ATI RN PHARMACOLOGY
ATI RN Pharmacology Proctored Exam Test Bank 9.0 | All
48 Chapters | Chapter-Based Questions With Detailed
Explanations
A client is prescribed digoxin for heart failure. Which finding requires immediate
intervention?
A. Heart rate of 58 bpm
B. Serum potassium of 3.2 mEq/L
C. Nausea and vomiting
D. Visual changes of yellow-green halos
Answer: B. Serum potassium of 3.2 mEq/L
Rationale: Hypokalemia (K <3.5) increases the risk of digoxin toxicity. The nurse
should hold digoxin and notify the provider for potassium repletion. HR of 58 is
acceptable (hold if <60 depending on protocol), but hypokalemia is more dangerous.
A client is prescribed warfarin for atrial fibrillation. Which laboratory test is used to
monitor therapy?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
Answer: B. INR
Rationale: INR (International Normalized Ratio) is the standard monitor for warfarin.
Target INR for atrial fibrillation is 2.0-3.0. aPTT monitors heparin.
A client is prescribed furosemide for heart failure. Which finding indicates the
medication is effective?
A. Weight loss of 2 kg in 24 hours
B. Blood pressure 90/60 mmHg
C. Potassium level 3.2 mEq/L
D. Increased shortness of breath
Answer: A. Weight loss of 2 kg in 24 hours
Rationale: Weight loss due to diuresis indicates effectiveness. Hypotension and
hypokalemia are adverse effects, not indicators of efficacy. Increased dyspnea suggests
worsening failure.
, ATI RN PHARMACOLOGY
A client is prescribed lisinopril. Which adverse effect requires discontinuation of the
medication?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. Dizziness
Answer: C. Angioedema
Rationale: Angioedema (swelling of lips, tongue, airway) is a life-threatening allergic
reaction requiring immediate discontinuation and emergency treatment.
A client is prescribed metformin for type 2 diabetes. Which side effect should the
client be instructed to report immediately?
A. Mild nausea
B. Diarrhea
C. Metallic taste
D. Muscle pain or weakness
Answer: D. Muscle pain or weakness
Rationale: Muscle pain or weakness may indicate lactic acidosis, a rare but serious
complication of metformin.
A client is prescribed albuterol via metered-dose inhaler. Which instruction is correct?
A. Inhale rapidly and deeply
B. Hold the breath for 10 seconds after inhalation
C. Use the inhaler every 2 hours around the clock
D. Rinse mouth after every use
Answer: B. Hold the breath for 10 seconds after inhalation
Rationale: After inhaling albuterol, hold breath for 10 seconds to allow deposition in
the airways. Inhale slowly, not rapidly. Use as needed (not scheduled).
A client receiving a blood transfusion develops chills, fever, and lower back pain 30
minutes after the start. What is the priority action?
A. Slow the infusion rate
B. Administer acetaminophen as ordered
C. Stop the transfusion and start normal saline
D. Obtain a urine sample
Answer: C. Stop the transfusion and start normal saline
Rationale: These symptoms suggest an acute hemolytic reaction. Stop the transfusion
immediately, keep the IV line open with saline, notify the provider, and send the blood
bag to the lab.
, ATI RN PHARMACOLOGY
A client with COPD has an oxygen saturation of 88% on room air. The nurse applies 2
L/min nasal cannula. Which finding indicates a complication of oxygen therapy?
A. Respiratory rate increase from 22 to 24
B. Patient reports less dyspnea
C. Oxygen saturation rises to 92%
D. Patient becomes lethargic with shallow breathing
Answer: D. Patient becomes lethargic with shallow breathing
Rationale: COPD patients may have hypoxic drive. Lethargy and hypoventilation
indicate oxygen-induced hypercapnia. Target SpO2 for COPD is 88-92%.
A client is admitted with diabetic ketoacidosis (DKA). Which lab finding is consistent
with this condition?
A. pH 7.38, HCO3 24, glucose 180
B. pH 7.30, HCO3 18, glucose 450
C. pH 7.50, HCO3 30, glucose 120
D. pH 7.45, HCO3 26, glucose 250
Answer: B. pH 7.30, HCO3 18, glucose 450
Rationale: DKA presents with metabolic acidosis (low pH, low HCO3), hyperglycemia
(>250), and often ketones.
A client is prescribed lithium for bipolar disorder. Which finding suggests toxicity?
A. Fine hand tremors and nausea
B. Coarse tremors, ataxia, and confusion
C. Weight gain and sedation
D. Polyuria and polydipsia
Answer: B. Coarse tremors, ataxia, and confusion
Rationale: Early lithium toxicity (1.5-2.0 mEq/L) includes coarse tremors, ataxia,
nausea, confusion. Fine tremors and nausea can occur at therapeutic levels (0.6-1.2).
