ATI NUR 520 Final Mcelroy SP 25
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Free ATI NUR 520 Final Mcelroy SP 25 Questions
A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body?
- A) It stimulates the liver to convert glycogen to glucose.
- B) It promotes the synthesis of amino acids into glucose.
- C) It stimulates the pancreas to reabsorb glucose.
- D) It promotes the passage of glucose into cells for energy.
Explanation
Explanation:
Insulin is a hormone produced by the pancreas that allows glucose to enter cells, where it can be used for energy. Without insulin, glucose stays in the bloodstream, leading to high blood sugar levels. In type 1 diabetes, the body doesn’t produce insulin, so glucose can’t move into the cells properly.
Why the other options are incorrect:
A) It stimulates the liver to convert glycogen to glucose:
This is the action of glucagon, not insulin. Insulin promotes glucose storage, not release.
B) It promotes the synthesis of amino acids into glucose:
This describes gluconeogenesis, a process insulin typically inhibits.
C) It stimulates the pancreas to reabsorb glucose:
The pancreas produces insulin; it doesn’t reabsorb glucose. This is not a function of insulin.
The healthcare provider orders Valium 8 mg IV now. The concentration available is 5 mg/mL. How many mL will the patient receive?
- A) 1.4 mL
- B) 1.8 mL
- C) 1.2 mL
- D) 1.6 mL
Explanation
Explanation:
Use the formula:
Dose ordered ÷ Concentration = Volume to administer
8 mg ÷ 5 mg/mL = 1.6 mL
The nurse will need to administer 1.6 mL of Valium to provide the prescribed 8 mg dose.
Why the other options are incorrect:
A) 1.4 mL:
1.4 mL × 5 mg/mL = 7 mg — too little.
B) 1.8 mL:
1.8 mL × 5 mg/mL = 9 mg — too much.
C) 1.2 mL:
1.2 mL × 5 mg/mL = 6 mg — too little.
A patient with a history of hypertension is admitted for a procedure. If the patient's blood pressure decreases, which clinical manifestation would the nurse expect to see?
- A) Decreased heart rate
- B) Erythema
- C) Increased temperature
- D) Increased heart rate
Explanation
Explanation:
When blood pressure drops, the body compensates by activating the sympathetic nervous system, which causes the heart to beat faster to maintain adequate perfusion to vital organs. This results in increased heart rate (tachycardia), a common physiological response to hypotension.
Why the other options are incorrect:
A) Decreased heart rate:
Bradycardia would not be expected in response to hypotension; it would worsen perfusion.
B) Erythema:
This refers to skin redness, often due to inflammation or infection, not related to changes in blood pressure.
C) Increased temperature:
Temperature changes are usually linked to infection or inflammation, not directly to blood pressure changes.
A patient is taking a drug that has known toxic side effects. What will the nurse do?
- A) Instruct patient on the importance of monitoring the function of all organs potentially affected by the drug.
- B) Ensure that complete blood counts are ordered periodically.
- C) Discontinue all the patient's medications
- D) Instruct the patient they should only follow-up if symptoms develop.
Explanation
Explanation:
When a patient is prescribed a medication with known toxic effects, it is essential for the nurse to educate the patient about ongoing monitoring, including the need for regular testing of affected organs (e.g., liver, kidneys, heart). This helps detect early signs of toxicity and ensures safe continuation of therapy.
Why the other options are incorrect:
B) Ensure that complete blood counts are ordered periodically:
While appropriate for drugs that affect blood cells, it may not cover all organ systems affected. Broader monitoring is usually needed.
C) Discontinue all the patient's medications:
This is inappropriate unless directed by the healthcare provider. Stopping medications abruptly could be harmful.
D) Instruct the patient they should only follow-up if symptoms develop:
This is unsafe, as toxic effects can be silent or progress before symptoms appear. Proactive monitoring is essential.
A patient has allergies and takes an antihistamine. The patient wants to know how the drug works. The nurse understands that antihistamines work because they are what?
- A) Agonists
- B) Antagonists
- C) Antidotes
- D) Activators
Explanation
Explanation:
Antihistamines work by acting as antagonists at histamine (H1) receptor sites. This means they block histamine from binding to its receptors, which helps reduce allergy symptoms such as itching, sneezing, and runny nose. They do not activate the receptors; instead, they prevent histamine from causing its usual effects during allergic reactions.
Why the other options are incorrect:
A) Agonists:
These stimulate or activate receptors to produce a response. Antihistamines block rather than activate.
C) Antidotes:
Used to counteract poisons or overdoses, not allergy symptoms.
D) Activators:
Not a standard pharmacologic term. Antihistamines do not activate receptors—they inhibit them.
The nurse is caring for a patient who has jaundice, dark urine, malaise, light-colored stools, nausea, and vomiting. What is this patient most likely experiencing?
