ATI RN
ATI RN Pharmacology Proctored Exam Test Bank
9.0 | All 48 Chapters | Chapter-Based Questions
with Detailed Explanations
================================================================================
CHAPTER 1: Cardiovascular System Drugs
================================================================================
1. A client with heart failure taking digoxin reports nausea and yellow vision. What is the priority action?
○ Administer antiemetic.
✅ Check serum digoxin level.
○ Hold next dose only.
○ Notify provider after labs.
Examiner’s note: Yellow halos and GI symptoms indicate digoxin toxicity; checking level guides next
steps.
2. A nurse is administering IV furosemide for acute pulmonary edema. Which finding indicates
effectiveness?
✅ Decreased dyspnea and clear breath sounds.
○ Increased BP.
○ Decreased urine output.
○ S3 heart sound.
Examiner’s note: Furosemide reduces preload, relieving pulmonary congestion; crackles resolve and
breathing improves.
, ATI RN
3. A client on lisinopril develops angioedema. What is the nurse's priority?
○ Give diphenhydramine.
✅ Ensure airway patency.
○ Administer epinephrine.
○ Stop lisinopril only.
Examiner’s note: Angioedema can cause rapid airway compromise; airway assessment and
management come first.
4. A client on metoprolol has HR 52 bpm and dizziness. What is the most appropriate action?
○ Increase next dose.
✅ Withhold and contact prescriber.
○ Give atropine.
○ Reassess in 1 hour.
Examiner’s note: Symptomatic bradycardia requires withholding beta-blockers and notifying provider.
5. A client prescribed amiodarone develops cough and dyspnea. What should the nurse suspect?
○ Corneal microdeposits.
○ Blue-gray skin.
✅ Pulmonary fibrosis.
○ Photosensitivity.
Examiner’s note: Amiodarone can cause fatal pulmonary toxicity; new respiratory symptoms require
immediate evaluation.
6. A client receives tissue plasminogen activator (tPA) for ischemic stroke. Which is a contraindication?
○ Age >80 years.
○ Mild hypertension.
✅ Recent intracranial surgery.
, ATI RN
○ Atrial fibrillation.
Examiner’s note: Any prior intracranial hemorrhage, recent surgery, or head trauma is a
contraindication due to bleeding risk.
7. A client taking clopidogrel is scheduled for surgery. When should it be stopped?
○ 24 hours before.
✅ 5–7 days before.
○ 12 hours before.
○ 2 weeks before.
Examiner’s note: Clopidogrel irreversibly inhibits platelets; stop 5–7 days preoperatively to reduce
bleeding risk.
8. A client on warfarin has INR 4.5 without bleeding. What intervention is needed?
○ Give vitamin K 10 mg IV.
✅ Hold warfarin and monitor.
○ Administer fresh frozen plasma.
○ Increase warfarin dose.
Examiner’s note: INR 4.5 without bleeding: hold warfarin; vitamin K only if INR >5 or bleeding.
9. A nurse teaches a client starting nitroglycerin patch. Which statement indicates understanding?
○ “I will apply it to the same spot daily.”
✅ “I will remove it at night for 10–12 hours.”
○ “I can cut the patch to adjust dose.”
○ “I will use it for chest pain emergencies.”
Examiner’s note: Nitrate-free interval (10–12 hours) prevents tolerance; patch not for acute pain.
, ATI RN
10. A client on hydralazine and isosorbide dinitrate for heart failure reports headache. What should the
nurse do?
○ Hold both medications.
✅ Reassure that headache is common and treat with acetaminophen.
○ Administer morphine.
○ Notify provider for dose decrease.
Examiner’s note: Headache is a common side effect of vasodilators; usually resolves or can be
managed with analgesics.
11. A client has new prescription for eplerenone. Which lab value requires caution?
○ Sodium 138 mEq/L.
✅ Potassium 5.5 mEq/L.
○ Calcium 9.0 mg/dL.
○ Magnesium 2.0 mg/dL.
Examiner’s note: Eplerenone is a potassium-sparing diuretic; hyperkalemia risk; hold if K+ >5.0–5.5.
12. A client taking verapamil develops constipation. What is the best response?
○ Stop the medication immediately.
✅ Increase fluid and fiber intake; stool softener if needed.
○ Switch to diltiazem.
○ Administer a laxative daily.
Examiner’s note: Constipation is common with verapamil; conservative measures first; do not stop
abruptly.
13. A client on atorvastatin reports muscle pain. Which lab is most important?
○ Liver function tests.
✅ Creatine kinase (CK).
