocytopenic purpura
- B. Bleeding during therapy
- C. CBC with differential and platelet count
- D. All of the above
Correct answer: D
Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.
2. A healthcare professional is preparing to administer Butorphanol to a client who has a history of substance use disorder. The healthcare professional should identify which of the following information as true regarding Butorphanol?
- A. Butorphanol has a lower risk of abuse than morphine.
- B. Butorphanol causes a lower incidence of respiratory depression than morphine.
- C. Butorphanol can be reversed with an opioid antagonist.
- D. Butorphanol can cause abstinence syndrome in opioid-dependent clients.
Correct answer: D
Rationale: The correct answer is D. Butorphanol is an opioid agonist/antagonist that can precipitate withdrawal symptoms in opioid-dependent individuals. Symptoms of abstinence syndrome can include abdominal pain, fever, and anxiety. This occurs because butorphanol competes with and displaces opioid agonists from receptors, leading to withdrawal symptoms in opioid-dependent clients. Choices A, B, and C are incorrect. Butorphanol does not have a lower risk of abuse than morphine, it can cause respiratory depression similar to other opioids, and although it is an opioid antagonist, it does not get reversed by opioid antagonists.
3. A client with cancer is prescribed methotrexate. Which supplement should the healthcare provider recommend to reduce the risk of methotrexate toxicity?
- A. Folic acid
- B. Magnesium
- C. Vitamin D
- D. Iron
Correct answer: A
Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, and supplementing with folic acid can help reduce the risk of methotrexate toxicity. Folic acid supplementation is commonly recommended to counteract the effects of methotrexate on folate metabolism. Magnesium, Vitamin D, and Iron are not specifically indicated to reduce the risk of methotrexate toxicity and therefore are incorrect choices in this scenario.
4. Which of the following conditions is not typically treated with Hydrochlorothiazide?
- A. CHF
- B. HTN
- C. Nephritis
- D. Hypercalciuria
Correct answer: C
Rationale: Nephritis is not commonly treated with Hydrochlorothiazide. Hydrochlorothiazide is primarily used for managing hypertension (HTN) and congestive heart failure (CHF) by reducing blood pressure and fluid retention. It is not a standard treatment for nephritis, which involves inflammation of the kidneys. Hypercalciuria, characterized by excessive calcium excretion in the urine, is not typically treated with Hydrochlorothiazide either.
5. A client prescribed Isosorbide Mononitrate for chronic stable Angina develops reflex tachycardia. Which of the following medications should the nurse expect to administer?
- A. Furosemide
- B. Captopril
- C. Ranolazine
- D. Metoprolol
Correct answer: D
Rationale: Metoprolol, a beta-adrenergic blocker, is commonly used to treat hypertension and stable angina pectoris. It is often prescribed to decrease heart rate in clients who develop tachycardia, such as in the case of reflex tachycardia induced by Isosorbide Mononitrate, making it the appropriate choice in this scenario. Furosemide (Choice A) is a loop diuretic used for conditions like heart failure and edema, not for reflex tachycardia. Captopril (Choice B) is an ACE inhibitor primarily used for hypertension and heart failure, not for reflex tachycardia. Ranolazine (Choice C) is used for chronic angina but does not specifically address reflex tachycardia.
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