ATI COMPREHENSIVE PN PHARMACOLOGY
EXAM 2025/2026 – 140 QUESTIONS WITH
NGN & SOLUTIONS (GRADED A+)
EXAM
1. A nurse is preparing to administer a subcutaneous injection of insulin. Which angle of
insertion is correct for an average adult using a 6 mm needle?
A. 15 degrees
B. 45 degrees
C. 90 degrees
D. 120 degrees
Correct answer: C – ✓✓ 90 degrees.
Rationale: *For a 6 mm needle (short), a 90-degree angle ensures subcutaneous
delivery. Longer needles may require 45 degrees, but standard practice with short
needles is 90 degrees.*
2. A client is prescribed lisinopril. Which finding indicates a therapeutic effect?
A. Heart rate 110 bpm
B. Blood pressure 150/95 mmHg
C. Blood pressure 125/80 mmHg
D. Swelling of the lips
Correct answer: C – ✓✓ *Blood pressure 125/80 mmHg.*
Rationale: Lisinopril is an ACE inhibitor used for hypertension. A therapeutic effect is
blood pressure control. Swelling of lips is angioedema, an adverse effect.
3. NGN – A client with diabetes reports blurred vision, headache, and blood glucose of
210 mg/dL. Which three actions should the nurse take? (Select all that apply)
A. Administer insulin as ordered
B. Give 15 g of fast-acting carbohydrate
C. Encourage water intake
D. Check for ketones if indicated
E. Repeat blood glucose in 1 hour
Correct answers: A, C, D – ✓✓ Administer insulin, encourage water intake, and check for
ketones.
Rationale: *Hyperglycemia (210 mg/dL) requires insulin, hydration, and monitoring for
,ketones. Carbohydrate would worsen hyperglycemia; repeating glucose is done after
treatment.*
4. A client is prescribed warfarin. The nurse should instruct the client to avoid which
over-the-counter medication?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
Correct answer: B – ✓✓ Ibuprofen.
Rationale: Ibuprofen (NSAID) increases bleeding risk when combined with warfarin.
Acetaminophen is safer in recommended doses. Antihistamines have no significant
interaction.
5. A client is prescribed metformin. Which finding should the nurse report to the
provider immediately?
A. Nausea
B. Diarrhea
C. Muscle pain and fatigue
D. Metallic taste
Correct answer: C – ✓✓ Muscle pain and fatigue.
Rationale: Muscle pain and fatigue may indicate lactic acidosis, a life-threatening
complication of metformin. Nausea, diarrhea, and metallic taste are common side effects.
6. A nurse is administering IV furosemide. Which finding requires immediate action?
A. Urine output 200 mL in 1 hour
B. Serum potassium 3.8 mEq/L
C. Tinnitus and hearing loss
D. Blood pressure 130/85 mmHg
Correct answer: C – ✓✓ Tinnitus and hearing loss.
Rationale: *Tinnitus and hearing loss indicate ototoxicity, a serious adverse effect of
furosemide. Increased urine output is therapeutic; K+ 3.8 is normal; BP is acceptable.*
7. A client with asthma is prescribed fluticasone/salmeterol. Which instruction is correct?
A. “Use this inhaler for sudden shortness of breath.”
B. “Rinse your mouth after each use to prevent thrush.”
C. “This medication works immediately to open airways.”
D. “You do not need a rescue inhaler.”
Correct answer: B – ✓✓ “Rinse your mouth after each use to prevent thrush.”
Rationale: Fluticasone is a corticosteroid; rinsing prevents oral candidiasis. Salmeterol is a
LABA, not a rescue medication. A rescue inhaler (albuterol) is still needed.
,8. A client is prescribed phenytoin. The nurse should monitor for which adverse effect
related to long-term use?
A. Gingival hyperplasia
B. Hyperglycemia
C. Weight loss
D. Alopecia
Correct answer: A – ✓✓ Gingival hyperplasia.
Rationale: Phenytoin causes overgrowth of gum tissue. Good oral hygiene is essential. It
does not cause hyperglycemia; weight gain and hirsutism may occur.
9. A client is prescribed digoxin. Which lab value should the nurse check before
administering the dose?
A. Serum calcium
B. Serum magnesium
C. Serum potassium
D. Serum sodium
Correct answer: C – ✓✓ Serum potassium.
Rationale: Hypokalemia increases the risk of digoxin toxicity. Potassium must be assessed
before each dose. Hypomagnesemia also increases risk, but potassium is the primary
concern.
10. A client is prescribed morphine sulfate. The nurse notes a respiratory rate of 8
breaths/min. Which medication should be prepared?
A. Flumazenil
B. Naloxone
C. Naltrexone
D. Acetylcysteine
Correct answer: B – ✓✓ Naloxone.
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression.
Flumazenil reverses benzodiazepines; naltrexone is for dependence; acetylcysteine is for
acetaminophen overdose.
