ATI COMPREHENSIVE PN PHARMACOLOGY
EXAM 2025/2026 – 140 QUESTIONS WITH
NGN & SOLUTIONS (GRADED A+)
EXAM
1. A nurse is preparing to administer a tuberculin skin test. Which route is
correct?
A. Subcutaneous
B. Intradermal
C. Intramuscular
D. Intravenous
Correct answer: B – ✓✓ Intradermal.
Rationale: The Mantoux tuberculin skin test is given intradermally on the forearm,
creating a wheal. Subcutaneous, IM, or IV routes are incorrect and would
invalidate the test.
2. A client with asthma is prescribed fluticasone inhaler. The nurse should instruct
the client to do which action after each use?
A. Inhale deeply and hold for 10 seconds
B. Rinse the mouth with water
C. Cough vigorously
D. Lie down for 15 minutes
Correct answer: B – ✓✓ Rinse the mouth with water.
Rationale: Rinsing the mouth after inhaled corticosteroid use prevents oral
candidiasis (thrush). Deep inhalation and holding are correct during
administration but not specifically after. Coughing and lying down are not
indicated.
3. A client is taking furosemide 40 mg daily. Which food should the nurse
encourage to prevent a common adverse effect?
A. Apples
,B. Bananas
C. White rice
D. Chicken breast
Correct answer: B – ✓✓ Bananas.
Rationale: Furosemide causes hypokalemia. Bananas are high in potassium.
Apples, rice, and chicken are low in potassium.
4. NGN – A client with a history of deep vein thrombosis is taking warfarin. The
nurse notes an INR of 3.8. The client has no bleeding. Which action should the
nurse take?
A. Administer vitamin K intramuscularly
B. Hold the next dose and notify the provider
C. Increase the warfarin dose
D. Give fresh frozen plasma
Correct answer: B – ✓✓ Hold the next dose and notify the provider.
Rationale: INR 3.8 is supratherapeutic but without bleeding. Standard practice is
to hold warfarin and notify the provider. Vitamin K or FFP is for bleeding or very
high INR (>10).
5. A client is prescribed sertraline. The nurse should teach the client to watch for
which early sign of serotonin syndrome?
A. Dry mouth
B. Agitation and restlessness
C. Constipation
D. Drowsiness
Correct answer: B – ✓✓ Agitation and restlessness.
Rationale: Serotonin syndrome early signs include agitation, restlessness,
confusion, and hyperreflexia. Dry mouth, constipation, and drowsiness are
common SSRI side effects but not signs of serotonin syndrome.
6. A nurse administers IV push morphine. Which finding indicates the need for
naloxone?
A. Pain rating from 8 to 3
B. Respiratory rate of 8 breaths/min
C. Blood pressure 110/70 mmHg
D. Pupils 4 mm bilaterally
,Correct answer: B – ✓✓ *Respiratory rate of 8 breaths/min.*
Rationale: *Respiratory depression (RR <10) is an opioid emergency requiring
naloxone. Pain relief is expected. BP 110/70 is normal. Pinpoint pupils, not
dilated, occur with opioid use.*
7. A client is prescribed metformin. Which instruction about timing is correct?
A. Take on an empty stomach 1 hour before meals
B. Take with meals to reduce gastrointestinal distress
C. Take only at bedtime
D. Take every 12 hours regardless of meals
Correct answer: B – ✓✓ Take with meals to reduce gastrointestinal distress.
Rationale: Metformin commonly causes nausea, diarrhea, and abdominal
discomfort. Taking with meals significantly reduces these effects. Empty stomach
worsens GI issues.
8. A client with heart failure is prescribed carvedilol. The nurse should monitor
which finding as a therapeutic effect?
A. Increased heart rate
B. Decreased blood pressure
C. Improved ejection fraction over time
D. Weight gain
Correct answer: C – ✓✓ Improved ejection fraction over time.
Rationale: Carvedilol improves cardiac remodeling and ejection fraction in heart
failure. It lowers heart rate and BP (side effects) and prevents weight gain. Weight
gain suggests fluid retention.
