ATI PN Pharmacology Proctored Exam Review –
Latest Update – 75 Questions with Answers
Actual Exam | Complete Rationales | Pass
Guaranteed - A+ Graded
[Cardiovascular & Hematologic Medications]
Q1: A patient who started taking lisinopril a week ago calls the clinic and reports a
persistent, dry, hacking cough that is keeping them awake at night. What is the best
response by the nurse?
A. "This is a sign of a secondary infection, and you will need an antibiotic."
B. "This is a common side effect of the medication, and your provider may need to
switch you to a different class like an ARB."
C. "Take an over-the-counter antihistamine to dry up the secretions causing the cough."
D. "Make sure you are drinking at least 3 liters of water daily to thin out the mucus."
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is explaining that the dry cough is a classic side effect of
ACE inhibitors caused by bradykinin buildup. For the PN exam, remember that
switching to an ARB like losartan is the standard fix because ARBs don't affect
bradykinin.
Q2: A patient is receiving a continuous heparin drip. The lab calls to report the patient's
aPTT is 90 seconds. What is the priority nursing action?
A. Administer the next scheduled dose of warfarin as ordered
B. Stop the heparin drip and prepare to administer protamine sulfate
C. Increase the heparin drip rate by 2 units/kg/hr
D. Document the finding and recheck the aPTT in 4 hours
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: This adverse effect requires immediate provider notification because an
aPTT of 90 seconds is critically high and puts the patient at major risk for severe
bleeding. The priority action is stopping the drip and getting protamine sulfate ready to
reverse the anticoagulation.
,Q3: A nurse is preparing to administer warfarin to a patient. Which laboratory value
indicates that the medication is within the desired therapeutic range for most patients?
A. INR of 1.5
B. INR of 2.5
C. aPTT of 45 seconds
D. Platelet count of 150,000
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is an INR of 2.5 because the standard therapeutic range for
warfarin is 2.0 to 3.0. For the PN exam, remember that aPTT is used to monitor heparin,
not warfarin, and a normal platelet count doesn't tell you if the warfarin dose is effective.
Q4: A nurse is providing discharge teaching to a patient who is going home on warfarin.
Which statement by the patient indicates that the teaching has been effective?
A. "I will eat plenty of spinach and kale to keep my heart healthy."
B. "I will use a soft-bristled toothbrush and use an electric razor to shave."
C. "I can take ibuprofen for my daily headaches without any problems."
D. "I only need to have my blood checked once a year while on this medication."
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The priority teaching point here is bleeding precautions, and using soft
toothbrushes and electric razors minimizes the risk of uncontrolled bleeding. The patient
should avoid sudden increases in vitamin K foods like spinach, avoid NSAIDs like
ibuprofen, and have their INR checked frequently, not yearly.
Q5: A patient is taking metoprolol for hypertension. Which finding requires the nurse to
hold the medication and notify the provider?
A. Blood pressure of 118/76 mmHg
B. Apical pulse of 52 bpm
C. Respiratory rate of 18 breaths/min
D. Blood glucose of 110 mg/dL
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is the apical pulse of 52 bpm because metoprolol is a
beta-blocker that lowers heart rate. For the PN exam, remember the absolute rule to
hold a beta-blocker if the apical pulse is below 60 bpm to prevent severe bradycardia
and heart block.
Q6: A patient is prescribed amlodipine for hypertension. They report to the nurse that
their ankles are swollen at the end of the day but there is no pain. How should the nurse
respond?
, A. "Stop taking the medication immediately as you are having an allergic reaction."
B. "This is a common side effect called peripheral edema, and I will let your provider
know."
C. "You need to restrict all salt and water intake for the next three days."
D. "Elevate your legs and take a diuretic; you do not need to call the doctor."
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is recognizing that dose-dependent peripheral edema is a
very common side effect of calcium channel blockers like amlodipine. This aligns with
the fact that while it isn't an allergy, the provider still needs to know so they can adjust
the dose or switch the medication.
Q7: A nurse is reviewing the morning labs for a patient taking furosemide. The
potassium level is 3.1 mEq/L. Which assessment finding should the nurse monitor for
related to this lab result?
A. Muscle weakness and leg cramps
B. Confusion and hyperreflexia
C. Tented skin turgor and dry mucous membranes
D. Bounding pulses and a flushed face
Correct Answer: A [CORRECT]
Correct Answer: A
Rationale: The best answer is muscle weakness and cramps because furosemide is a
loop diuretic that wastes potassium, leading to hypokalemia. For the PN exam,
remember that low potassium causes decreased muscle excitability, which presents as
weakness and cramping.
Q8: A patient with heart failure is prescribed spironolactone. Which statement by the
patient indicates a need for further teaching regarding this medication?
A. "I will call my doctor if I start feeling very weak or tired."
B. "I will use a salt substitute to flavor my food instead of table salt."
C. "I should avoid eating large amounts of bananas and oranges."
D. "I will weigh myself every morning to check for fluid retention."
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is the statement about salt substitutes because
spironolactone is a potassium-sparing diuretic, and most salt substitutes replace sodium
with potassium. This adverse effect requires immediate provider notification because
using them together can cause severe, life-threatening hyperkalemia.
