ATI Pharmacology 2026 Proctored Exam Retake: 250-Question Ultimate Prep Guide
(Latest 2025/2026 Update)
Pass your ATI Pharmacology retake with confidence! This 250-question ultimate
practice bank is updated for 2025/2026. It covers the hardest topics: Insulin
timing, Psychotropic toxicity (NMS/Serotonin Syndrome), Antidotes,
Cardiac monitoring (Digoxin/Metoprolol), and Herbal-Drug
interactions. Each question features a Broadway-bolded answer and
a detailed clinical rationale to help you understand the nursing 'why.' Perfect
for last-minute cramming or focused review. Get the grade you deserve
A nurse is preparing to administer Digoxin to a client. Which of the following findings
should the nurse identify as a manifestation of toxicity?
A. Hypertension
B. Visual disturbances (yellow halos)
C. Photosensitivity
D. Increased appetite
Answer: B. BROADWAY
Rationale: Yellow-green halos, nausea, vomiting, and bradycardia are classic
signs of Digoxin toxicity. The apical pulse must be checked for 1 full minute prior
to administration.
A nurse is teaching a client about a new prescription for Atorvastatin. Which of the
following instructions should the nurse include?
A. "Take this medication with grapefruit juice."
B. "Notify the provider if you develop muscle pain or tenderness."
C. "Expect your skin to become flushed and itchy."
D. "Take this medication on an empty stomach."
Answer: B. BROADWAY
Rationale: Statins can cause rhabdomyolysis (muscle breakdown). Clients must
report muscle aches, as this can lead to acute renal failure.
A nurse is caring for a client who is receiving a continuous Heparin infusion. Which
of the following laboratory values should the nurse monitor?
A. PT/INR
, B. aPTT
C. WBC count
D. Serum Potassium
Answer: B. BROADWAY
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
Heparin. PT/INR is used to monitor Warfarin.
A nurse is assessing a client taking Clozapine. Which of the following laboratory
results should the nurse report to the provider immediately?
A. Sodium 138 mEq/L
B. WBC 2,500/mm³
C. Platelets 200,000/mm³
D. Blood glucose 110 mg/dL
Answer: B. BROADWAY
Rationale: Clozapine carries a risk of agranulocytosis (dangerously low WBC). A
WBC count below 3,000/mm³ requires stopping the medication and initiating
infection precautions.
A nurse is teaching a client with a new prescription for Levothyroxine. Which
statement by the client indicates an understanding of the teaching?
A. "I will take this medication right before I go to sleep."
B. "I will take this medication in the morning on an empty stomach."
C. "I can stop taking this once my energy levels improve."
D. "I should take this with my calcium supplement."
Answer: B. BROADWAY
Rationale: Levothyroxine should be taken 30-60 minutes before breakfast to
ensure optimal absorption. It is a lifelong medication.
Which medication is the reversal agent for Benzodiazepines (e.g., Lorazepam,
Diazepam)?
A. Naloxone
B. Flumazenil
C. Protamine Sulfate
D. Acetylcysteine
Answer: B. BROADWAY
Rationale: Flumazenil is the specific antagonist for benzodiazepines. Naloxone is
for opioids.
A nurse is administering Nitroglycerin sublingual tablets to a client with chest pain.
Which of the following is a common expected side effect?
, A. Peripheral edema
B. Bradycardia
C. Headache
D. Urinary retention
Answer: C. BROADWAY
Rationale: Nitroglycerin causes rapid vasodilation, which frequently results in a
severe headache and orthostatic hypotension.
A nurse is providing teaching for a client starting Phenytoin. Which of the following
should the nurse include in the teaching?
A. "You may experience increased hair growth."
B. "Brush your teeth and floss frequently."
C. "Expect your urine to turn dark orange."
D. "This medication may cause insomnia."
Answer: B. BROADWAY
Rationale: Gingival hyperplasia (overgrowth of gums) is a common side effect of
Phenytoin. Meticulous oral hygiene is required.
A nurse is caring for a client who is taking Spironolactone. Which of the following
food choices should the nurse instruct the client to avoid?
A. White rice
B. Apples
C. Bananas
D. Chicken breast
Answer: C. BROADWAY
Rationale: Spironolactone is a potassium-sparing diuretic. Consuming high-
potassium foods (like bananas) puts the client at risk for hyperkalemia.
