2023 ATI RN Pharmacology Proctor Actual Exams |
NGN-Style Questions | ATI Nursing Exam, Exams of
2026 Exam · 189 Questions · With Rationales
2023ati.
ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology
Question: 1 of 189
A patient with a history of chronic stable angina is prescribed sublingual nitroglycerin for acute attacks. Which
of the following mechanisms best explains the rapid relief of chest pain?
A. Vasodilation of coronary arteries and arterioles, increasing oxygen supply
B. Reduction in preload and afterload, decreasing myocardial oxygen demand
C. Inhibition of platelet aggregation at the site of plaque rupture
D. Positive inotropic effect, enhancing cardiac output
PREVIOUS CONTINUE
A patient with a history of chronic stable angina is prescribed sublingual nitroglycerin for
acute attacks. Which of the following mechanisms best explains the rapid relief of chest
pain?
A. Vasodilation of coronary arteries and arterioles, increasing oxygen supply
' B. Reduction in preload and afterload, decreasing myocardial oxygen demand
C. Inhibition of platelet aggregation at the site of plaque rupture
D. Positive inotropic effect, enhancing cardiac output
Correct Answer: B
Nitroglycerin primarily dilates venous capacitance vessels, reducing preload, and to a lesser extent dilates
arterioles, reducing afterload. This decreases myocardial oxygen demand, relieving ischemia. It does not
significantly increase oxygen supply via coronary vasodilation in stable angina, nor does it inhibit platelets or
exert positive inotropy.
Page 1 | 2023 ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology 2026
, 2023 ATI RN Pharmacology Proctor Actual Exams |
NGN-Style Questions | ATI Nursing Exam, Exams of
2026 Exam · 189 Questions · With Rationales
2023ati.
ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology
Question: 2 of 189
A patient receiving intravenous heparin for deep vein thrombosis has an activated partial thromboplastin time
(aPTT) of 120 seconds (therapeutic range 60-80 seconds). The nurse anticipates which of the following
A. Administer protamine sulfate 1 mg per 100 units of heparin estimated in the body
B. Hold heparin infusion for 1 hour and decrease rate by 50%
C. Increase heparin infusion rate by 100 units/hour
D. Administer vitamin K 10 mg intravenously
PREVIOUS CONTINUE
A patient receiving intravenous heparin for deep vein thrombosis has an activated partial
thromboplastin time (aPTT) of 120 seconds (therapeutic range 60-80 seconds). The nurse
anticipates which of the following provider orders?
A. Administer protamine sulfate 1 mg per 100 units of heparin estimated in the body
' B. Hold heparin infusion for 1 hour and decrease rate by 50%
C. Increase heparin infusion rate by 100 units/hour
D. Administer vitamin K 10 mg intravenously
Correct Answer: B
An aPTT of 120 seconds indicates supratherapeutic anticoagulation, increasing bleeding risk. Standard protocol
recommends holding heparin until aPTT returns to therapeutic range, then resuming at a lower rate. Protamine
sulfate is used for severe bleeding or reversal, not routine over-anticoagulation. Vitamin K reverses warfarin,
not heparin.
Page 2 | 2023 ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology 2026
, 2023 ATI RN Pharmacology Proctor Actual Exams |
NGN-Style Questions | ATI Nursing Exam, Exams of
2026 Exam · 189 Questions · With Rationales
2023ati.
ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology
Question: 3 of 189
A patient with type 2 diabetes mellitus is started on metformin. Which of the following laboratory values should
be monitored before initiation and periodically thereafter to prevent a life-threatening adverse effect?
A. Serum creatinine and estimated glomerular filtration rate
B. Liver function tests including ALT and AST
C. Complete blood count with differential
D. Serum potassium and magnesium levels
PREVIOUS CONTINUE
A patient with type 2 diabetes mellitus is started on metformin. Which of the following
laboratory values should be monitored before initiation and periodically thereafter to
prevent a life-threatening adverse effect?
