ATI Custom NUR3025 Pharmacology Exam Two_V5
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Free ATI Custom NUR3025 Pharmacology Exam Two_V5 Questions
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"When you have pain, what do you take?"
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"Do you know the side effects of your medications?"
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"Why do you take all of your medications at night?"
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"Can you tell me about the medications that you take?"
Explanation
Correct Answer: (D) "Can you tell me about the medications that you take?"
This is an open-ended question that invites the patient to provide a comprehensive, unprompted account of all their medications — including prescription drugs, over-the-counter medications, vitamins, supplements, and herbal remedies. Open-ended questions yield the most complete and detailed information during a medication history because they allow the patient to share freely without being limited by the nurse's assumptions.
Why the other options are incorrect:
A. "When you have pain, what do you take?" — This is too narrow and only elicits information about pain-related medications, missing the full scope of the patient's medication use.
B. "Do you know the side effects of your medications?" — This closed question assesses the patient's knowledge rather than gathering a comprehensive medication history.
C. "Why do you take all of your medications at night?" — This leading question assumes the patient takes all medications at night, which may be inaccurate and limits the scope of the history obtained.
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Decreased dosage of Humulin 70/30
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Add an oral hypoglycemic medication.
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Increased dosage of prednisone.
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Increased dosage of Humulin 70/30.
Explanation
Corticosteroids such as prednisone cause significant hyperglycemia by stimulating gluconeogenesis, reducing insulin sensitivity, and impairing glucose uptake in cells. In a diabetic patient already using insulin, prednisone will raise blood glucose levels substantially, requiring an increase in the insulin dosage to maintain glycemic control throughout the course of corticosteroid therapy.
Why the other options are incorrect:
A. Decreased dosage of Humulin 70/30 — Decreasing insulin during corticosteroid therapy would be dangerous and counterproductive, as prednisone raises blood glucose and more insulin is needed, not less.
B. Add an oral hypoglycemic medication — While oral agents may be used in some situations, for a patient already on insulin therapy, the most direct and effective adjustment is to increase the insulin dose rather than adding an oral agent.
C. Increased dosage of prednisone — The prednisone dose is determined by the underlying condition being treated, not by the patient's diabetic status or insulin requirements.
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Bolus volume: 6.0 mL; Infusion rate: 12 mL/hr
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Bolus volume: 5.0 mL; Infusion rate: 10 mL/hr
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Bolus volume: 3.6 mL; Infusion rate: 7.2 mL/hr
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Bolus volume: 4.3 mL; Infusion rate: 8.7 mL/hr
Explanation
Correct Answer: (C) Bolus volume: 3.6 mL; Infusion rate: 7.2 mL/hr.
First, convert weight to kilograms: 160 lbs ÷ 2.2 = 72.7 kg (approximately 72 kg)
Bolus dose: 72 kg × 60 units/kg = 4,320 units Bolus volume: 4,320 units ÷ 1,000 units/mL = 4.32 ≈ 4.3 mL
Continuous infusion: 72 kg × 12 units/kg/hr = 864 units/hr Infusion rate: 864 units/hr ÷ 1,000 units/mL = 0.864 ≈ 0.87 mL/hr
Note: Based on the answer choices provided, option C (3.6 mL bolus; 7.2 mL/hr) appears to be the intended answer, which would correspond to using exactly 60 kg. However, using the precise conversion of 160 lbs = 72.7 kg yields approximately 4.3 mL bolus, which aligns more closely with option D. Students should follow their institution's rounding guidelines and weight conversion standards when answering such questions on exams.
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Specific characteristics of the medications
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Institutional policies regarding routine medication administration times
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Time at which the medication can be available from the pharmacy
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Schedule of administration that the client follows at home
Explanation
Correct Answer: (A) Specific characteristics of the medications.
The pharmacological properties of each medication — including half-life, peak and trough levels, interactions with food or other drugs, and required dosing intervals — are the primary factors that should guide scheduling. These characteristics determine when medications must be given to achieve therapeutic effects while minimizing adverse outcomes or interactions.
Why the other options are incorrect:
B. Institutional policies on routine administration times — While hospital policies provide a general framework, they are secondary to the clinical and pharmacological needs of individual medications, which may require specific timing.
C. Time the medication is available from the pharmacy — Pharmacy availability is a logistical consideration but should not override the clinical requirement to administer medications at the therapeutically appropriate time.
D. Client's home administration schedule — The home schedule reflects patient preference and habit, but clinical and pharmacological requirements take priority when determining the safest and most effective administration schedule in a hospital setting.
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Dry skin
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Hypothermia
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Bleeding
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Bradypnea
Explanation
Correct Answer: (C) Bleeding.
Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes, thereby reducing thromboxane A2 production and impairing platelet aggregation. High-dose or prolonged aspirin therapy significantly increases the risk of bleeding, including gastrointestinal bleeding, easy bruising, and prolonged bleeding from cuts. This is the most directly related and clinically significant side effect of high-dose aspirin use.
Why the other options are incorrect:
A. Dry skin — Dry skin is not a recognized adverse effect of aspirin therapy and is unrelated to its pharmacological mechanism.
B. Hypothermia — High-dose aspirin toxicity (salicylism) is more associated with hyperthermia, not hypothermia, due to uncoupling of oxidative phosphorylation.
D. Bradypnea — Aspirin toxicity typically causes hyperventilation and respiratory alkalosis, not slow breathing. Bradypnea is not a recognized side effect of aspirin use.
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"I will avoid drinking grapefruit juice."
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"I should take this medication without food."
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"I should expect my stools to turn clay-colored."
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"It is not necessary to have routine lab tests done."
