ATI PN Pharmacology & Medical Surgical (Med-Surg)
ATI PN Pharmacology & Medical Surgical
(Med-Surg) 2023–2026 Practice Exam | 70
NCLEX-Style Questions with Correct
Answers & Detailed Rationales | ATI PN
Comprehensive Review
Question 1
A nurse is caring for a client who is receiving furosemide for heart failure.
Which finding should the nurse report to the provider immediately?
A. Blood pressure 118/70 mm Hg
B. Potassium level 2.9 mEq/L
C. Urine output 1500 mL/day
D. Heart rate 82/min
Correct Answer: B. Potassium level 2.9 mEq/L
Rationale:
Furosemide is a loop diuretic that increases excretion of potassium,
sodium, and water. A potassium level of 2.9 mEq/L indicates
hypokalemia, which can cause life-threatening dysrhythmias. The nurse
should report this finding immediately. The other values are within expected
ranges.
Question 2
A client is prescribed warfarin. Which laboratory value should the nurse
monitor to evaluate the effectiveness of the medication?
A. Platelet count
B. Hemoglobin
C. INR
D. aPTT
Page 1 of 33
,ATI PN Pharmacology & Medical Surgical (Med-Surg)
Correct Answer: C. INR
Rationale:
Warfarin therapy is monitored using the International Normalized Ratio
(INR). The therapeutic range for most conditions is 2–3. Platelets evaluate
clotting ability but not warfarin effectiveness. aPTT is used for heparin
therapy.
Question 3
A nurse is caring for a client with chronic obstructive pulmonary disease
(COPD). Which oxygen delivery method is most appropriate?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 1–2 L/min
C. Venturi mask at 10 L/min
D. Simple mask at 8 L/min
Correct Answer: B. Nasal cannula at 1–2 L/min
Rationale:
Clients with COPD rely on hypoxic drive for breathing. High oxygen
levels can suppress respirations. Therefore, oxygen should be
administered at low flow (1–2 L/min via nasal cannula).
Question 4
A nurse is administering morphine to a client after surgery. Which
assessment is the priority before administering the medication?
A. Pain level
B. Respiratory rate
C. Blood pressure
D. Temperature
Correct Answer: B. Respiratory rate
Page 2 of 33
,ATI PN Pharmacology & Medical Surgical (Med-Surg)
Rationale:
Morphine is an opioid analgesic that can cause respiratory depression.
The nurse must assess respiratory rate before administration. If the
respiratory rate is below 12/min, the medication should be withheld and
the provider notified.
Question 5
A nurse is teaching a client about nitroglycerin sublingual tablets. Which
statement indicates understanding?
A. “I should swallow the tablet with water.”
B. “I can take up to three tablets every 5 minutes for chest pain.”
C. “I should take the medication daily at bedtime.”
D. “I should store the tablets in the refrigerator.”
Correct Answer: B. “I can take up to three tablets every 5 minutes for
chest pain.”
Rationale:
Nitroglycerin is used for angina relief. Clients should take one tablet
every 5 minutes, up to three doses. If pain persists after the third dose,
they should seek emergency care. Tablets should be kept in their original
dark container, not refrigerated.
Question 6
A client with diabetes mellitus is receiving regular insulin. When should
the nurse expect the peak effect?
A. 15 minutes
B. 1–3 hours
C. 6–8 hours
D. 12–18 hours
Correct Answer: B. 1–3 hours
Page 3 of 33
, ATI PN Pharmacology & Medical Surgical (Med-Surg)
Rationale:
Regular insulin is a short-acting insulin.
Typical timeline:
• Onset: 30–60 minutes
• Peak: 1–3 hours
• Duration: 5–8 hours
Understanding peak action helps prevent hypoglycemia.
Question 7
A nurse is caring for a client with hypertension who is prescribed
lisinopril. Which adverse effect should the nurse monitor for?
A. Dry cough
B. Weight gain
C. Hyperglycemia
D. Bradycardia
Correct Answer: A. Dry cough
Rationale:
Lisinopril is an ACE inhibitor. A common side effect is a persistent dry
cough due to bradykinin accumulation. Other risks include hyperkalemia
and angioedema.
Question 8
A client is receiving digoxin for heart failure. Which finding indicates
possible toxicity?
