ATI Custom NUR3025 Pharmacology Exam Two_V5

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Ace Your Test with ATI Custom NUR3025 Pharmacology Exam Two_V5 Actual Questions and Solutions - Full Set

Free ATI Custom NUR3025 Pharmacology Exam Two_V5 Questions

1.

When the nurse is teaching an older adult patient about their medications, which of these age-related changes is appropriate for the nurse to consider?

  • Decrease in short-term memory

  • Increased ability to concentrate

  • Decrease in intellectual abilities

  • Increased conduction of sound

Explanation

Explanation
Correct Answer: (A) Decrease in short-term memory
Older adults commonly experience a decline in short-term memory as part of normal aging. The nurse should account for this by using simple language, written instructions, and repetition to enhance medication understanding and adherence.
Why the other options are incorrect:
B. Aging is generally associated with decreased, not increased, ability to concentrate, making this an inaccurate consideration.
C. While processing speed may slow, intellectual abilities such as wisdom and long-term knowledge typically remain intact in normal aging.
D. Hearing ability typically decreases with age due to sensorineural changes; conduction of sound does not increase in older adults.
2.

The electronic health record indicates that a patient's continuous infusion of heparin intravenously was to be stopped at 1000. At 1900, the nurse notices that the heparin is still running. Which type of medication error has occurred?

  • Wrong route

  • Wrong drug

  • Wrong dose

  • Wrong time

Explanation

Explanation
Correct Answer: (D) Wrong time.
The heparin infusion was ordered to be discontinued at 1000 but was still running at 1900 — nine hours past the scheduled stop time. This is a wrong time medication error, as the prescribed timing of the medication administration or discontinuation was not followed correctly.
Why Other Options are Incorrect:
A. Wrong route — The route of administration (IV infusion) was correct as prescribed. The error was not related to how the medication was delivered.
B. Wrong drug — The correct medication (heparin) was being administered. The error did not involve giving the wrong drug.
C. Wrong dose — There is no information indicating the dose or rate was incorrect. The error was specifically that the medication was not stopped at the prescribed time.
3.

Several patients have standard orders for acetaminophen as needed for pain. While reviewing their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen. Which patient should not receive acetaminophen?

  • A patient with a fever of 103.4°F (39.7°C)

  • A patient who had abdominal surgery yesterday

  • A patient admitted with severe hepatitis

  • A patient admitted with deep vein thrombosis

Explanation

Explanation
Correct Answer: (C) A patient admitted with severe hepatitis.
Acetaminophen is metabolized by the liver, and in patients with severe hepatic disease such as hepatitis, the liver's ability to safely process the drug is significantly impaired. This increases the risk of hepatotoxicity and acute liver failure. Severe liver disease is a primary contraindication to acetaminophen use.
Why Other Options are Incorrect:
A. A patient with a fever — Fever is actually one of the indications for acetaminophen use, as it is an effective antipyretic. This patient would benefit from the medication.
B. A patient who had abdominal surgery yesterday — Post-surgical pain management is an appropriate indication for acetaminophen. Recent abdominal surgery alone is not a contraindication.
D. A patient with deep vein thrombosis — DVT does not contraindicate acetaminophen use. Unlike NSAIDs, acetaminophen does not significantly affect platelet function or anticoagulation, making it generally safe in this population.
4.

A patient has received an overdose of intravenous heparin and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose?

  • Vitamin K

  • Vitamin E

  • Potassium Chloride

  • Protamine Sulfate

Explanation

Explanation
Protamine sulfate is the specific antidote for heparin overdose. It is a positively charged protein that binds directly to heparin — a negatively charged molecule — forming a stable, inactive complex that neutralizes heparin's anticoagulant effect. It is administered intravenously and works rapidly to reverse excessive anticoagulation and control bleeding.
Why the other options are incorrect:
A. Vitamin K — Vitamin K is the antidote for warfarin overdose, not heparin. It works by replenishing the vitamin K-dependent clotting factors that warfarin inhibits, which is a completely different mechanism from heparin's action.
B. Vitamin E — Vitamin E has mild anticoagulant properties at high doses and has no role as an antidote for heparin toxicity.
C. Potassium Chloride — Potassium chloride is used to treat hypokalemia and has no antidotal properties against heparin. Administering it in this context would be inappropriate and potentially dangerous.
5.

A child must receive a loading dose of digoxin 30 mcg/kg IV. The child weighs 55 lbs. How many micrograms should the child receive?

Explanation

Explanation
First, convert weight from pounds to kilograms: 55 lbs ÷ 2.2 = 25 kg
Then calculate the dose: 25 kg × 30 mcg/kg = 750 micrograms
6.