ATI RN Pharmacology Proctored Exam Test Bank
9.0 | All 48 Chapters | Chapter-Based Questions
with Detailed Explanations
================================================================================
CHAPTER 1: Cardiovascular System Drugs
================================================================================
1. A client with heart failure taking digoxin reports nausea and yellow vision. What is the priority action?
○ Administer antiemetic.
✅ Check serum digoxin level.
○ Hold next dose only.
○ Notify provider after labs.
Examiner’s note: Yellow halos and GI symptoms indicate digoxin toxicity; checking level guides next
steps.
2. A nurse is administering IV furosemide for acute pulmonary edema. Which finding indicates
effectiveness?
✅ Decreased dyspnea and clear breath sounds.
○ Increased BP.
○ Decreased urine output.
○ S3 heart sound.
Examiner’s note: Furosemide reduces preload, relieving pulmonary congestion; crackles resolve and
breathing improves.
, ATI RN
3. A client on lisinopril develops angioedema. What is the nurse's priority?
○ Give diphenhydramine.
✅ Ensure airway patency.
○ Administer epinephrine.
○ Stop lisinopril only.
Examiner’s note: Angioedema can cause rapid airway compromise; airway assessment and
management come first.
4. A client on metoprolol has HR 52 bpm and dizziness. What is the most appropriate action?
○ Increase next dose.
✅ Withhold and contact prescriber.
○ Give atropine.
○ Reassess in 1 hour.
Examiner’s note: Symptomatic bradycardia requires withholding beta-blockers and notifying provider.
5. A client prescribed amiodarone develops cough and dyspnea. What should the nurse suspect?
○ Corneal microdeposits.
○ Blue-gray skin.
✅ Pulmonary fibrosis.
○ Photosensitivity.
Examiner’s note: Amiodarone can cause fatal pulmonary toxicity; new respiratory symptoms require
immediate evaluation.
6. A client receives tissue plasminogen activator (tPA) for ischemic stroke. Which is a contraindication?
○ Age >80 years.
○ Mild hypertension.
✅ Recent intracranial surgery.
, ATI RN
○ Atrial fibrillation.
Examiner’s note: Any prior intracranial hemorrhage, recent surgery, or head trauma is a
contraindication due to bleeding risk.
7. A client taking clopidogrel is scheduled for surgery. When should it be stopped?
○ 24 hours before.
✅ 5–7 days before.
○ 12 hours before.
○ 2 weeks before.
Examiner’s note: Clopidogrel irreversibly inhibits platelets; stop 5–7 days preoperatively to reduce
bleeding risk.
8. A client on warfarin has INR 4.5 without bleeding. What intervention is needed?
○ Give vitamin K 10 mg IV.
✅ Hold warfarin and monitor.
○ Administer fresh frozen plasma.
○ Increase warfarin dose.
Examiner’s note: INR 4.5 without bleeding: hold warfarin; vitamin K only if INR >5 or bleeding.
9. A nurse teaches a client starting nitroglycerin patch. Which statement indicates understanding?
○ “I will apply it to the same spot daily.”
✅ “I will remove it at night for 10–12 hours.”
○ “I can cut the patch to adjust dose.”
○ “I will use it for chest pain emergencies.”
Examiner’s note: Nitrate-free interval (10–12 hours) prevents tolerance; patch not for acute pain.
, ATI RN
10. A client on hydralazine and isosorbide dinitrate for heart failure reports headache. What should the
nurse do?
○ Hold both medications.
✅ Reassure that headache is common and treat with acetaminophen.
○ Administer morphine.
○ Notify provider for dose decrease.
Examiner’s note: Headache is a common side effect of vasodilators; usually resolves or can be
managed with analgesics.
11. A client has new prescription for eplerenone. Which lab value requires caution?
○ Sodium 138 mEq/L.
✅ Potassium 5.5 mEq/L.
○ Calcium 9.0 mg/dL.
○ Magnesium 2.0 mg/dL.
Examiner’s note: Eplerenone is a potassium-sparing diuretic; hyperkalemia risk; hold if K+ >5.0–5.5.
12. A client taking verapamil develops constipation. What is the best response?
○ Stop the medication immediately.
✅ Increase fluid and fiber intake; stool softener if needed.
○ Switch to diltiazem.
○ Administer a laxative daily.
Examiner’s note: Constipation is common with verapamil; conservative measures first; do not stop
abruptly.
13. A client on atorvastatin reports muscle pain. Which lab is most important?
○ Liver function tests.
✅ Creatine kinase (CK).
