CMS ATI Pharmacology Proctored Exam
ACTUAL EXAM 2026/2027 | ATI
Pharmacology Proctored | Verified Q&A |
Pass Guaranteed - A+ Graded
Total Questions: 70
Time Suggested: 70 Minutes
SECTION 1: CARDIOVASCULAR MEDICATIONS (Qs 1–12)
Q1: A nurse is caring for a client who has heart failure and is receiving digoxin (Lanoxin) daily. The client
reports nausea, vomiting, and seeing yellow halos around lights. The nurse notes the client’s heart rate
is 52/min. Which of the following actions should the nurse take first?
A. Administer an antiemetic.
B. Check the client’s electrolyte levels.
C. Obtain a serum digoxin level. [CORRECT]
D. Administer atropine for bradycardia.
Correct Answer: C
Rationale:
C is correct: The client is displaying classic signs of digoxin toxicity (nausea, visual disturbances,
bradycardia). The priority action is to confirm toxicity by obtaining a serum drug level before further
action.
A is wrong: Treating nausea does not address the underlying cause (toxicity).
,B is wrong: Hypokalemia increases risk of toxicity, so checking K+ is important, but confirming the
toxicity level is the immediate diagnostic priority.
D is wrong: Atropine is for symptomatic bradycardia, but treating toxicity is the priority here; holding the
digoxin is the first step.
Key Takeaway: Visual halos + Bradycardia = Digoxin Toxicity. Stop the drug & Check the level.
Q2: A nurse is teaching a client who is starting warfarin (Coumadin) therapy. The nurse should instruct
the client to avoid consuming large amounts of which of the following foods?
A. Citrus fruits
B. Green, leafy vegetables [CORRECT]
C. Dairy products
D. Whole grains
Correct Answer: B
Rationale:
B is correct: Green, leafy vegetables (spinach, kale, broccoli) are high in Vitamin K. Vitamin K is the
antidote for warfarin and antagonizes its effect, leading to unstable INR levels.
A is wrong: Citrus can affect other drugs (like grapefruit with statins), but not warfarin significantly.
Key Takeaway: Warfarin = Vitamin K antagonist. High Vitamin K intake = Decreased Warfarin effect (Risk
of Clot).
Q3: A client is receiving heparin therapy for a deep vein thrombosis (DVT). The nurse notes the aPTT is
90 seconds (control is 35 seconds). The protocol states to give Protamine Sulfate. The nurse understands
that this medication acts as:
A. A potent vasoconstrictor.
B. An agonist for antithrombin III.
C. A specific antagonist for heparin. [CORRECT]
D. A thrombolytic agent.
,Correct Answer: C
Rationale:
C is correct: Protamine sulfate is the specific antidote for heparin overdose (1 mg neutralizes ~100 units
of heparin).
A & B are wrong: Incorrect mechanisms.
D is wrong: Thrombolytics (tPA) dissolve clots; Protamine reverses anticoagulation.
Key Takeaway: Heparin Overdose (High aPTT) = Protamine Sulfate.
Q4: A nurse is monitoring a client who is taking enalapril (Vasotec) for hypertension. Which of the
following is an adverse effect the nurse should monitor for?
A. Hyperkalemia [CORRECT]
B. Hypoglycemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: A
Rationale:
A is correct: ACE inhibitors (ending in -pril) inhibit the release of aldosterone. Aldosterone normally
causes sodium retention and potassium excretion; blocking it leads to potassium retention
(hyperkalemia).
Key Takeaway: ACE Inhibitors (-prils) = Hold Potassium. Monitor K+ levels.
Q5: A nurse is providing teaching to a client who has a new prescription for nitroglycerin (Nitrostat)
sublingual tablets. Which instruction should the nurse include?
A. "Swallow the tablet whole with a glass of water."
B. "Take one tablet every 5 minutes for 15 minutes until chest pain is relieved."
C. "Store the medication in a dark, tightly closed container." [CORRECT]
, D. "Expect a headache to be a sign of toxicity."
Correct Answer: C
Rationale:
C is correct: Nitroglycerin loses potency when exposed to light, heat, and moisture. It must be stored in
a dark, glass container.
A is wrong: SL tablets must dissolve under the tongue.
B is wrong: The correct dosing is 1 tablet q5min x 3 doses. If pain persists after 3 doses (15 min), call 911.
D is wrong: Headache is a common side effect (vasodilation), not toxicity.
Key Takeaway: Nitro Storage = Dark, cool, dry. Headache = Vasodilation (Common).
Q6: A client is taking atorvastatin (Lipitor). Which finding should the nurse report to the provider
immediately?
A. Elevated liver enzymes
B. Muscle pain and weakness [CORRECT]
C. Dry cough
D. Photosensitivity
Correct Answer: B
Rationale:
B is correct: Statins carry a risk of rhabdomyolysis (muscle breakdown). Muscle pain/weakness is the
warning sign and can lead to acute kidney injury.
A is wrong: Elevated liver enzymes are a concern, but rhabdomyolysis is an acute medical emergency
causing kidney failure.
C is wrong: Dry cough is an ACE inhibitor side effect.
Key Takeaway: Statins + Muscle Pain = Rhabdomyolysis (Stop med, check CK levels).
