ATI RN PHARMACOLOGY PRACTICE C
2026 LATEST UPDATED TEST | WITH 2024
VERSION | A + GRADED
1. A nurse is preparing to administer digoxin 0.25 mg IV. Which of the following
findings would require the nurse to withhold the medication and notify the
provider?
a) Apical heart rate 58/min
b) Blood pressure 118/76 mm Hg
c) Potassium level 4.0 mEq/L
d) Respiratory rate 18/min
Correct Answer: a) Apical heart rate 58/min
Rationale: Digoxin increases myocardial contractility and decreases heart rate. The nurse
should withhold the dose and assess for toxicity if the apical pulse is below 60/min for an
adult (or below 70/min for a child) before administration.
2. A nurse is providing teaching to a client who has a new prescription for warfarin.
Which of the following statements by the client indicates a need for further
teaching?
a) "I will use a soft-bristled toothbrush."
b) "I will avoid eating large amounts of leafy green vegetables."
c) "I will take ibuprofen if I have a headache."
d) "I will wear a medical alert bracelet."
Correct Answer: c) "I will take ibuprofen if I have a headache."
Rationale: Ibuprofen (an NSAID) increases the risk of bleeding when taken with warfarin.
The client should use acetaminophen for pain or headaches instead. Soft-bristled
toothbrushes, consistent vitamin K intake, and medical alert bracelets are appropriate
safety measures.
3. A nurse is monitoring a client who is receiving IV heparin. Which of the following
laboratory values indicates a therapeutic response to the medication?
a) aPTT 75 seconds (control 35 seconds)
b) INR 2.5
c) Platelets 150,000/mm³
d) PT 12 seconds
Correct Answer: a) aPTT 75 seconds (control 35 seconds)
Rationale: For heparin therapy, the goal is to maintain the aPTT at 1.5 to 2.5 times the
normal control value. With a control of 35 seconds, a therapeutic range would be 52.5 to
87.5 seconds. INR is used to monitor warfarin.
,4. A nurse is caring for a client who is taking spironolactone. Which of the following
findings should the nurse report to the provider?
a) Potassium level 5.2 mEq/L
b) Sodium level 138 mEq/L
c) Urine output 30 mL/hr
d) Blood pressure 110/70 mm Hg
Correct Answer: a) Potassium level 5.2 mEq/L
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.2 mEq/L
is above the normal range (3.5-5.0 mEq/L) and indicates hyperkalemia, which can lead to
life-threatening cardiac dysrhythmias. This should be reported immediately.
5. A nurse is administering IV furosemide to a client. Which of the following adverse
effects should the nurse monitor for first?
a) Hyperkalemia
b) Ototoxicity
c) Orthostatic hypotension
d) Hypoglycemia
Correct Answer: c) Orthostatic hypotension
Rationale: Furosemide is a loop diuretic that causes rapid fluid loss, leading to decreased
blood volume and orthostatic hypotension. While ototoxicity is a serious adverse effect,
hypotension is the most immediate and common first effect.
6. A nurse is teaching a client about the use of sublingual nitroglycerin for angina.
Which of the following instructions should the nurse include?
a) "Take a tablet every 5 minutes until pain subsides, up to three doses."
b) "Swallow the tablet with a full glass of water for faster absorption."
c) "Store the medication in a clear glass bottle in the bathroom cabinet."
d) "You should feel a tingling sensation under the tongue if the medication is potent."
Correct Answer: a) "Take a tablet every 5 minutes until pain subsides, up to three
doses."
Rationale: The standard protocol for nitroglycerin is to take one tablet sublingually every 5
minutes for up to three doses. If pain is not relieved after the first dose, the client should
call 911. A burning or tingling sensation indicates potency, but its absence does not always
mean the drug is inactive.
7. A client who is taking atorvastatin reports severe muscle pain and tenderness. The
nurse should interpret these findings as indicating which of the following adverse
effects?
a) Hepatic toxicity
b) Rhabdomyolysis
c) Neuropathy
d) Steven-Johnson Syndrome
Correct Answer: b) Rhabdomyolysis
Rationale: Statins like atorvastatin can cause myopathy and rhabdomyolysis, which is the
breakdown of muscle tissue. Manifestations include severe muscle pain, weakness, and
, tenderness. This condition can lead to acute kidney failure and requires immediate
discontinuation of the medication.
