RN ATI PHARMACOLOGY
,Questions 1–10: Medication Safety & Administration
Question 1
A nurse is preparing to administer medications to a client. Which action follows the "Rights of
Medication Administration"?
A. Crushing a sustained-release pill for easier swallowing
B. Checking the client's ID band after giving the medication
C. Identifying the client using two identifiers (name and birth date)
D. Documenting administration before giving the medication
Answer: C
Rationale: Two client identifiers (e.g., name, DOB, MRN) are required before administration.
Never crush sustained-release medications unless specified. Check ID before giving meds.
Document after administration, not before.
Question 2
A nurse receives a verbal order for morphine 4 mg IV push. Which action should the nurse take?
A. Repeat the order back to the provider exactly as heard
B. Administer the medication immediately
C. Have another nurse listen to the order
D. Ask the provider to write the order within 24 hours
Answer: A
Rationale: For verbal orders, use read-back (repeat order to provider for verification). Then
write the order, obtain signature per policy (usually within 24 hours). Never administer without
verification.
Question 3
A client refuses a scheduled dose of lisinopril. What is the priority nursing action?
A. Hide the medication in the client's food
B. Document the refusal and notify the provider
C. Educate the client on the risks of nonadherence
D. Ask a family member to convince the client
Answer: B
Rationale: Client has the right to refuse. Document refusal, notify provider, try to understand
reason (side effects? cost?). Do not coerce or hide medications.
Question 4
A nurse is calculating a dosage for a pediatric client. Which action is most important?
A. Use the client's weight in pounds for all calculations
B. Round the final dose to the nearest milliliter
,C. Double-check the calculation with another nurse
D. Use a standard adult dose for children over 12 years
Answer: C
Rationale: Pediatric calculations have high risk for error. Independent double-check by second
nurse is critical. Use weight in kg (not lb). Round according to policy.
Question 5
Which medication order requires clarification before administration?
A. Metoprolol 25 mg PO daily
B. Digoxin 0.125 mg PO every morning
C. Insulin aspart 10 units subcut with meals
D. Furosemide 40 mg IV push "as needed"
Answer: D
Rationale: "As needed" (PRN) orders for IV loop diuretics are inappropriate unless specific
indication is stated (e.g., “for shortness of breath with crackles”). PRN IV diuretics can cause
rapid electrolyte imbalance.
Question 6
A client has a latex allergy. Which medication should the nurse avoid?
A. Oral acetaminophen
B. IV furosemide via vial with rubber stopper
C. Subcutaneous insulin via pen device
D. Inhaled albuterol via plastic inhaler
Answer: B
Rationale: Many vial stoppers contain latex. Use latex-free vials or ampules for clients with
latex allergy. Inhalers and most oral meds are safe.
Question 7
A nurse is administering an enteral feeding via NG tube. Which medication should never be
crushed?
A. Enteric-coated aspirin 81 mg
B. Metoprolol tartrate 25 mg
C. Levothyroxine 100 mcg
D. Furosemide 40 mg
Answer: A
Rationale: Enteric-coated tablets protect the stomach or delay release. Crushing causes gastric
irritation or dumping. Extended-release, sustained-release, and enteric-coated meds should not be
crushed.
, Question 8
A nurse administers IV vancomycin over 30 minutes instead of 60 minutes. The client develops
flushing and hypotension. What is the most likely cause?
A. Anaphylactic reaction
B. Stevens-Johnson syndrome
C. Red man syndrome
D. Extravasation
Answer: C
Rationale: Red man syndrome occurs with rapid vancomycin infusion (histamine release).
Slowing the infusion rate prevents it. Not an IgE-mediated allergy.
Question 9
A client is discharged with multiple medications. Which statement indicates a need for further
teaching?
A. "I will use one pharmacy for all my prescriptions."
B. "I will keep my medications in a weekly pill organizer."
C. "I will stop taking my blood pressure meds if I feel dizzy."
D. "I will bring my medication list to every appointment."
Answer: C
Rationale: Stopping antihypertensives without provider guidance can cause rebound
hypertension or stroke. Dizziness should be reported, but don't stop meds.
Question 10
A nurse drops a tablet of clopidogrel on the floor. What should the nurse do?
A. Rinse the tablet with sterile water and administer it
B. Discard the tablet and obtain a new one
C. Wipe the tablet with an alcohol swab
D. Administer it if the floor appeared clean
Answer: B
Rationale: Contaminated medications must be discarded. Patient safety first. Never rinse or
wipe – risk of infection and altered medication.
Questions 11–20: Cardiovascular Medications
Question 11
A client on digoxin has serum digoxin level of 2.5 ng/mL (therapeutic: 0.8–2.0). Which finding
would the nurse expect?
