ATI RN Pharmacology 2025/2026 Proctored Exam: 250 Verified Q&A & NGN
Rationale Pack
This ultimate 250-question mega-bank is designed for the ATI RN Pharmacology Proctored
Exam (2023–2026). It features the most frequent high-yield medications, antidotes, and
safety protocols with answers in Broadway and comprehensive clinical judgment
rationales. Perfect for original attempts or retakes, this set covers everything from NGN
case priorities to essential drug-drug interactions.
1.
A nurse is preparing to administer Digoxin to a patient with heart failure.
Which of the following findings should the nurse report as a sign of
toxicity?
A. Bradycardia and yellow-tinged vision
B. Hypertension and dry cough
C. Tachycardia and increased appetite
D. Polyuria and muscle cramps
Answer: A. BRADYCARDIA AND YELLOW-TINGED VISION
Rationale: Visual disturbances (halos/yellow vision) and bradycardia are
classic signs of digoxin toxicity. The nurse must check the apical pulse
for a full minute before administration.
2. A patient is receiving a continuous IV infusion of Heparin. Which
laboratory value should the nurse monitor to adjust the dosage?
A. PT
B. aPTT
C. INR
D. RBC count
Answer: B. APTT
Rationale: Activated partial thromboplastin time (aPTT) is used to
monitor heparin therapy. PT and INR are used for warfarin.
3. A nurse is teaching a patient about taking Alendronate for
osteoporosis. Which instruction is the priority?
A. Take the medication with a glass of milk.
B. Lie down for 30 minutes after taking the dose.
C. Take the medication on an empty stomach and remain upright for
, 30 minutes.
D. Take the medication right before bedtime.
Answer: C. TAKE THE MEDICATION ON AN EMPTY STOMACH
AND REMAIN UPRIGHT FOR 30 MINUTES
Rationale: Alendronate can cause severe esophagitis. Staying upright
and taking it with water on an empty stomach prevents esophageal
erosion.
4. A nurse is caring for a patient who has a prescription for Furosemide.
Which of the following lab values should the nurse withhold the dose
for?
A. Sodium 136 mEq/L
B. Potassium 3.2 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 1.9 mg/dL
Answer: B. POTASSIUM 3.2 MEQ/L
Rationale: Furosemide is a loop diuretic that causes potassium
wasting. A level of 3.2 is below the normal range (3.5–5.0), increasing
the risk for arrhythmias.
5. A patient is prescribed Lithium Carbonate for bipolar disorder. The
nurse should instruct the patient to maintain adequate intake of which
of the following?
A. Vitamin K
B. Sodium
C. Calcium
D. Potassium
Answer: B. SODIUM
Rationale: Lithium is a salt. If sodium levels drop (due to sweating or
low intake), the kidneys conserve lithium instead of sodium, leading
to toxicity.
6. What is the antidote for a Benzodiazepine (e.g., Lorazepam)
overdose?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
Answer: B. FLUMAZENIL
, Rationale: Flumazenil is the specific competitive antagonist for
benzodiazepines. Naloxone is for opioids.
7. A patient is starting Atorvastatin. Which of the following adverse
effects should the patient report immediately?
A. Dry mouth
B. Muscle pain or tenderness
C. Increased hunger
D. Orange-colored urine
Answer: B. MUSCLE PAIN OR TENDERNESS
Rationale: Statins carry a risk of rhabdomyolysis (muscle
breakdown). Unexplained muscle pain can indicate serious muscle
injury and potential kidney failure.
8. A nurse is preparing to administer Nitroglycerin sublingual for chest
pain. How many doses can be given before calling emergency
services?
A. 1 dose
B. 2 doses
C. 3 doses
D. 5 doses
Answer: A. 1 DOSE
Rationale: Current safety guidelines recommend taking one dose; if
the pain is not relieved or is worsening after 5 minutes, the patient
should call emergency services before taking subsequent doses.
9. A patient is receiving Vancomycin via IV intermittent infusion. The
nurse notes the patient’s neck and chest are bright red. What is the
priority action?
A. Administer epinephrine.
B. Slow the infusion rate.
C. Stop the infusion and document the allergy.
D. Apply cold compresses to the chest.
Answer: B. SLOW THE INFUSION RATE
Rationale: "Red Man Syndrome" is a rate-related infusion reaction,
not a true allergy. Slowing the rate usually resolves the flushing and
hypotension.
10. Which medication is the treatment of choice for an acute
asthma attack?
, A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Answer: B. ALBUTEROL
Rationale: Albuterol is a short-acting beta2-agonist (SABA) that
provides rapid bronchodilation. Fluticasone is for long-term
prevention.
11. A nurse is caring for a patient on Warfarin. The patient has an
INR of 5.2 but no signs of bleeding. Which medication should the
nurse anticipate?
