2021 ATI PN PHARMACOLOGY EXAM
REVIEW QUESTIONS AND ANSWERS
WITH RATIONALES GRADED A+
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
,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
, 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."
REVIEW QUESTIONS AND ANSWERS
WITH RATIONALES GRADED A+
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
,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
, 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."
