ATI PN Pharmacology Proctored Exam Review
2026/2027 | LPN Study Guide with NCLEX-Style
Questions & Rationales| Verified 100%|
1.) A nurse is assisting with caring for a client with cancer who is receiving
cisplatin. Select the adverse effects that the nurse monitors for that are associated
with this medication. Select all that apply.
1. Tinnitus
2. Ototoxicity
3. Hyperkalemia
4. Hypercalcemia
5. Nephrotoxicity
6. Hypomagnesemia - ANSWER -1. Tinnitus
2. Ototoxicity
5. Nephrotoxicity
6. Hypomagnesemia
Rationale:
Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-
nonspecific medications that affect the synthesis of DNA by causing the cross-
linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity,
tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity.
Amifostine (Ethyol) may be administered before cisplatin to reduce the potential
for renal toxicity.
2.) A nurse is caring for a client after thyroidectomy and notes that calcium
gluconate is prescribed for the client. The nurse determines that this medication has
been prescribed to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - ANSWER -3. Treat
hypocalcemic tetany.
Rationale:
,Hypocalcemia can develop after thyroidectomy if the parathyroid glands are
accidentally removed or injured during surgery. Manifestations develop 1 to 7 days
after surgery. If the client develops numbness and tingling around the mouth,
fingertips, or toes or muscle spasms or twitching, the health care provider is
notified immediately. Calcium gluconate should be kept at the bedside.
3.) A client who has been newly diagnosed with diabetes mellitus has been
stabilized with daily insulin injections. Which information should the nurse teach
when carrying out plans for discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - ANSWER -2.
Rotate the insulin injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual exercise. If
acetone is found in the urine, it may possibly indicate the need for additional
insulin. To minimize the discomfort associated with insulin injections, the insulin
should be administered at room temperature. Injection sites should be
systematically rotated from one area to another. The client should be instructed to
give injections in one area, about 1 inch apart, until the whole area has been used
and then to change to another site. This prevents dramatic changes in daily insulin
absorption.
4.) A nurse is reinforcing teaching for a client regarding how to mix regular
insulin and NPH insulin in the same syringe. Which of the following actions, if
performed by the client, indicates the need for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into the vial -
ANSWER -1. Withdraws the NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin preparation, the
regular insulin is drawn into the syringe first. This sequence will avoid
,contaminating the vial of regular insulin with insulin of another type. Options 2, 3,
and 4 identify the correct actions for preparing NPH and regular insulin.
5.) A home care nurse visits a client recently diagnosed with diabetes mellitus who
is taking Humulin NPH insulin daily. The client asks the nurse how to store the
unopened vials of insulin. The nurse tells the client to:
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
4. Keep the insulin at room temperature. - ANSWER -2. Refrigerate the insulin.
Rationale:
Insulin in unopened vials should be stored under refrigeration until needed. Vials
should not be frozen. When stored unopened under refrigeration, insulin can be
used up to the expiration date on the vial. Options 1, 3, and 4 are incorrect.
6.) Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse
reinforces instructions for the client and tells the client to avoid which of the
following while taking this medication?
1. Alcohol
2. Organ meats
3. Whole-grain cereals
4. Carbonated beverages - ANSWER -1. Alcohol
Rationale:
When alcohol is combined with glimepiride (Amaryl), a disulfiram-like reaction
may occur. This syndrome includes flushing, palpitations, and nausea. Alcohol can
also potentiate the hypoglycemic effects of the medication. Clients need to be
instructed to avoid alcohol consumption while taking this medication. The items in
options 2, 3, and 4 do not need to be avoided.
7.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A
nurse reviews the client's medical record and would question the prescription if
which of the following is noted in the client's history?
1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
, 4. Use of multivitamins - ANSWER -3. Use of nitroglycerin
Rationale:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus
cavernosum of the penis, thus sustaining an erection. Because of the effect of the
medication, it is contraindicated with concurrent use of organic nitrates and
nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia
and insomnia are side effects of the medication.
8.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with
type 1 diabetes mellitus who takes insulin. The nurse knows that which of the
following is the appropriate intervention?
1. The medication is administered within 60 minutes before the morning and
evening meal.
2. The medication is withheld and the HCP is called to question the prescription
for the client.
3. The client is monitored for gastrointestinal side effects after administration of
the medication.
4. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for
administration. - ANSWER -2. The medication is withheld and the HCP is called
to question the prescription for the client.
Rationale:
Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus only. It
is not recommended for clients taking insulin. Hence, the nurse should hold the
medication and question the HCP regarding this prescription. Although options 1
and 3 are correct statements about the medication, in this situation the medication
should not be administered. The medication is packaged in prefilled pens ready for
injection without the need for drawing it up into another syringe.
9.) A client is taking Humulin NPH insulin daily every morning. The nurse
reinforces instructions for the client and tells the client that the most likely time for
a hypoglycemic reaction to occur is:
1. 2 to 4 hours after administration
2. 4 to 12 hours after administration
3. 16 to 18 hours after administration
2026/2027 | LPN Study Guide with NCLEX-Style
Questions & Rationales| Verified 100%|
1.) A nurse is assisting with caring for a client with cancer who is receiving
cisplatin. Select the adverse effects that the nurse monitors for that are associated
with this medication. Select all that apply.
