1
CMS ATI Pharmacology Proctored Actual
Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Cardiovascular Pharmacology – Antihypertensives, Antidysrhythmics, Anticoagulants,
Heart Failure Meds
Q1: A nurse is preparing to administer lisinopril to a client with hypertension. Which of the
following assessments should the nurse prioritize before giving the first dose?
A. Monitoring the client’s serum potassium level
B. Checking the client’s blood pressure and heart rate
C. Assessing the client for a dry, hacking cough
D. Evaluating the client’s peripheral pulses
Correct Answer: B
Rationale: The best answer is checking blood pressure and heart rate because lisinopril can cause
a rapid drop in blood pressure, especially after the first dose (first-dose phenomenon). While
potassium levels are important due to the risk of hyperkalemia with ACE inhibitors, the
immediate safety priority before administration is ensuring the client isn't already hypotensive or
bradycardic.
Q2: A client with heart failure is prescribed digoxin. The nurse notes an apical pulse rate of 52
bpm. What is the priority nursing action?
A. Administer the dose and notify the provider
B. Hold the dose and notify the provider
C. Give the dose with a full glass of water
D. Check the radial pulse for another minute
Correct Answer: B
,2
Rationale: This is correct because the nurse should hold digoxin if the apical pulse is below 60
bpm in adults. Digoxin toxicity can cause severe bradycardia and heart block, so withholding the
dose prevents further complications while waiting for provider instructions.
Q3: A client taking furosemide reports frequent muscle cramps. Which electrolyte imbalance
should the nurse suspect?
A. Hypernatremia
B. Hypocalcemia
C. Hypokalemia
D. Hypermagnesemia
Correct Answer: C
Rationale: This is correct because furosemide is a loop diuretic that causes significant potassium
loss, leading to hypokalemia. Muscle cramps are a classic sign of low potassium levels, so the
nurse needs to monitor electrolytes and encourage potassium-rich foods or supplements as
ordered.
Q4: The nurse is teaching a client about warfarin therapy. Which statement by the client indicates
a need for further teaching?
A. "I will use a soft toothbrush to brush my teeth."
B. "I will eat green leafy vegetables in moderation every day."
C. "I will take ibuprofen for my headaches when needed."
D. "I will have my blood tested regularly at the lab."
Correct Answer: C
Rationale: The best answer is this statement because NSAIDs like ibuprofen increase the risk of
bleeding when combined with warfarin. The client should be instructed to avoid NSAIDs and
use acetaminophen for pain relief instead to maintain safety.
Q5: A client is admitted with a new diagnosis of atrial fibrillation and is prescribed amiodarone.
Which of the following baseline tests should the nurse anticipate being ordered?
A. Pulmonary function tests
,3
B. Chest x-ray and thyroid function tests
C. Liver biopsy and coagulation studies
D. Serum glucose and hemoglobin A1C
Correct Answer: B
Rationale: This is correct because amiodarone can cause serious adverse effects, including
pulmonary toxicity and thyroid dysfunction (both hypo and hyperthyroidism). Establishing a
baseline with a chest x-ray and thyroid tests is standard practice before starting long-term
therapy.
Q6: A nurse is caring for a client receiving heparin via continuous IV infusion. Which laboratory
value should the nurse monitor to evaluate the effectiveness of the therapy?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Correct Answer: C
Rationale: This is correct because aPTT is the primary lab value used to monitor unfractionated
heparin therapy. The goal is usually 1.5 to 2.5 times the control value, ensuring the blood is thin
enough to prevent clots but not so thin that the client risks hemorrhage.
Q7: A client with stable angina is prescribed nitroglycerin sublingual tablets. Which instruction
should the nurse include in the teaching plan?
A. "Take one tablet every 5 minutes for a total of three doses if pain persists."
B. "Swallow the tablet with water for immediate absorption."
C. "Store the tablets in a clear plastic pillbox on the counter."
D. "Avoid taking the tablets if you feel dizzy or lightheaded."
Correct Answer: A
Rationale: This is correct because the standard protocol for angina is to take one dose, wait 5
minutes, and if pain persists, take a second, and if pain continues after another 5 minutes, take a
, 4
third dose and call emergency services. Sublingual nitroglycerin must be placed under the
tongue, not swallowed.
Q8: A client is prescribed atenolol, a beta-blocker. Which finding in the client's history should
alert the nurse to a potential contraindication?
A. Asthma
B. Hypertension
C. Migraine headaches
D. Anxiety disorder
Correct Answer: A
Rationale: The best answer is asthma because beta-blockers, especially non-selective ones, can
induce bronchoconstriction and trigger severe asthma attacks. Although atenolol is
cardioselective, it is still used cautiously in clients with respiratory conditions due to the risk of
exacerbating bronchospasm.
Q9: A client is being discharged on simvastatin. The nurse teaches the client about potential
adverse effects. Which of the following should be reported to the provider immediately?
A. Mild headache
B. Muscle pain and tenderness
C. Slight nausea after eating
D. Dry cough
Correct Answer: B
Rationale: This is correct because unexplained muscle pain and tenderness can indicate
rhabdomyolysis, a serious and potentially life-threatening side effect of statin therapy. This
condition leads to muscle breakdown and kidney damage, so it requires immediate medical
attention.
Q10: A nurse is monitoring a client receiving a unit of packed red blood cells. The client
suddenly develops flank pain and dark urine. What should the nurse do first?