9. A nurse is teaching a client about alendronate. Which statement indicates
correct understanding?
A. “I will lie down for 30 minutes after taking it.”
B. “I will take it with orange juice first thing in the morning.”
C. “I will wait 30 minutes before eating or drinking anything else.”
D. “I can crush the tablet if I have trouble swallowing.”
Correct answer: C – ✓✓ “I will wait 30 minutes before eating or drinking anything
else.”
Rationale: *Alendronate must be taken with a full glass of water on an empty
, stomach, and the client must remain upright for 30 minutes. Waiting 30 minutes
to eat/drink is correct. Do not crush.*
10. A client is prescribed clozapine. The nurse knows that which laboratory test is
required weekly at the start of therapy?
A. Absolute neutrophil count (ANC)
B. Liver function tests
C. Serum creatinine
D. Thyroid-stimulating hormone
Correct answer: A – ✓✓ Absolute neutrophil count (ANC).
Rationale: Clozapine causes agranulocytosis. ANC must be monitored weekly for
the first 6 months, then every 2 weeks. LFTs, creatinine, and TSH are not weekly
requirements.
11. A client with a urinary tract infection is prescribed
trimethoprim/sulfamethoxazole. Which finding should the nurse report
immediately?
A. Nausea
B. Skin rash and fever
C. Headache
D. Metallic taste
Correct answer: B – ✓✓ Skin rash and fever.
Rationale: Rash with fever may indicate Stevens-Johnson syndrome or a severe
allergic reaction. Nausea, headache, and metallic taste are common but not
emergent.
12. A nurse is administering IV dopamine. The nurse notes extravasation at the IV
site. Which medication should be available?
A. Phentolamine
B. Naloxone
C. Vitamin K
D. Protamine sulfate
Correct answer: A – ✓✓ Phentolamine.
Rationale: Dopamine extravasation causes tissue ischemia. Phentolamine, an
alpha-adrenergic antagonist, is injected locally to prevent necrosis. Naloxone is for
opioids; vitamin K for warfarin; protamine for heparin.
EXAM 2025/2026 – 140 QUESTIONS WITH
NGN & SOLUTIONS (GRADED A+)
EXAM
1. A nurse is preparing to administer a tuberculin skin test. Which route is
correct?
A. Subcutaneous
B. Intradermal
C. Intramuscular
D. Intravenous
Correct answer: B – ✓✓ Intradermal.
Rationale: The Mantoux tuberculin skin test is given intradermally on the forearm,
creating a wheal. Subcutaneous, IM, or IV routes are incorrect and would
invalidate the test.
2. A client with asthma is prescribed fluticasone inhaler. The nurse should instruct
the client to do which action after each use?
A. Inhale deeply and hold for 10 seconds
B. Rinse the mouth with water
C. Cough vigorously
D. Lie down for 15 minutes
Correct answer: B – ✓✓ Rinse the mouth with water.
Rationale: Rinsing the mouth after inhaled corticosteroid use prevents oral
candidiasis (thrush). Deep inhalation and holding are correct during
administration but not specifically after. Coughing and lying down are not
indicated.
3. A client is taking furosemide 40 mg daily. Which food should the nurse
encourage to prevent a common adverse effect?
A. Apples
,B. Bananas
C. White rice
D. Chicken breast
Correct answer: B – ✓✓ Bananas.
Rationale: Furosemide causes hypokalemia. Bananas are high in potassium.
Apples, rice, and chicken are low in potassium.
4. NGN – A client with a history of deep vein thrombosis is taking warfarin. The
nurse notes an INR of 3.8. The client has no bleeding. Which action should the
nurse take?
A. Administer vitamin K intramuscularly
B. Hold the next dose and notify the provider
C. Increase the warfarin dose
D. Give fresh frozen plasma
Correct answer: B – ✓✓ Hold the next dose and notify the provider.
Rationale: INR 3.8 is supratherapeutic but without bleeding. Standard practice is
to hold warfarin and notify the provider. Vitamin K or FFP is for bleeding or very
high INR (>10).
