CREATED BY FutureBright
ATI Pharmacology Proctored Exam| Q141–160 | High-Yield
Real Questions + Correct Answers & Rationales
1. A nurse is preparing to administer warfarin to a client who has atrial fibrillation.
Which of the following client laboratory values should the nurse review prior to
administration?
A. Hemoglobin level
B. Blood glucose level
C. INR value
D. White blood cell count
Rationale: The International Normalized Ratio (INR) is the critical lab value
for monitoring the effectiveness and safety of warfarin therapy. It should typically
range between 2.0–3.0 for clients with atrial fibrillation. An elevated INR increases
the risk of bleeding, while a low INR indicates ineffective anticoagulation.
Hemoglobin and WBC are not primary indicators for warfarin adjustment.
2. A client receiving lithium carbonate for bipolar disorder presents with nausea,
vomiting, and hand tremors. Which of the following actions should the nurse take
first?
A. Administer the next scheduled dose of lithium
B. Reassure the client and monitor closely
C. Encourage oral fluid intake
D. Notify the provider immediately
Rationale: The client is displaying early signs of lithium toxicity, which include
gastrointestinal disturbances and fine hand tremors. The priority is to notify the
provider before continuing the medication, as toxicity can progress to seizures or
death. Lithium levels should be assessed, and the drug withheld if toxicity is
suspected.
,CREATED BY FutureBright
3. A nurse is providing discharge teaching to a client prescribed nitroglycerin
sublingual tablets for angina. Which of the following client statements indicates a
need for further teaching?
A. "I will swallow the tablet whole if I feel chest pain."
B. "I should sit down before taking the tablet."
C. "If I don’t feel relief in 5 minutes, I can take another tablet."
D. "I should store the tablets in a dark container."
Rationale: Sublingual nitroglycerin should not be swallowed, as this bypasses
the rapid absorption needed for therapeutic effect. It must be placed under the
tongue to dissolve. The other statements reflect proper use — sitting prevents
hypotension, and storing in a dark container preserves potency.
4. A nurse is reviewing the medication history of a client who is scheduled for
surgery and notes the client takes aspirin daily for arthritis. Which of the
following actions should the nurse take?
A. Document this and continue with the surgery as scheduled
B. Notify the provider due to increased bleeding risk
C. Administer vitamin K prior to surgery
D. Instruct the client to take aspirin with food
Rationale: Aspirin is an antiplatelet agent that inhibits clot formation, increasing
bleeding risk during surgery. It should typically be discontinued 7 days prior to
elective surgery. The nurse must notify the provider to prevent perioperative
complications such as hemorrhage.
5. A nurse is caring for a client prescribed gentamicin IV for a severe infection.
Which of the following findings requires immediate intervention?
A. Nausea
B. Decreased urine output
C. Mild rash
D. Metallic taste
,CREATED BY FutureBright
Rationale: Gentamicin is nephrotoxic, and a decrease in urine output may
indicate acute kidney injury. Immediate intervention is needed to prevent further
renal damage. The provider should be notified, and serum creatinine/BUN should
be evaluated. Nausea and metallic taste are common but less concerning.
6. A nurse is administering IV morphine to a postoperative client. Which of the
following assessments is the nurse’s priority?
A. Heart rate
B. Pain score
C. Respiratory rate
D. Urine output
Rationale: Respiratory depression is the most serious adverse effect of
morphine. Assessing the respiratory rate ensures the client is breathing
adequately before and after administration. If respirations fall below 12/min, the
dose should be held and the provider contacted.
7. A nurse is caring for a client who takes digoxin and is experiencing anorexia,
blurred vision, and fatigue. Which of the following lab results should the nurse
evaluate first?
A. Potassium level
B. Digoxin level
C. Sodium level
D. Magnesium level
Rationale: These symptoms suggest digoxin toxicity. The therapeutic serum
digoxin level is 0.5–2.0 ng/mL, and levels above this increase the risk of toxicity,
especially in clients with low potassium. Monitoring digoxin levels is the priority
before continuing the dose.
8. A client is prescribed enalapril for hypertension. Which of the following side
effects should the nurse instruct the client to report immediately?
, CREATED BY FutureBright
A. Fatigue
B. Swelling of the tongue or lips
C. Persistent cough
D. Dizziness upon standing
Rationale: Swelling of the lips or tongue indicates angioedema, a rare but
potentially life-threatening adverse effect of ACE inhibitors like enalapril. This is a
medical emergency that can lead to airway obstruction. Persistent cough and
dizziness are more common, less urgent effects.
9. A nurse is preparing to administer vancomycin IV to a client with MRSA.
Which of the following nursing actions is a priority?
A. Monitor for constipation
B. Infuse medication slowly over at least 60 minutes
C. Ensure client is NPO
D. Monitor for signs of depression
Rationale: Vancomycin should be administered over 60 minutes or more to
prevent Red Man Syndrome, a histamine reaction characterized by flushing,
hypotension, and rash. Rapid infusion increases this risk. Monitoring GI function
and mood are not relevant priorities here.
10. A nurse is providing teaching about alendronate to a client with osteoporosis.
Which of the following instructions should the nurse include?
A. "Take this medication with a full glass of water and remain upright for 30
minutes."
B. "Take with orange juice in the morning."
C. "Lie down and rest after taking the medication."
D. "Take with food to reduce gastric irritation."
Rationale: Alendronate can cause esophageal irritation or ulceration. The client
should take it with water and remain upright for at least 30 minutes to prevent
reflux. It should be taken on an empty stomach in the morning. Citrus and food
interfere with absorption.
