ATI RN Pharmacology Proctored Exam Retake 2023/2026 with NGN 180 Verified
Questions
🩺 SECTION 1: CARDIOVASCULAR MEDICATIONS
1. A client with heart failure is prescribed sacubitril/valsartan (Entresto). Which
adverse effect requires immediate provider notification?
A. Dry cough
B. Angioedema
C. Dizziness
D. Hypotension
Answer: B
Rationale: Angioedema (swelling of lips, tongue, throat) is a life-threatening
adverse effect of ARNI therapy. The medication should be discontinued
immediately .
2. A client on apixaban (Eliquis) for atrial fibrillation is scheduled for a
colonoscopy. The nurse should advise the client to:
A. Stop apixaban 48 hours before the procedure per provider order
B. Continue apixaban as usual
,C. Double the dose the day before
D. Switch to warfarin temporarily
Answer: A
Rationale: DOACs (apixaban, rivaroxaban) are typically held 24-48 hours before
invasive procedures based on bleeding risk and renal function .
3. A client on warfarin (Coumadin) has an INR of 4.5 (therapeutic range 2-3).
Which actions are correct? (Select all that apply)
A. Hold the next dose of warfarin
B. Administer vitamin K orally or IV as ordered
C. Check for signs of bleeding
D. Increase the warfarin dose
E. Notify the provider
Answer: A, B, C, E
Rationale: INR >3.5 typically requires holding the dose. Vitamin K is the reversal
agent. Bleeding assessment is essential. Increasing warfarin would worsen the
elevation .
,4. A patient is receiving IV heparin for DVT. Which interventions are appropriate?
(Select all that apply)
A. Monitor aPTT every 6 hours
B. Have protamine sulfate at the bedside
C. Infuse heparin through the same line as a continuous vancomycin drip
D. Apply firm pressure after removing an IV site
E. Massage the abdomen after subcutaneous heparin
Answer: A, B, D
Rationale: aPTT guides dosing (1.5-2.5× control). Protamine is the antidote.
Pressure prevents hematoma/bleeding. No other medications should be mixed in
the heparin line. Never massage subcutaneous heparin sites .
5. A client on clopidogrel (Plavix) after a coronary stent placement. Which
statement indicates understanding?
A. "I can stop this medication if I have no chest pain."
B. "I will take this medication with food to prevent bleeding."
C. "I will not stop this medication without my provider's approval."
D. "I can take ibuprofen for headaches."
, Answer: C
Rationale: Premature discontinuation of antiplatelet therapy after stent
placement increases the risk of stent thrombosis, MI, and death .
6. A client is prescribed nitroglycerin sublingual for angina. Which teaching
statements are correct? (Select all that apply)
A. Take one tablet at the first sign of chest pain
B. If pain is not relieved after 3 doses (one every 5 minutes), call 911
C. Store tablets in the original glass bottle with the cap tightly closed
D. Swallow the tablet for faster effect
E. Expect a headache, which usually decreases with continued use
Answer: A, B, C, E
Rationale: Dose: up to 3 tablets (0.4 mg) q5min. Three-plus doses with no relief =
possible MI. Keep in glass bottle (plastic absorbs drug). Headache is common
(vasodilation). Sublingual = under tongue; swallowing inactivates it .
7. A client is taking digoxin 0.125 mg daily. Which findings suggest digoxin
toxicity? (Select all that apply)
A. Yellow-green halos around lights
Questions
🩺 SECTION 1: CARDIOVASCULAR MEDICATIONS
1. A client with heart failure is prescribed sacubitril/valsartan (Entresto). Which
adverse effect requires immediate provider notification?
A. Dry cough
B. Angioedema
C. Dizziness
D. Hypotension
Answer: B
Rationale: Angioedema (swelling of lips, tongue, throat) is a life-threatening
adverse effect of ARNI therapy. The medication should be discontinued
immediately .
2. A client on apixaban (Eliquis) for atrial fibrillation is scheduled for a
colonoscopy. The nurse should advise the client to:
A. Stop apixaban 48 hours before the procedure per provider order
B. Continue apixaban as usual
,C. Double the dose the day before
D. Switch to warfarin temporarily
Answer: A
Rationale: DOACs (apixaban, rivaroxaban) are typically held 24-48 hours before
invasive procedures based on bleeding risk and renal function .
3. A client on warfarin (Coumadin) has an INR of 4.5 (therapeutic range 2-3).
Which actions are correct? (Select all that apply)
A. Hold the next dose of warfarin
B. Administer vitamin K orally or IV as ordered
C. Check for signs of bleeding
D. Increase the warfarin dose
E. Notify the provider
Answer: A, B, C, E
Rationale: INR >3.5 typically requires holding the dose. Vitamin K is the reversal
agent. Bleeding assessment is essential. Increasing warfarin would worsen the
elevation .
,4. A patient is receiving IV heparin for DVT. Which interventions are appropriate?
(Select all that apply)
A. Monitor aPTT every 6 hours
B. Have protamine sulfate at the bedside
C. Infuse heparin through the same line as a continuous vancomycin drip
D. Apply firm pressure after removing an IV site
E. Massage the abdomen after subcutaneous heparin
Answer: A, B, D
Rationale: aPTT guides dosing (1.5-2.5× control). Protamine is the antidote.
Pressure prevents hematoma/bleeding. No other medications should be mixed in
the heparin line. Never massage subcutaneous heparin sites .
5. A client on clopidogrel (Plavix) after a coronary stent placement. Which
statement indicates understanding?
A. "I can stop this medication if I have no chest pain."
B. "I will take this medication with food to prevent bleeding."
C. "I will not stop this medication without my provider's approval."
D. "I can take ibuprofen for headaches."
, Answer: C
Rationale: Premature discontinuation of antiplatelet therapy after stent
placement increases the risk of stent thrombosis, MI, and death .
6. A client is prescribed nitroglycerin sublingual for angina. Which teaching
statements are correct? (Select all that apply)
A. Take one tablet at the first sign of chest pain
B. If pain is not relieved after 3 doses (one every 5 minutes), call 911
C. Store tablets in the original glass bottle with the cap tightly closed
D. Swallow the tablet for faster effect
E. Expect a headache, which usually decreases with continued use
Answer: A, B, C, E
Rationale: Dose: up to 3 tablets (0.4 mg) q5min. Three-plus doses with no relief =
possible MI. Keep in glass bottle (plastic absorbs drug). Headache is common
(vasodilation). Sublingual = under tongue; swallowing inactivates it .
7. A client is taking digoxin 0.125 mg daily. Which findings suggest digoxin
toxicity? (Select all that apply)
A. Yellow-green halos around lights
