NR 293 Pharmacology Exam 4 Practice (ATI-Based) 2026 |Chamberlain
College
1. A nurse is caring for a client who is taking levothyroxine for hypothyroidism.
Which of the following findings should the nurse report to the provider as a sign
of toxicity?
A. Weight gain
B. Constipation
C. Dry skin
D. Palpitations
Answer: D
Rationale: Levothyroxine toxicity manifests as symptoms of hyperthyroidism, such as
palpitations, tachycardia, heat intolerance, and insomnia.
2. A client is prescribed lispro insulin. When should the nurse instruct the client
to administer this medication?
A. 30 to 60 minutes before a meal
B. Immediately after a meal
C. 15 minutes before a meal
D. At bedtime
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes; it should be
administered within 15 minutes of eating.
,3. A nurse is teaching a client who has a new prescription for metformin. Which
of the following side effects should the nurse include in the teaching?
A. Weight gain
B. Constipation
C. Hyperglycemia
D. Lactic acidosis
Answer: D
Rationale: Metformin can cause lactic acidosis, a rare but serious complication, especially
in clients with renal impairment.
4. Which of the following instructions should the nurse provide to a client taking
alendronate for osteoporosis?
A. Take the medication with a glass of milk.
B. Lie down for 30 minutes after taking the medication.
C. Take the medication on an empty stomach with a full glass of water.
D. Take the medication at bedtime.
Answer: C
Rationale: Alendronate should be taken on an empty stomach with 8 oz of water, and the
client must remain upright for at least 30 minutes to prevent esophageal irritation.
5. A client is starting propylthiouracil (PTU) for Graves’ disease. Which
laboratory test should the nurse monitor?
A. White blood cell (WBC) count
B. Serum calcium
C. Serum potassium
D. Platelet count
Answer: A
Rationale: PTU can cause agranulocytosis (a dangerous drop in WBCs). Clients should be
monitored for fever and sore throat.
, 6. A nurse is administering glargine insulin to a client. Which of the following is a
characteristic of this medication?
A. It has a peak effect in 2 to 4 hours.
B. It can be mixed with NPH insulin.
C. It is administered intravenously.
D. It provides a continuous steady blood level for 24 hours.
Answer: D
Rationale: Glargine is a long-acting insulin that lacks a peak and provides basal coverage
for 24 hours. It should never be mixed with other insulins.
7. A client is taking prednisone for an acute asthma exacerbation. The nurse
should monitor for which of the following adverse effects?
A. Hypoglycemia
B. Hyperkalemia
C. Weight loss
D. Fluid retention
Answer: D
Rationale: Glucocorticoids like prednisone cause sodium and water retention, leading to
weight gain and edema.
8. Which of the following medications is used to treat a client experiencing an
overdose of heparin?
A. Vitamin K
B. Glucagon
C. Protamine sulfate
D. Acetylcysteine
Answer: C
Rationale: Protamine sulfate is the antidote used to reverse the effects of heparin.
College
1. A nurse is caring for a client who is taking levothyroxine for hypothyroidism.
Which of the following findings should the nurse report to the provider as a sign
of toxicity?
A. Weight gain
B. Constipation
C. Dry skin
D. Palpitations
Answer: D
Rationale: Levothyroxine toxicity manifests as symptoms of hyperthyroidism, such as
palpitations, tachycardia, heat intolerance, and insomnia.
2. A client is prescribed lispro insulin. When should the nurse instruct the client
to administer this medication?
A. 30 to 60 minutes before a meal
B. Immediately after a meal
C. 15 minutes before a meal
D. At bedtime
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes; it should be
administered within 15 minutes of eating.
,3. A nurse is teaching a client who has a new prescription for metformin. Which
of the following side effects should the nurse include in the teaching?
A. Weight gain
B. Constipation
C. Hyperglycemia
D. Lactic acidosis
Answer: D
Rationale: Metformin can cause lactic acidosis, a rare but serious complication, especially
in clients with renal impairment.
4. Which of the following instructions should the nurse provide to a client taking
alendronate for osteoporosis?
A. Take the medication with a glass of milk.
B. Lie down for 30 minutes after taking the medication.
C. Take the medication on an empty stomach with a full glass of water.
D. Take the medication at bedtime.
Answer: C
Rationale: Alendronate should be taken on an empty stomach with 8 oz of water, and the
client must remain upright for at least 30 minutes to prevent esophageal irritation.
5. A client is starting propylthiouracil (PTU) for Graves’ disease. Which
laboratory test should the nurse monitor?
A. White blood cell (WBC) count
B. Serum calcium
C. Serum potassium
D. Platelet count
Answer: A
Rationale: PTU can cause agranulocytosis (a dangerous drop in WBCs). Clients should be
monitored for fever and sore throat.
, 6. A nurse is administering glargine insulin to a client. Which of the following is a
characteristic of this medication?
A. It has a peak effect in 2 to 4 hours.
B. It can be mixed with NPH insulin.
C. It is administered intravenously.
D. It provides a continuous steady blood level for 24 hours.
Answer: D
Rationale: Glargine is a long-acting insulin that lacks a peak and provides basal coverage
for 24 hours. It should never be mixed with other insulins.
7. A client is taking prednisone for an acute asthma exacerbation. The nurse
should monitor for which of the following adverse effects?
A. Hypoglycemia
B. Hyperkalemia
C. Weight loss
D. Fluid retention
Answer: D
Rationale: Glucocorticoids like prednisone cause sodium and water retention, leading to
weight gain and edema.
8. Which of the following medications is used to treat a client experiencing an
overdose of heparin?
A. Vitamin K
B. Glucagon
C. Protamine sulfate
D. Acetylcysteine
Answer: C
Rationale: Protamine sulfate is the antidote used to reverse the effects of heparin.
