RN ATI PHARMACOLOGY PROCTORED EXAM 2025 WITH
ANSWERS AND RATIONALE (70 QUESTIONS)
Question 1
A nurse inadvertently administers 160 mg of valsartan PO to a client scheduled for 80 mg. Which
action is the priority?
A. Evaluate for orthostatic hypotension.
B. Monitor urine output.
C. Obtain laboratory results.
D. Check for nasal congestion.
Answer: A
Rationale: Overdosing valsartan, an angiotensin II receptor blocker, increases the risk of
hypotension, particularly orthostatic hypotension, which can lead to falls or shock. Prioritizing
evaluation of vital signs and symptoms ensures client safety. Monitoring urine output (B) and labs
(C) are secondary, and nasal congestion (D) is unrelated to valsartan overdose.
Question 2
A client has a prescription for lactated Ringer’s IV at 4,000 mL over 24 hours. What rate (mL/hr)
should the nurse set the IV pump to deliver? (Round to the nearest whole number.)
Answer: 167 mL/hr
,Rationale: Calculate the rate: 4,000 mL ÷ 24 hours = 166.67 mL/hr, rounded to 167 mL/hr. This
ensures the total volume is delivered evenly over 24 hours, maintaining fluid balance.
Question 3
A quality control nurse reviews medication prescriptions. Which is complete?
A. Tetracycline 200 mg PO
B. Epoetin alfa 150 units/kg three times weekly
C. Digoxin 0.25 mg PO daily
D. Cimetidine PO twice daily
Answer: C
Rationale: A complete prescription includes drug name, dose, route, and frequency. Digoxin 0.25 mg
PO daily (C) meets all criteria. Tetracycline (A) lacks frequency, epoetin alfa (B) lacks route, and
cimetidine (D) lacks dose, making them incomplete.
Question 4
A nurse teaches a client with a new prescription for enoxaparin. Which pain relief medication can
be taken concurrently?
A. Ibuprofen
B. Naproxen sodium
,C. Acetaminophen
D. Aspirin
Answer: C
Rationale: Enoxaparin, a low-molecular-weight heparin, increases bleeding risk. Acetaminophen
(C) is safe as it does not affect coagulation. Ibuprofen (A), naproxen (B), and aspirin (D) have
antiplatelet or anticoagulant effects, increasing bleeding risk.
Question 5
A client on haloperidol experiences pseudoparkinsonism. Which finding should the nurse
document?
A. Serpentine limb movements
B. Shuffling gait
C. Nonreactive pupils
D. Smacking lips
Answer: B
Rationale: Pseudoparkinsonism, an extrapyramidal side effect of haloperidol, mimics Parkinson’s
disease, presenting with shuffling gait (B). Serpentine movements (A) and smacking lips (D)
indicate tardive dyskinesia, while nonreactive pupils (C) are unrelated.
, Question 6
A nurse is preparing to start a blood transfusion. Which action is appropriate?
A. Titrate the infusion rate to maintain BP ≥ 90/60 mm Hg.
B. Stay with the client for the first 15 minutes.
C. Start an IV bolus of lactated Ringer’s solution.
D. Infuse the blood over 6 hours.
Answer: B
Rationale: Staying with the client for the first 15 minutes (B) is critical to monitor for transfusion
reactions (e.g., hemolytic or allergic). Titrating for BP (A) is inappropriate, a fluid bolus (C) requires
a separate order, and blood should be infused within 4 hours (D) to prevent bacterial growth.
Question 7
A client 12 hours postpartum with a third-degree perineal laceration hasn’t had a bowel movement
in 4 days. Which medication should the nurse administer?
A. Bisacodyl 10 mg rectal suppository
B. Magnesium hydroxide 30 mL PO
C. Famotidine 20 mg PO
ANSWERS AND RATIONALE (70 QUESTIONS)
Question 1
A nurse inadvertently administers 160 mg of valsartan PO to a client scheduled for 80 mg. Which
action is the priority?
A. Evaluate for orthostatic hypotension.
B. Monitor urine output.
C. Obtain laboratory results.
D. Check for nasal congestion.
Answer: A
Rationale: Overdosing valsartan, an angiotensin II receptor blocker, increases the risk of
hypotension, particularly orthostatic hypotension, which can lead to falls or shock. Prioritizing
evaluation of vital signs and symptoms ensures client safety. Monitoring urine output (B) and labs
(C) are secondary, and nasal congestion (D) is unrelated to valsartan overdose.
Question 2
A client has a prescription for lactated Ringer’s IV at 4,000 mL over 24 hours. What rate (mL/hr)
should the nurse set the IV pump to deliver? (Round to the nearest whole number.)
Answer: 167 mL/hr
,Rationale: Calculate the rate: 4,000 mL ÷ 24 hours = 166.67 mL/hr, rounded to 167 mL/hr. This
ensures the total volume is delivered evenly over 24 hours, maintaining fluid balance.
Question 3
A quality control nurse reviews medication prescriptions. Which is complete?
A. Tetracycline 200 mg PO
B. Epoetin alfa 150 units/kg three times weekly
C. Digoxin 0.25 mg PO daily
D. Cimetidine PO twice daily
Answer: C
Rationale: A complete prescription includes drug name, dose, route, and frequency. Digoxin 0.25 mg
PO daily (C) meets all criteria. Tetracycline (A) lacks frequency, epoetin alfa (B) lacks route, and
cimetidine (D) lacks dose, making them incomplete.
Question 4
A nurse teaches a client with a new prescription for enoxaparin. Which pain relief medication can
be taken concurrently?
A. Ibuprofen
B. Naproxen sodium
,C. Acetaminophen
D. Aspirin
Answer: C
Rationale: Enoxaparin, a low-molecular-weight heparin, increases bleeding risk. Acetaminophen
(C) is safe as it does not affect coagulation. Ibuprofen (A), naproxen (B), and aspirin (D) have
antiplatelet or anticoagulant effects, increasing bleeding risk.
Question 5
A client on haloperidol experiences pseudoparkinsonism. Which finding should the nurse
document?
A. Serpentine limb movements
B. Shuffling gait
C. Nonreactive pupils
D. Smacking lips
Answer: B
Rationale: Pseudoparkinsonism, an extrapyramidal side effect of haloperidol, mimics Parkinson’s
disease, presenting with shuffling gait (B). Serpentine movements (A) and smacking lips (D)
indicate tardive dyskinesia, while nonreactive pupils (C) are unrelated.
, Question 6
A nurse is preparing to start a blood transfusion. Which action is appropriate?
A. Titrate the infusion rate to maintain BP ≥ 90/60 mm Hg.
B. Stay with the client for the first 15 minutes.
C. Start an IV bolus of lactated Ringer’s solution.
D. Infuse the blood over 6 hours.
Answer: B
Rationale: Staying with the client for the first 15 minutes (B) is critical to monitor for transfusion
reactions (e.g., hemolytic or allergic). Titrating for BP (A) is inappropriate, a fluid bolus (C) requires
a separate order, and blood should be infused within 4 hours (D) to prevent bacterial growth.
Question 7
A client 12 hours postpartum with a third-degree perineal laceration hasn’t had a bowel movement
in 4 days. Which medication should the nurse administer?
A. Bisacodyl 10 mg rectal suppository
B. Magnesium hydroxide 30 mL PO
C. Famotidine 20 mg PO