,Questions 1–10: Medication Safety & Administration
Question 1
A nurse is preparing to administer medications to a client. Which action follows the "Rights of
Medication Administration"?
A. Crushing a sustained-release pill for easier swallowing
B. Checking the client's ID band after giving the medication
C. Identifying the client using two identifiers (name and birth date)
D. Documenting administration before giving the medication
Answer: C
Rationale: Two client identifiers (e.g., name, DOB, MRN) are required before administration.
Never crush sustained-release medications unless specified. Check ID before giving meds.
Document after administration, not before.
Question 2
A nurse receives a verbal order for morphine 4 mg IV push. Which action should the nurse take?
A. Repeat the order back to the provider exactly as heard
B. Administer the medication immediately
C. Have another nurse listen to the order
D. Ask the provider to write the order within 24 hours
Answer: A
Rationale: For verbal orders, use read-back (repeat order to provider for verification). Then
write the order, obtain signature per policy (usually within 24 hours). Never administer without
verification.
Question 3
A client refuses a scheduled dose of lisinopril. What is the priority nursing action?
A. Hide the medication in the client's food
B. Document the refusal and notify the provider
C. Educate the client on the risks of nonadherence
D. Ask a family member to convince the client
Answer: B
Rationale: Client has the right to refuse. Document refusal, notify provider, try to understand
reason (side effects? cost?). Do not coerce or hide medications.
Question 4
A nurse is calculating a dosage for a pediatric client. Which action is most important?
A. Use the client's weight in pounds for all calculations
B. Round the final dose to the nearest milliliter
,C. Double-check the calculation with another nurse
D. Use a standard adult dose for children over 12 years
Answer: C
Rationale: Pediatric calculations have high risk for error. Independent double-check by second
nurse is critical. Use weight in kg (not lb). Round according to policy.
Question 5
Which medication order requires clarification before administration?
A. Metoprolol 25 mg PO daily
B. Digoxin 0.125 mg PO every morning
C. Insulin aspart 10 units subcut with meals
D. Furosemide 40 mg IV push "as needed"
Answer: D
Rationale: "As needed" (PRN) orders for IV loop diuretics are inappropriate unless specific
indication is stated (e.g., “for shortness of breath with crackles”). PRN IV diuretics can cause
rapid electrolyte imbalance.
Question 6
A client has a latex allergy. Which medication should the nurse avoid?
A. Oral acetaminophen
B. IV furosemide via vial with rubber stopper
C. Subcutaneous insulin via pen device
D. Inhaled albuterol via plastic inhaler
Answer: B
Rationale: Many vial stoppers contain latex. Use latex-free vials or ampules for clients with
latex allergy. Inhalers and most oral meds are safe.
Question 7
A nurse is administering an enteral feeding via NG tube. Which medication should never be
crushed?
A. Enteric-coated aspirin 81 mg
B. Metoprolol tartrate 25 mg
C. Levothyroxine 100 mcg
D. Furosemide 40 mg
Answer: A
Rationale: Enteric-coated tablets protect the stomach or delay release. Crushing causes gastric
irritation or dumping. Extended-release, sustained-release, and enteric-coated meds should not be
crushed.
, Question 8
A nurse administers IV vancomycin over 30 minutes instead of 60 minutes. The client develops
flushing and hypotension. What is the most likely cause?
A. Anaphylactic reaction
B. Stevens-Johnson syndrome
C. Red man syndrome
D. Extravasation
Answer: C
Rationale: Red man syndrome occurs with rapid vancomycin infusion (histamine release).
Slowing the infusion rate prevents it. Not an IgE-mediated allergy.
Question 9
A client is discharged with multiple medications. Which statement indicates a need for further
teaching?
A. "I will use one pharmacy for all my prescriptions."
B. "I will keep my medications in a weekly pill organizer."
C. "I will stop taking my blood pressure meds if I feel dizzy."
D. "I will bring my medication list to every appointment."
Answer: C
Rationale: Stopping antihypertensives without provider guidance can cause rebound
hypertension or stroke. Dizziness should be reported, but don't stop meds.
Question 10
A nurse drops a tablet of clopidogrel on the floor. What should the nurse do?
A. Rinse the tablet with sterile water and administer it
B. Discard the tablet and obtain a new one
C. Wipe the tablet with an alcohol swab
D. Administer it if the floor appeared clean
Answer: B
Rationale: Contaminated medications must be discarded. Patient safety first. Never rinse or
wipe – risk of infection and altered medication.
Questions 11–20: Cardiovascular Medications
Question 11
A client on digoxin has serum digoxin level of 2.5 ng/mL (therapeutic: 0.8–2.0). Which finding
would the nurse expect?
