NEW 2026 ATI RN Pharmacology Proctored
Exam | Q&A | Includes NGN Case Studies &
Dosage Calc | 100% Verified for 2026-2028
|PDF
1. A nurse is preparing to administer a medication to a client who has a history of renal
failure. Which pharmacokinetic process should the nurse expect to be most affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: D. Excretion
Explanation: The kidneys are the primary organs responsible for the excretion of drugs
and their metabolites. Impaired renal function leads to decreased drug clearance and a
high risk for toxicity.
2. A nurse is preparing to administer 0.5 g of a medication. The available dose is
250 mg tablets. How many tablets should the nurse administer?
A. 0.5 tablets
B. 1 tablet
C. 2 tablets
D. 4 tablets
Answer: C. 2 tablets
Explanation: First, convert grams to milligrams: 0.5 g = 500 mg. Divide the ordered
dose (500 mg) by the available dose (250 mg) to get 2 tablets.
3. A nurse is reviewing a client’s medication record and notes a prescription for a
"trough level." When should the nurse schedule the blood draw?
A. 30 minutes after the dose is administered
B. Exactly mid-way between doses
C. 15 minutes before the next dose
D. 2 hours after the start of the infusion
Answer: C. 15 minutes before the next dose
,Explanation: The trough level represents the lowest concentration of the drug in the
bloodstream. It is measured immediately (usually 15–30 minutes) before the next
scheduled dose.
4. A nurse is preparing to administer an intramuscular (IM) injection to an adult
client who has a BMI of 32. Which needle length should the nurse select?
A. 5/8 inch
B. 1 inch
C. 1 1/2 inches
D. 2 inches
Answer: C. 1 1/2 inches
Explanation: For an obese client, a longer needle (1.5 inches) is required to ensure the
medication reaches the muscle tissue rather than staying in the subcutaneous fat.
5. A nurse is preparing to administer phenobarbital to a client. Which
pharmacokinetic concept explains why this drug has a long duration of action?
A. First-pass effect
B. High lipid solubility
C. Protein binding
D. Half-life
Answer: D. Half-life
Explanation: Half-life is the time it takes for the concentration of a drug in the body to
reduce by 50%. Phenobarbital has a long half-life, meaning it stays in the system longer
and requires less frequent dosing.
6. A nurse is teaching a client about the "First-pass effect." Which route of
administration is most affected by this process?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Answer: C. Oral
Explanation: Oral medications are absorbed in the GI tract and travel to the liver via
the portal vein. The liver may metabolize a large portion of the drug before it ever
reaches systemic circulation.
,7. A nurse is calculating the IV flow rate for a client who is to receive 1,000 mL of
0.9% Sodium Chloride over 8 hours. The drop factor is 15 gtt/mL. What is the flow rate
in gtt/min? (Round to the nearest whole number).
A. 21 gtt/min
B. 31 gtt/min
C. 42 gtt/min
D. 63 gtt/min
Answer: B. 31 gtt/min
Explanation: Total volume (1,000 mL) x Drop factor (15) / Total time in minutes (480
min) = 31.25. Rounded to the nearest whole number is 31 gtt/min.
8. A nurse is reviewing a prescription for a medication to be given "AC." When
should the nurse administer this drug?
A. After meals
B. Before meals
C. At bedtime
D. As needed
Answer: B. Before meals
Explanation: "AC" stands for ante cibum, meaning before meals. "PC" stands for post
cibum, meaning after meals.
9. A nurse is preparing to administer a liquid medication to an infant. Which of the
following is the safest action?
A. Use a medicine cup
B. Mix the medication with a full bottle of formula
C. Place the syringe in the side of the infant's mouth
D. Administer the medication while the infant is lying flat
Answer: C. Place the syringe in the side of the infant's mouth
Explanation: Placing the syringe in the side of the cheek prevents choking and
aspiration. Medications should never be mixed with a full bottle because the infant may
not finish it, leading to an incomplete dose.
10. A nurse is caring for a client who is to receive a medication that is highly protein-
bound. The client’s albumin level is 2.5 g/dL (Low). The nurse should monitor for:
A. Decreased drug effectiveness
B. Drug toxicity
, C. Rapid excretion of the drug
D. Poor absorption
Answer: B. Drug toxicity
Explanation: When albumin is low, there are fewer binding sites for the drug. This
increases the amount of "free" drug in the blood, which can lead to toxicity.
11. A nurse is teaching a client about a transdermal patch. Which instruction should
the nurse include?
A. Apply the patch to the same site every time
B. Shave the area before applying the patch
C. Rotate the site of application with each new patch
D. Apply heat over the patch to increase absorption
Answer: C. Rotate the site of application with each new patch
Explanation: Rotating sites prevents skin irritation. Applying heat is dangerous as it can
cause rapid, toxic absorption of the medication.
12. A nurse is preparing to administer an intradermal injection for a TB skin test. At
what angle should the nurse insert the needle?
A. 10 to 15 degrees
B. 30 degrees
C. 45 degrees
D. 90 degrees
Answer: A. 10 to 15 degrees
Explanation: Intradermal injections are given into the dermis, just under the epidermis,
requiring a very shallow angle (10–15 degrees) with the bevel up.
13. A nurse is reviewing a STAT order. The nurse understands this medication
should be given:
A. Within 30 minutes of the order
B. Once, immediately
C. Only when the client requests it
D. Every time the client has pain
Answer: B. Once, immediately
Explanation: A STAT order indicates a one-time dose that must be administered
immediately due to an urgent clinical situation.