ATI Pharmacology Proctored Exam| Q141–160 | High-Yield
Real Questions + Correct Answers & Rationales
1. A nurse is preparing to administer warfarin to a client who has atrial fibrillation.
Which of the following client laboratory values should the nurse review prior to
administration?
A. Hemoglobin level
B. Blood glucose level
C. INR value
D. White blood cell count
Rationale: The International Normalized Ratio (INR) is the critical lab value
for monitoring the effectiveness and safety of warfarin therapy. It should typically
range between 2.0–3.0 for clients with atrial fibrillation. An elevated INR increases
the risk of bleeding, while a low INR indicates ineffective anticoagulation.
Hemoglobin and WBC are not primary indicators for warfarin adjustment.
2. A client receiving lithium carbonate for bipolar disorder presents with nausea,
vomiting, and hand tremors. Which of the following actions should the nurse take
first?
A. Administer the next scheduled dose of lithium
B. Reassure the client and monitor closely
C. Encourage oral fluid intake
D. Notify the provider immediately
Rationale: The client is displaying early signs of lithium toxicity, which include
gastrointestinal disturbances and fine hand tremors. The priority is to notify the
provider before continuing the medication, as toxicity can progress to seizures or
death. Lithium levels should be assessed, and the drug withheld if toxicity is
suspected.
,CREATED BY FutureBright
3. A nurse is providing discharge teaching to a client prescribed nitroglycerin
sublingual tablets for angina. Which of the following client statements indicates a
need for further teaching?
A. "I will swallow the tablet whole if I feel chest pain."
B. "I should sit down before taking the tablet."
C. "If I don’t feel relief in 5 minutes, I can take another tablet."
D. "I should store the tablets in a dark container."
Rationale: Sublingual nitroglycerin should not be swallowed, as this bypasses
the rapid absorption needed for therapeutic effect. It must be placed under the
tongue to dissolve. The other statements reflect proper use — sitting prevents
hypotension, and storing in a dark container preserves potency.
4. A nurse is reviewing the medication history of a client who is scheduled for
surgery and notes the client takes aspirin daily for arthritis. Which of the
following actions should the nurse take?
A. Document this and continue with the surgery as scheduled
B. Notify the provider due to increased bleeding risk
C. Administer vitamin K prior to surgery
D. Instruct the client to take aspirin with food
Rationale: Aspirin is an antiplatelet agent that inhibits clot formation, increasing
bleeding risk during surgery. It should typically be discontinued 7 days prior to
elective surgery. The nurse must notify the provider to prevent perioperative
complications such as hemorrhage.
5. A nurse is caring for a client prescribed gentamicin IV for a severe infection.
Which of the following findings requires immediate intervention?
A. Nausea
B. Decreased urine output
C. Mild rash
D. Metallic taste
,CREATED BY FutureBright
Rationale: Gentamicin is nephrotoxic, and a decrease in urine output may
indicate acute kidney injury. Immediate intervention is needed to prevent further
renal damage. The provider should be notified, and serum creatinine/BUN should
be evaluated. Nausea and metallic taste are common but less concerning.
6. A nurse is administering IV morphine to a postoperative client. Which of the
following assessments is the nurse’s priority?
A. Heart rate
B. Pain score
C. Respiratory rate
D. Urine output
Rationale: Respiratory depression is the most serious adverse effect of
morphine. Assessing the respiratory rate ensures the client is breathing
adequately before and after administration. If respirations fall below 12/min, the
dose should be held and the provider contacted.
7. A nurse is caring for a client who takes digoxin and is experiencing anorexia,
blurred vision, and fatigue. Which of the following lab results should the nurse
evaluate first?
A. Potassium level
B. Digoxin level
C. Sodium level
D. Magnesium level
Rationale: These symptoms suggest digoxin toxicity. The therapeutic serum
digoxin level is 0.5–2.0 ng/mL, and levels above this increase the risk of toxicity,
especially in clients with low potassium. Monitoring digoxin levels is the priority
before continuing the dose.
8. A client is prescribed enalapril for hypertension. Which of the following side
effects should the nurse instruct the client to report immediately?
, CREATED BY FutureBright
A. Fatigue
B. Swelling of the tongue or lips
C. Persistent cough
D. Dizziness upon standing
Rationale: Swelling of the lips or tongue indicates angioedema, a rare but
potentially life-threatening adverse effect of ACE inhibitors like enalapril. This is a
medical emergency that can lead to airway obstruction. Persistent cough and
dizziness are more common, less urgent effects.
9. A nurse is preparing to administer vancomycin IV to a client with MRSA.
Which of the following nursing actions is a priority?
A. Monitor for constipation
B. Infuse medication slowly over at least 60 minutes
C. Ensure client is NPO
D. Monitor for signs of depression
Rationale: Vancomycin should be administered over 60 minutes or more to
prevent Red Man Syndrome, a histamine reaction characterized by flushing,
hypotension, and rash. Rapid infusion increases this risk. Monitoring GI function
and mood are not relevant priorities here.
10. A nurse is providing teaching about alendronate to a client with osteoporosis.
Which of the following instructions should the nurse include?
A. "Take this medication with a full glass of water and remain upright for 30
minutes."
B. "Take with orange juice in the morning."
C. "Lie down and rest after taking the medication."
D. "Take with food to reduce gastric irritation."
Rationale: Alendronate can cause esophageal irritation or ulceration. The client
should take it with water and remain upright for at least 30 minutes to prevent
reflux. It should be taken on an empty stomach in the morning. Citrus and food
interfere with absorption.
