ATI RN Pharmacology Proctored Exam 2024 (NGN)
**Target Question Count:** 74
**The Drug Blueprint: NGN Pharmacology Mastery**
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1. Metformin for type 2 diabetes. Most serious adverse effect?
💫RATIONALE✔️✔️: Lactic acidosis (rare but fatal). Hold for surgery, contrast dye, or renal impairment.
💫ANSWER✔️✔️: C. Lactic acidosis
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2. Warfarin and phenytoin interaction. Expected effect?
💫RATIONALE✔️✔️: Phenytoin induces hepatic enzymes. Decreases warfarin levels, INR drops.
💫ANSWER✔️✔️: B. Decreased INR
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3. Digoxin toxicity, patient on furosemide. Which electrolyte contributes?
💫RATIONALE✔️✔️: Hypokalemia from loop diuretic increases digoxin binding to cardiac receptors.
💫ANSWER✔️✔️: A. Potassium 3.1 mEq/L
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4. Lisinopril (ACE inhibitor) first dose. Priority nursing action?
💫RATIONALE✔️✔️: Severe hypotension after first dose. Give with low salt diet, hold diuretic.
💫ANSWER✔️✔️: D. Administer with small amount of water, monitor BP q15min x 1h
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5. Alendronate (Fosamax) teaching. Correct instruction?
, 💫RATIONALE✔️✔️: Take on empty stomach with full water, sit upright 30 min. Prevents esophagitis.
💫ANSWER✔️✔️: C. Remain upright for 30 minutes after taking
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6. Patient on MAOI (phenelzine) wants meal. Which food is safe?
💫RATIONALE✔️✔️: Fresh chicken breast (low tyramine). Avoid aged cheese, cured meats, soy.
💫ANSWER✔️✔️: D. Grilled chicken breast
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7. IV heparin infusion for PE. aPTT 110 sec (control 30). Action?
💫RATIONALE✔️✔️: Goal aPTT 60-80 sec. Supratherapeutic level, high bleeding risk.
💫ANSWER✔️✔️: B. Stop heparin infusion
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8. Carbamazepine (Tegretol) for seizures. Which lab requires monitoring?
💫RATIONALE✔️✔️: Carbamazepine causes leukopenia and agranulocytosis. CBC with differential.
💫ANSWER✔️✔️: A. White blood cell count
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9. Naloxone (Narcan) for opioid overdose. Half-life consideration?
💫RATIONALE✔️✔️: Naloxone half-life 30-60 min. Opioids last hours. Re-dosing needed.
💫ANSWER✔️✔️: C. Monitor for recurrent respiratory depression
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10. Amiodarone IV push. Which adverse effect requires immediate stop?
💫RATIONALE✔️✔️: Hypotension and bradycardia. Infuse slowly over 10 min.
💫ANSWER✔️✔️: D. Blood pressure drops to 80/50
**Target Question Count:** 74
**The Drug Blueprint: NGN Pharmacology Mastery**
---
1. Metformin for type 2 diabetes. Most serious adverse effect?
💫RATIONALE✔️✔️: Lactic acidosis (rare but fatal). Hold for surgery, contrast dye, or renal impairment.
💫ANSWER✔️✔️: C. Lactic acidosis
---
2. Warfarin and phenytoin interaction. Expected effect?
💫RATIONALE✔️✔️: Phenytoin induces hepatic enzymes. Decreases warfarin levels, INR drops.
💫ANSWER✔️✔️: B. Decreased INR
---
3. Digoxin toxicity, patient on furosemide. Which electrolyte contributes?
💫RATIONALE✔️✔️: Hypokalemia from loop diuretic increases digoxin binding to cardiac receptors.
💫ANSWER✔️✔️: A. Potassium 3.1 mEq/L
---
4. Lisinopril (ACE inhibitor) first dose. Priority nursing action?
💫RATIONALE✔️✔️: Severe hypotension after first dose. Give with low salt diet, hold diuretic.
💫ANSWER✔️✔️: D. Administer with small amount of water, monitor BP q15min x 1h
---
5. Alendronate (Fosamax) teaching. Correct instruction?
, 💫RATIONALE✔️✔️: Take on empty stomach with full water, sit upright 30 min. Prevents esophagitis.
💫ANSWER✔️✔️: C. Remain upright for 30 minutes after taking
---
6. Patient on MAOI (phenelzine) wants meal. Which food is safe?
💫RATIONALE✔️✔️: Fresh chicken breast (low tyramine). Avoid aged cheese, cured meats, soy.
💫ANSWER✔️✔️: D. Grilled chicken breast
---
7. IV heparin infusion for PE. aPTT 110 sec (control 30). Action?
💫RATIONALE✔️✔️: Goal aPTT 60-80 sec. Supratherapeutic level, high bleeding risk.
💫ANSWER✔️✔️: B. Stop heparin infusion
---
8. Carbamazepine (Tegretol) for seizures. Which lab requires monitoring?
💫RATIONALE✔️✔️: Carbamazepine causes leukopenia and agranulocytosis. CBC with differential.
💫ANSWER✔️✔️: A. White blood cell count
---
9. Naloxone (Narcan) for opioid overdose. Half-life consideration?
💫RATIONALE✔️✔️: Naloxone half-life 30-60 min. Opioids last hours. Re-dosing needed.
💫ANSWER✔️✔️: C. Monitor for recurrent respiratory depression
---
10. Amiodarone IV push. Which adverse effect requires immediate stop?
💫RATIONALE✔️✔️: Hypotension and bradycardia. Infuse slowly over 10 min.
💫ANSWER✔️✔️: D. Blood pressure drops to 80/50