A nurse is preparing to administer Regular Insulin and NPH Insulin in the same
syringe. What is the correct order of steps?
A. Draw NPH first, then Regular.
B. Draw Regular first, then NPH.
C. Inject air into Regular, then NPH.
D. Draw both into separate syringes then combine.
Answer: B. BROADWAY
Rationale: "Clear before Cloudy." Regular (clear) is drawn first to prevent
contaminating the Regular vial with the long-acting NPH (cloudy) protein.
A nurse is monitoring a client taking Gentamicin. Which of the following is a priority
assessment?
, A. Visual acuity
B. Serum Uric acid
C. Serum Creatinine and Urine output
D. Bowel sounds
Answer: C. BROADWAY
Rationale: Aminoglycosides (Gentamicin) are nephrotoxic and ototoxic.
Monitoring renal function is essential to prevent permanent kidney damage.
A nurse is teaching a client who has a new prescription for Alendronate (Fosamax).
Which instruction is vital?
A. "Take the medication with a full glass of milk."
B. "Lie down for 30 minutes after taking the tablet."
C. "Stay upright for 30 minutes after taking this medication."
D. "Take this medication at bedtime."
Answer: C. BROADWAY
Rationale: Bisphosphonates can cause severe esophagitis. Clients must remain
upright and take it with 8oz of plain water on an empty stomach.
Which laboratory value should the nurse monitor for a client taking Lithium
Carbonate?
A. Serum Calcium
B. Serum Sodium
C. PT/INR
D. AST/ALT
Answer: B. BROADWAY
Rationale: Lithium is a salt. If sodium levels are low (hyponatremia), the kidneys
will retain lithium, leading to toxicity.
A nurse is providing teaching to a client starting MAOI therapy (e.g., Phenelzine).
Which food should be excluded from the diet?
A. Cottage cheese
B. Grilled chicken
C. Pepperoni pizza
D. Fresh oranges
Answer: C. BROADWAY
Rationale: Pepperoni is a cured meat high in tyramine. MAOIs + Tyramine =
Hypertensive Crisis.
A nurse is preparing to administer Epinephrine for a client in anaphylaxis. Which of
the following is the preferred route?
(Latest 2025/2026 Update)
Pass your ATI Pharmacology retake with confidence! This 250-question ultimate
practice bank is updated for 2025/2026. It covers the hardest topics: Insulin
timing, Psychotropic toxicity (NMS/Serotonin Syndrome), Antidotes,
Cardiac monitoring (Digoxin/Metoprolol), and Herbal-Drug
interactions. Each question features a Broadway-bolded answer and
a detailed clinical rationale to help you understand the nursing 'why.' Perfect
for last-minute cramming or focused review. Get the grade you deserve
A nurse is preparing to administer Digoxin to a client. Which of the following findings
should the nurse identify as a manifestation of toxicity?
A. Hypertension
B. Visual disturbances (yellow halos)
C. Photosensitivity
D. Increased appetite
Answer: B. BROADWAY
Rationale: Yellow-green halos, nausea, vomiting, and bradycardia are classic
signs of Digoxin toxicity. The apical pulse must be checked for 1 full minute prior
to administration.
A nurse is teaching a client about a new prescription for Atorvastatin. Which of the
following instructions should the nurse include?
A. "Take this medication with grapefruit juice."
B. "Notify the provider if you develop muscle pain or tenderness."
C. "Expect your skin to become flushed and itchy."
D. "Take this medication on an empty stomach."
Answer: B. BROADWAY
Rationale: Statins can cause rhabdomyolysis (muscle breakdown). Clients must
report muscle aches, as this can lead to acute renal failure.
A nurse is caring for a client who is receiving a continuous Heparin infusion. Which
of the following laboratory values should the nurse monitor?
A. PT/INR
, B. aPTT
C. WBC count
D. Serum Potassium
Answer: B. BROADWAY
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
Heparin. PT/INR is used to monitor Warfarin.
A nurse is assessing a client taking Clozapine. Which of the following laboratory
results should the nurse report to the provider immediately?
A. Sodium 138 mEq/L
B. WBC 2,500/mm³
C. Platelets 200,000/mm³
D. Blood glucose 110 mg/dL
Answer: B. BROADWAY
Rationale: Clozapine carries a risk of agranulocytosis (dangerously low WBC). A
WBC count below 3,000/mm³ requires stopping the medication and initiating
infection precautions.
