ATI-Style RN Pharmacology Practice Exam| latest
updated test 2026| 2027
Question 1
A nurse is preparing to administer digoxin 0.125 mg PO to a client with heart
failure. The client's apical pulse is 58/min. Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the dose and notify the provider
C. Administer half the dose and recheck pulse in 1 hour
D. Give the medication with food to reduce GI upset
Correct Answer: B
Rationale: Digoxin is a cardiac glycoside that slows heart rate. The therapeutic
apical pulse threshold for administration is typically ≥60/min in adults. A pulse of
58/min indicates bradycardia, a sign of potential digoxin toxicity. The nurse
should hold the dose and notify the provider before administering. Administering
the dose (A) could worsen bradycardia. Giving half the dose (C) is not within
nursing scope without a new order. Food (D) does not mitigate cardiac effects.
,Question 2
A client receiving vancomycin IV develops red man syndrome. Which finding
should the nurse expect?
A. Urticaria and wheezing
B. Flushing of the face, neck, and upper torso
C. Hypotension and tachycardia
D. Crystalluria and flank pain
Correct Answer: B
Rationale: Red man syndrome is a histamine-mediated reaction to rapid
vancomycin infusion, characterized by erythema/flushing of the face, neck, and
upper torso, often with pruritus. It is not a true allergy. Urticaria/wheezing (A)
suggests anaphylaxis. Hypotension/tachycardia (C) may occur in severe reactions
but are not hallmark signs. Crystalluria (D) is associated with sulfonamides or
acyclovir, not vancomycin. Prevention includes infusing vancomycin over ≥60
minutes.
Question 3
A nurse is teaching a client about sublingual nitroglycerin for angina. Which
statement by the client indicates understanding?
A. "I should swallow the tablet with water for faster absorption."
B. "I can store the tablets in my pill organizer for convenience."
,C. "If my pain isn't relieved after 3 tablets 5 minutes apart, I should call 911."
D. "I should take this medication daily at bedtime to prevent angina."
Correct Answer: C
Rationale: For acute angina, the protocol is 1 sublingual nitroglycerin tablet every
5 minutes × 3 doses. If pain persists after 3 doses, it may indicate MI, and
emergency services should be activated. Nitroglycerin is absorbed sublingually;
swallowing (A) reduces efficacy due to first-pass metabolism. Tablets degrade
with light/air exposure and should remain in original dark glass bottle (B).
Nitroglycerin SL is for acute relief, not daily prophylaxis (D); long-acting nitrates
are used for prevention.
Question 4
A client with type 1 diabetes is prescribed insulin glargine. Which instruction
should the nurse include?
A. "Rotate injection sites within the same anatomical area to prevent
lipodystrophy."
B. "Mix this insulin with regular insulin in the same syringe for better coverage."
C. "Administer this insulin 30 minutes before meals for peak effect."
D. "This insulin can be given IV during hyperglycemic emergencies."
, Correct Answer: A
Rationale: Insulin glargine is a long-acting basal insulin. Site rotation within one
area (abdomen, thigh, arm) ensures consistent absorption and prevents
lipohypertrophy or lipoatrophy. Glargine is never mixed with other insulins (B)
because its acidic pH would precipitate regular insulin. It has no pronounced peak
and is given once daily at the same time, not tied to meals (C). Glargine is for
subcutaneous use only; IV insulin for emergencies is regular insulin (D).
Question 5
A nurse is caring for a client receiving heparin IV infusion. The aPTT is 98 seconds
(control: 30 seconds). Which action should the nurse take?
