2023 ATI PN Pharmacology – Proctor Exam
| NGN-Style Questions & Case Studies
Updated 2026
,Question 1
A nurse is reinforcing teaching with a client who has a new prescription for
omeprazole oral capsules. Which of the following instructions should the nurse
include?
a. Chew the medication thoroughly before swallowing
b. Swallow the medication whole
c. Crush the capsules and mix with food
d. Take the medication with an antacid
Answer: b
Expert Rationale: The nurse should instruct the client to swallow omeprazole
capsules whole as it is available in delayed-release form. Chewing or crushing the
medication can destroy the coating and reduce effectiveness. Omeprazole is a
proton pump inhibitor that blocks gastric acid secretion and must be absorbed
intact.
Question 2
A nurse is reinforcing teaching about comfort measures with the guardian of a 10-
year-old child who has a viral infection. The nurse should plan to tell the parent
that aspirin is contraindicated because of the risk for which of the following
conditions?
a. Hemophilia
b. Reye syndrome
c. Appendicitis
d. Anaphylaxis
Answer: b
Expert Rationale: Aspirin is contraindicated in children and adolescents with
viral infections due to the increased risk of Reye syndrome, a rare but potentially
fatal condition causing encephalopathy and liver damage.
Question 3
A nurse is caring for a client who has a prescription for an IM injection of
penicillin G benzathine. The client asks why the injection must be given IM
,instead of through the IV line. Which of the following responses should the nurse
make?
a. "IV administration causes an allergic reaction."
b. "Your medication can't be given IV because it is not water-soluble."
c. "IV doses are usually lower than IM doses."
d. "IM provides faster absorption than IV."
Answer: b
Expert Rationale: Penicillin G benzathine is poorly water-soluble; administering
it IV can cause serious reactions such as embolism. It is formulated for slow
absorption from the IM site.
Question 4
A nurse is planning to reinforce teaching about newborn immunizations with a
client who is 24 hr postpartum. Which of the following information should the
nurse plan to include?
a. "Your baby will receive the first hepatitis B vaccine before discharge."
b. "Your baby will receive the MMR vaccine before discharge."
c. "Your baby will receive the varicella vaccine before discharge."
d. "Your baby will receive the flu vaccine before discharge."
Answer: a
Expert Rationale: The newborn should receive the first dose of the hepatitis B
vaccine within 24 hours of birth to provide early immunity against hepatitis B
infection.
Question 5
A client comes to an urgent care clinic and announces with great enthusiasm, "I am
an expert at all things medical as they apply to me, and I require zolpidem." The
client's pupils are dilated, along with an elevated heart rate and blood pressure
level. The nurse should suspect intoxication with which of the following
substances?
a. Alcohol
b. Heroin
, c. Cocaine
d. Benzodiazepines
Answer: c
Expert Rationale: Cocaine intoxication presents with tachycardia, hypertension,
dilated pupils, and behavioral changes including euphoria and agitation.
Question 6
A nurse is caring for a client who is receiving 0.9% sodium chloride 1,000 mL to
infuse over 8 hr. The drop factor on the manual IV tubing is 15 gtt/mL. The nurse
should ensure that the manual IV infusion is set to deliver how many gtt/min?
(Round the answer to the nearest whole number. Use a leading zero if it applies.
Do not use a trailing zero).
a. 20 gtt/min
b. 31 gtt/min
c. 18 gtt/min
d. 25 gtt/min
Answer: b
Expert Rationale: To calculate: (Total volume / time in hours) × (drop factor / 60)
= drops per minute. (1000 mL / 8 hr) × (15 gtt/mL) ÷ 60 min = 31.25 ≈ 31 gtt/min.
