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NGN ATI PHARMACOLOGY CASE STUDIES 2026-2027 BANK
QUESTIONS WITH DETAILED VERIFIED ANSWERS EXAM
QUESTIONS WILL COME FROM HERE (100% CORRECT
ANSWERS A+ GRADED
1. A nurse is caring for a patient receiving intravenous heparin therapy.
The patient’s aPTT is 90 seconds. The nurse anticipates which order?
A) Administer protamine sulfate
B) Increase the heparin infusion rate
C) Administer vitamin K
D) Discontinue the heparin infusion and restart at a lower rate
Answer: D) Discontinue the heparin infusion and restart at a lower rate
Explanation: A therapeutic aPTT for heparin is typically 1.5 to 2.5 times
the control value, often 46-70 seconds. An aPTT of 90 seconds is
supratherapeutic, increasing bleeding risk. The appropriate action is to
stop the infusion temporarily and resume at a reduced rate per facility
protocol. Protamine sulfate is reserved for severe hemorrhage, not
asymptomatic lab elevation. Vitamin K reverses warfarin, not heparin.
2. A patient with tuberculosis is prescribed isoniazid. The nurse should
monitor for which adverse effect?
A) Ototoxicity
B) Peripheral neuropathy
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C) Nephrotoxicity
D) Orange-red body secretions
Answer: B) Peripheral neuropathy
Explanation: Isoniazid can cause peripheral neuropathy due to
pyridoxine (vitamin B6) deficiency. Patients are often prescribed
concurrent B6 supplementation to prevent this. Ototoxicity is
associated with aminoglycosides, nephrotoxicity with multiple drugs
including aminoglycosides and vancomycin, and orange-red secretions
with rifampin.
3. A patient is receiving warfarin following a deep vein thrombosis. The
INR is 5.0 and the patient reports bleeding gums. Which medication
does the nurse anticipate administering?
A) Protamine sulfate
B) Vitamin K
C) Idarucizumab
D) Protamine sulfate and fresh frozen plasma
Answer: B) Vitamin K
Explanation: Vitamin K is the antagonist for warfarin, promoting
synthesis of clotting factors and reversing anticoagulation. For active
bleeding with elevated INR, oral or IV vitamin K is indicated. Protamine
sulfate reverses heparin. Idarucizumab reverses dabigatran.
,3|Page
4. A nurse administers naloxone to a patient with respiratory
depression from opioid overdose. Which finding is most concerning
after administration?
A) Drowsiness returning within 2 hours
B) Acute onset of severe pain and agitation
C) Blood pressure of 110/70 mmHg
D) Respiratory rate of 16 breaths per minute
Answer: B) Acute onset of severe pain and agitation
Explanation: Naloxone is an opioid antagonist that can precipitate acute
withdrawal in opioid-dependent patients, leading to severe pain,
agitation, vomiting, and sympathetic surge. The short half-life means
drowsiness may return as naloxone wears off, but acute withdrawal is
immediately dangerous. Normal respiratory rate and stable blood
pressure are desired outcomes.
5. A patient receiving gentamicin should be assessed for which adverse
effects?
A) Hepatotoxicity and tinnitus
B) Nephrotoxicity and ototoxicity
C) Cardiotoxicity and rash
D) Pulmonary fibrosis and nephrotoxicity
Answer: B) Nephrotoxicity and ototoxicity
Explanation: Aminoglycosides like gentamicin are known for
nephrotoxicity and ototoxicity (both vestibular and auditory). Peak and
trough levels are monitored to minimize these risks. Hepatotoxicity is
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more associated with antituberculars or antifungals, and pulmonary
fibrosis with bleomycin or amiodarone.
6. A patient on furosemide develops muscle weakness and cardiac
dysrhythmias. Which laboratory abnormality is the likely cause?
A) Hyponatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypomagnesemia
Answer: B) Hypokalemia
Explanation: Furosemide, a loop diuretic, promotes potassium
excretion, leading to hypokalemia which manifests as muscle weakness,
cramping, and cardiac dysrhythmias. While it can also cause
hyponatremia and hypomagnesemia, hypokalemia is the most direct
cause of these presenting symptoms.
7. A patient with asthma is prescribed albuterol. What is the primary
mechanism of action?