A client is prescribed enoxaparin subcutaneously for DVT prophylaxis. Which
technique is correct?
A. Expel the air bubble before injection
B. Massage the site after injection
C. Inject into the abdomen while pinching a skin fold
D. Use a 21-gauge needle
Answer: C. Inject into the abdomen while pinching a skin fold
Rationale: Enoxaparin (Lovenox) is given subcutaneously in the abdomen, pinching a
skin fold. Do not expel the air bubble (prevents leakage). Do not massage (increases
bruising).
, ATI RN PHARMACOLOGY
A client is prescribed omeprazole for peptic ulcer disease. The nurse should teach the
client to take this medication:
A. With food at bedtime
B. 30 minutes before breakfast
C. Immediately after meals
D. With an antacid for best effect
Answer: B. 30 minutes before breakfast
Rationale: Proton pump inhibitors like omeprazole are most effective when taken 30-
60 minutes before the first meal of the day (empty stomach).
A client is prescribed morphine for pain. The client becomes hypotensive and
bradycardic. Which medication should the nurse prepare to administer?
A. Naloxone
B. Flumazenil
C. Atropine
D. Epinephrine
Answer: A. Naloxone
Rationale: Naloxone reverses opioid effects including respiratory depression,
hypotension, and bradycardia. Flumazenil reverses benzodiazepines. Atropine treats
bradycardia but does not address the cause (morphine).
A client is prescribed vancomycin IV. The client reports flushing and a rash on the
neck and chest. What is the priority action?
A. Stop the infusion
B. Slow the infusion rate
C. Administer diphenhydramine
D. Document the finding as a known side effect
Answer: A. Stop the infusion
Rationale: These symptoms suggest Red Man Syndrome, a histamine reaction from
rapid vancomycin infusion. The priority is to stop the infusion, then notify the provider.
Slowing the rate may be done after the reaction is controlled.
A client is prescribed insulin glargine. The nurse should teach the client that this
insulin:
A. Should be given twice daily before meals
B. Has a peak effect in 2-4 hours
C. Cannot be mixed with other insulins in the same syringe
D. Is clear in appearance and given IV
Answer: C. Cannot be mixed with other insulins in the same syringe
Rationale: Insulin glargine is a long-acting basal insulin that is clear but should not be
ATI RN Pharmacology Proctored Exam Test Bank 9.0 | All
48 Chapters | Chapter-Based Questions With Detailed
Explanations
A client is prescribed digoxin for heart failure. Which finding requires immediate
intervention?
A. Heart rate of 58 bpm
B. Serum potassium of 3.2 mEq/L
C. Nausea and vomiting
D. Visual changes of yellow-green halos
Answer: B. Serum potassium of 3.2 mEq/L
Rationale: Hypokalemia (K <3.5) increases the risk of digoxin toxicity. The nurse
should hold digoxin and notify the provider for potassium repletion. HR of 58 is
acceptable (hold if <60 depending on protocol), but hypokalemia is more dangerous.
A client is prescribed warfarin for atrial fibrillation. Which laboratory test is used to
monitor therapy?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
Answer: B. INR
Rationale: INR (International Normalized Ratio) is the standard monitor for warfarin.
Target INR for atrial fibrillation is 2.0-3.0. aPTT monitors heparin.
A client is prescribed furosemide for heart failure. Which finding indicates the
medication is effective?
A. Weight loss of 2 kg in 24 hours
B. Blood pressure 90/60 mmHg
C. Potassium level 3.2 mEq/L
D. Increased shortness of breath
Answer: A. Weight loss of 2 kg in 24 hours
Rationale: Weight loss due to diuresis indicates effectiveness. Hypotension and
hypokalemia are adverse effects, not indicators of efficacy. Increased dyspnea suggests
worsening failure.
, ATI RN PHARMACOLOGY
A client is prescribed lisinopril. Which adverse effect requires discontinuation of the
medication?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. Dizziness
Answer: C. Angioedema
Rationale: Angioedema (swelling of lips, tongue, airway) is a life-threatening allergic
reaction requiring immediate discontinuation and emergency treatment.
A client is prescribed metformin for type 2 diabetes. Which side effect should the
client be instructed to report immediately?
A. Mild nausea
B. Diarrhea
C. Metallic taste
D. Muscle pain or weakness
Answer: D. Muscle pain or weakness
Rationale: Muscle pain or weakness may indicate lactic acidosis, a rare but serious
complication of metformin.
A client is prescribed albuterol via metered-dose inhaler. Which instruction is correct?