' A. Serum creatinine and estimated glomerular filtration rate
B. Liver function tests including ALT and AST
C. Complete blood count with differential
D. Serum potassium and magnesium levels
Correct Answer: A
Metformin is contraindicated in patients with significant renal impairment (eGFR <30 mL/min) due to the risk of
lactic acidosis. Renal function must be assessed before starting therapy and monitored annually or more
frequently in at-risk patients. Lactic acidosis is rare but often fatal; other options are not required for metformin
safety.
Page 3 | 2023 ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology 2026
, 2023 ATI RN Pharmacology Proctor Actual Exams |
NGN-Style Questions | ATI Nursing Exam, Exams of
2026 Exam · 189 Questions · With Rationales
2023ati.
ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology
Question: 4 of 189
A patient receiving morphine sulfate via patient-controlled analgesia (PCA) has a respiratory rate of 8 breaths
per minute and is difficult to arouse. Which of the following is the priority nursing action?
A. Administer naloxone 0.4 mg intravenously and repeat every 2 minutes as needed
B. Increase the oxygen flow rate to 4 L/min via nasal cannula
C. Stop the PCA infusion and call the provider for a decrease in dose
D. Administer flumazenil 0.2 mg intravenously over 30 seconds
PREVIOUS CONTINUE
A patient receiving morphine sulfate via patient-controlled analgesia (PCA) has a
respiratory rate of 8 breaths per minute and is difficult to arouse. Which of the following is
the priority nursing action?
' A. Administer naloxone 0.4 mg intravenously and repeat every 2 minutes as needed
B. Increase the oxygen flow rate to 4 L/min via nasal cannula
C. Stop the PCA infusion and call the provider for a decrease in dose
D. Administer flumazenil 0.2 mg intravenously over 30 seconds
Correct Answer: A
Morphine overdose causing respiratory depression and decreased level of consciousness requires immediate
reversal with naloxone, a competitive opioid antagonist. Naloxone should be titrated to restore adequate
respirations without precipitating severe withdrawal. Oxygen alone is insufficient; flumazenil reverses
benzodiazepines, not opioids.
Page 4 | 2023 ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology 2026
NGN-Style Questions | ATI Nursing Exam, Exams of
2026 Exam · 189 Questions · With Rationales
2023ati.
ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology
Question: 1 of 189
A patient with a history of chronic stable angina is prescribed sublingual nitroglycerin for acute attacks. Which
of the following mechanisms best explains the rapid relief of chest pain?
A. Vasodilation of coronary arteries and arterioles, increasing oxygen supply
B. Reduction in preload and afterload, decreasing myocardial oxygen demand
C. Inhibition of platelet aggregation at the site of plaque rupture
D. Positive inotropic effect, enhancing cardiac output
PREVIOUS CONTINUE
A patient with a history of chronic stable angina is prescribed sublingual nitroglycerin for
acute attacks. Which of the following mechanisms best explains the rapid relief of chest
pain?
A. Vasodilation of coronary arteries and arterioles, increasing oxygen supply
' B. Reduction in preload and afterload, decreasing myocardial oxygen demand
C. Inhibition of platelet aggregation at the site of plaque rupture
D. Positive inotropic effect, enhancing cardiac output
Correct Answer: B
Nitroglycerin primarily dilates venous capacitance vessels, reducing preload, and to a lesser extent dilates
arterioles, reducing afterload. This decreases myocardial oxygen demand, relieving ischemia. It does not
significantly increase oxygen supply via coronary vasodilation in stable angina, nor does it inhibit platelets or
exert positive inotropy.
Page 1 | 2023 ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology 2026
, 2023 ATI RN Pharmacology Proctor Actual Exams |
NGN-Style Questions | ATI Nursing Exam, Exams of
2026 Exam · 189 Questions · With Rationales
2023ati.
ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology
Question: 2 of 189
A patient receiving intravenous heparin for deep vein thrombosis has an activated partial thromboplastin time
(aPTT) of 120 seconds (therapeutic range 60-80 seconds). The nurse anticipates which of the following
A. Administer protamine sulfate 1 mg per 100 units of heparin estimated in the body
B. Hold heparin infusion for 1 hour and decrease rate by 50%
C. Increase heparin infusion rate by 100 units/hour
D. Administer vitamin K 10 mg intravenously
PREVIOUS CONTINUE
A patient receiving intravenous heparin for deep vein thrombosis has an activated partial
thromboplastin time (aPTT) of 120 seconds (therapeutic range 60-80 seconds). The nurse
anticipates which of the following provider orders?