A) Blocking leukotriene receptors
B) Stabilizing mast cells
C) Beta-2 adrenergic agonism
D) Muscarinic receptor antagonism
Answer: C) Beta-2 adrenergic agonism
NGN ATI PHARMACOLOGY CASE STUDIES 2026-2027 BANK
QUESTIONS WITH DETAILED VERIFIED ANSWERS EXAM
QUESTIONS WILL COME FROM HERE (100% CORRECT
ANSWERS A+ GRADED
1. A nurse is caring for a patient receiving intravenous heparin therapy.
The patient’s aPTT is 90 seconds. The nurse anticipates which order?
A) Administer protamine sulfate
B) Increase the heparin infusion rate
C) Administer vitamin K
D) Discontinue the heparin infusion and restart at a lower rate
Answer: D) Discontinue the heparin infusion and restart at a lower rate
Explanation: A therapeutic aPTT for heparin is typically 1.5 to 2.5 times
the control value, often 46-70 seconds. An aPTT of 90 seconds is
supratherapeutic, increasing bleeding risk. The appropriate action is to
stop the infusion temporarily and resume at a reduced rate per facility
protocol. Protamine sulfate is reserved for severe hemorrhage, not
asymptomatic lab elevation. Vitamin K reverses warfarin, not heparin.
2. A patient with tuberculosis is prescribed isoniazid. The nurse should
monitor for which adverse effect?
A) Ototoxicity
B) Peripheral neuropathy
,2|Page
C) Nephrotoxicity
D) Orange-red body secretions
Answer: B) Peripheral neuropathy
Explanation: Isoniazid can cause peripheral neuropathy due to
pyridoxine (vitamin B6) deficiency. Patients are often prescribed
concurrent B6 supplementation to prevent this. Ototoxicity is
associated with aminoglycosides, nephrotoxicity with multiple drugs
including aminoglycosides and vancomycin, and orange-red secretions
with rifampin.
3. A patient is receiving warfarin following a deep vein thrombosis. The
INR is 5.0 and the patient reports bleeding gums. Which medication
does the nurse anticipate administering?
A) Protamine sulfate
B) Vitamin K
C) Idarucizumab
D) Protamine sulfate and fresh frozen plasma
Answer: B) Vitamin K
Explanation: Vitamin K is the antagonist for warfarin, promoting
synthesis of clotting factors and reversing anticoagulation. For active
bleeding with elevated INR, oral or IV vitamin K is indicated. Protamine
sulfate reverses heparin. Idarucizumab reverses dabigatran.
,3|Page
4. A nurse administers naloxone to a patient with respiratory
depression from opioid overdose. Which finding is most concerning
after administration?
A) Drowsiness returning within 2 hours
B) Acute onset of severe pain and agitation
C) Blood pressure of 110/70 mmHg
D) Respiratory rate of 16 breaths per minute
Answer: B) Acute onset of severe pain and agitation
Explanation: Naloxone is an opioid antagonist that can precipitate acute
withdrawal in opioid-dependent patients, leading to severe pain,
agitation, vomiting, and sympathetic surge. The short half-life means
drowsiness may return as naloxone wears off, but acute withdrawal is
immediately dangerous. Normal respiratory rate and stable blood
pressure are desired outcomes.
5. A patient receiving gentamicin should be assessed for which adverse
effects?
A) Hepatotoxicity and tinnitus
B) Nephrotoxicity and ototoxicity
C) Cardiotoxicity and rash
D) Pulmonary fibrosis and nephrotoxicity
Answer: B) Nephrotoxicity and ototoxicity
Explanation: Aminoglycosides like gentamicin are known for
nephrotoxicity and ototoxicity (both vestibular and auditory). Peak and
trough levels are monitored to minimize these risks. Hepatotoxicity is
, 4|Page
more associated with antituberculars or antifungals, and pulmonary
fibrosis with bleomycin or amiodarone.
6. A patient on furosemide develops muscle weakness and cardiac
dysrhythmias. Which laboratory abnormality is the likely cause?
A) Hyponatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypomagnesemia
Answer: B) Hypokalemia
Explanation: Furosemide, a loop diuretic, promotes potassium
excretion, leading to hypokalemia which manifests as muscle weakness,
cramping, and cardiac dysrhythmias. While it can also cause
hyponatremia and hypomagnesemia, hypokalemia is the most direct
cause of these presenting symptoms.
7. A patient with asthma is prescribed albuterol. What is the primary
mechanism of action?
A) Blocking leukotriene receptors
B) Stabilizing mast cells
C) Beta-2 adrenergic agonism
D) Muscarinic receptor antagonism
Answer: C) Beta-2 adrenergic agonism