Which type of insulin has a duration of action lasting 24 hours after administration?

  • Detemir

  • Glargine

  • Humulin R

  • Lispro

Explanation

Explanation
Insulin glargine (Lantus) is a long-acting basal insulin with a relatively peakless, steady absorption profile and a duration of action of approximately 24 hours. It is administered once daily to provide consistent background insulin coverage throughout the day and night, making it ideal for basal glycemic control in both type 1 and type 2 diabetes.
Why the other options are incorrect:
A. Detemir — Insulin detemir is also a long-acting insulin but has a duration of action of approximately 18 to 23 hours, which is shorter and more variable than glargine. It is often dosed twice daily for consistent coverage.
C. Humulin R — Humulin R is a short-acting (regular) insulin with an onset of 30 to 60 minutes and a duration of approximately 6 to 10 hours. It is used for mealtime coverage, not basal control.
D. Lispro — Insulin lispro is a rapid-acting insulin with an onset of 15 minutes and a duration of only 3 to 5 hours. It is used immediately before meals to manage postprandial glucose spikes.
7.

During a teaching session for a patient on antithyroid drugs, the nurse knows which dietary instructions are needed. Which of the following is the correct information for this patient?

  • Restricting fluid intake to 2500 mL/day

  • Avoiding foods containing iodine

  • Increasing intake of sodium and potassium

  • Using iodized salt when cooking

Explanation

Explanation
Antithyroid drugs such as methimazole and propylthiouracil (PTU) work by inhibiting thyroid hormone synthesis. Patients on antithyroid therapy should avoid foods high in iodine — such as seaweed, shellfish, and iodized salt — because excess iodine can stimulate thyroid hormone production and counteract the effects of the medication.
Why the other options are incorrect:
A. Restricting fluid intake to 2500 mL/day — Fluid restriction is not a standard dietary instruction for patients on antithyroid medications. This is more relevant to conditions such as heart failure or renal disease.
C. Increasing intake of sodium and potassium — There is no clinical indication to increase sodium or potassium intake specifically for patients on antithyroid therapy.
D. Using iodized salt when cooking — Iodized salt is a significant source of dietary iodine and should be avoided, not encouraged, in patients taking antithyroid medications.
8.

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications is a potassium-sparing diuretic?

  • Furosemide

  • Metolazone

  • Hydrochlorothiazide

  • Spironolactone

Explanation

Explanation
Spironolactone is a potassium-sparing diuretic that works by blocking aldosterone receptors in the distal nephron, promoting sodium and water excretion while retaining potassium. It is commonly used in heart failure management, particularly to reduce fluid overload while minimizing the risk of hypokalemia that is associated with other diuretics.
Why the other options are incorrect:
A. Furosemide — Furosemide is a loop diuretic that acts on the loop of Henle to eliminate sodium, water, and potassium. It causes significant potassium loss and is not potassium-sparing.
B. Metolazone — Metolazone is a thiazide-like diuretic that inhibits sodium reabsorption in the distal tubule. It causes potassium loss and is not potassium-sparing.
C. Hydrochlorothiazide — Hydrochlorothiazide is a thiazide diuretic that also promotes potassium excretion. It is not a potassium-sparing diuretic.
9.

A nurse is administering timolol eye drops to a client who has glaucoma. Which of the following actions should the nurse take?

  • Protect the distal portion of the eyedropper using clean technique.

  • Drop prescribed amount of medication into the conjunctival sac.

  • Wipe the eye from the outer canthus to the inner canthus before instillation.

  • Apply pressure to the bridge of the nose after administration.

Explanation

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.
10.

Which drug prescription should the nurse question if the patient is taking sildenafil (a phosphodiesterase inhibitor)?

  • Testosterone

  • Nitroglycerin

  • Sumatriptan

  • Epinephrine

Explanation

Explanation
Correct Answer: (B) Nitroglycerin
Both sildenafil and nitroglycerin cause vasodilation through different mechanisms. When used together, they produce a synergistic effect that can cause severe, life-threatening hypotension. This combination is therefore contraindicated.
Why the other options are incorrect:
A. Testosterone does not interact dangerously with sildenafil and does not share the vasodilatory mechanism that creates the risk seen with nitrates.
C. Sumatriptan is a serotonin receptor agonist used for migraines. While caution is advised in some cardiovascular contexts, it does not carry the same severe interaction risk with sildenafil as nitroglycerin.
D. Epinephrine is a vasopressor and does not produce the dangerous hypotensive interaction seen when sildenafil is combined with nitrates.

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