ATI RN Pharmacology Proctored Exam 2026 Test Bank |
High-Yield NCLEX-Style Questions & Answers with Detailed
Rationales (Full-Length Scenarios Questions) | Ultimate
Study Guide Bundle
Q1.
A nurse is preparing to administer lisinopril to a client who has hypertension and a history of
chronic kidney disease. The nurse reviews the client’s morning laboratory results and vital
signs. Which finding should prompt the nurse to withhold the medication and notify the
provider?
A. Blood pressure of 142/88 mmHg
B. Heart rate of 82 bpm
C. Potassium level of 5.9 mEq/L
D. Respiratory rate of 18 breaths per minute
Rationale: ACE inhibitors like lisinopril increase potassium levels. Hyperkalemia places the
client at risk for life-threatening dysrhythmias.
Q2.
A nurse is teaching a client newly prescribed metformin for type 2 diabetes mellitus. Which
statement by the client demonstrates appropriate understanding of the medication regimen?
A. “I will take the medication only when my blood sugar is elevated.”
B. “I should avoid eating while taking this medication.”
C. “If I feel dizzy, I will double my dose the next time.”
D. “I will take this medication with meals to reduce stomach upset.”
Rationale: Metformin commonly causes GI upset; taking it with meals reduces adverse
effects.
Q3
A nurse is monitoring a client receiving warfarin therapy for atrial fibrillation. Which
laboratory result indicates that the medication is within the therapeutic range?
,A. INR of 2.4
B. INR of 1.1
C. INR of 1.5
D. INR of 4.8
Rationale: Therapeutic INR range for most conditions is 2.0–3.0.
Q4.
A nurse is caring for a client receiving furosemide for fluid overload secondary to heart
failure. Which assessment finding requires immediate intervention?
A. Weight loss of 1 kg in 24 hours
B. Urine output of 45 mL/hr
C. Blood pressure of 130/78 mmHg
D. Serum potassium level of 3.1 mEq/L
Rationale: Loop diuretics cause potassium loss; hypokalemia can lead to dysrhythmias.
Q5.
A nurse is administering digoxin to a client with heart failure. Which finding should prompt
the nurse to withhold the medication?
A. Blood pressure 130/82 mmHg
B. Apical pulse of 52 beats per minute
C. Respiratory rate of 20 breaths per minute
D. Oxygen saturation of 95%
Rationale: Digoxin should be held if HR <60 bpm due to risk of bradycardia.
Q6.
A nurse is caring for a client receiving IV heparin therapy who develops sudden bleeding
and bruising. Which medication should the nurse anticipate administering?
A. Vitamin K
B. Protamine sulfate
C. Atropine
D. Naloxone
Rationale: Protamine sulfate reverses heparin.
,Q7.
A nurse administers vancomycin IV to a client. During infusion, the client develops flushing
of the face and neck along with hypotension. What is the most appropriate action?
A. Continue infusion at same rate
B. Stop infusion permanently
C. Administer epinephrine immediately
D. Slow the infusion rate and monitor
Rationale: Red man syndrome occurs with rapid infusion; slowing rate resolves symptoms.
Q8.
A nurse is evaluating the effectiveness of albuterol inhaler therapy in a client with asthma.
Which finding indicates the medication is working?
A. Increased wheezing
B. Decreased oxygen saturation
C. Improved airflow and reduced dyspnea
D. Increased respiratory effort
Rationale: Albuterol causes bronchodilation, improving breathing.
Q9.
A nurse is preparing to administer morphine to a client postoperatively. Which assessment
finding is the priority before administration?
A. Pain rating
B. Blood pressure
C. Temperature
D. Respiratory rate
Rationale: Opioids can suppress respirations; RR is priority.
Q10.
A client taking isoniazid reports numbness and tingling in extremities. What should the
nurse anticipate?
, A. Discontinue medication
B. Increase dose
C. Administer vitamin B6 (pyridoxine)
D. Start calcium supplements
Rationale: INH causes neuropathy; B6 prevents it.
Q11.
A nurse is administering insulin glargine to a client with diabetes. Which characteristic is
true of this medication?
A. Peaks within 2 hours
B. Short-acting insulin
C. Must be mixed with other insulins
D. Provides long-acting basal glucose control with no pronounced peak
Rationale: Glargine is long-acting and should not be mixed.
Q12.
A client taking prednisone for chronic inflammation reports new-onset weight gain and facial
swelling. What is the nurse’s best interpretation?
A. Medication is ineffective
B. Allergic reaction
C. Dehydration
D. Expected corticosteroid side effects (Cushingoid features)
Rationale: Steroids cause fluid retention and fat redistribution.
Q13.
A nurse is caring for a client receiving nitroglycerin for chest pain. Which instruction should
be given?
A. Swallow tablet immediately
B. Take with food
C. Lie flat after taking
D. Place tablet under tongue and allow it to dissolve
Rationale: Sublingual nitroglycerin acts rapidly for angina.