A. Administer protamine sulfate 1 mg per 100 units of heparin estimated in the body
' B. Hold heparin infusion for 1 hour and decrease rate by 50%
C. Increase heparin infusion rate by 100 units/hour
D. Administer vitamin K 10 mg intravenously
Correct Answer: B
An aPTT of 120 seconds indicates supratherapeutic anticoagulation, increasing bleeding risk. Standard protocol
recommends holding heparin until aPTT returns to therapeutic range, then resuming at a lower rate. Protamine
sulfate is used for severe bleeding or reversal, not routine over-anticoagulation. Vitamin K reverses warfarin,
not heparin.
Page 2 | 2023 ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology 2026
, 2023 ATI RN Pharmacology Proctor Actual Exams |
NGN-Style Questions | ATI Nursing Exam, Exams of
2026 Exam · 189 Questions · With Rationales
2023ati.
ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology
Question: 3 of 189
A patient with type 2 diabetes mellitus is started on metformin. Which of the following laboratory values should
be monitored before initiation and periodically thereafter to prevent a life-threatening adverse effect?
A. Serum creatinine and estimated glomerular filtration rate
B. Liver function tests including ALT and AST
C. Complete blood count with differential
D. Serum potassium and magnesium levels
PREVIOUS CONTINUE
A patient with type 2 diabetes mellitus is started on metformin. Which of the following
laboratory values should be monitored before initiation and periodically thereafter to
prevent a life-threatening adverse effect?
' A. Serum creatinine and estimated glomerular filtration rate
B. Liver function tests including ALT and AST
C. Complete blood count with differential
D. Serum potassium and magnesium levels
Correct Answer: A
Metformin is contraindicated in patients with significant renal impairment (eGFR <30 mL/min) due to the risk of
lactic acidosis. Renal function must be assessed before starting therapy and monitored annually or more
frequently in at-risk patients. Lactic acidosis is rare but often fatal; other options are not required for metformin
safety.
Page 3 | 2023 ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology 2026
, 2023 ATI RN Pharmacology Proctor Actual Exams |
NGN-Style Questions | ATI Nursing Exam, Exams of
2026 Exam · 189 Questions · With Rationales
2023ati.
ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology
Question: 4 of 189
A patient receiving morphine sulfate via patient-controlled analgesia (PCA) has a respiratory rate of 8 breaths
per minute and is difficult to arouse. Which of the following is the priority nursing action?
A. Administer naloxone 0.4 mg intravenously and repeat every 2 minutes as needed
B. Increase the oxygen flow rate to 4 L/min via nasal cannula
C. Stop the PCA infusion and call the provider for a decrease in dose
D. Administer flumazenil 0.2 mg intravenously over 30 seconds
PREVIOUS CONTINUE
A patient receiving morphine sulfate via patient-controlled analgesia (PCA) has a
respiratory rate of 8 breaths per minute and is difficult to arouse. Which of the following is
the priority nursing action?
' A. Administer naloxone 0.4 mg intravenously and repeat every 2 minutes as needed
B. Increase the oxygen flow rate to 4 L/min via nasal cannula
C. Stop the PCA infusion and call the provider for a decrease in dose
D. Administer flumazenil 0.2 mg intravenously over 30 seconds
Correct Answer: A
Morphine overdose causing respiratory depression and decreased level of consciousness requires immediate
reversal with naloxone, a competitive opioid antagonist. Naloxone should be titrated to restore adequate
respirations without precipitating severe withdrawal. Oxygen alone is insufficient; flumazenil reverses
benzodiazepines, not opioids.
Page 4 | 2023 ATI RN Pharmacology Proctor Actual Exams | NGN-Style Questions | ATI Nursing Exam, Exams of Pharmacology 2026