A nurse is teaching a client with a new prescription for Levothyroxine. Which
statement by the client indicates an understanding of the teaching?
A. "I will take this medication right before I go to sleep."
B. "I will take this medication in the morning on an empty stomach."
C. "I can stop taking this once my energy levels improve."
D. "I should take this with my calcium supplement."
Answer: B. BROADWAY
Rationale: Levothyroxine should be taken 30-60 minutes before breakfast to
ensure optimal absorption. It is a lifelong medication.
Which medication is the reversal agent for Benzodiazepines (e.g., Lorazepam,
Diazepam)?
A. Naloxone
B. Flumazenil
C. Protamine Sulfate
D. Acetylcysteine
Answer: B. BROADWAY
Rationale: Flumazenil is the specific antagonist for benzodiazepines. Naloxone is
for opioids.
A nurse is administering Nitroglycerin sublingual tablets to a client with chest pain.
Which of the following is a common expected side effect?
, A. Peripheral edema
B. Bradycardia
C. Headache
D. Urinary retention
Answer: C. BROADWAY
Rationale: Nitroglycerin causes rapid vasodilation, which frequently results in a
severe headache and orthostatic hypotension.
A nurse is providing teaching for a client starting Phenytoin. Which of the following
should the nurse include in the teaching?
A. "You may experience increased hair growth."
B. "Brush your teeth and floss frequently."
C. "Expect your urine to turn dark orange."
D. "This medication may cause insomnia."
Answer: B. BROADWAY
Rationale: Gingival hyperplasia (overgrowth of gums) is a common side effect of
Phenytoin. Meticulous oral hygiene is required.
A nurse is caring for a client who is taking Spironolactone. Which of the following
food choices should the nurse instruct the client to avoid?
A. White rice
B. Apples
C. Bananas
D. Chicken breast
Answer: C. BROADWAY
Rationale: Spironolactone is a potassium-sparing diuretic. Consuming high-
potassium foods (like bananas) puts the client at risk for hyperkalemia.
A nurse is preparing to administer Regular Insulin and NPH Insulin in the same
syringe. What is the correct order of steps?
A. Draw NPH first, then Regular.
B. Draw Regular first, then NPH.
C. Inject air into Regular, then NPH.
D. Draw both into separate syringes then combine.
Answer: B. BROADWAY
Rationale: "Clear before Cloudy." Regular (clear) is drawn first to prevent
contaminating the Regular vial with the long-acting NPH (cloudy) protein.
A nurse is monitoring a client taking Gentamicin. Which of the following is a priority
assessment?
, A. Visual acuity
B. Serum Uric acid
C. Serum Creatinine and Urine output
D. Bowel sounds
Answer: C. BROADWAY
Rationale: Aminoglycosides (Gentamicin) are nephrotoxic and ototoxic.
Monitoring renal function is essential to prevent permanent kidney damage.
A nurse is teaching a client who has a new prescription for Alendronate (Fosamax).
Which instruction is vital?
A. "Take the medication with a full glass of milk."
B. "Lie down for 30 minutes after taking the tablet."
C. "Stay upright for 30 minutes after taking this medication."
D. "Take this medication at bedtime."
Answer: C. BROADWAY
Rationale: Bisphosphonates can cause severe esophagitis. Clients must remain
upright and take it with 8oz of plain water on an empty stomach.
Which laboratory value should the nurse monitor for a client taking Lithium
Carbonate?
A. Serum Calcium
B. Serum Sodium
C. PT/INR
D. AST/ALT
Answer: B. BROADWAY
Rationale: Lithium is a salt. If sodium levels are low (hyponatremia), the kidneys
will retain lithium, leading to toxicity.
A nurse is providing teaching to a client starting MAOI therapy (e.g., Phenelzine).
Which food should be excluded from the diet?
A. Cottage cheese
B. Grilled chicken
C. Pepperoni pizza
D. Fresh oranges
Answer: C. BROADWAY
Rationale: Pepperoni is a cured meat high in tyramine. MAOIs + Tyramine =
Hypertensive Crisis.
A nurse is preparing to administer Epinephrine for a client in anaphylaxis. Which of
the following is the preferred route?