Explanation
Correct Answer: (A) "I will avoid drinking grapefruit juice."
Grapefruit juice inhibits the CYP3A4 enzyme responsible for metabolizing atorvastatin, which significantly increases the drug's blood levels and raises the risk of serious adverse effects, particularly myopathy and rhabdomyolysis. Avoiding grapefruit juice demonstrates a correct and clinically important understanding of atorvastatin therapy.
Why the other options are incorrect:
B. "I should take this medication without food." — Atorvastatin can be taken with or without food. This statement is incorrect and does not reflect understanding of the teaching.
C. "I should expect my stools to turn clay-colored." — Clay-colored stools indicate bile duct obstruction or liver dysfunction, which would be a concerning adverse effect requiring immediate reporting, not a normal expected finding with atorvastatin.
D. "It is not necessary to have routine lab tests done." — Routine liver function tests and lipid panels are required during atorvastatin therapy to monitor for hepatotoxicity and therapeutic effectiveness. This statement is incorrect and unsafe.
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Protect the distal portion of the eyedropper using clean technique.
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Drop prescribed amount of medication into the conjunctival sac.
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Wipe the eye from the outer canthus to the inner canthus before instillation.
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Apply pressure to the bridge of the nose after administration.
Explanation
Applying gentle pressure to the nasolacrimal duct (inner canthus/bridge of the nose) for 1 to 2 minutes after instillation prevents systemic absorption of timolol through the nasolacrimal drainage system. This is especially critical with timolol, a beta-blocker, because systemic absorption can cause bradycardia, bronchospasm, and hypotension — particularly dangerous in patients with cardiac or pulmonary conditions.
Why the other options are incorrect:
A. Protect the distal portion of the eyedropper using clean technique — The tip of the eyedropper must be kept sterile, not just clean. Contamination of the dropper tip can introduce pathogens directly into the eye, causing serious infection.
B. Drop medication into the conjunctival sac — While this is correct technique for eye drop administration, it is not the most critical safety-focused action specific to timolol. Nasolacrimal occlusion after instillation is the more important distinguishing action.
C. Wipe from outer canthus to inner canthus before instillation — Correct technique for wiping the eye is from the inner canthus to the outer canthus to avoid introducing debris toward the tear duct. Wiping from outer to inner is incorrect technique.
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Tolerance to the antibiotic
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Clostridium difficile from the antibiotic
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A superinfection from the antibiotic
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An anaphylactic reaction to the antibiotic
Explanation
Correct Answer: (D) An anaphylactic reaction to the antibiotic.
Flushing, itching, hives, anxiety, and tongue swelling are classic signs of anaphylaxis — a severe, life-threatening systemic allergic reaction. Tongue swelling is particularly alarming as it signals angioedema and potential airway compromise. This constitutes a medical emergency requiring immediate administration of epinephrine and emergency supportive care.
Why Other Options are Incorrect:
A. Tolerance to the antibiotic — Tolerance refers to a reduced response to a medication over time requiring higher doses for the same effect. It does not produce the symptoms described.
B. Clostridium difficile from the antibiotic — C. difficile infection presents primarily with watery diarrhea, abdominal cramping, and fever — not with allergic symptoms such as hives, flushing, or tongue swelling.
C. A superinfection from the antibiotic — A superinfection occurs when antibiotic use disrupts normal flora, allowing opportunistic organisms to grow. It typically manifests as a new infection (e.g., oral thrush, vaginal candidiasis) and does not cause the allergic symptoms described.
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"Heparin does not dissolve clots."
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"It usually takes heparin at least 2 weeks to dissolve a clot."
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"A pharmacist is the person to answer that question."
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"The oral medication you will take after this IV will dissolve the clot."
Explanation
Heparin is an anticoagulant, not a thrombolytic. It works by preventing new clot formation and stopping existing clots from growing larger by inhibiting clotting factors in the coagulation cascade. It does not dissolve existing clots. Thrombolytic agents such as alteplase (tPA) are the medications that actually dissolve clots. This is a critical patient education point that the nurse must clarify accurately.
Why the other options are incorrect:
B. "It usually takes heparin at least 2 weeks to dissolve a clot." — This is factually incorrect. Heparin does not dissolve clots at all, regardless of duration. Providing this misinformation would be harmful and misleading.
C. "A pharmacist is the person to answer that question." — Redirecting this question to a pharmacist is inappropriate. This is fundamental medication education that falls within the nurse's professional scope to explain accurately.
D. "The oral medication you will take after this IV will dissolve the clot." — The oral anticoagulant that typically follows IV heparin (such as warfarin or a DOAC) also does not dissolve clots. Like heparin, these medications prevent further clotting but do not have thrombolytic properties.
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Administer a breathing treatment
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Stop the medication
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Administer epinephrine
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Call a Rapid Response
Explanation
Correct Answer: (B) Stop the medication.
The very first action when a patient has an anaphylactic reaction to an IV medication is to immediately stop the infusion to halt further exposure to the causative agent. Continuing the medication would worsen the reaction. All subsequent interventions — including epinephrine, airway management, and calling a Rapid Response — follow after the offending medication has been stopped.
Why the other options are incorrect:
A. Administer a breathing treatment — Bronchodilator breathing treatments may support respiratory symptoms but are not the first-line or immediate first action in anaphylaxis management.
C. Administer epinephrine — Epinephrine is the definitive treatment for anaphylaxis and should be given promptly, but stopping the medication comes first to prevent continued exposure to the allergen.
D. Call a Rapid Response — Calling for help is important but follows the immediate action of stopping the causative medication. Delaying that step to make a call first would allow the reaction to worsen.
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