ATI CMS PHARMACOLOGY RETAKE EXAM 2
LATEST 2026 QUESTIONS & CORRECT
ANSWERS WITH RATIONALES
Exam Blueprint:
Cardiovascular & Hematologic Medications (20%) – 40 Qs
Respiratory & Allergy Medications (10%) – 20 Qs
Endocrine & Metabolic Medications (15%) – 30 Qs
Neurologic & Psychiatric Medications (15%) – 30 Qs
Antimicrobial & Anti-infective Medications (15%) – 30 Qs
Gastrointestinal & Genitourinary Medications (10%) – 20 Qs
Pain Management & Anti-inflammatory Medications (15%) – 30 Qs
SECTION 1: CARDIOVASCULAR & HEMATOLOGIC MEDICATIONS –
Questions 1–40
1. A nurse is administering IV furosemide to a client with heart failure. Which
finding should the nurse report to the provider immediately?
A) Urine output of 200 mL in 2 hours
B) Serum potassium level of 3.2 mEq/L
C) Blood pressure of 110/70 mmHg
D) Weight loss of 1 kg in 24 hours
Answer: B
*Rationale: Furosemide is a loop diuretic that causes potassium wasting.
Hypokalemia (K⁺ <3.5 mEq/L) can lead to cardiac arrhythmias, especially in
clients taking digoxin. The nurse should report this finding and monitor for ECG
changes.*
2. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor to evaluate therapeutic effect?
,A) aPTT
B) INR
C) Platelet count
D) Bleeding time
Answer: B
Rationale: Warfarin anticoagulation is monitored by the INR (International
Normalized Ratio). For atrial fibrillation, the target INR is typically 2-3. aPTT
monitors heparin, not warfarin.
3. A client is prescribed digoxin for heart failure. Which finding indicates digoxin
toxicity?
A) Heart rate 72 bpm and regular
B) Nausea, vomiting, and yellow-green halos around lights
C) Weight loss of 2 kg in 1 week
D) Blood pressure 130/80 mmHg
Answer: B
Rationale: Digoxin toxicity causes GI symptoms (nausea, vomiting, anorexia),
visual disturbances (yellow-green halos, blurred vision), and cardiac arrhythmias
(bradycardia, heart block, ventricular ectopy).
4. A nurse is teaching a client about self-administration of enoxaparin (Lovenox).
Which instruction is correct?
A) “Inject the medication into the deltoid muscle.”
B) “Expel the air bubble from the prefilled syringe before injection.”
C) “Administer the medication into the abdomen, rotating injection sites.”
D) “Massage the injection site thoroughly after administration.”
Answer: C
Rationale: Enoxaparin is a low-molecular-weight heparin (LMWH) given
subcutaneously, preferably in the abdomen. The air bubble should not be expelled
(helps prevent medication loss). Do not massage the site (may cause bruising).
5. A client is taking clopidogrel after a recent coronary stent placement. The nurse
should teach the client to avoid which over-the-counter medication?
,A) Acetaminophen
B) Ibuprofen
C) Diphenhydramine
D) Loratadine
Answer: B
Rationale: NSAIDs (ibuprofen, naproxen) increase the risk of bleeding when taken
with antiplatelet medications like clopidogrel, aspirin, and other anticoagulants.
Acetaminophen is the preferred analgesic for these clients.
6. A client with heart failure is prescribed carvedilol. The nurse should monitor for
which therapeutic effect?
A) Increased heart rate
B) Improved left ventricular ejection fraction (LVEF)
C) Increased blood pressure
D) Decreased urinary output
Answer: B
Rationale: Carvedilol is a beta-blocker used in heart failure with reduced ejection
fraction (HFrEF). Over time, beta-blockers improve LVEF, reduce hospitalization,
and decrease mortality.
7. A nurse is administering IV dopamine to a client with cardiogenic shock. Which
finding indicates a therapeutic response?
A) Decreased urine output
B) Increased blood pressure and improved perfusion
C) Heart rate of 45 bpm
D) Decreased cardiac output
Answer: B
Rationale: Dopamine is a vasopressor and inotrope used to increase blood pressure
and improve cardiac output in shock. Therapeutic effects include increased BP,
improved urine output, and adequate tissue perfusion.
8. A client is prescribed lisinopril for hypertension. The nurse should instruct the
client to report which adverse effect?
, A) Dry cough
B) Weight gain
C) Hyperglycemia
D) Drowsiness
Answer: A
Rationale: ACE inhibitors (lisinopril, enalapril) commonly cause a persistent dry
cough due to bradykinin accumulation. If the cough is intolerable, the provider
may switch to an ARB (e.g., losartan).
9. A client is taking spironolactone for heart failure. Which laboratory value
requires immediate nursing intervention?
A) Sodium 138 mEq/L
B) Potassium 5.9 mEq/L
C) Chloride 100 mEq/L
D) Blood glucose 110 mg/dL
Answer: B
*Rationale: Spironolactone is a potassium-sparing diuretic (aldosterone
antagonist). It can cause life-threatening hyperkalemia, especially when given with
ACE inhibitors or in clients with renal impairment. A potassium level >5.5 mEq/L
requires notification of the provider.*
10. A client with a mechanical heart valve is prescribed warfarin. The nurse should
teach the client to avoid which food?
A) Apples
B) Carrots
C) Spinach (large, consistent amounts cause fluctuations)
D) White rice
Answer: C
Rationale: Consistency in vitamin K intake is key to maintaining a stable INR.
Sudden large amounts of leafy green vegetables (spinach, kale, collards) can
decrease warfarin’s effect. Clients should not avoid them entirely but should keep
intake consistent.