A. Stop the transfusion immediately
CMS ATI Pharmacology Proctored Actual
Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Cardiovascular Pharmacology – Antihypertensives, Antidysrhythmics, Anticoagulants,
Heart Failure Meds
Q1: A nurse is preparing to administer lisinopril to a client with hypertension. Which of the
following assessments should the nurse prioritize before giving the first dose?
A. Monitoring the client’s serum potassium level
B. Checking the client’s blood pressure and heart rate
C. Assessing the client for a dry, hacking cough
D. Evaluating the client’s peripheral pulses
Correct Answer: B
Rationale: The best answer is checking blood pressure and heart rate because lisinopril can cause
a rapid drop in blood pressure, especially after the first dose (first-dose phenomenon). While
potassium levels are important due to the risk of hyperkalemia with ACE inhibitors, the
immediate safety priority before administration is ensuring the client isn't already hypotensive or
bradycardic.
Q2: A client with heart failure is prescribed digoxin. The nurse notes an apical pulse rate of 52
bpm. What is the priority nursing action?
A. Administer the dose and notify the provider
B. Hold the dose and notify the provider
C. Give the dose with a full glass of water
D. Check the radial pulse for another minute
Correct Answer: B
,2
Rationale: This is correct because the nurse should hold digoxin if the apical pulse is below 60
bpm in adults. Digoxin toxicity can cause severe bradycardia and heart block, so withholding the
dose prevents further complications while waiting for provider instructions.
Q3: A client taking furosemide reports frequent muscle cramps. Which electrolyte imbalance
should the nurse suspect?
A. Hypernatremia
B. Hypocalcemia
C. Hypokalemia
D. Hypermagnesemia
Correct Answer: C
Rationale: This is correct because furosemide is a loop diuretic that causes significant potassium
loss, leading to hypokalemia. Muscle cramps are a classic sign of low potassium levels, so the
nurse needs to monitor electrolytes and encourage potassium-rich foods or supplements as
ordered.
Q4: The nurse is teaching a client about warfarin therapy. Which statement by the client indicates
a need for further teaching?
A. "I will use a soft toothbrush to brush my teeth."
B. "I will eat green leafy vegetables in moderation every day."
C. "I will take ibuprofen for my headaches when needed."
D. "I will have my blood tested regularly at the lab."
Correct Answer: C
Rationale: The best answer is this statement because NSAIDs like ibuprofen increase the risk of
bleeding when combined with warfarin. The client should be instructed to avoid NSAIDs and
use acetaminophen for pain relief instead to maintain safety.
Q5: A client is admitted with a new diagnosis of atrial fibrillation and is prescribed amiodarone.
Which of the following baseline tests should the nurse anticipate being ordered?
A. Pulmonary function tests
,3
B. Chest x-ray and thyroid function tests
C. Liver biopsy and coagulation studies
D. Serum glucose and hemoglobin A1C
Correct Answer: B
Rationale: This is correct because amiodarone can cause serious adverse effects, including
pulmonary toxicity and thyroid dysfunction (both hypo and hyperthyroidism). Establishing a
baseline with a chest x-ray and thyroid tests is standard practice before starting long-term
therapy.
Q6: A nurse is caring for a client receiving heparin via continuous IV infusion. Which laboratory
value should the nurse monitor to evaluate the effectiveness of the therapy?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Correct Answer: C
Rationale: This is correct because aPTT is the primary lab value used to monitor unfractionated
heparin therapy. The goal is usually 1.5 to 2.5 times the control value, ensuring the blood is thin
enough to prevent clots but not so thin that the client risks hemorrhage.
Q7: A client with stable angina is prescribed nitroglycerin sublingual tablets. Which instruction
should the nurse include in the teaching plan?
A. "Take one tablet every 5 minutes for a total of three doses if pain persists."
B. "Swallow the tablet with water for immediate absorption."
C. "Store the tablets in a clear plastic pillbox on the counter."
D. "Avoid taking the tablets if you feel dizzy or lightheaded."
Correct Answer: A
Rationale: This is correct because the standard protocol for angina is to take one dose, wait 5
minutes, and if pain persists, take a second, and if pain continues after another 5 minutes, take a
, 4
third dose and call emergency services. Sublingual nitroglycerin must be placed under the
tongue, not swallowed.
Q8: A client is prescribed atenolol, a beta-blocker. Which finding in the client's history should
alert the nurse to a potential contraindication?
A. Asthma
B. Hypertension
C. Migraine headaches
D. Anxiety disorder
Correct Answer: A
Rationale: The best answer is asthma because beta-blockers, especially non-selective ones, can
induce bronchoconstriction and trigger severe asthma attacks. Although atenolol is
cardioselective, it is still used cautiously in clients with respiratory conditions due to the risk of
exacerbating bronchospasm.
Q9: A client is being discharged on simvastatin. The nurse teaches the client about potential
adverse effects. Which of the following should be reported to the provider immediately?
A. Mild headache
B. Muscle pain and tenderness
C. Slight nausea after eating
D. Dry cough
Correct Answer: B
Rationale: This is correct because unexplained muscle pain and tenderness can indicate
rhabdomyolysis, a serious and potentially life-threatening side effect of statin therapy. This
condition leads to muscle breakdown and kidney damage, so it requires immediate medical
attention.
Q10: A nurse is monitoring a client receiving a unit of packed red blood cells. The client
suddenly develops flank pain and dark urine. What should the nurse do first?
A. Stop the transfusion immediately
