ATI PN Pharmacology Proctored Exam Practice – NGN Style
(1–240)
1. A nurse is preparing to administer digoxin to a client with heart failure. The client’s
apical pulse is 50 bpm. What action should the nurse take?
A. Administer the dose as scheduled.
B. Withhold the medication and notify the provider.
C. Recheck the pulse in 30 minutes.
D. Give half the prescribed dose.
Rationale:
Digoxin slows the heart rate. If the pulse is below 60 bpm, the nurse must withhold and notify
the provider. Administering it could cause bradycardia or heart block.
2. A client taking furosemide reports muscle cramps. Which laboratory value supports the
nurse’s suspicion?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.1 mg/dL
Rationale:
Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia, which
manifests as muscle cramps and weakness.
3. A nurse is reinforcing teaching for a client on warfarin therapy. Which statement
indicates understanding?
A. “I can take aspirin for headaches.”
B. “I’ll double my dose if I miss one.”
C. “I will have my INR checked regularly.”
D. “I will avoid all foods with vitamin K.”
Rationale:
Regular INR monitoring ensures warfarin effectiveness and safety. Vitamin K foods should be
consistent, not eliminated. Aspirin increases bleeding risk.
,4. A client on lithium therapy reports tremors and nausea. What should the nurse suspect?
A. Lithium tolerance
B. Lithium toxicity
C. Dehydration only
D. Normal side effect
Rationale:
Fine tremors, nausea, and confusion indicate lithium toxicity, especially if the client is
dehydrated or has sodium imbalance.
5. A nurse is preparing regular insulin for IV administration in DKA. Which solution
should be used?
A. D5W
B. 0.9% Normal Saline
C. Lactated Ringer’s
D. Sterile water
Rationale:
Regular insulin should be diluted in normal saline (0.9% NaCl). Dextrose solutions interfere
with glucose control.
6. A client taking prednisone for asthma should be monitored for which adverse effect?
A. Hypoglycemia
B. Hyperglycemia
C. Bradycardia
D. Hypocalcemia
Rationale:
Prednisone, a corticosteroid, increases glucose levels, suppresses immunity, and causes fluid
retention.
7. A client receiving gentamicin develops elevated BUN and creatinine. What does this
indicate?
A. Ototoxicity
B. Nephrotoxicity
C. Hepatotoxicity
D. Neurotoxicity
Rationale:
Gentamicin, an aminoglycoside, can cause nephrotoxicity. Monitor kidney function and drug
levels closely.
,8. A nurse is reinforcing teaching about nitroglycerin tablets. Which instruction is correct?
A. “Store them in a plastic container.”
B. “Take one tablet with food.”
C. “Place one under your tongue for chest pain.”
D. “Chew the tablet for faster relief.”
Rationale:
Sublingual nitroglycerin works within minutes when placed under the tongue; it should be kept
in a dark glass container.
9. Which medication is contraindicated in a client with a history of gastric ulcers?
A. Acetaminophen
B. Ibuprofen
C. Sucralfate
D. Pantoprazole
Rationale:
NSAIDs like ibuprofen can cause gastric irritation and bleeding. Acetaminophen is safer for
pain in ulcer patients.
10. A nurse is teaching a client about levothyroxine. Which statement indicates
understanding?
A. “I should take it on an empty stomach in the morning.”
B. “I can take it with breakfast.”
C. “I can stop it once I feel better.”
D. “It can be taken with calcium.”
Rationale:
Levothyroxine absorption decreases with food or calcium; it should be taken on an empty
stomach, 30–60 minutes before breakfast.
11. Which nursing action is priority before administering morphine IV?
A. Assess pain level
B. Assess respiratory rate
C. Check bowel sounds
D. Check urine output
, Rationale:
Morphine depresses the respiratory center; always check respiratory rate before administration
(hold if <12 breaths/min).
12. A nurse is reinforcing teaching about metformin. Which statement is correct?
A. “It increases insulin production.”
B. “It helps my body use insulin effectively.”
C. “It causes low blood sugar.”
D. “I can take it before bedtime.”
Rationale:
Metformin improves insulin sensitivity and decreases hepatic glucose production. It does not
cause hypoglycemia when used alone.
13. A client using albuterol inhaler reports tremors and palpitations. The nurse should
explain this as:
A. An expected side effect.
B. A sign of toxicity.
C. A drug interaction.
D. A reason to stop medication.
Rationale:
Beta-2 agonists like albuterol can cause mild tremors and tachycardia due to sympathetic
stimulation.
14. Which instruction should be given to a client taking ferrous sulfate?
A. Take with orange juice.
B. Take with milk.
C. Take with antacids.
D. Avoid vitamin C.
Rationale:
Vitamin C (orange juice) enhances iron absorption, while milk and antacids decrease it.