Exam | Q&A | Includes NGN Case Studies &
Dosage Calc | 100% Verified for 2026-2028
1. A nurse is preparing to administer a medication to a client who has a history of renal
failure. Which pharmacokinetic process should the nurse expect to be most affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: D. Excretion
Explanation: The kidneys are the primary organs responsible for the excretion of drugs
and their metabolites. Impaired renal function leads to decreased drug clearance and a
high risk for toxicity.
2. A nurse is preparing to administer 0.5 g of a medication. The available dose is
250 mg tablets. How many tablets should the nurse administer?
A. 0.5 tablets
B. 1 tablet
C. 2 tablets
D. 4 tablets
Answer: C. 2 tablets
Explanation: First, convert grams to milligrams: 0.5 g = 500 mg. Divide the ordered
dose (500 mg) by the available dose (250 mg) to get 2 tablets.
3. A nurse is reviewing a client’s medication record and notes a prescription for a
"trough level." When should the nurse schedule the blood draw?
A. 30 minutes after the dose is administered
B. Exactly mid-way between doses
C. 15 minutes before the next dose
D. 2 hours after the start of the infusion
Answer: C. 15 minutes before the next dose
,Explanation: The trough level represents the lowest concentration of the drug in the
bloodstream. It is measured immediately (usually 15–30 minutes) before the next
scheduled dose.
4. A nurse is preparing to administer an intramuscular (IM) injection to an adult
client who has a BMI of 32. Which needle length should the nurse select?
A. 5/8 inch
B. 1 inch
C. 1 1/2 inches
D. 2 inches
Answer: C. 1 1/2 inches
Explanation: For an obese client, a longer needle (1.5 inches) is required to ensure the
medication reaches the muscle tissue rather than staying in the subcutaneous fat.
5. A nurse is preparing to administer phenobarbital to a client. Which
pharmacokinetic concept explains why this drug has a long duration of action?
A. First-pass effect
B. High lipid solubility
C. Protein binding
D. Half-life
Answer: D. Half-life
Explanation: Half-life is the time it takes for the concentration of a drug in the body to
reduce by 50%. Phenobarbital has a long half-life, meaning it stays in the system longer
and requires less frequent dosing.
6. A nurse is teaching a client about the "First-pass effect." Which route of
administration is most affected by this process?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Answer: C. Oral
Explanation: Oral medications are absorbed in the GI tract and travel to the liver via
the portal vein. The liver may metabolize a large portion of the drug before it ever
reaches systemic circulation.
,7. A nurse is calculating the IV flow rate for a client who is to receive 1,000 mL of
0.9% Sodium Chloride over 8 hours. The drop factor is 15 gtt/mL. What is the flow rate
in gtt/min? (Round to the nearest whole number).
A. 21 gtt/min
B. 31 gtt/min
C. 42 gtt/min
D. 63 gtt/min
Answer: B. 31 gtt/min
Explanation: Total volume (1,000 mL) x Drop factor (15) / Total time in minutes (480
min) = 31.25. Rounded to the nearest whole number is 31 gtt/min.
8. A nurse is reviewing a prescription for a medication to be given "AC." When
should the nurse administer this drug?
A. After meals
B. Before meals
C. At bedtime
D. As needed
Answer: B. Before meals
Explanation: "AC" stands for ante cibum, meaning before meals. "PC" stands for post
cibum, meaning after meals.
9. A nurse is preparing to administer a liquid medication to an infant. Which of the
following is the safest action?
A. Use a medicine cup
B. Mix the medication with a full bottle of formula
C. Place the syringe in the side of the infant's mouth
D. Administer the medication while the infant is lying flat
Answer: C. Place the syringe in the side of the infant's mouth
Explanation: Placing the syringe in the side of the cheek prevents choking and
aspiration. Medications should never be mixed with a full bottle because the infant may
not finish it, leading to an incomplete dose.
10. A nurse is caring for a client who is to receive a medication that is highly protein-
bound. The client’s albumin level is 2.5 g/dL (Low). The nurse should monitor for:
A. Decreased drug effectiveness
B. Drug toxicity
, C. Rapid excretion of the drug
D. Poor absorption
Answer: B. Drug toxicity
Explanation: When albumin is low, there are fewer binding sites for the drug. This
increases the amount of "free" drug in the blood, which can lead to toxicity.
11. A nurse is teaching a client about a transdermal patch. Which instruction should
the nurse include?
A. Apply the patch to the same site every time
B. Shave the area before applying the patch
C. Rotate the site of application with each new patch
D. Apply heat over the patch to increase absorption
Answer: C. Rotate the site of application with each new patch
Explanation: Rotating sites prevents skin irritation. Applying heat is dangerous as it can
cause rapid, toxic absorption of the medication.
12. A nurse is preparing to administer an intradermal injection for a TB skin test. At
what angle should the nurse insert the needle?
A. 10 to 15 degrees
B. 30 degrees
C. 45 degrees
D. 90 degrees
Answer: A. 10 to 15 degrees
Explanation: Intradermal injections are given into the dermis, just under the epidermis,
requiring a very shallow angle (10–15 degrees) with the bevel up.
13. A nurse is reviewing a STAT order. The nurse understands this medication
should be given:
A. Within 30 minutes of the order
B. Once, immediately
C. Only when the client requests it
D. Every time the client has pain
Answer: B. Once, immediately
Explanation: A STAT order indicates a one-time dose that must be administered
immediately due to an urgent clinical situation.