Question 7
A nurse is administering digoxin to a client with heart failure. Which of the
following findings indicates a therapeutic response to the medication?
a. Increased heart rate
b. Decreased shortness of breath
c. Increased jugular vein distention
d. Decreased urine output
Answer: b
Expert Rationale: Digoxin increases cardiac contractility and slows heart rate,
leading to improved cardiac output and decreased symptoms of heart failure such
as shortness of breath. Increased heart rate, JVD, and decreased urine output
indicate worsening failure.
| NGN-Style Questions & Case Studies
Updated 2026
,Question 1
A nurse is reinforcing teaching with a client who has a new prescription for
omeprazole oral capsules. Which of the following instructions should the nurse
include?
a. Chew the medication thoroughly before swallowing
b. Swallow the medication whole
c. Crush the capsules and mix with food
d. Take the medication with an antacid
Answer: b
Expert Rationale: The nurse should instruct the client to swallow omeprazole
capsules whole as it is available in delayed-release form. Chewing or crushing the
medication can destroy the coating and reduce effectiveness. Omeprazole is a
proton pump inhibitor that blocks gastric acid secretion and must be absorbed
intact.
Question 2
A nurse is reinforcing teaching about comfort measures with the guardian of a 10-
year-old child who has a viral infection. The nurse should plan to tell the parent
that aspirin is contraindicated because of the risk for which of the following
conditions?
a. Hemophilia
b. Reye syndrome
c. Appendicitis
d. Anaphylaxis
Answer: b
Expert Rationale: Aspirin is contraindicated in children and adolescents with
viral infections due to the increased risk of Reye syndrome, a rare but potentially
fatal condition causing encephalopathy and liver damage.
Question 3
A nurse is caring for a client who has a prescription for an IM injection of
penicillin G benzathine. The client asks why the injection must be given IM
,instead of through the IV line. Which of the following responses should the nurse
make?
a. "IV administration causes an allergic reaction."
b. "Your medication can't be given IV because it is not water-soluble."
c. "IV doses are usually lower than IM doses."
d. "IM provides faster absorption than IV."
Answer: b
Expert Rationale: Penicillin G benzathine is poorly water-soluble; administering
it IV can cause serious reactions such as embolism. It is formulated for slow
absorption from the IM site.
Question 4
A nurse is planning to reinforce teaching about newborn immunizations with a
client who is 24 hr postpartum. Which of the following information should the
nurse plan to include?
a. "Your baby will receive the first hepatitis B vaccine before discharge."
b. "Your baby will receive the MMR vaccine before discharge."
c. "Your baby will receive the varicella vaccine before discharge."
d. "Your baby will receive the flu vaccine before discharge."
Answer: a
Expert Rationale: The newborn should receive the first dose of the hepatitis B
vaccine within 24 hours of birth to provide early immunity against hepatitis B
infection.
Question 5
A client comes to an urgent care clinic and announces with great enthusiasm, "I am
an expert at all things medical as they apply to me, and I require zolpidem." The
client's pupils are dilated, along with an elevated heart rate and blood pressure
level. The nurse should suspect intoxication with which of the following
substances?
a. Alcohol
b. Heroin
, c. Cocaine
d. Benzodiazepines
Answer: c
Expert Rationale: Cocaine intoxication presents with tachycardia, hypertension,
dilated pupils, and behavioral changes including euphoria and agitation.
Question 6
A nurse is caring for a client who is receiving 0.9% sodium chloride 1,000 mL to
infuse over 8 hr. The drop factor on the manual IV tubing is 15 gtt/mL. The nurse
should ensure that the manual IV infusion is set to deliver how many gtt/min?
(Round the answer to the nearest whole number. Use a leading zero if it applies.
Do not use a trailing zero).
a. 20 gtt/min
b. 31 gtt/min
c. 18 gtt/min
d. 25 gtt/min
Answer: b
Expert Rationale: To calculate: (Total volume / time in hours) × (drop factor / 60)
= drops per minute. (1000 mL / 8 hr) × (15 gtt/mL) ÷ 60 min = 31.25 ≈ 31 gtt/min.
Question 7
A nurse is administering digoxin to a client with heart failure. Which of the
following findings indicates a therapeutic response to the medication?
a. Increased heart rate
b. Decreased shortness of breath
c. Increased jugular vein distention
d. Decreased urine output
Answer: b
Expert Rationale: Digoxin increases cardiac contractility and slows heart rate,
leading to improved cardiac output and decreased symptoms of heart failure such
as shortness of breath. Increased heart rate, JVD, and decreased urine output
indicate worsening failure.