8. A nurse is preparing to administer enoxaparin subcutaneously. Which of the
following actions should the nurse take?
a) Aspirate for blood return before injecting.
b) Expel the air bubble from the prefilled syringe.
c) Administer the medication in the abdomen, 2 inches from the umbilicus.
d) Massage the site after injection to promote absorption.
Correct Answer: c) Administer the medication in the abdomen, 2 inches from the
umbilicus.
Rationale: Enoxaparin (a low molecular weight heparin) should be administered
subcutaneously in the abdomen, alternating sides. The nurse should not aspirate, should
not expel the air bubble (it ensures full dose delivery), and should not massage the site to
prevent bruising.
9. A nurse is reviewing the medication record of a client who has heart failure and is
receiving digoxin. Which of the following medications, if administered concurrently,
increases the risk for digoxin toxicity?
a) Furosemide
b) Metoprolol
c) Hydrochlorothiazide
d) Losartan
Correct Answer: a) Furosemide
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. Low potassium levels
increase the sensitivity of cardiac muscle to digoxin, significantly increasing the risk of
digoxin toxicity (dysrhythmias, nausea, visual changes).
10. A nurse is providing discharge teaching for a client who has a new prescription
for clopidogrel. Which of the following instructions should the nurse include?
a) "You will need to have your INR monitored every month."
b) "This medication will help to prevent blood clots from forming."
c) "Take this medication with food to prevent stomach upset."
d) "Discontinue the medication 5 days before any scheduled dental procedure."
Correct Answer: b) "This medication will help to prevent blood clots from forming."
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation,
preventing clots in patients with recent MI, stroke, or peripheral artery disease. INR is for
warfarin. It does not need to be taken with food. Discontinuation should be guided by a
provider, but the patient should inform all providers they are taking it.
11. A nurse is teaching a client about self-administration of insulin. Which of the
following instructions is correct for mixing regular insulin and NPH insulin in the
same syringe?
a) "Inject air into the NPH vial first, then inject air into the regular vial."
b) "Draw up the NPH insulin first, then the regular insulin."
2026 LATEST UPDATED TEST | WITH 2024
VERSION | A + GRADED
1. A nurse is preparing to administer digoxin 0.25 mg IV. Which of the following
findings would require the nurse to withhold the medication and notify the
provider?
a) Apical heart rate 58/min
b) Blood pressure 118/76 mm Hg
c) Potassium level 4.0 mEq/L
d) Respiratory rate 18/min
Correct Answer: a) Apical heart rate 58/min
Rationale: Digoxin increases myocardial contractility and decreases heart rate. The nurse
should withhold the dose and assess for toxicity if the apical pulse is below 60/min for an
adult (or below 70/min for a child) before administration.
2. A nurse is providing teaching to a client who has a new prescription for warfarin.
Which of the following statements by the client indicates a need for further
teaching?
a) "I will use a soft-bristled toothbrush."
b) "I will avoid eating large amounts of leafy green vegetables."
c) "I will take ibuprofen if I have a headache."
d) "I will wear a medical alert bracelet."
Correct Answer: c) "I will take ibuprofen if I have a headache."
Rationale: Ibuprofen (an NSAID) increases the risk of bleeding when taken with warfarin.
The client should use acetaminophen for pain or headaches instead. Soft-bristled
toothbrushes, consistent vitamin K intake, and medical alert bracelets are appropriate
safety measures.
3. A nurse is monitoring a client who is receiving IV heparin. Which of the following
laboratory values indicates a therapeutic response to the medication?
a) aPTT 75 seconds (control 35 seconds)
b) INR 2.5
c) Platelets 150,000/mm³
d) PT 12 seconds
Correct Answer: a) aPTT 75 seconds (control 35 seconds)
Rationale: For heparin therapy, the goal is to maintain the aPTT at 1.5 to 2.5 times the
normal control value. With a control of 35 seconds, a therapeutic range would be 52.5 to
87.5 seconds. INR is used to monitor warfarin.
