1|Page
ATI PHARMACOLOGY PROCTORED EXAM –
200+ REMEDIATION QUESTIONS WITH
RATIONALES (MOST RELIABLE FOR BEST
SCORES)**
# SECTION 1: CARDIOVASCULAR MEDICATIONS (Questions 1–
35)
**1.** A nurse is caring for a patient receiving digoxin. Which finding
is most indicative of digoxin toxicity?
A. Heart rate 72 bpm and blood pressure 120/80 mmHg
B. Nausea, vomiting, and yellow-tinged vision
C. Dry cough and hyperkalemia
D. Constipation and headache
**Correct Answer:** B – Nausea, vomiting, and yellow-tinged vision
**Rationale:** Digoxin toxicity presents with gastrointestinal symptoms
(nausea, vomiting, anorexia), visual disturbances (yellow-green halos,
blurred vision), and cardiac dysrhythmias (bradycardia, heart block).
Hypokalemia increases toxicity risk.
---
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**2.** A patient with heart failure is prescribed digoxin and furosemide.
The nurse should monitor for which electrolyte imbalance that increases
digoxin toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
**Correct Answer:** B – Hypokalemia
**Rationale:** Furosemide is a loop diuretic that causes potassium loss.
Hypokalemia increases the risk of digoxin toxicity by enhancing digoxin
binding to cardiac sodium-potassium ATPase pumps.
---
**3.** A patient taking warfarin has an INR of 4.8 without active
bleeding. What is the most appropriate nursing action?
A. Administer vitamin K subcutaneously
B. Hold the next dose and notify the provider
C. Increase the warfarin dose
D. Give protamine sulfate immediately
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**Correct Answer:** B – Hold the next dose and notify the provider
**Rationale:** For asymptomatic INR >4.5 but <10, the standard
approach is to hold warfarin and monitor. Vitamin K is reserved for INR
>10 or active bleeding. Protamine reverses heparin, not warfarin.
---
**4.** A patient on warfarin reports black, tarry stools. What is the
priority nursing action?
A. Administer vitamin K intravenously
B. Check the INR and notify the provider immediately
C. Give oral iron supplements
D. Recommend over-the-counter antacids
**Correct Answer:** B – Check the INR and notify the provider
immediately
**Rationale:** Black, tarry stools indicate gastrointestinal bleeding, a
serious complication of warfarin. Immediate assessment (INR) and
provider notification are required. Vitamin K may be ordered based on
INR and bleeding severity.
---
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**5.** A patient receives IV heparin for deep vein thrombosis. Which
laboratory value will the nurse monitor to assess therapeutic effect?
A. INR
B. aPTT
C. Platelet count
D. Prothrombin time
**Correct Answer:** B – aPTT
**Rationale:** Heparin therapy is monitored by activated partial
thromboplastin time (aPTT), with a goal typically 1.5–2.5 times the
normal control value. INR monitors warfarin.
---
**6.** A patient on enoxaparin (Lovenox) is scheduled for spinal
anesthesia. The nurse should take which action?
A. Administer the enoxaparin as ordered
B. Hold the enoxaparin and notify the provider
C. Give protamine sulfate before the procedure
D. Increase the enoxaparin dose
**Correct Answer:** B – Hold the enoxaparin and notify the provider
ATI PHARMACOLOGY PROCTORED EXAM –
200+ REMEDIATION QUESTIONS WITH
RATIONALES (MOST RELIABLE FOR BEST
SCORES)**
# SECTION 1: CARDIOVASCULAR MEDICATIONS (Questions 1–
35)
**1.** A nurse is caring for a patient receiving digoxin. Which finding
is most indicative of digoxin toxicity?
A. Heart rate 72 bpm and blood pressure 120/80 mmHg
B. Nausea, vomiting, and yellow-tinged vision
C. Dry cough and hyperkalemia
D. Constipation and headache
**Correct Answer:** B – Nausea, vomiting, and yellow-tinged vision
**Rationale:** Digoxin toxicity presents with gastrointestinal symptoms
(nausea, vomiting, anorexia), visual disturbances (yellow-green halos,
blurred vision), and cardiac dysrhythmias (bradycardia, heart block).
Hypokalemia increases toxicity risk.
---
,2|Page
**2.** A patient with heart failure is prescribed digoxin and furosemide.
The nurse should monitor for which electrolyte imbalance that increases
digoxin toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
**Correct Answer:** B – Hypokalemia
**Rationale:** Furosemide is a loop diuretic that causes potassium loss.
Hypokalemia increases the risk of digoxin toxicity by enhancing digoxin
binding to cardiac sodium-potassium ATPase pumps.
---
**3.** A patient taking warfarin has an INR of 4.8 without active
bleeding. What is the most appropriate nursing action?
A. Administer vitamin K subcutaneously
B. Hold the next dose and notify the provider
C. Increase the warfarin dose
D. Give protamine sulfate immediately
,3|Page
**Correct Answer:** B – Hold the next dose and notify the provider
**Rationale:** For asymptomatic INR >4.5 but <10, the standard
approach is to hold warfarin and monitor. Vitamin K is reserved for INR
>10 or active bleeding. Protamine reverses heparin, not warfarin.
---
**4.** A patient on warfarin reports black, tarry stools. What is the
priority nursing action?
A. Administer vitamin K intravenously
B. Check the INR and notify the provider immediately
C. Give oral iron supplements
D. Recommend over-the-counter antacids
**Correct Answer:** B – Check the INR and notify the provider
immediately
**Rationale:** Black, tarry stools indicate gastrointestinal bleeding, a
serious complication of warfarin. Immediate assessment (INR) and
provider notification are required. Vitamin K may be ordered based on
INR and bleeding severity.
---
, 4|Page
**5.** A patient receives IV heparin for deep vein thrombosis. Which
laboratory value will the nurse monitor to assess therapeutic effect?
A. INR
B. aPTT
C. Platelet count
D. Prothrombin time
**Correct Answer:** B – aPTT
**Rationale:** Heparin therapy is monitored by activated partial
thromboplastin time (aPTT), with a goal typically 1.5–2.5 times the
normal control value. INR monitors warfarin.
---
**6.** A patient on enoxaparin (Lovenox) is scheduled for spinal
anesthesia. The nurse should take which action?
A. Administer the enoxaparin as ordered
B. Hold the enoxaparin and notify the provider
C. Give protamine sulfate before the procedure
D. Increase the enoxaparin dose
**Correct Answer:** B – Hold the enoxaparin and notify the provider