LATEST 2026 QUESTIONS & CORRECT
ANSWERS WITH RATIONALES
Exam Blueprint:
Cardiovascular & Hematologic Medications (20%) – 40 Qs
Respiratory & Allergy Medications (10%) – 20 Qs
Endocrine & Metabolic Medications (15%) – 30 Qs
Neurologic & Psychiatric Medications (15%) – 30 Qs
Antimicrobial & Anti-infective Medications (15%) – 30 Qs
Gastrointestinal & Genitourinary Medications (10%) – 20 Qs
Pain Management & Anti-inflammatory Medications (15%) – 30 Qs
SECTION 1: CARDIOVASCULAR & HEMATOLOGIC MEDICATIONS –
Questions 1–40
1. A nurse is administering IV furosemide to a client with heart failure. Which
finding should the nurse report to the provider immediately?
A) Urine output of 200 mL in 2 hours
B) Serum potassium level of 3.2 mEq/L
C) Blood pressure of 110/70 mmHg
D) Weight loss of 1 kg in 24 hours
Answer: B
*Rationale: Furosemide is a loop diuretic that causes potassium wasting.
Hypokalemia (K⁺ <3.5 mEq/L) can lead to cardiac arrhythmias, especially in
clients taking digoxin. The nurse should report this finding and monitor for ECG
changes.*
2. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor to evaluate therapeutic effect?
,A) aPTT
B) INR
C) Platelet count
D) Bleeding time
Answer: B
Rationale: Warfarin anticoagulation is monitored by the INR (International
Normalized Ratio). For atrial fibrillation, the target INR is typically 2-3. aPTT
monitors heparin, not warfarin.
3. A client is prescribed digoxin for heart failure. Which finding indicates digoxin
toxicity?
A) Heart rate 72 bpm and regular
B) Nausea, vomiting, and yellow-green halos around lights
C) Weight loss of 2 kg in 1 week
D) Blood pressure 130/80 mmHg
Answer: B
Rationale: Digoxin toxicity causes GI symptoms (nausea, vomiting, anorexia),
visual disturbances (yellow-green halos, blurred vision), and cardiac arrhythmias
(bradycardia, heart block, ventricular ectopy).
4. A nurse is teaching a client about self-administration of enoxaparin (Lovenox).
Which instruction is correct?
A) “Inject the medication into the deltoid muscle.”
B) “Expel the air bubble from the prefilled syringe before injection.”
C) “Administer the medication into the abdomen, rotating injection sites.”
D) “Massage the injection site thoroughly after administration.”
Answer: C
Rationale: Enoxaparin is a low-molecular-weight heparin (LMWH) given
subcutaneously, preferably in the abdomen. The air bubble should not be expelled
(helps prevent medication loss). Do not massage the site (may cause bruising).
5. A client is taking clopidogrel after a recent coronary stent placement. The nurse
should teach the client to avoid which over-the-counter medication?
,A) Acetaminophen
B) Ibuprofen
C) Diphenhydramine
D) Loratadine
Answer: B
Rationale: NSAIDs (ibuprofen, naproxen) increase the risk of bleeding when taken
with antiplatelet medications like clopidogrel, aspirin, and other anticoagulants.
Acetaminophen is the preferred analgesic for these clients.
6. A client with heart failure is prescribed carvedilol. The nurse should monitor for
which therapeutic effect?
A) Increased heart rate
B) Improved left ventricular ejection fraction (LVEF)
C) Increased blood pressure
D) Decreased urinary output
Answer: B
Rationale: Carvedilol is a beta-blocker used in heart failure with reduced ejection
fraction (HFrEF). Over time, beta-blockers improve LVEF, reduce hospitalization,
and decrease mortality.
7. A nurse is administering IV dopamine to a client with cardiogenic shock. Which
finding indicates a therapeutic response?
A) Decreased urine output
B) Increased blood pressure and improved perfusion
C) Heart rate of 45 bpm
D) Decreased cardiac output
Answer: B
Rationale: Dopamine is a vasopressor and inotrope used to increase blood pressure
and improve cardiac output in shock. Therapeutic effects include increased BP,
improved urine output, and adequate tissue perfusion.
8. A client is prescribed lisinopril for hypertension. The nurse should instruct the
client to report which adverse effect?
, A) Dry cough
B) Weight gain
C) Hyperglycemia
D) Drowsiness
Answer: A
Rationale: ACE inhibitors (lisinopril, enalapril) commonly cause a persistent dry
cough due to bradykinin accumulation. If the cough is intolerable, the provider
may switch to an ARB (e.g., losartan).
9. A client is taking spironolactone for heart failure. Which laboratory value
requires immediate nursing intervention?
A) Sodium 138 mEq/L
B) Potassium 5.9 mEq/L
C) Chloride 100 mEq/L
D) Blood glucose 110 mg/dL
Answer: B
*Rationale: Spironolactone is a potassium-sparing diuretic (aldosterone
antagonist). It can cause life-threatening hyperkalemia, especially when given with
ACE inhibitors or in clients with renal impairment. A potassium level >5.5 mEq/L
requires notification of the provider.*
10. A client with a mechanical heart valve is prescribed warfarin. The nurse should
teach the client to avoid which food?
A) Apples
B) Carrots
C) Spinach (large, consistent amounts cause fluctuations)
D) White rice
Answer: C
Rationale: Consistency in vitamin K intake is key to maintaining a stable INR.
Sudden large amounts of leafy green vegetables (spinach, kale, collards) can
decrease warfarin’s effect. Clients should not avoid them entirely but should keep
intake consistent.
