ATI RN
Pharmacology ATI Proctored Exam 2023
1. The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?
- A. Atenolol (Tenormin)
- B. Nitroglycerin (Nitrostat)
- C. Sildenafil (Viagra)
- D. Ranolazine (Ranexa)
Correct answer: D
Rationale: In cases of chronic angina where initial treatment has not been successful, Ranolazine (Ranexa) is often prescribed. This medication helps by reducing the frequency of angina episodes. Atenolol, Nitroglycerin, and Sildenafil are also used in angina management but Ranolazine is more specifically indicated in cases of refractory angina where other treatments have failed.
2. A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should NOT be included in client teaching?
- A. Reflex tachycardia
- B. Dizziness
- C. Hyponatremia
- D. Hypotension
Correct answer: C
Rationale: Hyponatremia is not a common side effect associated with nitroglycerin use. Nitroglycerin typically causes side effects such as reflex tachycardia, dizziness, and hypotension due to its vasodilatory effects. Therefore, it is important for the nurse to educate the client about these potential side effects to promote understanding and appropriate management.
3. Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?
- A. 45 minutes to 18 hours
- B. 30 minutes to 12 hours
- C. 90 minutes to 36 hours
- D. 60 minutes to 24 hours
Correct answer: B
Rationale: Reteplase (Retavase) is a thrombolytic medication used in the treatment of myocardial infarction (MI). It is crucial to administer this drug within 30 minutes to 12 hours following the onset of symptoms to achieve optimal therapeutic effects and improve patient outcomes. Administering Reteplase within this time frame helps in restoring blood flow to the affected areas of the heart by dissolving blood clots, reducing myocardial damage, and potentially preventing further complications associated with MI.
4. When a client is discharged with nitroglycerin (Nitrostat), what should the nurse include in client education?
- A. “Your chest pain should go away with one tablet.”
- B. “If your chest pain doesn’t go away after three tablets, call 911; you might be having a heart attack.”
- C. “If your chest pain doesn’t go away with one tablet, you can repeat the dose as many times as you need to.”
- D. “Be sure to call 911 before you take any tablets.”
Correct answer: B
Rationale: The correct answer instructs the client on the appropriate use of nitroglycerin. Nitroglycerin is used to relieve chest pain or angina. If the chest pain does not subside after taking one tablet, the client should take a maximum of three tablets at 5-minute intervals. If the pain persists after three tablets, it could indicate a heart attack, and emergency medical help should be sought. This education is crucial to ensure the client knows when to seek immediate medical attention.
5. Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?
- A. Antiplatelets
- B. Beta-adrenergic blockers
- C. ACE inhibitors
- D. Calcium channel blockers
Correct answer: B
Rationale: Beta-adrenergic blockers have been shown to decrease mortality when administered within 8 hours of a myocardial infarction (MI). They do so by reducing cardiac workload, which helps improve outcomes post-MI. These drugs work by blocking the effects of adrenaline on the heart, leading to decreased heart rate, blood pressure, and myocardial oxygen demand, thereby protecting the heart muscle from further damage. This makes them a crucial part of the treatment regimen for acute coronary syndromes like MI.
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