2019 ATI Pharmacology Proctored Exam

2019 ATI Pharmacology Proctored Exam Related

Review 2019 ATI Pharmacology Proctored Exam related questions and content

What should you monitor when given a patient Clopidogrel?

  • A. Signs of thrombotic thrombolytic purpura
  • B. Bleeding during therapy
  • C. CBC with differential and platelet count
  • D. All the above
Correct Answer: D

Rationale: When monitoring a patient on Clopidogrel therapy, it is important to monitor for signs of thrombotic thrombolytic purpura (TTP), bleeding during therapy, and changes in blood counts. Clopidogrel is an antiplatelet medication that works by preventing platelets from sticking together and forming clots. Monitoring for signs of TTP is necessary as clopidogrel has been associated with an increased risk of TTP in some patients. Additionally, monitoring for bleeding is crucial as clopidogrel, like other antiplatelet medications, can increase the risk of bleeding complications. Monitoring a complete blood count (CBC) with differential and platelet count allows healthcare providers to assess the patient's blood cell levels and ensure that the medication is not causing any adverse effects on blood counts. Therefore, monitoring all of the above parameters is essential to ensure the safety and efficacy of clopidogrel therapy.

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A patient has been started on therapy of a continuous infusion of lidocaine after receiving a loading dose of the drug. The nurse will monitor the patient for which adverse effect?

  • A. Drowsiness
  • B. Nystagmus
  • C. Dry mouth
  • D. Convulsions
Correct Answer: D

Rationale: Lidocaine is a local anesthetic that can have systemic effects if levels become toxic. Continuous infusion of lidocaine can lead to lidocaine toxicity, which can manifest as adverse effects including convulsions, altered mental status, confusion, seizures, and cardiac arrhythmias. Monitoring for signs of lidocaine toxicity, such as convulsions, is crucial when a patient is receiving continuous lidocaine infusion. It is important for the nurse to closely monitor the patient's neurological status and vital signs to promptly recognize and manage any adverse effects.

When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the use

  • A. ? (Select all that apply.)
  • B. The patient reports seeing colorful halos around lights.
  • C. The patient™s serum potassium level is above 5 mEq/L.
  • D. The patient is experiencing nausea and anorexi
Correct Answer: D

Rationale: When a patient is experiencing digoxin toxicity, severe sinus bradycardia that does not respond to cardiac pacing is a clinical situation that would necessitate the use of digoxin-specific antibody fragments (Digibind). This intervention is required to counteract the toxic effects of digoxin on the heart, especially in cases of severe bradycardia that can compromise cardiac output and lead to serious consequences. In this scenario, Digibind works by binding to digoxin molecules, thereby neutralizing their effects and helping to restore normal cardiac function.

A contraindication for topical corticosteroid usage in a male patient with atopic dermatitis (eczema) is:

  • A. Parasite infection.
  • B. Viral infection.
  • C. Bacterial infection.
  • D. Spirochete infection.
Correct Answer: B

Rationale: Topical corticosteroids can exacerbate viral infections, such as herpes simplex, by suppressing the immune response. They are contraindicated in the presence of viral infections to prevent worsening of the condition. Bacterial, parasitic, and spirochete infections are not absolute contraindications, although caution is advised.

The nurse is administering Penicillin to a patient who has tested positive for strep throat. The nurse knows to look for which of the following adverse e昀昀ects as a sign of an acute allergic reaction?

  • A. blurred vision
  • B. tinnitus
  • C. skin rash/hives
  • D. vomiting
Correct Answer: C

Rationale: An acute allergic reaction to Penicillin can present with symptoms such as skin rash or hives. This is a common sign of an allergic reaction and can indicate the patient is having an adverse response to the medication. It is essential for the nurse to monitor the patient closely for any signs of allergic reactions, including hives, as they can quickly progress to more severe reactions such as anaphylaxis. Other adverse effects listed in the choices, such as blurred vision, tinnitus, and vomiting, are not typically associated with an acute allergic reaction to Penicillin.

A patient is in the emergency department with new-onset atrial fibrillation. Which order for digoxin would most likely have the fastest therapeutic effect?

  • A. Digoxin 0.25 mg PO daily
  • B. Digoxin 1 mg PO now; then 0.25 mg PO daily
  • C. Digoxin 0.5 mg IV push daily
  • D. Digoxin 1 mg IV push now; then 0.25 mg IV daily
Correct Answer: D

Rationale: When a patient requires immediate treatment for atrial fibrillation with digoxin, the fastest way to achieve a therapeutic effect is through intravenous administration. Option D, Digoxin 1 mg IV push now; then 0.25 mg IV daily, is the most appropriate order in this scenario. Intravenous administration allows for rapid absorption and onset of action, making it the preferred route for urgent situations like atrial fibrillation. By giving an initial loading dose intravenously, followed by a lower maintenance dose IV daily or orally, the patient can quickly achieve therapeutic digoxin levels to help stabilize the heart rhythm. Option D provides the most rapid and effective way to manage new-onset atrial fibrillation with digoxin.

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