ACTUAL EXAM 2026/2027 | ATI
Pharmacology Proctored | Verified Q&A |
Pass Guaranteed - A+ Graded
Total Questions: 70
Time Suggested: 70 Minutes
SECTION 1: CARDIOVASCULAR MEDICATIONS (Qs 1–12)
Q1: A nurse is caring for a client who has heart failure and is receiving digoxin (Lanoxin) daily. The client
reports nausea, vomiting, and seeing yellow halos around lights. The nurse notes the client’s heart rate
is 52/min. Which of the following actions should the nurse take first?
A. Administer an antiemetic.
B. Check the client’s electrolyte levels.
C. Obtain a serum digoxin level. [CORRECT]
D. Administer atropine for bradycardia.
Correct Answer: C
Rationale:
C is correct: The client is displaying classic signs of digoxin toxicity (nausea, visual disturbances,
bradycardia). The priority action is to confirm toxicity by obtaining a serum drug level before further
action.
A is wrong: Treating nausea does not address the underlying cause (toxicity).
,B is wrong: Hypokalemia increases risk of toxicity, so checking K+ is important, but confirming the
toxicity level is the immediate diagnostic priority.
D is wrong: Atropine is for symptomatic bradycardia, but treating toxicity is the priority here; holding the
digoxin is the first step.
Key Takeaway: Visual halos + Bradycardia = Digoxin Toxicity. Stop the drug & Check the level.
Q2: A nurse is teaching a client who is starting warfarin (Coumadin) therapy. The nurse should instruct
the client to avoid consuming large amounts of which of the following foods?
A. Citrus fruits
B. Green, leafy vegetables [CORRECT]
C. Dairy products
D. Whole grains
Correct Answer: B
Rationale:
B is correct: Green, leafy vegetables (spinach, kale, broccoli) are high in Vitamin K. Vitamin K is the
antidote for warfarin and antagonizes its effect, leading to unstable INR levels.
A is wrong: Citrus can affect other drugs (like grapefruit with statins), but not warfarin significantly.
Key Takeaway: Warfarin = Vitamin K antagonist. High Vitamin K intake = Decreased Warfarin effect (Risk
of Clot).
Q3: A client is receiving heparin therapy for a deep vein thrombosis (DVT). The nurse notes the aPTT is
90 seconds (control is 35 seconds). The protocol states to give Protamine Sulfate. The nurse understands
that this medication acts as:
A. A potent vasoconstrictor.
B. An agonist for antithrombin III.
C. A specific antagonist for heparin. [CORRECT]
D. A thrombolytic agent.
,Correct Answer: C
Rationale:
C is correct: Protamine sulfate is the specific antidote for heparin overdose (1 mg neutralizes ~100 units
of heparin).
A & B are wrong: Incorrect mechanisms.
D is wrong: Thrombolytics (tPA) dissolve clots; Protamine reverses anticoagulation.
Key Takeaway: Heparin Overdose (High aPTT) = Protamine Sulfate.
Q4: A nurse is monitoring a client who is taking enalapril (Vasotec) for hypertension. Which of the
following is an adverse effect the nurse should monitor for?
A. Hyperkalemia [CORRECT]
B. Hypoglycemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: A
Rationale:
A is correct: ACE inhibitors (ending in -pril) inhibit the release of aldosterone. Aldosterone normally
causes sodium retention and potassium excretion; blocking it leads to potassium retention
(hyperkalemia).
Key Takeaway: ACE Inhibitors (-prils) = Hold Potassium. Monitor K+ levels.
Q5: A nurse is providing teaching to a client who has a new prescription for nitroglycerin (Nitrostat)
sublingual tablets. Which instruction should the nurse include?
A. "Swallow the tablet whole with a glass of water."
B. "Take one tablet every 5 minutes for 15 minutes until chest pain is relieved."
C. "Store the medication in a dark, tightly closed container." [CORRECT]
, D. "Expect a headache to be a sign of toxicity."
Correct Answer: C
Rationale:
C is correct: Nitroglycerin loses potency when exposed to light, heat, and moisture. It must be stored in
a dark, glass container.
A is wrong: SL tablets must dissolve under the tongue.
B is wrong: The correct dosing is 1 tablet q5min x 3 doses. If pain persists after 3 doses (15 min), call 911.
D is wrong: Headache is a common side effect (vasodilation), not toxicity.
Key Takeaway: Nitro Storage = Dark, cool, dry. Headache = Vasodilation (Common).
Q6: A client is taking atorvastatin (Lipitor). Which finding should the nurse report to the provider
immediately?
A. Elevated liver enzymes
B. Muscle pain and weakness [CORRECT]
C. Dry cough
D. Photosensitivity
Correct Answer: B
Rationale:
B is correct: Statins carry a risk of rhabdomyolysis (muscle breakdown). Muscle pain/weakness is the
warning sign and can lead to acute kidney injury.
A is wrong: Elevated liver enzymes are a concern, but rhabdomyolysis is an acute medical emergency
causing kidney failure.
C is wrong: Dry cough is an ACE inhibitor side effect.
Key Takeaway: Statins + Muscle Pain = Rhabdomyolysis (Stop med, check CK levels).
