PHARMACOLOGY
PROCTORED EXAM
(NGN-STYLE QUESTIONS & CASE “SCENARIO”)
Actual Qs & Ans to Pass the Exam
This ATI test contains:
➢ Passing Score Guarantee
➢ Exam has 70 PHARMACOLOGY nursing questions
➢ multiple-choice format (A, B, C, D) with correct
answers
➢ structured rationales.
➢ incorporate Next Generation NCLEX (NGN)-style.
➢ Some questions feature brief “scenario” elements and rationales.
,1. A nurse is reviewing the medication administration record of a
client who has an NG tube. Which of the following medications should
the nurse plan to administer through the NG tube?
A. Lovastatin
B. Warfarin
C. Metoprolol
D. Furosemide
Answer: C. Metoprolol
Expert Rationale:
Lovastatin tablets are extended-release formulations that should not be
crushed and administered via NG tube due to alteration of drug absorption
and effect. Metoprolol tablets can be crushed and safely given via NG tube.
The nurse must know which medications can be crushed or administered
through feeding tubes without affecting their efficacy or safety. Warfarin and
furosemide can be crushed if prescribed, but specific instructions must be
followed.
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2. A nurse is collecting data from a client who is taking lithium
carbonate to treat bipolar disorder. For which of the following findings
should the nurse monitor and report to the provider?
A. Fine tremor
B. Constipation
C. Hypotension
,D. Bradycardia
Answer: A. Fine tremor
Expert Rationale:
Tremors can be an early sign of lithium toxicity and should always be
monitored. Lithium has a narrow therapeutic window, and manifestations
like tremor, confusion, or gastrointestinal upset require prompt evaluation.
Constipation, hypotension, and bradycardia are not primary adverse effects
of lithium.
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3. A nurse is caring for a client who has prescriptions for
spironolactone and lisinopril. The nurse should monitor for which of
the following adverse effects?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B. Hyperkalemia
Expert Rationale:
Both spironolactone (a potassium-sparing diuretic) and lisinopril (an ACE
inhibitor) can increase serum potassium levels, increasing the risk of
,hyperkalemia, which can cause cardiac arrhythmias. Monitoring potassium
levels is essential when these drugs are combined.
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4. A nurse is preparing to administer acetaminophen 650 mg rectally.
Which of the following actions should the nurse take?
A. Insert the suppository 5 cm (2 in) into the client's rectum.
B. Warm the suppository to body temperature before administration.
C. Have the client void before inserting the suppository.
D. Remove packaging after inserting the suppository.
Answer: A. Insert the suppository 5 cm (2 in) into the client's rectum.
Expert Rationale:
Proper insertion depth ensures the suppository is retained in the rectum for
absorption. Inserting it approximately 5 cm (2 in) past the anal sphincter
helps reduce the risk of expulsion. It is important to remove packaging
before insertion, and warming the suppository is unnecessary and can
cause melting.
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5. A nurse is collecting data from a client who takes furosemide daily
for heart failure. Which of the following laboratory values should the
nurse review before administering the medication?
A. Serum sodium
,B. Serum potassium
C. Serum magnesium
D. Serum calcium
Answer: B. Serum potassium
Expert Rationale:
Furosemide is a loop diuretic that can cause significant potassium loss,
leading to hypokalemia. Hypokalemia can cause cardiac arrhythmias,
especially in clients with heart failure. Serum potassium levels must be
checked prior to administration.
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6. A nurse is caring for a client who has a new prescription for
valproic acid. The nurse should review which of the following
baseline laboratory values prior to administering the medication?
A. Renal function tests
B. Liver function tests
C. Electrolyte panel
D. Complete blood count
Answer: B. Liver function tests
Expert Rationale:
,Valproic acid has hepatotoxic potential; therefore, baseline liver function
tests (LFTs) are necessary before administration to monitor for
hepatotoxicity during therapy. Renal function tests are less critical unless
the client has concomitant renal disease.
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7. A nurse is caring for a client who is postoperative. For which of the
following findings should the nurse administer ondansetron?
A. Client reports nausea
B. Client has abdominal distension
C. Client reports headache
D. Client develops diarrhea
Answer: A. Client reports nausea
Expert Rationale:
Ondansetron is an antiemetic medication commonly given to control
postoperative nausea and vomiting. Administering it when the client reports
nausea helps prevent or reduce vomiting.
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8. A nurse is reinforcing teaching with a client who has diabetes
mellitus and takes insulin glargine and insulin aspart. Which of the
following actions indicates that the client understands the
instructions?
,A. The client mixes insulin glargine and insulin aspart in one syringe before
administration.
B. The client administers insulin glargine at the same time every day.
C. The client injects insulin aspart once daily.
D. The client skips meals after administering insulin aspart.
Answer: B. The client administers insulin glargine at the same time every
day.
Expert Rationale:
Insulin glargine is a long-acting insulin and should be administered at the
same time daily for consistent basal insulin levels. Insulin aspart is a rapid-
acting insulin taken with meals. Mixing insulin glargine with other insulins is
not recommended.
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9. A nurse is reinforcing teaching with a young adult client who has a
new prescription for ear drops. Which of the following instructions
should the nurse include?
A. Pull the pinna down and back to administer medication.
B. Pull the pinna up and back to administer medication.
C. Place the client in supine position during administration.
D. Administer drops without warming the bottle.
Answer: B. Pull the pinna up and back to administer medication.
, Expert Rationale:
For clients older than 3 years, pulling the pinna up and back straightens the
ear canal for better medication administration. For children under 3, the
pinna is pulled down and back.
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10. A nurse is reinforcing teaching with a client who has a
prescription for alendronate. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I will remain seated for 30 minutes after I take my medication."
B. "I will take the medication with my evening meal."
C. "I will chew the tablet before swallowing."
D. "I will drink orange juice with the medication."
Answer: A. "I will remain seated for 30 minutes after I take my medication."
Expert Rationale:
Alendronate can cause esophageal irritation; the client should remain
upright for at least 30 minutes after taking the medication and should take it
with a full glass of water on an empty stomach to enhance absorption and
reduce adverse effects.
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