ATI RN
Proctored Pharmacology ATI
1. Which drug undergoes extensive first-pass hepatic metabolism?
- A. Heparin
- B. Insulin
- C. Propranolol
- D. Nitroglycerin
Correct answer: C
Rationale: Propranolol undergoes extensive first-pass hepatic metabolism in the liver. When administered orally, propranolol is extensively metabolized by the liver before reaching systemic circulation, leading to reduced bioavailability. This process is known as first-pass hepatic metabolism, which significantly affects the drug's effectiveness and necessitates higher oral doses compared to other routes of administration. Heparin (Choice A) is not metabolized by the liver but excreted unchanged by the kidneys. Insulin (Choice B) is a peptide hormone that is not subject to significant first-pass metabolism. Nitroglycerin (Choice D) is primarily metabolized in the blood and tissues, bypassing significant first-pass metabolism in the liver.
2. Is the elbow distal to the wrist?
- A. True
- B. False
- C. Not Sure
- D. None of the above
Correct answer: False
Rationale: The correct answer is False. In anatomical terms, 'distal' means farther away from the center of the body or the point of attachment. The elbow is proximal to the wrist because it is closer to the center of the body. Therefore, the statement that the elbow is distal to the wrist is incorrect. Choice A is incorrect because the elbow is not distal to the wrist. Choice C is incorrect as the anatomical relationship between the elbow and wrist can be determined. Choice D is incorrect as there is a definitive answer to this anatomical question.
3. Where is Vitamin K synthesized?
- A. by bacteria in the GI tract
- B. by the body by sunlight
- C. deficiency is called beriberi
- D. found in vegetable oils
Correct answer: A
Rationale: Vitamin K is synthesized by bacteria in the gastrointestinal tract. Choice B is incorrect as the synthesis of Vitamin D, not K, can be induced by sunlight exposure. Choice C is incorrect as beriberi is a condition caused by thiamine (Vitamin B1) deficiency, not Vitamin K. Choice D is incorrect as Vitamin E is commonly found in vegetable oils, not Vitamin K.
4. Which of the following cardiac valves prevents blood from returning to the left ventricle of the heart?
- A. pulmonic
- B. mitral
- C. tricuspid
- D. aortic
Correct answer: aortic
Rationale: The correct answer is the aortic valve. The aortic valve is located between the left ventricle and the aorta, preventing the backflow of blood into the left ventricle once it has been pumped out during systole. Choice A, pulmonic, is incorrect as it is associated with the right side of the heart. Choice B, mitral, is incorrect as it is the valve between the left atrium and ventricle. Choice C, tricuspid, is incorrect as it is located between the right atrium and ventricle.
5. The charge nurse in the pediatric unit is teaching nursing students about pyloric stenosis. A student asks what causes pyloric stenosis. How should the nurse respond?
- A. One portion of the intestines invaginates or telescopes into another
- B. Hypertrophy of the circular pylorus muscle
- C. Relaxed cardiac sphincter
- D. Absent ganglion cells in the colon
Correct answer: B
Rationale: Pyloric stenosis is caused by the hypertrophy (thickening) of the circular muscle of the pylorus, leading to obstruction. Choice A is incorrect as it describes intussusception, not pyloric stenosis. Choice C is incorrect as a relaxed cardiac sphincter is related to gastroesophageal reflux. Choice D is incorrect as it describes Hirschsprung's disease, not pyloric stenosis.
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