ATI Pharmacology Proctored Exam
Edition
70 NGN-Style Questions with Verified Rationales
Graded A+
Total Questions: 70
Item Types: Multiple choice, multiple response, bow-tie, matrix/grid, drag &
drop cloze, highlight, case study
Content Areas:
• Cardiovascular & Hematologic Drugs
• Endocrine & Diabetes Medications
• Neurological & Psychiatric Drugs
• Pain Management & Opioids
• Antibiotics & Anti-infectives
• Respiratory & GI Medications
• Maternal-Child & Reproductive Drugs
• Safety & Adverse Effects
EXAM INSTRUCTIONS
1. Time Limit: 70 minutes (1 minute per question).
2. Scoring: Partial credit for select NGN items.
3. Rationales: Provided after each question.
4. Simulate NCLEX: Answer without external resources first; then review
rationales.
Candidate Name: _________________________
Date: _________________________
Start Time: _________________________
pg. 1
,End Time: _________________________
Total Score: ________ / 70
Apply clinical judgment and medication safety principles.
QUESTIONS & RATIONALES
Section 1: Cardiovascular & Hematologic Drugs (Questions
1–15)
1. A nurse is administering digoxin to a client with heart failure. Which of
the following findings indicates digoxin toxicity?
1. Heart rate 62 bpm
2. Serum potassium 4.0 mEq/L
3. Anorexia, nausea, and blurred vision
4. Blood pressure 120/80 mm Hg
Answer: 3. Anorexia, nausea, and blurred vision
Rationale: Early signs of digoxin toxicity include GI symptoms (anorexia, nausea,
vomiting) and visual disturbances (blurred or yellow vision). Bradycardia (HR
<60) is also a sign, but 62 is borderline. Hypokalemia increases toxicity risk, but
K+ 4.0 is normal.
2. A client taking warfarin (Coumadin) has an INR of 4.5. The client has no
signs of bleeding. Which of the following actions should the nurse
anticipate?
1. Administer vitamin K orally
2. Hold the next dose of warfarin
3. Increase the warfarin dose
4. Administer fresh frozen plasma
Answer: 2. Hold the next dose of warfarin
Rationale: For an INR of 4.5 without bleeding, the standard intervention is to
hold the next dose(s) and monitor INR. Vitamin K is given if INR >10 or if
bleeding occurs. FFP is for active bleeding or emergency reversal.
pg. 2
, 3. A nurse is teaching a client about atorvastatin (Lipitor). Which of the
following should the nurse include?
1. “Take the medication in the morning with breakfast.”
2. “Report any unexplained muscle pain or weakness.”
3. “You may drink grapefruit juice daily.”
4. “Liver function tests are not needed.”
Answer: 2. “Report any unexplained muscle pain or weakness.”
Rationale: Statins can cause myopathy and rhabdomyolysis. Clients should
report muscle pain, tenderness, or weakness. Atorvastatin is usually taken in the
evening (better LDL reduction). Grapefruit juice increases statin levels and
toxicity. Liver function tests are monitored.
4. A client is receiving IV heparin for deep vein thrombosis. The nurse
notes a partial thromboplastin time (PTT) of 120 seconds (control 30
seconds). What is the priority nursing action?
1. Continue the infusion as ordered
2. Stop the heparin infusion
3. Administer protamine sulfate
4. Draw a stat PTT
Answer: 2. Stop the heparin infusion
Rationale: Therapeutic PTT for heparin is usually 1.5-2.5 times control (45-75
seconds). A PTT of 120 seconds indicates excessive anticoagulation and
bleeding risk. The infusion should be stopped, and the provider notified.
Protamine sulfate is given only if bleeding occurs or PTT is dangerously high.
5. A nurse is administering furosemide (Lasix) IV push to a client with
pulmonary edema. Which of the following should the nurse monitor most
closely?
1. Blood pressure
2. Urinary output
3. Potassium level
4. Respiratory rate
Answer: 1. Blood pressure
Rationale: IV furosemide causes rapid diuresis and vasodilation, leading to
significant hypotension. The nurse should monitor BP closely during and after
administration. Urinary output and potassium are also important but not as
immediate a safety concern as hypotension.
6. A client is prescribed clopidogrel (Plavix) after a stent placement. Which
of the following medications should the nurse instruct the client to avoid?