15. A nurse is reinforcing teaching for clonidine. Which instruction is essential?
A. Increase salt intake.
B. Take with fatty foods.
C. Do not stop the medication suddenly.
D. Use aspirin for headaches.
(1–240)
1. A nurse is preparing to administer digoxin to a client with heart failure. The client’s
apical pulse is 50 bpm. What action should the nurse take?
A. Administer the dose as scheduled.
B. Withhold the medication and notify the provider.
C. Recheck the pulse in 30 minutes.
D. Give half the prescribed dose.
Rationale:
Digoxin slows the heart rate. If the pulse is below 60 bpm, the nurse must withhold and notify
the provider. Administering it could cause bradycardia or heart block.
2. A client taking furosemide reports muscle cramps. Which laboratory value supports the
nurse’s suspicion?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.1 mg/dL
Rationale:
Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia, which
manifests as muscle cramps and weakness.
3. A nurse is reinforcing teaching for a client on warfarin therapy. Which statement
indicates understanding?
A. “I can take aspirin for headaches.”
B. “I’ll double my dose if I miss one.”
C. “I will have my INR checked regularly.”
D. “I will avoid all foods with vitamin K.”
Rationale:
Regular INR monitoring ensures warfarin effectiveness and safety. Vitamin K foods should be
consistent, not eliminated. Aspirin increases bleeding risk.
,4. A client on lithium therapy reports tremors and nausea. What should the nurse suspect?
A. Lithium tolerance
B. Lithium toxicity
C. Dehydration only
D. Normal side effect
Rationale:
Fine tremors, nausea, and confusion indicate lithium toxicity, especially if the client is
dehydrated or has sodium imbalance.
5. A nurse is preparing regular insulin for IV administration in DKA. Which solution
should be used?
A. D5W
B. 0.9% Normal Saline
C. Lactated Ringer’s
D. Sterile water
Rationale:
Regular insulin should be diluted in normal saline (0.9% NaCl). Dextrose solutions interfere
with glucose control.
6. A client taking prednisone for asthma should be monitored for which adverse effect?
A. Hypoglycemia
B. Hyperglycemia
C. Bradycardia
D. Hypocalcemia
Rationale:
Prednisone, a corticosteroid, increases glucose levels, suppresses immunity, and causes fluid
retention.
7. A client receiving gentamicin develops elevated BUN and creatinine. What does this
indicate?
A. Ototoxicity
B. Nephrotoxicity
C. Hepatotoxicity
D. Neurotoxicity
Rationale:
Gentamicin, an aminoglycoside, can cause nephrotoxicity. Monitor kidney function and drug
levels closely.
,8. A nurse is reinforcing teaching about nitroglycerin tablets. Which instruction is correct?
A. “Store them in a plastic container.”
B. “Take one tablet with food.”
C. “Place one under your tongue for chest pain.”
D. “Chew the tablet for faster relief.”
Rationale:
Sublingual nitroglycerin works within minutes when placed under the tongue; it should be kept
in a dark glass container.
9. Which medication is contraindicated in a client with a history of gastric ulcers?
A. Acetaminophen
B. Ibuprofen
C. Sucralfate
D. Pantoprazole
Rationale:
NSAIDs like ibuprofen can cause gastric irritation and bleeding. Acetaminophen is safer for
pain in ulcer patients.
10. A nurse is teaching a client about levothyroxine. Which statement indicates
understanding?
A. “I should take it on an empty stomach in the morning.”
B. “I can take it with breakfast.”
C. “I can stop it once I feel better.”
D. “It can be taken with calcium.”
Rationale:
Levothyroxine absorption decreases with food or calcium; it should be taken on an empty
stomach, 30–60 minutes before breakfast.
11. Which nursing action is priority before administering morphine IV?
A. Assess pain level
B. Assess respiratory rate
C. Check bowel sounds
D. Check urine output
, Rationale:
Morphine depresses the respiratory center; always check respiratory rate before administration
(hold if <12 breaths/min).
12. A nurse is reinforcing teaching about metformin. Which statement is correct?
A. “It increases insulin production.”
B. “It helps my body use insulin effectively.”
C. “It causes low blood sugar.”
D. “I can take it before bedtime.”
Rationale:
Metformin improves insulin sensitivity and decreases hepatic glucose production. It does not
cause hypoglycemia when used alone.
13. A client using albuterol inhaler reports tremors and palpitations. The nurse should
explain this as:
A. An expected side effect.
B. A sign of toxicity.
C. A drug interaction.
D. A reason to stop medication.
Rationale:
Beta-2 agonists like albuterol can cause mild tremors and tachycardia due to sympathetic
stimulation.
14. Which instruction should be given to a client taking ferrous sulfate?
A. Take with orange juice.
B. Take with milk.
C. Take with antacids.
D. Avoid vitamin C.
Rationale:
Vitamin C (orange juice) enhances iron absorption, while milk and antacids decrease it.
15. A nurse is reinforcing teaching for clonidine. Which instruction is essential?
A. Increase salt intake.
B. Take with fatty foods.
C. Do not stop the medication suddenly.
D. Use aspirin for headaches.