5. A client is prescribed sertraline. The nurse should teach the client to watch for
which early sign of serotonin syndrome?
A. Dry mouth
B. Agitation and restlessness
C. Constipation
D. Drowsiness
Correct answer: B – ✓✓ Agitation and restlessness.
Rationale: Serotonin syndrome early signs include agitation, restlessness,
confusion, and hyperreflexia. Dry mouth, constipation, and drowsiness are
common SSRI side effects but not signs of serotonin syndrome.
6. A nurse administers IV push morphine. Which finding indicates the need for
naloxone?
A. Pain rating from 8 to 3
B. Respiratory rate of 8 breaths/min
C. Blood pressure 110/70 mmHg
D. Pupils 4 mm bilaterally
,Correct answer: B – ✓✓ *Respiratory rate of 8 breaths/min.*
Rationale: *Respiratory depression (RR <10) is an opioid emergency requiring
naloxone. Pain relief is expected. BP 110/70 is normal. Pinpoint pupils, not
dilated, occur with opioid use.*
7. A client is prescribed metformin. Which instruction about timing is correct?
A. Take on an empty stomach 1 hour before meals
B. Take with meals to reduce gastrointestinal distress
C. Take only at bedtime
D. Take every 12 hours regardless of meals
Correct answer: B – ✓✓ Take with meals to reduce gastrointestinal distress.
Rationale: Metformin commonly causes nausea, diarrhea, and abdominal
discomfort. Taking with meals significantly reduces these effects. Empty stomach
worsens GI issues.
8. A client with heart failure is prescribed carvedilol. The nurse should monitor
which finding as a therapeutic effect?
A. Increased heart rate
B. Decreased blood pressure
C. Improved ejection fraction over time
D. Weight gain
Correct answer: C – ✓✓ Improved ejection fraction over time.
Rationale: Carvedilol improves cardiac remodeling and ejection fraction in heart
failure. It lowers heart rate and BP (side effects) and prevents weight gain. Weight
gain suggests fluid retention.
9. A nurse is teaching a client about alendronate. Which statement indicates
correct understanding?
A. “I will lie down for 30 minutes after taking it.”
B. “I will take it with orange juice first thing in the morning.”
C. “I will wait 30 minutes before eating or drinking anything else.”
D. “I can crush the tablet if I have trouble swallowing.”
Correct answer: C – ✓✓ “I will wait 30 minutes before eating or drinking anything
else.”
Rationale: *Alendronate must be taken with a full glass of water on an empty
, stomach, and the client must remain upright for 30 minutes. Waiting 30 minutes
to eat/drink is correct. Do not crush.*
10. A client is prescribed clozapine. The nurse knows that which laboratory test is
required weekly at the start of therapy?
A. Absolute neutrophil count (ANC)
B. Liver function tests
C. Serum creatinine
D. Thyroid-stimulating hormone
Correct answer: A – ✓✓ Absolute neutrophil count (ANC).
Rationale: Clozapine causes agranulocytosis. ANC must be monitored weekly for
the first 6 months, then every 2 weeks. LFTs, creatinine, and TSH are not weekly
requirements.
11. A client with a urinary tract infection is prescribed
trimethoprim/sulfamethoxazole. Which finding should the nurse report
immediately?
A. Nausea
B. Skin rash and fever
C. Headache
D. Metallic taste
Correct answer: B – ✓✓ Skin rash and fever.
Rationale: Rash with fever may indicate Stevens-Johnson syndrome or a severe
allergic reaction. Nausea, headache, and metallic taste are common but not
emergent.
12. A nurse is administering IV dopamine. The nurse notes extravasation at the IV
site. Which medication should be available?
A. Phentolamine
B. Naloxone
C. Vitamin K
D. Protamine sulfate
Correct answer: A – ✓✓ Phentolamine.
Rationale: Dopamine extravasation causes tissue ischemia. Phentolamine, an
alpha-adrenergic antagonist, is injected locally to prevent necrosis. Naloxone is for
opioids; vitamin K for warfarin; protamine for heparin.