1. Acetaminophen (Tylenol)
pg. 3
Edition
70 NGN-Style Questions with Verified Rationales
Graded A+
Total Questions: 70
Item Types: Multiple choice, multiple response, bow-tie, matrix/grid, drag &
drop cloze, highlight, case study
Content Areas:
• Cardiovascular & Hematologic Drugs
• Endocrine & Diabetes Medications
• Neurological & Psychiatric Drugs
• Pain Management & Opioids
• Antibiotics & Anti-infectives
• Respiratory & GI Medications
• Maternal-Child & Reproductive Drugs
• Safety & Adverse Effects
EXAM INSTRUCTIONS
1. Time Limit: 70 minutes (1 minute per question).
2. Scoring: Partial credit for select NGN items.
3. Rationales: Provided after each question.
4. Simulate NCLEX: Answer without external resources first; then review
rationales.
Candidate Name: _________________________
Date: _________________________
Start Time: _________________________
pg. 1
,End Time: _________________________
Total Score: ________ / 70
Apply clinical judgment and medication safety principles.
QUESTIONS & RATIONALES
Section 1: Cardiovascular & Hematologic Drugs (Questions
1–15)
1. A nurse is administering digoxin to a client with heart failure. Which of
the following findings indicates digoxin toxicity?
1. Heart rate 62 bpm
2. Serum potassium 4.0 mEq/L
3. Anorexia, nausea, and blurred vision
4. Blood pressure 120/80 mm Hg
Answer: 3. Anorexia, nausea, and blurred vision
Rationale: Early signs of digoxin toxicity include GI symptoms (anorexia, nausea,
vomiting) and visual disturbances (blurred or yellow vision). Bradycardia (HR
<60) is also a sign, but 62 is borderline. Hypokalemia increases toxicity risk, but
K+ 4.0 is normal.
2. A client taking warfarin (Coumadin) has an INR of 4.5. The client has no
signs of bleeding. Which of the following actions should the nurse
anticipate?
1. Administer vitamin K orally
2. Hold the next dose of warfarin
3. Increase the warfarin dose
4. Administer fresh frozen plasma
Answer: 2. Hold the next dose of warfarin
Rationale: For an INR of 4.5 without bleeding, the standard intervention is to
hold the next dose(s) and monitor INR. Vitamin K is given if INR >10 or if
bleeding occurs. FFP is for active bleeding or emergency reversal.
pg. 2
, 3. A nurse is teaching a client about atorvastatin (Lipitor). Which of the
following should the nurse include?
1. “Take the medication in the morning with breakfast.”
2. “Report any unexplained muscle pain or weakness.”
3. “You may drink grapefruit juice daily.”
4. “Liver function tests are not needed.”
Answer: 2. “Report any unexplained muscle pain or weakness.”
Rationale: Statins can cause myopathy and rhabdomyolysis. Clients should
report muscle pain, tenderness, or weakness. Atorvastatin is usually taken in the
evening (better LDL reduction). Grapefruit juice increases statin levels and
toxicity. Liver function tests are monitored.
4. A client is receiving IV heparin for deep vein thrombosis. The nurse
notes a partial thromboplastin time (PTT) of 120 seconds (control 30
seconds). What is the priority nursing action?
1. Continue the infusion as ordered
2. Stop the heparin infusion
3. Administer protamine sulfate
4. Draw a stat PTT
Answer: 2. Stop the heparin infusion
Rationale: Therapeutic PTT for heparin is usually 1.5-2.5 times control (45-75
seconds). A PTT of 120 seconds indicates excessive anticoagulation and
bleeding risk. The infusion should be stopped, and the provider notified.
Protamine sulfate is given only if bleeding occurs or PTT is dangerously high.
5. A nurse is administering furosemide (Lasix) IV push to a client with
pulmonary edema. Which of the following should the nurse monitor most
closely?
1. Blood pressure
2. Urinary output
3. Potassium level
4. Respiratory rate
Answer: 1. Blood pressure
Rationale: IV furosemide causes rapid diuresis and vasodilation, leading to
significant hypotension. The nurse should monitor BP closely during and after
administration. Urinary output and potassium are also important but not as
immediate a safety concern as hypotension.
6. A client is prescribed clopidogrel (Plavix) after a stent placement. Which
of the following medications should the nurse instruct the client to avoid?
1. Acetaminophen (Tylenol)
pg. 3
