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ATI RN Pharmacology Proctored Exam 2025 | 75 Real
NGN Questions + Detailed Rationales | Medications, Side
Effects, Toxicities & Nursing Interventions
Question 1
A nurse is caring for a 68-year-old patient with a history of chronic atrial fibrillation who
has been prescribed warfarin. The patient states they have recently begun taking herbal
supplements, including ginkgo biloba. Which of the following actions should the nurse
take?
A. Instruct the patient to stop all herbal supplements immediately
B. Monitor the patient for signs of bleeding and notify the provider
C. Suggest switching from warfarin to aspirin therapy
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D. Reassure the patient that herbal supplements are natural and safe
E. Schedule the next INR check in 4 weeks
Correct Answer: B
Rationale:
Ginkgo biloba can increase the risk of bleeding when taken concurrently with
anticoagulants like warfarin due to its antiplatelet properties. The nurse should closely
monitor the patient for signs of bleeding (e.g., bruising, hematuria, melena) and
immediately notify the provider to assess the potential need for adjusting the warfarin
dose or stopping the supplement. Herbal products often interact with medications and
should be reviewed thoroughly. Abruptly stopping all supplements (Option A) may not
be realistic without provider input, and Option C involves a medication change outside
the nurse’s scope. Waiting 4 weeks (Option E) is unsafe given the risk.
Question 2
A patient in the emergency department is being treated for acute angina and is
administered sublingual nitroglycerin. Which nursing action is priority following
administration?
A. Encourage fluid intake to prevent dehydration
B. Place the patient in a supine position to prevent dizziness
C. Reassess pain level after 30 minutes
D. Administer a second dose immediately after the first
E. Instruct the patient to chew the tablet thoroughly
, 3
Correct Answer: B
Rationale:
Nitroglycerin causes systemic vasodilation, which can result in significant hypotension
and dizziness. Therefore, the priority nursing action is to place the patient in a supine or
semi-Fowler's position to reduce the risk of falls and maintain cerebral perfusion. Option
C delays pain reassessment unnecessarily (it should be done within 5 minutes), and
chewing the tablet (Option E) is contraindicated as sublingual nitroglycerin must dissolve
under the tongue. Option D violates safety guidelines, which require spacing doses 5
minutes apart if chest pain persists, and Option A is not immediately relevant.
Question 3
A nurse is preparing to administer vancomycin IV to a client with MRSA pneumonia.
Which of the following assessments should the nurse prioritize before initiating therapy?
A. Liver enzyme levels
B. Cardiac rhythm
C. Trough vancomycin level
D. Capillary blood glucose
E. Mental status and cognition
Correct Answer: C
Rationale:
Vancomycin has a narrow therapeutic index and can cause nephrotoxicity and ototoxicity
if not dosed correctly. The trough level must be assessed prior to administration to
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ensure the drug is within therapeutic range (usually 10–20 mcg/mL). If the level is too
high, the provider may adjust the dose or timing. Cardiac rhythm, blood glucose, and
liver enzymes are not directly relevant to vancomycin toxicity, and changes in mental
status are not typical early indicators of toxicity for this drug.
Question 4
A nurse is caring for a client who is taking furosemide for heart failure. The client
reports generalized weakness and muscle cramps. Which laboratory value is the nurse’s
priority to assess?
A. Sodium
B. Creatinine
C. Potassium
D. Hemoglobin
E. Chloride
Correct Answer: C
Rationale:
Furosemide, a loop diuretic, can lead to significant potassium loss, causing symptoms
like muscle cramps, weakness, and even dysrhythmias. Hypokalemia is a life-threatening
electrolyte imbalance and should be evaluated promptly. Sodium and chloride may also
decrease, but potassium is the most critical. Creatinine indicates kidney function but isn’t
related to acute muscle symptoms. Hemoglobin changes aren’t expected with furosemide
unless there's concurrent blood loss or chronic anemia.