Latest Update – 75 Questions with Answers
Actual Exam | Complete Rationales | Pass
Guaranteed - A+ Graded
[Cardiovascular & Hematologic Medications]
Q1: A patient who started taking lisinopril a week ago calls the clinic and reports a
persistent, dry, hacking cough that is keeping them awake at night. What is the best
response by the nurse?
A. "This is a sign of a secondary infection, and you will need an antibiotic."
B. "This is a common side effect of the medication, and your provider may need to
switch you to a different class like an ARB."
C. "Take an over-the-counter antihistamine to dry up the secretions causing the cough."
D. "Make sure you are drinking at least 3 liters of water daily to thin out the mucus."
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is explaining that the dry cough is a classic side effect of
ACE inhibitors caused by bradykinin buildup. For the PN exam, remember that
switching to an ARB like losartan is the standard fix because ARBs don't affect
bradykinin.
Q2: A patient is receiving a continuous heparin drip. The lab calls to report the patient's
aPTT is 90 seconds. What is the priority nursing action?
A. Administer the next scheduled dose of warfarin as ordered
B. Stop the heparin drip and prepare to administer protamine sulfate
C. Increase the heparin drip rate by 2 units/kg/hr
D. Document the finding and recheck the aPTT in 4 hours
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: This adverse effect requires immediate provider notification because an
aPTT of 90 seconds is critically high and puts the patient at major risk for severe
bleeding. The priority action is stopping the drip and getting protamine sulfate ready to
reverse the anticoagulation.
,Q3: A nurse is preparing to administer warfarin to a patient. Which laboratory value
indicates that the medication is within the desired therapeutic range for most patients?
A. INR of 1.5
B. INR of 2.5
C. aPTT of 45 seconds
D. Platelet count of 150,000
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is an INR of 2.5 because the standard therapeutic range for
warfarin is 2.0 to 3.0. For the PN exam, remember that aPTT is used to monitor heparin,
not warfarin, and a normal platelet count doesn't tell you if the warfarin dose is effective.
Q4: A nurse is providing discharge teaching to a patient who is going home on warfarin.
Which statement by the patient indicates that the teaching has been effective?
A. "I will eat plenty of spinach and kale to keep my heart healthy."
B. "I will use a soft-bristled toothbrush and use an electric razor to shave."
C. "I can take ibuprofen for my daily headaches without any problems."
D. "I only need to have my blood checked once a year while on this medication."
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The priority teaching point here is bleeding precautions, and using soft
toothbrushes and electric razors minimizes the risk of uncontrolled bleeding. The patient
should avoid sudden increases in vitamin K foods like spinach, avoid NSAIDs like
ibuprofen, and have their INR checked frequently, not yearly.
Q5: A patient is taking metoprolol for hypertension. Which finding requires the nurse to
hold the medication and notify the provider?
A. Blood pressure of 118/76 mmHg
B. Apical pulse of 52 bpm
C. Respiratory rate of 18 breaths/min
D. Blood glucose of 110 mg/dL
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is the apical pulse of 52 bpm because metoprolol is a
beta-blocker that lowers heart rate. For the PN exam, remember the absolute rule to
hold a beta-blocker if the apical pulse is below 60 bpm to prevent severe bradycardia
and heart block.
Q6: A patient is prescribed amlodipine for hypertension. They report to the nurse that
their ankles are swollen at the end of the day but there is no pain. How should the nurse
respond?
, A. "Stop taking the medication immediately as you are having an allergic reaction."
B. "This is a common side effect called peripheral edema, and I will let your provider
know."
C. "You need to restrict all salt and water intake for the next three days."
D. "Elevate your legs and take a diuretic; you do not need to call the doctor."
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is recognizing that dose-dependent peripheral edema is a
very common side effect of calcium channel blockers like amlodipine. This aligns with
the fact that while it isn't an allergy, the provider still needs to know so they can adjust
the dose or switch the medication.
Q7: A nurse is reviewing the morning labs for a patient taking furosemide. The
potassium level is 3.1 mEq/L. Which assessment finding should the nurse monitor for
related to this lab result?
A. Muscle weakness and leg cramps
B. Confusion and hyperreflexia
C. Tented skin turgor and dry mucous membranes
D. Bounding pulses and a flushed face
Correct Answer: A [CORRECT]
Correct Answer: A
Rationale: The best answer is muscle weakness and cramps because furosemide is a
loop diuretic that wastes potassium, leading to hypokalemia. For the PN exam,
remember that low potassium causes decreased muscle excitability, which presents as
weakness and cramping.
Q8: A patient with heart failure is prescribed spironolactone. Which statement by the
patient indicates a need for further teaching regarding this medication?
A. "I will call my doctor if I start feeling very weak or tired."
B. "I will use a salt substitute to flavor my food instead of table salt."
C. "I should avoid eating large amounts of bananas and oranges."
D. "I will weigh myself every morning to check for fluid retention."
Correct Answer: B [CORRECT]
Correct Answer: B
Rationale: The best answer is the statement about salt substitutes because
spironolactone is a potassium-sparing diuretic, and most salt substitutes replace sodium
with potassium. This adverse effect requires immediate provider notification because
using them together can cause severe, life-threatening hyperkalemia.