- A) An allergic reaction
- B) An idiosyncratic drug effect on the bone marrow
- C) Iatrogenic disease of the skin
- D) Drug toxicity of the liver
Explanation
Explanation:
The symptoms described—jaundice, dark urine, light-colored stools, nausea, vomiting, and malaise—are classic signs of liver dysfunction, often due to hepatotoxicity or drug-induced liver injury. Many medications can damage liver cells, leading to impaired bile excretion and systemic symptoms.
Why the other options are incorrect:
A) An allergic reaction:
Usually presents with rash, itching, hives, swelling, or respiratory issues—not liver-related symptoms like jaundice.
B) An idiosyncratic drug effect on the bone marrow:
Would more likely cause blood-related issues such as anemia, infection, or bleeding—not liver-specific signs.
C) Iatrogenic disease of the skin:
Refers to a skin condition caused by medical treatment, not systemic liver symptoms like jaundice or digestive distress.
A patient has had blood pressures of 150/95 and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order:
- A) An adrenergic neuron blocker
- B) A beta blocker
- C) Counseling on lifestyle changes
- D) A thiazide diuretic
Explanation
Explanation:
This patient meets the criteria for Stage 1 hypertension (systolic 130–139 or diastolic 80–89 mm Hg), but with normal diagnostic tests and no evidence of end-organ damage, the first-line recommendation is lifestyle modification. These include dietary changes, exercise, weight loss, limiting alcohol, and reducing sodium intake. Medications are typically considered if lifestyle changes are ineffective or if the patient has additional risk factors.
Why the other options are incorrect:
A) An adrenergic neuron blocker:
These are rarely used due to significant side effects and are not first-line treatment.
B) A beta blocker:
Beta blockers are not recommended as initial therapy for uncomplicated hypertension unless the patient has other conditions like heart failure or post-MI.
D) A thiazide diuretic:
Although effective, this medication would be considered after lifestyle changes have been attempted and failed or if additional risk factors exist.
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?
- A) Monitor plasma drug levels
- B) Administer this medication intravenously
- C) Administer the drug at intervals longer than the drug half-life
- D) Teach the patient that maximum drug effects will occur within a short period
Explanation
Explanation:
Drugs with a narrow therapeutic range have a small margin between therapeutic and toxic doses. Because of this, the nurse must monitor plasma drug levels closely to ensure the drug concentration stays within the safe and effective range. This helps prevent toxicity or subtherapeutic effects.
Why the other options are incorrect:
B) Administer this medication intravenously:
Route of administration depends on the drug, not its therapeutic range. Narrow-range drugs can be oral, IV, or other forms.
C) Administer the drug at intervals longer than the drug half-life:
This could lead to subtherapeutic levels. Dosing is usually more frequent to maintain steady levels.
D) Teach the patient that maximum drug effects will occur within a short period:
The timing of effects varies with each drug and is not directly related to the therapeutic range.
A patient reports becoming "immune" to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:
- A) Synthesis of more receptor sites in response to the medication.
- B) Decreased selectivity of receptor sites, resulting in a variety of effects.
- C) Desensitization of receptor sites by continual exposure to the drug.
- D) Antagonists produced by the body that compete with the drug for receptor sites.
Explanation
Explanation:
When a medication is used over a prolonged period, the body can become tolerant to it. This often happens because the drug’s target receptors become desensitized, meaning they no longer respond as effectively to stimulation. As a result, the drug loses its effectiveness even though the dose remains the same. This phenomenon is a common reason why long-term drug regimens may stop working.
Why the other options are incorrect:
A) Synthesis of more receptor sites in response to the medication:
This would likely increase sensitivity, not reduce it, and is more common with upregulation after blocking agents are used.
B) Decreased selectivity of receptor sites, resulting in a variety of effects:
Selectivity refers to how specific a drug is to certain receptors, not how effective it is. This doesn't explain reduced response.
D) Antagonists produced by the body that compete with the drug for receptor sites:
The body does not normally produce antagonists against medications. This is not a recognized physiological mechanism of tolerance.
A nurse teaches a patient who takes daily low-dose aspirin for protection against myocardial infarction and stroke to avoid also taking which medication?
- A) Diphenhydramine [Benadryl]
- B) Loratadine [Claritin]
- C) Ibuprofen [Motrin]
- D) Multivitamin
Explanation
Explanation:
Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can interfere with the antiplatelet effect of low-dose aspirin when taken concurrently. It may reduce aspirin’s cardioprotective benefits and increase the risk of gastrointestinal bleeding. Patients taking daily aspirin for heart protection are advised to avoid ibuprofen or to consult a healthcare provider about proper timing if absolutely needed.
Why the other options are incorrect:
A) Diphenhydramine [Benadryl]:
An antihistamine used for allergies and sleep aid. It doesn’t interfere with aspirin’s antiplatelet effect.
B) Loratadine [Claritin]:
A non-sedating antihistamine, safe to use with low-dose aspirin.
D) Multivitamin:
Generally safe unless it contains high doses of vitamin E, which may slightly affect bleeding risk—but not in the way NSAIDs like ibuprofen do.
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