A. Inhale rapidly and deeply
B. Hold the breath for 10 seconds after inhalation
C. Use the inhaler every 2 hours around the clock
D. Rinse mouth after every use
Answer: B. Hold the breath for 10 seconds after inhalation
Rationale: After inhaling albuterol, hold breath for 10 seconds to allow deposition in
the airways. Inhale slowly, not rapidly. Use as needed (not scheduled).
A client receiving a blood transfusion develops chills, fever, and lower back pain 30
minutes after the start. What is the priority action?
A. Slow the infusion rate
B. Administer acetaminophen as ordered
C. Stop the transfusion and start normal saline
D. Obtain a urine sample
Answer: C. Stop the transfusion and start normal saline
Rationale: These symptoms suggest an acute hemolytic reaction. Stop the transfusion
immediately, keep the IV line open with saline, notify the provider, and send the blood
bag to the lab.
, ATI RN PHARMACOLOGY
A client with COPD has an oxygen saturation of 88% on room air. The nurse applies 2
L/min nasal cannula. Which finding indicates a complication of oxygen therapy?
A. Respiratory rate increase from 22 to 24
B. Patient reports less dyspnea
C. Oxygen saturation rises to 92%
D. Patient becomes lethargic with shallow breathing
Answer: D. Patient becomes lethargic with shallow breathing
Rationale: COPD patients may have hypoxic drive. Lethargy and hypoventilation
indicate oxygen-induced hypercapnia. Target SpO2 for COPD is 88-92%.
A client is admitted with diabetic ketoacidosis (DKA). Which lab finding is consistent
with this condition?
A. pH 7.38, HCO3 24, glucose 180
B. pH 7.30, HCO3 18, glucose 450
C. pH 7.50, HCO3 30, glucose 120
D. pH 7.45, HCO3 26, glucose 250
Answer: B. pH 7.30, HCO3 18, glucose 450
Rationale: DKA presents with metabolic acidosis (low pH, low HCO3), hyperglycemia
(>250), and often ketones.
A client is prescribed lithium for bipolar disorder. Which finding suggests toxicity?
A. Fine hand tremors and nausea
B. Coarse tremors, ataxia, and confusion
C. Weight gain and sedation
D. Polyuria and polydipsia
Answer: B. Coarse tremors, ataxia, and confusion
Rationale: Early lithium toxicity (1.5-2.0 mEq/L) includes coarse tremors, ataxia,
nausea, confusion. Fine tremors and nausea can occur at therapeutic levels (0.6-1.2).
A client is prescribed enoxaparin subcutaneously for DVT prophylaxis. Which
technique is correct?
A. Expel the air bubble before injection
B. Massage the site after injection
C. Inject into the abdomen while pinching a skin fold
D. Use a 21-gauge needle
Answer: C. Inject into the abdomen while pinching a skin fold
Rationale: Enoxaparin (Lovenox) is given subcutaneously in the abdomen, pinching a
skin fold. Do not expel the air bubble (prevents leakage). Do not massage (increases
bruising).
, ATI RN PHARMACOLOGY
A client is prescribed omeprazole for peptic ulcer disease. The nurse should teach the
client to take this medication:
A. With food at bedtime
B. 30 minutes before breakfast
C. Immediately after meals
D. With an antacid for best effect
Answer: B. 30 minutes before breakfast
Rationale: Proton pump inhibitors like omeprazole are most effective when taken 30-
60 minutes before the first meal of the day (empty stomach).
A client is prescribed morphine for pain. The client becomes hypotensive and
bradycardic. Which medication should the nurse prepare to administer?
A. Naloxone
B. Flumazenil
C. Atropine
D. Epinephrine
Answer: A. Naloxone
Rationale: Naloxone reverses opioid effects including respiratory depression,
hypotension, and bradycardia. Flumazenil reverses benzodiazepines. Atropine treats
bradycardia but does not address the cause (morphine).
A client is prescribed vancomycin IV. The client reports flushing and a rash on the
neck and chest. What is the priority action?
A. Stop the infusion
B. Slow the infusion rate
C. Administer diphenhydramine
D. Document the finding as a known side effect
Answer: A. Stop the infusion
Rationale: These symptoms suggest Red Man Syndrome, a histamine reaction from
rapid vancomycin infusion. The priority is to stop the infusion, then notify the provider.
Slowing the rate may be done after the reaction is controlled.
A client is prescribed insulin glargine. The nurse should teach the client that this
insulin:
A. Should be given twice daily before meals
B. Has a peak effect in 2-4 hours
C. Cannot be mixed with other insulins in the same syringe
D. Is clear in appearance and given IV
Answer: C. Cannot be mixed with other insulins in the same syringe
Rationale: Insulin glargine is a long-acting basal insulin that is clear but should not be
