ATI Capstone Pharmacology Assessment 1

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A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?

  • A. Vitamin E
  • B. Vitamin K
  • C. Protamine sulfate
  • D. Potassium chloride
Correct Answer: B

Rationale: Vitamin K is the antidote for warfarin (Coumadin) toxicity. Warfarin is a vitamin K antagonist that inhibits the synthesis of vitamin K-dependent coagulation factors (II, VII, IX, X) in the liver. In cases of excessive anticoagulation and bleeding, administering vitamin K can help reverse the effects of warfarin by replenishing the depleted vitamin K-dependent clotting factors. Vitamin K helps the liver produce clotting factors, thereby promoting the clotting process and reversing the excessive anticoagulant effects of warfarin. Other options mentioned, such as Vitamin E, Protamine sulfate, and Potassium chloride, are not appropriate antidotes for warfarin toxicity.

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Heparin is classified under what class?

  • A. Laxative
  • B. ACE inhibitor
  • C. Anti-convulsant
  • D. Antithrombotic
Correct Answer: D

Rationale: Heparin is classified as an antithrombotic agent. It is a medication that helps prevent blood clot formation by inhibiting the activity of certain clotting factors in the blood. Heparin is commonly used in the treatment and prevention of conditions such as deep vein thrombosis, pulmonary embolism, and during certain medical procedures to prevent clot formation. It is not classified as a laxative, ACE inhibitor, or anti-convulsant based on its mechanism of action and therapeutic use.

A patient is experiencing mucositis (stomatitis) after receiving chemotherapy. Which symptomatic treatments will be appropriate? (Select all that apply.)

  • A. Frequent mouth rinses
  • B. Antiemetics
  • C. Topical anesthetics
  • D. Stress reduction
Correct Answer: A

Rationale: Mucositis, or stomatitis, is a painful inflammation of the mucous membranes caused by chemotherapy. Frequent mouth rinses with saline or baking soda solutions help keep the mouth clean and promote healing. Topical anesthetics, such as lidocaine, can provide pain relief. Stress reduction techniques, such as relaxation or mindfulness, may help manage the discomfort associated with mucositis. Antiemetics are used to control nausea and vomiting, which are not directly related to mucositis. Antibiotics are only necessary if there is a secondary infection, which is not mentioned in this scenario.

Which of the following medications would you administer for an overdose of acetaminophen?

  • A. Naloxone
  • B. Vitamin K
  • C. Acetylcysteine
  • D. Atropine
Correct Answer: C

Rationale: Acetylcysteine is the antidote for an acetaminophen overdose. Acetaminophen overdose can cause liver damage due to its toxic metabolite buildup in the liver. Acetylcysteine works by replenishing glutathione, which helps in detoxifying the toxic metabolite of acetaminophen. Administering acetylcysteine within 8-10 hours of the overdose is crucial in preventing severe liver damage and improving the patient's outcome. Naloxone is used for opioid overdose, Vitamin K for treating specific types of bleeding disorders, and Atropine for drug poisoning or certain types of poisoning, but they are not indicated for an acetaminophen overdose.

Which of the following medications would you administer for an overdose of acetaminophen?

  • A. Naloxone
  • B. Vitamin K
  • C. Acetylcysteine
  • D. Atropine
Correct Answer: C

Rationale: Acetylcysteine is the specific antidote for acetaminophen overdose. Acetaminophen (also known as paracetamol) toxicity can cause severe liver damage if not treated promptly. Acetylcysteine works by replenishing the depleted glutathione stores in the liver, helping to prevent liver damage and improving the patient's outcome. Naloxone is used for opioid overdose, vitamin K for reversing the effects of certain anticoagulants, and atropine for specific heart and nerve related conditions.

This is the basis for calculation of infant dose in Clark's Rule :

  • A. age ;
  • B. weight ;
  • C. height ;
  • D. surface area ;
Correct Answer: B

Rationale: In Clark's Rule, the basis for calculating the infant dose is weight. This is because weight is a crucial factor in determining the appropriate dosage for infants. Adjusting the dose based on weight helps in ensuring that the medication is administered safely and effectively. Infants have different proportions of body weight compared to older children and adults, which can influence how medications are metabolized in their bodies. Therefore, using weight as the basis for dosage calculation in Clark's Rule helps in providing a more accurate and individualized dose for infants.

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