11. A client with type 2 diabetes is starting metformin. Which instruction is most
important?
A. “Take this medication on an empty stomach.”
B. “Expect your urine to turn orange.”
C. “Report muscle pain or fatigue to your provider.”
D. “You may stop taking it if your blood sugar is normal.”
Correct answer: C – ✓✓ “Report muscle pain or fatigue to your provider.”
Rationale: Metformin can cause lactic acidosis. Early symptoms include unexplained
, muscle pain, malaise, and fatigue. Take with meals; orange urine is not expected; never
stop without guidance.
12. NGN – A client is receiving a heparin infusion. The nurse notes a platelet count drop
from 250,000 to 80,000 over 3 days. Which two actions should the nurse take? (Select all
that apply)
A. Stop the heparin infusion
B. Continue heparin as ordered
C. Notify the provider
D. Administer vitamin K
E. Prepare for alternative anticoagulation
Correct answers: A, C, E – ✓✓ Stop the heparin infusion, notify the provider, and prepare
for alternative anticoagulation.
Rationale: This platelet drop suggests heparin-induced thrombocytopenia (HIT). Heparin
must be stopped immediately. The provider should be notified, and a non-heparin
anticoagulant will be needed.
13. A nurse teaches a client about albuterol metered-dose inhaler use. Which statement
indicates correct understanding?
A. “I will use this daily to prevent attacks.”
B. “I should wait 1 minute between puffs.”
C. “I can store the canister in the freezer.”
D. “I will inhale then press down on the canister.”
Correct answer: B – ✓✓ “I should wait 1 minute between puffs.”
Rationale: Waiting 1 minute between puffs allows the second dose to reach the airways
more effectively. Albuterol is a rescue medication, not a daily controller. Freezing damages
the inhaler. The correct technique is to press the canister while inhaling slowly.
14. A client is prescribed spironolactone. Which finding would prompt the nurse to hold
the medication?
A. Serum potassium 5.4 mEq/L
B. Serum sodium 138 mEq/L
C. Blood pressure 130/85 mmHg
D. Urine output 60 mL/hr
Correct answer: A – ✓✓ *Serum potassium 5.4 mEq/L.*
Rationale: *Spironolactone is a potassium-sparing diuretic. Hyperkalemia (K+ >5.0) is a
serious adverse effect. A level of 5.4 mEq/L requires holding the medication and
notifying the provider.*
15. A client receiving chemotherapy reports nausea. The nurse administers ondansetron.
Which adverse effect should the nurse monitor?
EXAM 2025/2026 – 140 QUESTIONS WITH
NGN & SOLUTIONS (GRADED A+)
EXAM
1. A nurse is preparing to administer a subcutaneous injection of insulin. Which angle of
insertion is correct for an average adult using a 6 mm needle?
A. 15 degrees
B. 45 degrees
C. 90 degrees
D. 120 degrees
Correct answer: C – ✓✓ 90 degrees.
Rationale: *For a 6 mm needle (short), a 90-degree angle ensures subcutaneous
delivery. Longer needles may require 45 degrees, but standard practice with short
needles is 90 degrees.*
2. A client is prescribed lisinopril. Which finding indicates a therapeutic effect?
A. Heart rate 110 bpm
B. Blood pressure 150/95 mmHg
C. Blood pressure 125/80 mmHg
D. Swelling of the lips
Correct answer: C – ✓✓ *Blood pressure 125/80 mmHg.*
Rationale: Lisinopril is an ACE inhibitor used for hypertension. A therapeutic effect is
blood pressure control. Swelling of lips is angioedema, an adverse effect.
3. NGN – A client with diabetes reports blurred vision, headache, and blood glucose of
210 mg/dL. Which three actions should the nurse take? (Select all that apply)
A. Administer insulin as ordered
B. Give 15 g of fast-acting carbohydrate
C. Encourage water intake
D. Check for ketones if indicated
E. Repeat blood glucose in 1 hour
Correct answers: A, C, D – ✓✓ Administer insulin, encourage water intake, and check for
ketones.
Rationale: *Hyperglycemia (210 mg/dL) requires insulin, hydration, and monitoring for
,ketones. Carbohydrate would worsen hyperglycemia; repeating glucose is done after
treatment.*
4. A client is prescribed warfarin. The nurse should instruct the client to avoid which
over-the-counter medication?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
Correct answer: B – ✓✓ Ibuprofen.
Rationale: Ibuprofen (NSAID) increases bleeding risk when combined with warfarin.
Acetaminophen is safer in recommended doses. Antihistamines have no significant
interaction.
5. A client is prescribed metformin. Which finding should the nurse report to the
provider immediately?
A. Nausea
B. Diarrhea
C. Muscle pain and fatigue
D. Metallic taste
Correct answer: C – ✓✓ Muscle pain and fatigue.
Rationale: Muscle pain and fatigue may indicate lactic acidosis, a life-threatening
complication of metformin. Nausea, diarrhea, and metallic taste are common side effects.