,4. A nurse is caring for a client who is taking spironolactone. Which of the following
findings should the nurse report to the provider?
a) Potassium level 5.2 mEq/L
b) Sodium level 138 mEq/L
c) Urine output 30 mL/hr
d) Blood pressure 110/70 mm Hg
Correct Answer: a) Potassium level 5.2 mEq/L
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.2 mEq/L
is above the normal range (3.5-5.0 mEq/L) and indicates hyperkalemia, which can lead to
life-threatening cardiac dysrhythmias. This should be reported immediately.
5. A nurse is administering IV furosemide to a client. Which of the following adverse
effects should the nurse monitor for first?
a) Hyperkalemia
b) Ototoxicity
c) Orthostatic hypotension
d) Hypoglycemia
Correct Answer: c) Orthostatic hypotension
Rationale: Furosemide is a loop diuretic that causes rapid fluid loss, leading to decreased
blood volume and orthostatic hypotension. While ototoxicity is a serious adverse effect,
hypotension is the most immediate and common first effect.
6. A nurse is teaching a client about the use of sublingual nitroglycerin for angina.
Which of the following instructions should the nurse include?
a) "Take a tablet every 5 minutes until pain subsides, up to three doses."
b) "Swallow the tablet with a full glass of water for faster absorption."
c) "Store the medication in a clear glass bottle in the bathroom cabinet."
d) "You should feel a tingling sensation under the tongue if the medication is potent."
Correct Answer: a) "Take a tablet every 5 minutes until pain subsides, up to three
doses."
Rationale: The standard protocol for nitroglycerin is to take one tablet sublingually every 5
minutes for up to three doses. If pain is not relieved after the first dose, the client should
call 911. A burning or tingling sensation indicates potency, but its absence does not always
mean the drug is inactive.
7. A client who is taking atorvastatin reports severe muscle pain and tenderness. The
nurse should interpret these findings as indicating which of the following adverse
effects?
a) Hepatic toxicity
b) Rhabdomyolysis
c) Neuropathy
d) Steven-Johnson Syndrome
Correct Answer: b) Rhabdomyolysis
Rationale: Statins like atorvastatin can cause myopathy and rhabdomyolysis, which is the
breakdown of muscle tissue. Manifestations include severe muscle pain, weakness, and
, tenderness. This condition can lead to acute kidney failure and requires immediate
discontinuation of the medication.
8. A nurse is preparing to administer enoxaparin subcutaneously. Which of the
following actions should the nurse take?
a) Aspirate for blood return before injecting.
b) Expel the air bubble from the prefilled syringe.
c) Administer the medication in the abdomen, 2 inches from the umbilicus.
d) Massage the site after injection to promote absorption.
Correct Answer: c) Administer the medication in the abdomen, 2 inches from the
umbilicus.
Rationale: Enoxaparin (a low molecular weight heparin) should be administered
subcutaneously in the abdomen, alternating sides. The nurse should not aspirate, should
not expel the air bubble (it ensures full dose delivery), and should not massage the site to
prevent bruising.
9. A nurse is reviewing the medication record of a client who has heart failure and is
receiving digoxin. Which of the following medications, if administered concurrently,
increases the risk for digoxin toxicity?
a) Furosemide
b) Metoprolol
c) Hydrochlorothiazide
d) Losartan
Correct Answer: a) Furosemide
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. Low potassium levels
increase the sensitivity of cardiac muscle to digoxin, significantly increasing the risk of
digoxin toxicity (dysrhythmias, nausea, visual changes).
10. A nurse is providing discharge teaching for a client who has a new prescription
for clopidogrel. Which of the following instructions should the nurse include?
a) "You will need to have your INR monitored every month."
b) "This medication will help to prevent blood clots from forming."
c) "Take this medication with food to prevent stomach upset."
d) "Discontinue the medication 5 days before any scheduled dental procedure."
Correct Answer: b) "This medication will help to prevent blood clots from forming."
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation,
preventing clots in patients with recent MI, stroke, or peripheral artery disease. INR is for
warfarin. It does not need to be taken with food. Discontinuation should be guided by a
provider, but the patient should inform all providers they are taking it.
11. A nurse is teaching a client about self-administration of insulin. Which of the
following instructions is correct for mixing regular insulin and NPH insulin in the
same syringe?
a) "Inject air into the NPH vial first, then inject air into the regular vial."
b) "Draw up the NPH insulin first, then the regular insulin."
