ATI RN
ATI Proctored Pharmacology 2023
1. A patient has been taking hydrocodone, an opioid analgesic for their moderate pain, and they have taken more than the prescribed dose. What should you administer as the antidote if they experience toxicity?
- A. Naloxone
- B. N-acetylcysteine
- C. Atropine
- D. Digoxin immune Fab
Correct answer: A
Rationale: Naloxone is the specific antidote for opioid toxicity. It works by blocking the effects of opioids on the central nervous system, thereby reversing symptoms like respiratory depression and sedation. N-acetylcysteine is used for acetaminophen overdose, while atropine is indicated for certain types of poisonings. Digoxin immune Fab is used for digoxin toxicity. Therefore, in the case of opioid toxicity due to hydrocodone overdose, naloxone is the appropriate antidote.
2. A patient states he experiences anxiety and has panic attacks at least once a week. What might be helpful for this patient?
- A. Phenytoin (Dilantin)
- B. Lithium
- C. Alprazolam (Xanax)
- D. Spironolactone
Correct answer: C
Rationale: Alprazolam (Xanax) is a medication commonly prescribed to treat anxiety disorders and panic attacks. It belongs to the class of medications known as benzodiazepines, which work by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain to produce a calming effect. Phenytoin is an antiepileptic drug, not typically used for anxiety or panic attacks. Lithium is primarily used to treat bipolar disorder, not anxiety. Spironolactone is a diuretic primarily used to treat conditions like high blood pressure and heart failure, not anxiety or panic attacks.
3. A hospitalized client receiving IV heparin for a deep-vein thrombosis begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?
- A. Vitamin K1
- B. Atropine
- C. Protamine
- D. Calcium gluconate
Correct answer: C
Rationale: In this scenario, the client is experiencing a serious complication of heparin therapy, likely due to heparin-induced thrombocytopenia. Protamine is the antidote for heparin and can reverse its anticoagulant effects. It is essential to administer protamine promptly to counteract the effects of heparin and manage the bleeding. Vitamin K1 is used to reverse the effects of warfarin, not heparin. Atropine is used to treat bradycardia or some types of poisoning. Calcium gluconate is used to manage hyperkalemia or calcium channel blocker toxicity, not to reverse heparin's effects.
4. A client is prescribed Bethanechol to treat urinary retention. Which of the following findings is a manifestation of muscarinic stimulation?
- A. Dry mouth
- B. Hypertension
- C. Excessive perspiration
- D. Fecal impaction
Correct answer: C
Rationale: Bethanechol is a muscarinic agonist, which stimulates muscarinic receptors. Activation of these receptors can lead to increased sweating (excessive perspiration) as a manifestation of muscarinic stimulation. Options A, B, and D are not typically associated with muscarinic stimulation. Dry mouth is a common side effect of anticholinergic medications, hypertension is not a common manifestation of muscarinic stimulation, and fecal impaction is not directly related to muscarinic receptor activation.
5. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?
- A. Sodium level of 138 mEq/L
- B. Potassium level of 5.2 mEq/L
- C. Chloride level of 100 mEq/L
- D. Calcium level of 9.5 mg/dL
Correct answer: B
Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.
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