6. A nurse is administering IV furosemide. Which finding requires immediate action?
A. Urine output 200 mL in 1 hour
B. Serum potassium 3.8 mEq/L
C. Tinnitus and hearing loss
D. Blood pressure 130/85 mmHg
Correct answer: C – ✓✓ Tinnitus and hearing loss.
Rationale: *Tinnitus and hearing loss indicate ototoxicity, a serious adverse effect of
furosemide. Increased urine output is therapeutic; K+ 3.8 is normal; BP is acceptable.*
7. A client with asthma is prescribed fluticasone/salmeterol. Which instruction is correct?
A. “Use this inhaler for sudden shortness of breath.”
B. “Rinse your mouth after each use to prevent thrush.”
C. “This medication works immediately to open airways.”
D. “You do not need a rescue inhaler.”
Correct answer: B – ✓✓ “Rinse your mouth after each use to prevent thrush.”
Rationale: Fluticasone is a corticosteroid; rinsing prevents oral candidiasis. Salmeterol is a
LABA, not a rescue medication. A rescue inhaler (albuterol) is still needed.
,8. A client is prescribed phenytoin. The nurse should monitor for which adverse effect
related to long-term use?
A. Gingival hyperplasia
B. Hyperglycemia
C. Weight loss
D. Alopecia
Correct answer: A – ✓✓ Gingival hyperplasia.
Rationale: Phenytoin causes overgrowth of gum tissue. Good oral hygiene is essential. It
does not cause hyperglycemia; weight gain and hirsutism may occur.
9. A client is prescribed digoxin. Which lab value should the nurse check before
administering the dose?
A. Serum calcium
B. Serum magnesium
C. Serum potassium
D. Serum sodium
Correct answer: C – ✓✓ Serum potassium.
Rationale: Hypokalemia increases the risk of digoxin toxicity. Potassium must be assessed
before each dose. Hypomagnesemia also increases risk, but potassium is the primary
concern.
10. A client is prescribed morphine sulfate. The nurse notes a respiratory rate of 8
breaths/min. Which medication should be prepared?
A. Flumazenil
B. Naloxone
C. Naltrexone
D. Acetylcysteine
Correct answer: B – ✓✓ Naloxone.
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression.
Flumazenil reverses benzodiazepines; naltrexone is for dependence; acetylcysteine is for
acetaminophen overdose.
11. A client with type 2 diabetes is starting metformin. Which instruction is most
important?
A. “Take this medication on an empty stomach.”
B. “Expect your urine to turn orange.”
C. “Report muscle pain or fatigue to your provider.”
D. “You may stop taking it if your blood sugar is normal.”
Correct answer: C – ✓✓ “Report muscle pain or fatigue to your provider.”
Rationale: Metformin can cause lactic acidosis. Early symptoms include unexplained
, muscle pain, malaise, and fatigue. Take with meals; orange urine is not expected; never
stop without guidance.
12. NGN – A client is receiving a heparin infusion. The nurse notes a platelet count drop
from 250,000 to 80,000 over 3 days. Which two actions should the nurse take? (Select all
that apply)
A. Stop the heparin infusion
B. Continue heparin as ordered
C. Notify the provider
D. Administer vitamin K
E. Prepare for alternative anticoagulation
Correct answers: A, C, E – ✓✓ Stop the heparin infusion, notify the provider, and prepare
for alternative anticoagulation.
Rationale: This platelet drop suggests heparin-induced thrombocytopenia (HIT). Heparin
must be stopped immediately. The provider should be notified, and a non-heparin
anticoagulant will be needed.
13. A nurse teaches a client about albuterol metered-dose inhaler use. Which statement
indicates correct understanding?
A. “I will use this daily to prevent attacks.”
B. “I should wait 1 minute between puffs.”
C. “I can store the canister in the freezer.”
D. “I will inhale then press down on the canister.”
Correct answer: B – ✓✓ “I should wait 1 minute between puffs.”
Rationale: Waiting 1 minute between puffs allows the second dose to reach the airways
more effectively. Albuterol is a rescue medication, not a daily controller. Freezing damages
the inhaler. The correct technique is to press the canister while inhaling slowly.
14. A client is prescribed spironolactone. Which finding would prompt the nurse to hold
the medication?
A. Serum potassium 5.4 mEq/L
B. Serum sodium 138 mEq/L
C. Blood pressure 130/85 mmHg
D. Urine output 60 mL/hr
Correct answer: A – ✓✓ *Serum potassium 5.4 mEq/L.*
Rationale: *Spironolactone is a potassium-sparing diuretic. Hyperkalemia (K+ >5.0) is a
serious adverse effect. A level of 5.4 mEq/L requires holding the medication and
notifying the provider.*
15. A client receiving chemotherapy reports nausea. The nurse administers ondansetron.
Which adverse effect should the nurse monitor?