1. Tinnitus
2. Ototoxicity
3. Hyperkalemia
4. Hypercalcemia
5. Nephrotoxicity
6. Hypomagnesemia - ANSWER -1. Tinnitus
2. Ototoxicity
5. Nephrotoxicity
6. Hypomagnesemia
Rationale:
Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-
nonspecific medications that affect the synthesis of DNA by causing the cross-
linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity,
tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity.
Amifostine (Ethyol) may be administered before cisplatin to reduce the potential
for renal toxicity.
2.) A nurse is caring for a client after thyroidectomy and notes that calcium
gluconate is prescribed for the client. The nurse determines that this medication has
been prescribed to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - ANSWER -3. Treat
hypocalcemic tetany.
Rationale:
,Hypocalcemia can develop after thyroidectomy if the parathyroid glands are
accidentally removed or injured during surgery. Manifestations develop 1 to 7 days
after surgery. If the client develops numbness and tingling around the mouth,
fingertips, or toes or muscle spasms or twitching, the health care provider is
notified immediately. Calcium gluconate should be kept at the bedside.
3.) A client who has been newly diagnosed with diabetes mellitus has been
stabilized with daily insulin injections. Which information should the nurse teach
when carrying out plans for discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - ANSWER -2.
Rotate the insulin injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual exercise. If
acetone is found in the urine, it may possibly indicate the need for additional
insulin. To minimize the discomfort associated with insulin injections, the insulin
should be administered at room temperature. Injection sites should be
systematically rotated from one area to another. The client should be instructed to
give injections in one area, about 1 inch apart, until the whole area has been used
and then to change to another site. This prevents dramatic changes in daily insulin
absorption.
4.) A nurse is reinforcing teaching for a client regarding how to mix regular
insulin and NPH insulin in the same syringe. Which of the following actions, if
performed by the client, indicates the need for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into the vial -
ANSWER -1. Withdraws the NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin preparation, the
regular insulin is drawn into the syringe first. This sequence will avoid
,contaminating the vial of regular insulin with insulin of another type. Options 2, 3,
and 4 identify the correct actions for preparing NPH and regular insulin.
5.) A home care nurse visits a client recently diagnosed with diabetes mellitus who
is taking Humulin NPH insulin daily. The client asks the nurse how to store the
unopened vials of insulin. The nurse tells the client to:
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
4. Keep the insulin at room temperature. - ANSWER -2. Refrigerate the insulin.
Rationale:
Insulin in unopened vials should be stored under refrigeration until needed. Vials
should not be frozen. When stored unopened under refrigeration, insulin can be
used up to the expiration date on the vial. Options 1, 3, and 4 are incorrect.
6.) Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse
reinforces instructions for the client and tells the client to avoid which of the
following while taking this medication?
1. Alcohol
2. Organ meats
3. Whole-grain cereals
4. Carbonated beverages - ANSWER -1. Alcohol
Rationale:
When alcohol is combined with glimepiride (Amaryl), a disulfiram-like reaction
may occur. This syndrome includes flushing, palpitations, and nausea. Alcohol can
also potentiate the hypoglycemic effects of the medication. Clients need to be
instructed to avoid alcohol consumption while taking this medication. The items in
options 2, 3, and 4 do not need to be avoided.
7.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A
nurse reviews the client's medical record and would question the prescription if
which of the following is noted in the client's history?
1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
, 4. Use of multivitamins - ANSWER -3. Use of nitroglycerin
Rationale:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus
cavernosum of the penis, thus sustaining an erection. Because of the effect of the
medication, it is contraindicated with concurrent use of organic nitrates and
nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia
and insomnia are side effects of the medication.
8.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with
type 1 diabetes mellitus who takes insulin. The nurse knows that which of the
following is the appropriate intervention?
1. The medication is administered within 60 minutes before the morning and
evening meal.
2. The medication is withheld and the HCP is called to question the prescription
for the client.
3. The client is monitored for gastrointestinal side effects after administration of
the medication.
4. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for
administration. - ANSWER -2. The medication is withheld and the HCP is called
to question the prescription for the client.
Rationale:
Exenatide (Byetta) is an incretin mimetic used for type 2 diabetes mellitus only. It
is not recommended for clients taking insulin. Hence, the nurse should hold the
medication and question the HCP regarding this prescription. Although options 1
and 3 are correct statements about the medication, in this situation the medication
should not be administered. The medication is packaged in prefilled pens ready for
injection without the need for drawing it up into another syringe.
9.) A client is taking Humulin NPH insulin daily every morning. The nurse
reinforces instructions for the client and tells the client that the most likely time for
a hypoglycemic reaction to occur is:
1. 2 to 4 hours after administration
2. 4 to 12 hours after administration
3. 16 to 18 hours after administration
