ATI PN PHARMACOLOGY PROCTORED EXAM WITH NGN 2023 RETAKE.
1–20: Basic Pharmacology & Safe Administration
1. A nurse is teaching a client about sublingual nitroglycerin. Which statement
indicates understanding?
A) “I will swallow the tablet with a full glass of water.”
B) “I can take up to 5 tablets in 15 minutes if pain continues.”
C) “I should feel a burning or tingling sensation under my tongue.”
D) “I will take it with food to prevent stomach upset.”
Answer: C
Rationale: Sublingual nitroglycerin causes a burning/tingling sensation if potent.
Swallowing inactivates it; max 3 tablets 5 min apart; take on empty stomach.
2. A client is prescribed metformin. The nurse should monitor for which adverse
effect?
A) Hypoglycemia
B) Lactic acidosis
C) Hyperkalemia
D) Hyperthyroidism
,Answer: B
Rationale: Metformin can cause lactic acidosis (rare but serious), especially in
renal impairment. Hypoglycemia is rare unless combined with other DM meds.
3. A nurse administers digoxin and notes a heart rate of 52 bpm. What is the
priority action?
A) Administer the dose as ordered
B) Hold the dose and notify the provider
C) Give atropine immediately
D) Recheck the heart rate in 30 minutes
Answer: B
Rationale: Hold digoxin if HR <60 bpm in adults (or per protocol) and notify
provider to prevent toxicity.
4. Which lab value should be monitored closely for a client on lisinopril?
A) Serum potassium
B) Platelet count
C) INR
D) Hemoglobin
,Answer: A
Rationale: ACE inhibitors (lisinopril) can cause hyperkalemia due to aldosterone
suppression.
5. A client taking warfarin has an INR of 4.5. The nurse should expect which
intervention?
A) Increase the warfarin dose
B) Administer vitamin K
C) Give protamine sulfate
D) No change in therapy
Answer: B
Rationale: INR >4.0 (therapeutic range 2–3 for most) indicates elevated bleeding
risk; vitamin K reverses warfarin effect.
6. Which statement by a client on prednisone requires immediate intervention?
A) “I take my dose every morning.”
B) “I stop the drug when I feel better.”
C) “I carry a medical alert card.”
, D) “I avoid people with infections.”
Answer: B
Rationale: Abruptly stopping corticosteroids can cause adrenal insufficiency.
Tapering is required.
7. The nurse administers furosemide. Which finding indicates a therapeutic
response?
A) Weight gain of 2 kg/day
B) Decreased crackles in lung bases
C) Increased blood pressure
D) Urine output of 20 mL/hr
Answer: B
Rationale: Furosemide reduces fluid overload → decreased crackles, weight loss,
increased urine output (>30 mL/hr).
8. A client receives morphine sulfate. The nurse should have which medication
available for reversal?
A) Flumazenil
1–20: Basic Pharmacology & Safe Administration
1. A nurse is teaching a client about sublingual nitroglycerin. Which statement
indicates understanding?
A) “I will swallow the tablet with a full glass of water.”
B) “I can take up to 5 tablets in 15 minutes if pain continues.”
C) “I should feel a burning or tingling sensation under my tongue.”
D) “I will take it with food to prevent stomach upset.”
Answer: C
Rationale: Sublingual nitroglycerin causes a burning/tingling sensation if potent.
Swallowing inactivates it; max 3 tablets 5 min apart; take on empty stomach.
2. A client is prescribed metformin. The nurse should monitor for which adverse
effect?
A) Hypoglycemia
B) Lactic acidosis
C) Hyperkalemia
D) Hyperthyroidism
,Answer: B
Rationale: Metformin can cause lactic acidosis (rare but serious), especially in
renal impairment. Hypoglycemia is rare unless combined with other DM meds.
3. A nurse administers digoxin and notes a heart rate of 52 bpm. What is the
priority action?
A) Administer the dose as ordered
B) Hold the dose and notify the provider
C) Give atropine immediately
D) Recheck the heart rate in 30 minutes
Answer: B
Rationale: Hold digoxin if HR <60 bpm in adults (or per protocol) and notify
provider to prevent toxicity.
4. Which lab value should be monitored closely for a client on lisinopril?
A) Serum potassium
B) Platelet count
C) INR
D) Hemoglobin
,Answer: A
Rationale: ACE inhibitors (lisinopril) can cause hyperkalemia due to aldosterone
suppression.
5. A client taking warfarin has an INR of 4.5. The nurse should expect which
intervention?
A) Increase the warfarin dose
B) Administer vitamin K
C) Give protamine sulfate
D) No change in therapy
Answer: B
Rationale: INR >4.0 (therapeutic range 2–3 for most) indicates elevated bleeding
risk; vitamin K reverses warfarin effect.
6. Which statement by a client on prednisone requires immediate intervention?
A) “I take my dose every morning.”
B) “I stop the drug when I feel better.”
C) “I carry a medical alert card.”
, D) “I avoid people with infections.”
Answer: B
Rationale: Abruptly stopping corticosteroids can cause adrenal insufficiency.
Tapering is required.
7. The nurse administers furosemide. Which finding indicates a therapeutic
response?
A) Weight gain of 2 kg/day
B) Decreased crackles in lung bases
C) Increased blood pressure
D) Urine output of 20 mL/hr
Answer: B
Rationale: Furosemide reduces fluid overload → decreased crackles, weight loss,
increased urine output (>30 mL/hr).
8. A client receives morphine sulfate. The nurse should have which medication
available for reversal?
A) Flumazenil