ATI RN Pharmacology Proctored Exam 2025 | 75 Real
NGN Questions + Detailed Rationales | Medications, Side
Effects, Toxicities & Nursing Interventions
Question 1
A nurse is caring for a 68-year-old patient with a history of chronic atrial fibrillation who
has been prescribed warfarin. The patient states they have recently begun taking herbal
supplements, including ginkgo biloba. Which of the following actions should the nurse
take?
A. Instruct the patient to stop all herbal supplements immediately
B. Monitor the patient for signs of bleeding and notify the provider
C. Suggest switching from warfarin to aspirin therapy
, 2
D. Reassure the patient that herbal supplements are natural and safe
E. Schedule the next INR check in 4 weeks
Correct Answer: B
Rationale:
Ginkgo biloba can increase the risk of bleeding when taken concurrently with
anticoagulants like warfarin due to its antiplatelet properties. The nurse should closely
monitor the patient for signs of bleeding (e.g., bruising, hematuria, melena) and
immediately notify the provider to assess the potential need for adjusting the warfarin
dose or stopping the supplement. Herbal products often interact with medications and
should be reviewed thoroughly. Abruptly stopping all supplements (Option A) may not
be realistic without provider input, and Option C involves a medication change outside
the nurse’s scope. Waiting 4 weeks (Option E) is unsafe given the risk.
Question 2
A patient in the emergency department is being treated for acute angina and is
administered sublingual nitroglycerin. Which nursing action is priority following
administration?
A. Encourage fluid intake to prevent dehydration
B. Place the patient in a supine position to prevent dizziness
C. Reassess pain level after 30 minutes
D. Administer a second dose immediately after the first
E. Instruct the patient to chew the tablet thoroughly
, 3
Correct Answer: B
Rationale:
Nitroglycerin causes systemic vasodilation, which can result in significant hypotension
and dizziness. Therefore, the priority nursing action is to place the patient in a supine or
semi-Fowler's position to reduce the risk of falls and maintain cerebral perfusion. Option
C delays pain reassessment unnecessarily (it should be done within 5 minutes), and
chewing the tablet (Option E) is contraindicated as sublingual nitroglycerin must dissolve
under the tongue. Option D violates safety guidelines, which require spacing doses 5
minutes apart if chest pain persists, and Option A is not immediately relevant.
Question 3
A nurse is preparing to administer vancomycin IV to a client with MRSA pneumonia.
Which of the following assessments should the nurse prioritize before initiating therapy?
A. Liver enzyme levels
B. Cardiac rhythm
C. Trough vancomycin level
D. Capillary blood glucose
E. Mental status and cognition
Correct Answer: C
Rationale:
Vancomycin has a narrow therapeutic index and can cause nephrotoxicity and ototoxicity
if not dosed correctly. The trough level must be assessed prior to administration to
, 4
ensure the drug is within therapeutic range (usually 10–20 mcg/mL). If the level is too
high, the provider may adjust the dose or timing. Cardiac rhythm, blood glucose, and
liver enzymes are not directly relevant to vancomycin toxicity, and changes in mental
status are not typical early indicators of toxicity for this drug.
Question 4
A nurse is caring for a client who is taking furosemide for heart failure. The client
reports generalized weakness and muscle cramps. Which laboratory value is the nurse’s
priority to assess?
A. Sodium
B. Creatinine
C. Potassium
D. Hemoglobin
E. Chloride
Correct Answer: C
Rationale:
Furosemide, a loop diuretic, can lead to significant potassium loss, causing symptoms
like muscle cramps, weakness, and even dysrhythmias. Hypokalemia is a life-threatening
electrolyte imbalance and should be evaluated promptly. Sodium and chloride may also
decrease, but potassium is the most critical. Creatinine indicates kidney function but isn’t
related to acute muscle symptoms. Hemoglobin changes aren’t expected with furosemide
unless there's concurrent blood loss or chronic anemia.
