ATI RN PHARMACOLOGY EXAM WITH
ALL NGN QUESTION AND ANSWER
1. A nurse is preparing to administer digoxin 0.25 mg PO.
Available is digoxin 0.125 mg tablets. How many tablets should
the nurse administer?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets
D. 4 tablets
Answer: C – 2 tablets
Rationale: (Desired dose / available dose) = 0.25/0.125 = 2
tablets. Always double-check calculation errors; digoxin toxicity is
common.
2. A client with heart failure is prescribed furosemide (Lasix).
Which laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum calcium
C. Serum potassium
D. Serum magnesium
Answer: C – Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium
,wasting. Hypokalemia increases the risk of digoxin toxicity and
cardiac arrhythmias.
3. A nurse administers enoxaparin (Lovenox) subcutaneously.
Which technique is correct?
A. Expel the air bubble from the prefilled syringe.
B. Insert the needle at a 45-degree angle.
C. Aspirate before injection.
D. Rub the site after injection.
Answer: B – Insert the needle at a 45-degree angle
Rationale: Enoxaparin is given subcutaneously with the needle at
45–90 degrees (usually 45 for thin patients). Do not expel the air
bubble (prevents needle clogging). Do not aspirate or massage
the site.
4. A client takes warfarin (Coumadin). Which INR level indicates
therapeutic effect for atrial fibrillation?
A. 0.8–1.2
B. 2.0–3.0
C. 3.5–4.5
D. 4.5–5.5
Answer: B – 2.0–3.0
Rationale: For most indications (AFib, DVT, PE) therapeutic INR is
2–3. Mechanical heart valves require 2.5–3.5.
,5. A nurse provides discharge teaching for a new prescription of
lisinopril. Which adverse effect should the client report
immediately?
A. Dry cough
B. Angioedema (swelling of lips/tongue)
C. Hyperkalemia
D. Hypotension
Answer: B – Angioedema
Rationale: Angioedema is a life-threatening allergic reaction to
ACE inhibitors requiring immediate medical attention. Dry cough
is common but not emergent.
6. A client is prescribed metformin. Which instruction should the
nurse include?
A. Take on an empty stomach.
B. Report any muscle pain or weakness.
C. Skip dose if you are having a CT scan with contrast.
D. Expect weight gain as a side effect.
Answer: C – Skip dose if you are having a CT scan with contrast
Rationale: Metformin should be held 48 hours before and after
iodinated contrast to prevent lactic acidosis. Muscle pain is not
typical.
, 7. A nurse monitors a client receiving IV vancomycin. Which
finding indicates an infusion reaction (Red Man syndrome)?
A. Flushing and rash on the face and upper body
B. Wheezing and stridor
C. Hypotension and tachycardia
D. Nausea and vomiting
Answer: A – Flushing and rash on the face and upper body
Rationale: Red Man syndrome results from rapid vancomycin
infusion; it is not an IgE allergy. Slow infusion over 60 minutes can
prevent it.
8. Which medication requires the nurse to avoid crushing the
tablet?
A. Metoprolol tartrate
B. Levothyroxine
C. Nifedipine extended release (Procardia XL)
D. Acetaminophen
Answer: C – Nifedipine extended release
Rationale: ER/XR formulations must be swallowed whole to
prevent dose dumping and toxicity.
9. A client on isoniazid (INH) for tuberculosis complains of
numbness and tingling in the feet. The nurse anticipates a
prescription for which vitamin?
ALL NGN QUESTION AND ANSWER
1. A nurse is preparing to administer digoxin 0.25 mg PO.
Available is digoxin 0.125 mg tablets. How many tablets should
the nurse administer?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets
D. 4 tablets
Answer: C – 2 tablets
Rationale: (Desired dose / available dose) = 0.25/0.125 = 2
tablets. Always double-check calculation errors; digoxin toxicity is
common.
2. A client with heart failure is prescribed furosemide (Lasix).
Which laboratory value should the nurse monitor most closely?
A. Serum sodium
B. Serum calcium
C. Serum potassium
D. Serum magnesium
Answer: C – Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium
,wasting. Hypokalemia increases the risk of digoxin toxicity and
cardiac arrhythmias.
3. A nurse administers enoxaparin (Lovenox) subcutaneously.
Which technique is correct?
A. Expel the air bubble from the prefilled syringe.
B. Insert the needle at a 45-degree angle.
C. Aspirate before injection.
D. Rub the site after injection.
Answer: B – Insert the needle at a 45-degree angle
Rationale: Enoxaparin is given subcutaneously with the needle at
45–90 degrees (usually 45 for thin patients). Do not expel the air
bubble (prevents needle clogging). Do not aspirate or massage
the site.
4. A client takes warfarin (Coumadin). Which INR level indicates
therapeutic effect for atrial fibrillation?
A. 0.8–1.2
B. 2.0–3.0
C. 3.5–4.5
D. 4.5–5.5
Answer: B – 2.0–3.0
Rationale: For most indications (AFib, DVT, PE) therapeutic INR is
2–3. Mechanical heart valves require 2.5–3.5.
,5. A nurse provides discharge teaching for a new prescription of
lisinopril. Which adverse effect should the client report
immediately?
A. Dry cough
B. Angioedema (swelling of lips/tongue)
C. Hyperkalemia
D. Hypotension
Answer: B – Angioedema
Rationale: Angioedema is a life-threatening allergic reaction to
ACE inhibitors requiring immediate medical attention. Dry cough
is common but not emergent.
6. A client is prescribed metformin. Which instruction should the
nurse include?
A. Take on an empty stomach.
B. Report any muscle pain or weakness.
C. Skip dose if you are having a CT scan with contrast.
D. Expect weight gain as a side effect.
Answer: C – Skip dose if you are having a CT scan with contrast
Rationale: Metformin should be held 48 hours before and after
iodinated contrast to prevent lactic acidosis. Muscle pain is not
typical.
, 7. A nurse monitors a client receiving IV vancomycin. Which
finding indicates an infusion reaction (Red Man syndrome)?
A. Flushing and rash on the face and upper body
B. Wheezing and stridor
C. Hypotension and tachycardia
D. Nausea and vomiting
Answer: A – Flushing and rash on the face and upper body
Rationale: Red Man syndrome results from rapid vancomycin
infusion; it is not an IgE allergy. Slow infusion over 60 minutes can
prevent it.
8. Which medication requires the nurse to avoid crushing the
tablet?
A. Metoprolol tartrate
B. Levothyroxine
C. Nifedipine extended release (Procardia XL)
D. Acetaminophen
Answer: C – Nifedipine extended release
Rationale: ER/XR formulations must be swallowed whole to
prevent dose dumping and toxicity.
9. A client on isoniazid (INH) for tuberculosis complains of
numbness and tingling in the feet. The nurse anticipates a
prescription for which vitamin?