High-Yield NCLEX-Style Questions & Answers with Detailed
Rationales (Full-Length Scenarios Questions) | Ultimate
Study Guide Bundle
Q1.
A nurse is preparing to administer lisinopril to a client who has hypertension and a history of
chronic kidney disease. The nurse reviews the client’s morning laboratory results and vital
signs. Which finding should prompt the nurse to withhold the medication and notify the
provider?
A. Blood pressure of 142/88 mmHg
B. Heart rate of 82 bpm
C. Potassium level of 5.9 mEq/L
D. Respiratory rate of 18 breaths per minute
Rationale: ACE inhibitors like lisinopril increase potassium levels. Hyperkalemia places the
client at risk for life-threatening dysrhythmias.
Q2.
A nurse is teaching a client newly prescribed metformin for type 2 diabetes mellitus. Which
statement by the client demonstrates appropriate understanding of the medication regimen?
A. “I will take the medication only when my blood sugar is elevated.”
B. “I should avoid eating while taking this medication.”
C. “If I feel dizzy, I will double my dose the next time.”
D. “I will take this medication with meals to reduce stomach upset.”
Rationale: Metformin commonly causes GI upset; taking it with meals reduces adverse
effects.
Q3
A nurse is monitoring a client receiving warfarin therapy for atrial fibrillation. Which
laboratory result indicates that the medication is within the therapeutic range?
,A. INR of 2.4
B. INR of 1.1
C. INR of 1.5
D. INR of 4.8
Rationale: Therapeutic INR range for most conditions is 2.0–3.0.
Q4.
A nurse is caring for a client receiving furosemide for fluid overload secondary to heart
failure. Which assessment finding requires immediate intervention?
A. Weight loss of 1 kg in 24 hours
B. Urine output of 45 mL/hr
C. Blood pressure of 130/78 mmHg
D. Serum potassium level of 3.1 mEq/L
Rationale: Loop diuretics cause potassium loss; hypokalemia can lead to dysrhythmias.
Q5.
A nurse is administering digoxin to a client with heart failure. Which finding should prompt
the nurse to withhold the medication?
A. Blood pressure 130/82 mmHg
B. Apical pulse of 52 beats per minute
C. Respiratory rate of 20 breaths per minute
D. Oxygen saturation of 95%
Rationale: Digoxin should be held if HR <60 bpm due to risk of bradycardia.
Q6.
A nurse is caring for a client receiving IV heparin therapy who develops sudden bleeding
and bruising. Which medication should the nurse anticipate administering?
A. Vitamin K
B. Protamine sulfate
C. Atropine
D. Naloxone
Rationale: Protamine sulfate reverses heparin.
,Q7.
A nurse administers vancomycin IV to a client. During infusion, the client develops flushing
of the face and neck along with hypotension. What is the most appropriate action?
A. Continue infusion at same rate
B. Stop infusion permanently
C. Administer epinephrine immediately
D. Slow the infusion rate and monitor
Rationale: Red man syndrome occurs with rapid infusion; slowing rate resolves symptoms.
Q8.
A nurse is evaluating the effectiveness of albuterol inhaler therapy in a client with asthma.
Which finding indicates the medication is working?
A. Increased wheezing
B. Decreased oxygen saturation
C. Improved airflow and reduced dyspnea
D. Increased respiratory effort
Rationale: Albuterol causes bronchodilation, improving breathing.
Q9.
A nurse is preparing to administer morphine to a client postoperatively. Which assessment
finding is the priority before administration?
A. Pain rating
B. Blood pressure
C. Temperature
D. Respiratory rate
Rationale: Opioids can suppress respirations; RR is priority.
Q10.
A client taking isoniazid reports numbness and tingling in extremities. What should the
nurse anticipate?
, A. Discontinue medication
B. Increase dose
C. Administer vitamin B6 (pyridoxine)
D. Start calcium supplements
Rationale: INH causes neuropathy; B6 prevents it.
Q11.
A nurse is administering insulin glargine to a client with diabetes. Which characteristic is
true of this medication?
A. Peaks within 2 hours
B. Short-acting insulin
C. Must be mixed with other insulins
D. Provides long-acting basal glucose control with no pronounced peak
Rationale: Glargine is long-acting and should not be mixed.
Q12.
A client taking prednisone for chronic inflammation reports new-onset weight gain and facial
swelling. What is the nurse’s best interpretation?
A. Medication is ineffective
B. Allergic reaction
C. Dehydration
D. Expected corticosteroid side effects (Cushingoid features)
Rationale: Steroids cause fluid retention and fat redistribution.
Q13.
A nurse is caring for a client receiving nitroglycerin for chest pain. Which instruction should
be given?
A. Swallow tablet immediately
B. Take with food
C. Lie flat after taking
D. Place tablet under tongue and allow it to dissolve
Rationale: Sublingual nitroglycerin acts rapidly for angina.
