ATI Pharmacology Proctored Exam 2025 Study Guide –
Latest Update with 100% Correct Questions, Answers, and
Rationales | Guaranteed Pass Preparation for Nursing
Students
Chapter 1: Pharmacokinetics and Routes of Administration
• Absorption
▪
Route of admin affects the rate and amount of absorption o
Oral:
▪
GI pH and emptying time
▪
Presence of food in the stomach or intestines
▪
Form of meds (liquid/XR) o Sublingual/buccal
▪
Quick absorption systemically through highly vascular mucous
membranes
o Inhalation via mouth/nose
▪
Rapid absorption through alveolar capillary networks o Intradermal,
topical
▪
Slow, gradual absorption o SQ/IM
▪
Highly soluble meds have rapid absorption (10-30min), poorly soluble have
slower absorption
▪
Blood perfusion at site of injection affect absorption
o IV
▪
Immediate and complete
• Distribution o Transportation of meds to sites of action by body fluids
o Plasma binding protein: meds compete for protein binding sites within
bloodstream, primarily albumin. The ability of med to bind to protein can
affect how much med will leave and travel to target tissues.
• Metabolism
o Primarily occurs in the liver but can take place in the kidney o Factors
that influence metabolism:
▪
Age (infants/older adults require smaller doses)
▪
First pass effect: liver inactivates some meds on first pass through and thus
require sublingual or IV route (may need higher dose)
• Excretion: o Eliminated through the kidneys.
o Kidney dysfunction can result in elevated levels of medications.
,Downloaded by John Kabiru ()
,• Med Response o Maintain plasma levels between minimum effective concentration
and the toxic concentration:
• Therapeutic index (TI)
o High TI has a wide safety margin. o Low TI
requires monitoring of serum levels. o Tough
levels: obtain immediately before next dose.
Downloaded by John Kabiru ()
, • Half-life: o Time it takes a medication level to drop in the body by
50%. o Short vs long half-life: long half-life has greater risk for
med accumulation in body.
• Agonist: enhance
• Antagonist: blocks
• Routes of admin: o Oral/Enteral:
▪
90 degrees upright
▪
do not mix with large amounts of food
▪ lean chin in to help facilitate swallowing o
Sublingual/buccal
▪ Keep med in place until completely dissolved o
Transdermal
▪
Wash skin with soap and water then dry it thoroughly
before placing patch. Place patch on hairless area and rotate
sites to prevent irritation. o Drops:
▪
Place drop in center of sac.
▪
Avoid placing directly on cornea.
▪
If blink repeat process.
▪
Apply gentle pressure with finger and a clean facial
tissue on the nasolacrimal duct for 30-60 seconds to prevent
systemic absorption. o Ears:
▪
Have client lay on unaffected side.
▪
Up and out for adults
▪
Down and back for children o Inhalation:
▪
MDI
• Shake vigorously 5-6 times
• Take a deep breath and then exhale
• Slow deep breath for 3-5 seconds from MDI
• Hold breath for 10 seconds after
▪
DPI
• DO NOT SHAKE DEVICE
• Place mouthpiece between lips and take a deep breath
• Hold breath for 5-10 seconds
o NG/Gastrostomy tubes
▪
To prevent clogging flush tube before and after each med with 15-30ml of warm sterile
water.
o Suppositories:
▪
Left lateral sims position.
▪
Insert beyond internal sphincter
▪
Remain flat or left lateral for 5 min after insertion. o
Intradermal:
▪
Used for allergy testing
Downloaded by John Kabiru ()
Latest Update with 100% Correct Questions, Answers, and
Rationales | Guaranteed Pass Preparation for Nursing
Students
Chapter 1: Pharmacokinetics and Routes of Administration
• Absorption
▪
Route of admin affects the rate and amount of absorption o
Oral:
▪
GI pH and emptying time
▪
Presence of food in the stomach or intestines
▪
Form of meds (liquid/XR) o Sublingual/buccal
▪
Quick absorption systemically through highly vascular mucous
membranes
o Inhalation via mouth/nose
▪
Rapid absorption through alveolar capillary networks o Intradermal,
topical
▪
Slow, gradual absorption o SQ/IM
▪
Highly soluble meds have rapid absorption (10-30min), poorly soluble have
slower absorption
▪
Blood perfusion at site of injection affect absorption
o IV
▪
Immediate and complete
• Distribution o Transportation of meds to sites of action by body fluids
o Plasma binding protein: meds compete for protein binding sites within
bloodstream, primarily albumin. The ability of med to bind to protein can
affect how much med will leave and travel to target tissues.
• Metabolism
o Primarily occurs in the liver but can take place in the kidney o Factors
that influence metabolism:
▪
Age (infants/older adults require smaller doses)
▪
First pass effect: liver inactivates some meds on first pass through and thus
require sublingual or IV route (may need higher dose)
• Excretion: o Eliminated through the kidneys.
o Kidney dysfunction can result in elevated levels of medications.
,Downloaded by John Kabiru ()
,• Med Response o Maintain plasma levels between minimum effective concentration
and the toxic concentration:
• Therapeutic index (TI)
o High TI has a wide safety margin. o Low TI
requires monitoring of serum levels. o Tough
levels: obtain immediately before next dose.
Downloaded by John Kabiru ()
, • Half-life: o Time it takes a medication level to drop in the body by
50%. o Short vs long half-life: long half-life has greater risk for
med accumulation in body.
• Agonist: enhance
• Antagonist: blocks
• Routes of admin: o Oral/Enteral:
▪
90 degrees upright
▪
do not mix with large amounts of food
▪ lean chin in to help facilitate swallowing o
Sublingual/buccal
▪ Keep med in place until completely dissolved o
Transdermal
▪
Wash skin with soap and water then dry it thoroughly
before placing patch. Place patch on hairless area and rotate
sites to prevent irritation. o Drops:
▪
Place drop in center of sac.
▪
Avoid placing directly on cornea.
▪
If blink repeat process.
▪
Apply gentle pressure with finger and a clean facial
tissue on the nasolacrimal duct for 30-60 seconds to prevent
systemic absorption. o Ears:
▪
Have client lay on unaffected side.
▪
Up and out for adults
▪
Down and back for children o Inhalation:
▪
MDI
• Shake vigorously 5-6 times
• Take a deep breath and then exhale
• Slow deep breath for 3-5 seconds from MDI
• Hold breath for 10 seconds after
▪
DPI
• DO NOT SHAKE DEVICE
• Place mouthpiece between lips and take a deep breath
• Hold breath for 5-10 seconds
o NG/Gastrostomy tubes
▪
To prevent clogging flush tube before and after each med with 15-30ml of warm sterile
water.
o Suppositories:
▪
Left lateral sims position.
▪
Insert beyond internal sphincter
▪
Remain flat or left lateral for 5 min after insertion. o
Intradermal:
▪
Used for allergy testing
Downloaded by John Kabiru ()
