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11/13/23, 12:44 AM ATI PN Pharmacology Proctored EXAM Review 2021
2021 ATI PN PHARMACOLOGY EXAM REVIEW
Q&A WITH RATIONALES
1. A 52-yr-old male patient has received a bolus dose and an infusion of
alteplase (Activase) for an ST-segment elevation myocardial infarction
(STEMI). Which patient assessment would determine the effectiveness of the
medication?
A Presence of chest pain
B Blood in the urine or stool
C Tachycardia with hypotension
D Decreased level of consciousness Correct ans - A
Alteplase is a fibrinolytic agent that is administered to patients who have had
an STEMI. If the medication is effective, the patient's chest pain will resolve
because the medication dissolves the thrombus in the coronary artery and
results in reperfusion of the myocardium. Bleeding is a major complication of
fibrinolytic therapy. Signs of major bleeding include decreased level of
consciousness, blood in the urine or stool, and increased heart rate with
decreased blood pressure.
2. A 74-yr-old man with a history of prostate cancer and hypertension is
admitted to the emergency department with substernal chest pain. Which
action will the nurse complete before administering sublingual nitroglycerin?
A Administer morphine sulfate IV.
B Auscultate heart and lung sounds.
C Obtain a 12-lead electrocardiogram (ECG).
D Assess for coronary artery disease risk factors. Correct ans - C
If a patient has chest pain, the nurse should institute the following measures:
(1) administer supplemental oxygen and position the patient in upright
position unless contraindicated, (2) assess vital signs, (3) obtain a 12-lead
ECG, (4) provide prompt pain relief first with a nitrate followed by an opioid
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2021 ATI PN PHARMACOLOGY EXAM REVIEW
Q&A WITH RATIONALES
analgesic if needed, and (5) auscultate heart sounds. Obtaining a 12-lead
ECG during chest pain aids in the diagnosis.
3. Which patient is at greatest risk for sudden cardiac death (SCD)?
A A 42-yr-old white woman with hypertension and dyslipidemia
B A 52-yr-old African American man with left ventricular failure
C A 62-yr-old obese man with diabetes mellitus and high cholesterol
D A 72-yr-old Native American woman with a family history of heart disease
Correct ans - B
Patients with left ventricular dysfunction (ejection fraction
4. Which factor should be considered when caring for a woman with
suspected coronary artery disease?
A Fatigue may be the first symptom.
B Classic signs and symptoms are expected.
C Increased risk is present before
menopause.
D Women are more likely to develop collateral circulation. Correct ans
- A
Fatigue, rather than pain or shortness of breath, may be the first symptom of
impaired cardiac circulation. Women may not exhibit the classic signs and
symptoms of ischemia such as chest pain which radiates down the left arm.
Neck, throat, or back pain may be symptoms experienced by women. Risk
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2021 ATI PN PHARMACOLOGY EXAM REVIEW
Q&A WITH RATIONALES
for coronary artery disease increases four times after menopause. Men are
more likely to develop collateral circulation.
5. Which individuals would the nurse identify as having the highest risk for
coronary artery disease (CAD)?
A A 45-yr-old depressed man with a high-stress job
B A 60-yr-old man with below normal homocysteine levels
C A 54-yr-old woman vegetarian with elevated high-density lipoprotein (HDL)
levels
D A 62-yr-old woman who has a sedentary lifestyle and body mass
index (BMI) of 23 kg/m2 Correct ans - A
The 45-yr-old depressed man with a high-stress job is at the highest risk for
CAD. Studies demonstrate that depression and stressful states can
contribute to the development of CAD. Elevated HDL levels and low
homocysteine levels actually help to prevent CAD. Although a sedentary
lifestyle is a risk factor, a BMI of 23 kg/m2 depicts normal weight, and thus
the patient with two risk factors is at greatest risk for developing CAD.
6. After teaching a patient with chronic stable angina about nitroglycerin, the
nurse recognizes the need for further teaching when the patient makes
which statement?
A "I will replace my nitroglycerin supply every 6 months."
B "I can take up to five tablets every 3 minutes for relief of my chest pain."
C "I will take acetaminophen (Tylenol) to treat the headache caused by
nitroglycerin."
D "I will take the nitroglycerin 10 minutes before planned activity that usually
causes chest pain." Correct ans - B
The recommended dose of nitroglycerin is one tablet taken sublingually (SL)
or one metered spray for symptoms of angina. If symptoms are unchanged
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2021 ATI PN PHARMACOLOGY EXAM REVIEW
Q&A WITH RATIONALES
or worse after 5 minutes, the patient should be instructed to activate the
emergency medical services (EMS) system. If symptoms are improved,
repeat the nitroglycerin every 5 minutes for a maximum of three doses
and contact EMS if symptoms have not resolved completely.
7. When planning emergent care for a patient with a suspected myocardial
infarction (MI), what should the nurse anticipate administrating?
A Oxygen, nitroglycerin, aspirin, and morphine
B Aspirin, nitroprusside, dopamine, and oxygen
C Oxygen, furosemide (Lasix), nitroglycerin, and meperidine
D Nitroglycerin, lorazepam (Ativan), oxygen, and warfarin (Coumadin)
Correct ans - A
The American Heart Association's guidelines for emergency care of the
patient with chest pain include the administration of oxygen, nitroglycerin,
aspirin, and morphine. These interventions serve to relieve chest pain,
improve oxygenation, decrease myocardial workload, and prevent further
platelet aggregation. The other medications may be used later in the
patient's treatment.
8. When evaluating a patient's knowledge regarding a low-sodium, low-fat
cardiac diet, the nurse recognizes additional teaching is needed when the
patient selects which food?
A Baked flounder
B Angel food cake
C Baked potato with margarine
D Canned chicken noodle soup Correct ans - D
Canned soups are very high in sodium content. Patients need to be taught to
read food labels for sodium and fat content.
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