A. Pulse 88/min
B. Nausea and vomiting
C. Blood pressure 130/80 mm Hg
D. Urine output 40 mL/hr
Page 4 of 33
ATI PN Pharmacology & Medical Surgical
(Med-Surg) 2023–2026 Practice Exam | 70
NCLEX-Style Questions with Correct
Answers & Detailed Rationales | ATI PN
Comprehensive Review
Question 1
A nurse is caring for a client who is receiving furosemide for heart failure.
Which finding should the nurse report to the provider immediately?
A. Blood pressure 118/70 mm Hg
B. Potassium level 2.9 mEq/L
C. Urine output 1500 mL/day
D. Heart rate 82/min
Correct Answer: B. Potassium level 2.9 mEq/L
Rationale:
Furosemide is a loop diuretic that increases excretion of potassium,
sodium, and water. A potassium level of 2.9 mEq/L indicates
hypokalemia, which can cause life-threatening dysrhythmias. The nurse
should report this finding immediately. The other values are within expected
ranges.
Question 2
A client is prescribed warfarin. Which laboratory value should the nurse
monitor to evaluate the effectiveness of the medication?
A. Platelet count
B. Hemoglobin
C. INR
D. aPTT
Page 1 of 33
,ATI PN Pharmacology & Medical Surgical (Med-Surg)
Correct Answer: C. INR
Rationale:
Warfarin therapy is monitored using the International Normalized Ratio
(INR). The therapeutic range for most conditions is 2–3. Platelets evaluate
clotting ability but not warfarin effectiveness. aPTT is used for heparin
therapy.
Question 3
A nurse is caring for a client with chronic obstructive pulmonary disease
(COPD). Which oxygen delivery method is most appropriate?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 1–2 L/min
C. Venturi mask at 10 L/min
D. Simple mask at 8 L/min
Correct Answer: B. Nasal cannula at 1–2 L/min
Rationale:
Clients with COPD rely on hypoxic drive for breathing. High oxygen
levels can suppress respirations. Therefore, oxygen should be
administered at low flow (1–2 L/min via nasal cannula).
Question 4
A nurse is administering morphine to a client after surgery. Which
assessment is the priority before administering the medication?
A. Pain level
B. Respiratory rate
C. Blood pressure
D. Temperature
Correct Answer: B. Respiratory rate
Page 2 of 33
,ATI PN Pharmacology & Medical Surgical (Med-Surg)
Rationale:
Morphine is an opioid analgesic that can cause respiratory depression.
The nurse must assess respiratory rate before administration. If the
respiratory rate is below 12/min, the medication should be withheld and
the provider notified.
Question 5
A nurse is teaching a client about nitroglycerin sublingual tablets. Which
statement indicates understanding?
A. “I should swallow the tablet with water.”
B. “I can take up to three tablets every 5 minutes for chest pain.”
C. “I should take the medication daily at bedtime.”
D. “I should store the tablets in the refrigerator.”
Correct Answer: B. “I can take up to three tablets every 5 minutes for
chest pain.”
Rationale:
Nitroglycerin is used for angina relief. Clients should take one tablet
every 5 minutes, up to three doses. If pain persists after the third dose,
they should seek emergency care. Tablets should be kept in their original
dark container, not refrigerated.
Question 6
A client with diabetes mellitus is receiving regular insulin. When should
the nurse expect the peak effect?
A. 15 minutes
B. 1–3 hours
C. 6–8 hours
D. 12–18 hours
Correct Answer: B. 1–3 hours
Page 3 of 33
, ATI PN Pharmacology & Medical Surgical (Med-Surg)
Rationale:
Regular insulin is a short-acting insulin.
Typical timeline:
• Onset: 30–60 minutes
• Peak: 1–3 hours
• Duration: 5–8 hours
Understanding peak action helps prevent hypoglycemia.
Question 7
A nurse is caring for a client with hypertension who is prescribed
lisinopril. Which adverse effect should the nurse monitor for?
A. Dry cough
B. Weight gain
C. Hyperglycemia
D. Bradycardia
Correct Answer: A. Dry cough
Rationale:
Lisinopril is an ACE inhibitor. A common side effect is a persistent dry
cough due to bradykinin accumulation. Other risks include hyperkalemia
and angioedema.
Question 8
A client is receiving digoxin for heart failure. Which finding indicates
possible toxicity?
A. Pulse 88/min
B. Nausea and vomiting
C. Blood pressure 130/80 mm Hg
D. Urine output 40 mL/hr
Page 4 of 33