A. Increase the infusion rate per protocol
B. Continue the infusion and recheck aPTT in 6 hours
C. Hold the infusion and notify the provider
D. Administer vitamin K as an antidote
Correct Answer: C
Rationale: Therapeutic aPTT for heparin is typically 1.5–2.5 times the control
value (45–75 seconds if control is 30). An aPTT of 98 seconds indicates
supratherapeutic anticoagulation and high bleeding risk. The nurse should hold
the infusion and notify the provider for rate adjustment or protamine sulfate
updated test 2026| 2027
Question 1
A nurse is preparing to administer digoxin 0.125 mg PO to a client with heart
failure. The client's apical pulse is 58/min. Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the dose and notify the provider
C. Administer half the dose and recheck pulse in 1 hour
D. Give the medication with food to reduce GI upset
Correct Answer: B
Rationale: Digoxin is a cardiac glycoside that slows heart rate. The therapeutic
apical pulse threshold for administration is typically ≥60/min in adults. A pulse of
58/min indicates bradycardia, a sign of potential digoxin toxicity. The nurse
should hold the dose and notify the provider before administering. Administering
the dose (A) could worsen bradycardia. Giving half the dose (C) is not within
nursing scope without a new order. Food (D) does not mitigate cardiac effects.
,Question 2
A client receiving vancomycin IV develops red man syndrome. Which finding
should the nurse expect?
A. Urticaria and wheezing
B. Flushing of the face, neck, and upper torso
C. Hypotension and tachycardia
D. Crystalluria and flank pain
Correct Answer: B
Rationale: Red man syndrome is a histamine-mediated reaction to rapid
vancomycin infusion, characterized by erythema/flushing of the face, neck, and
upper torso, often with pruritus. It is not a true allergy. Urticaria/wheezing (A)
suggests anaphylaxis. Hypotension/tachycardia (C) may occur in severe reactions
but are not hallmark signs. Crystalluria (D) is associated with sulfonamides or
acyclovir, not vancomycin. Prevention includes infusing vancomycin over ≥60
minutes.
Question 3
A nurse is teaching a client about sublingual nitroglycerin for angina. Which
statement by the client indicates understanding?
A. "I should swallow the tablet with water for faster absorption."
B. "I can store the tablets in my pill organizer for convenience."
,C. "If my pain isn't relieved after 3 tablets 5 minutes apart, I should call 911."
D. "I should take this medication daily at bedtime to prevent angina."
Correct Answer: C
Rationale: For acute angina, the protocol is 1 sublingual nitroglycerin tablet every
5 minutes × 3 doses. If pain persists after 3 doses, it may indicate MI, and
emergency services should be activated. Nitroglycerin is absorbed sublingually;
swallowing (A) reduces efficacy due to first-pass metabolism. Tablets degrade
with light/air exposure and should remain in original dark glass bottle (B).
Nitroglycerin SL is for acute relief, not daily prophylaxis (D); long-acting nitrates
are used for prevention.
Question 4
A client with type 1 diabetes is prescribed insulin glargine. Which instruction
should the nurse include?
A. "Rotate injection sites within the same anatomical area to prevent
lipodystrophy."
B. "Mix this insulin with regular insulin in the same syringe for better coverage."
C. "Administer this insulin 30 minutes before meals for peak effect."
D. "This insulin can be given IV during hyperglycemic emergencies."
, Correct Answer: A
Rationale: Insulin glargine is a long-acting basal insulin. Site rotation within one
area (abdomen, thigh, arm) ensures consistent absorption and prevents
lipohypertrophy or lipoatrophy. Glargine is never mixed with other insulins (B)
because its acidic pH would precipitate regular insulin. It has no pronounced peak
and is given once daily at the same time, not tied to meals (C). Glargine is for
subcutaneous use only; IV insulin for emergencies is regular insulin (D).
Question 5
A nurse is caring for a client receiving heparin IV infusion. The aPTT is 98 seconds
(control: 30 seconds). Which action should the nurse take?
A. Increase the infusion rate per protocol
B. Continue the infusion and recheck aPTT in 6 hours
C. Hold the infusion and notify the provider
D. Administer vitamin K as an antidote
Correct Answer: C
Rationale: Therapeutic aPTT for heparin is typically 1.5–2.5 times the control
value (45–75 seconds if control is 30). An aPTT of 98 seconds indicates
supratherapeutic anticoagulation and high bleeding risk. The nurse should hold
the infusion and notify the provider for rate adjustment or protamine sulfate
