1
ATI Pharmacology Proctored Exam 2025 (V1 & V2) |
160 Verified Questions with NGN-Style Rationales & A+
Answers
1.
A 68-year-old patient with a history of chronic heart failure is admitted to the
medical unit with shortness of breath and lower extremity edema. The provider
prescribes digoxin 0.125 mg PO daily. The patient’s apical heart rate is 56 bpm,
blood pressure is 110/72 mmHg, and potassium level is 3.7 mEq/L.
Which of the following actions should the nurse take before administering the
medication?
A. Hold the dose and notify the provider
B. Administer the dose as prescribed
C. Check the patient’s blood glucose level
D. Provide supplemental potassium
, 2
Answer: A. Hold the dose and notify the provider
Rationale: Digoxin slows cardiac conduction and increases myocardial
contractility. Bradycardia (<60 bpm in adults) is a sign of potential digoxin
toxicity and requires the nurse to withhold the medication and notify the
provider. Checking blood glucose or providing potassium is not indicated unless
abnormalities are present, and potassium 3.7 mEq/L is within the normal range.
2.
A 55-year-old patient is newly prescribed warfarin after a diagnosis of deep vein
thrombosis (DVT). During discharge teaching, the patient states, “I eat spinach
and kale salads almost every day.”
Which lab value is most important to monitor to ensure safe anticoagulation?
A. Hemoglobin A1C
B. Sodium (Na⁺)
C. International Normalized Ratio (INR)
D. Potassium (K⁺)
Answer: C. International Normalized Ratio (INR)
Rationale: Warfarin works by inhibiting vitamin K-dependent clotting factors.
Leafy green vegetables like spinach are high in vitamin K, which can reduce
, 3
warfarin’s effectiveness and lower INR, increasing the risk of clot formation.
Monitoring INR ensures the patient remains in the therapeutic range (2–3 for
DVT).
3.
A 72-year-old patient with congestive heart failure is receiving furosemide 40
mg IV push for fluid overload. Morning labs reveal:
• Potassium: 2.9 mEq/L
• Sodium: 139 mEq/L
• Blood Pressure: 134/82 mmHg
Which finding requires immediate intervention?
A. Potassium 2.9 mEq/L
B. Sodium 139 mEq/L
C. Blood pressure 134/82 mmHg
D. Mild thirst
Answer: A. Potassium 2.9 mEq/L
Rationale: Furosemide, a loop diuretic, can cause significant potassium loss. A
potassium level of 2.9 mEq/L is critically low and can lead to life-threatening
, 4
arrhythmias. This is the priority over mild changes in blood pressure or sodium
because cardiac stability is at risk.
4.
A 63-year-old patient is prescribed gentamicin for a severe urinary tract
infection. After three days of therapy, the patient reports decreased urine output
and ringing in the ears (tinnitus).
Which complication should the nurse suspect?
A. Hepatotoxicity
B. Nephrotoxicity
C. Constipation
D. Bradycardia
Answer: B. Nephrotoxicity
Rationale: Aminoglycosides like gentamicin can accumulate in the kidneys and
inner ear, causing nephrotoxicity and ototoxicity. Decreased urine output and
tinnitus indicate toxicity, and the nurse should notify the provider immediately
and monitor BUN, creatinine, and urine output.
ATI Pharmacology Proctored Exam 2025 (V1 & V2) |
160 Verified Questions with NGN-Style Rationales & A+
Answers
1.
A 68-year-old patient with a history of chronic heart failure is admitted to the
medical unit with shortness of breath and lower extremity edema. The provider
prescribes digoxin 0.125 mg PO daily. The patient’s apical heart rate is 56 bpm,
blood pressure is 110/72 mmHg, and potassium level is 3.7 mEq/L.
Which of the following actions should the nurse take before administering the
medication?
A. Hold the dose and notify the provider
B. Administer the dose as prescribed
C. Check the patient’s blood glucose level
D. Provide supplemental potassium
, 2
Answer: A. Hold the dose and notify the provider
Rationale: Digoxin slows cardiac conduction and increases myocardial
contractility. Bradycardia (<60 bpm in adults) is a sign of potential digoxin
toxicity and requires the nurse to withhold the medication and notify the
provider. Checking blood glucose or providing potassium is not indicated unless
abnormalities are present, and potassium 3.7 mEq/L is within the normal range.
2.
A 55-year-old patient is newly prescribed warfarin after a diagnosis of deep vein
thrombosis (DVT). During discharge teaching, the patient states, “I eat spinach
and kale salads almost every day.”
Which lab value is most important to monitor to ensure safe anticoagulation?
A. Hemoglobin A1C
B. Sodium (Na⁺)
C. International Normalized Ratio (INR)
D. Potassium (K⁺)
Answer: C. International Normalized Ratio (INR)
Rationale: Warfarin works by inhibiting vitamin K-dependent clotting factors.
Leafy green vegetables like spinach are high in vitamin K, which can reduce
, 3
warfarin’s effectiveness and lower INR, increasing the risk of clot formation.
Monitoring INR ensures the patient remains in the therapeutic range (2–3 for
DVT).
3.
A 72-year-old patient with congestive heart failure is receiving furosemide 40
mg IV push for fluid overload. Morning labs reveal:
• Potassium: 2.9 mEq/L
• Sodium: 139 mEq/L
• Blood Pressure: 134/82 mmHg
Which finding requires immediate intervention?
A. Potassium 2.9 mEq/L
B. Sodium 139 mEq/L
C. Blood pressure 134/82 mmHg
D. Mild thirst
Answer: A. Potassium 2.9 mEq/L
Rationale: Furosemide, a loop diuretic, can cause significant potassium loss. A
potassium level of 2.9 mEq/L is critically low and can lead to life-threatening
, 4
arrhythmias. This is the priority over mild changes in blood pressure or sodium
because cardiac stability is at risk.
4.
A 63-year-old patient is prescribed gentamicin for a severe urinary tract
infection. After three days of therapy, the patient reports decreased urine output
and ringing in the ears (tinnitus).
Which complication should the nurse suspect?
A. Hepatotoxicity
B. Nephrotoxicity
C. Constipation
D. Bradycardia
Answer: B. Nephrotoxicity
Rationale: Aminoglycosides like gentamicin can accumulate in the kidneys and
inner ear, causing nephrotoxicity and ototoxicity. Decreased urine output and
tinnitus indicate toxicity, and the nurse should notify the provider immediately
and monitor BUN, creatinine, and urine output.