A. Protamine sulfate
B. Vitamin K
C. Epoetin alfa
D. Enoxaparin
Answer: B. VITAMIN K
Rationale: Vitamin K is the antagonist for warfarin. For high INRs
without bleeding, the dose is usually held and Vitamin K may be
given.
12. A patient is prescribed Spironolactone. Which food should the
nurse tell the patient to avoid?
A. Apples
B. Bananas
C. White bread
D. Green beans
Answer: B. BANANAS
Rationale: Spironolactone is a potassium-sparing diuretic. Consuming
high-potassium foods like bananas increases the risk of
hyperkalemia.
13. What is the primary adverse effect of ACE inhibitors like
Lisinopril that often leads to treatment discontinuation?
A. Yellow vision
B. Dry, nonproductive cough
C. Constipation
D. Weight gain
Answer: B. DRY, NONPRODUCTIVE COUGH
Rationale Pack
This ultimate 250-question mega-bank is designed for the ATI RN Pharmacology Proctored
Exam (2023–2026). It features the most frequent high-yield medications, antidotes, and
safety protocols with answers in Broadway and comprehensive clinical judgment
rationales. Perfect for original attempts or retakes, this set covers everything from NGN
case priorities to essential drug-drug interactions.
1.
A nurse is preparing to administer Digoxin to a patient with heart failure.
Which of the following findings should the nurse report as a sign of
toxicity?
A. Bradycardia and yellow-tinged vision
B. Hypertension and dry cough
C. Tachycardia and increased appetite
D. Polyuria and muscle cramps
Answer: A. BRADYCARDIA AND YELLOW-TINGED VISION
Rationale: Visual disturbances (halos/yellow vision) and bradycardia are
classic signs of digoxin toxicity. The nurse must check the apical pulse
for a full minute before administration.
2. A patient is receiving a continuous IV infusion of Heparin. Which
laboratory value should the nurse monitor to adjust the dosage?
A. PT
B. aPTT
C. INR
D. RBC count
Answer: B. APTT
Rationale: Activated partial thromboplastin time (aPTT) is used to
monitor heparin therapy. PT and INR are used for warfarin.
3. A nurse is teaching a patient about taking Alendronate for
osteoporosis. Which instruction is the priority?
A. Take the medication with a glass of milk.
B. Lie down for 30 minutes after taking the dose.
C. Take the medication on an empty stomach and remain upright for
, 30 minutes.
D. Take the medication right before bedtime.
Answer: C. TAKE THE MEDICATION ON AN EMPTY STOMACH
AND REMAIN UPRIGHT FOR 30 MINUTES
Rationale: Alendronate can cause severe esophagitis. Staying upright
and taking it with water on an empty stomach prevents esophageal
erosion.
4. A nurse is caring for a patient who has a prescription for Furosemide.
Which of the following lab values should the nurse withhold the dose
for?
A. Sodium 136 mEq/L
B. Potassium 3.2 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 1.9 mg/dL
Answer: B. POTASSIUM 3.2 MEQ/L
Rationale: Furosemide is a loop diuretic that causes potassium
wasting. A level of 3.2 is below the normal range (3.5–5.0), increasing
the risk for arrhythmias.
5. A patient is prescribed Lithium Carbonate for bipolar disorder. The
nurse should instruct the patient to maintain adequate intake of which
of the following?
A. Vitamin K
B. Sodium
C. Calcium
D. Potassium
Answer: B. SODIUM
Rationale: Lithium is a salt. If sodium levels drop (due to sweating or
low intake), the kidneys conserve lithium instead of sodium, leading
to toxicity.
6. What is the antidote for a Benzodiazepine (e.g., Lorazepam)
overdose?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
Answer: B. FLUMAZENIL
, Rationale: Flumazenil is the specific competitive antagonist for
benzodiazepines. Naloxone is for opioids.
7. A patient is starting Atorvastatin. Which of the following adverse
effects should the patient report immediately?
A. Dry mouth
B. Muscle pain or tenderness
C. Increased hunger
D. Orange-colored urine
Answer: B. MUSCLE PAIN OR TENDERNESS
Rationale: Statins carry a risk of rhabdomyolysis (muscle
breakdown). Unexplained muscle pain can indicate serious muscle
injury and potential kidney failure.
8. A nurse is preparing to administer Nitroglycerin sublingual for chest
pain. How many doses can be given before calling emergency
services?
A. 1 dose
B. 2 doses
C. 3 doses
D. 5 doses
Answer: A. 1 DOSE
Rationale: Current safety guidelines recommend taking one dose; if
the pain is not relieved or is worsening after 5 minutes, the patient
should call emergency services before taking subsequent doses.
9. A patient is receiving Vancomycin via IV intermittent infusion. The
nurse notes the patient’s neck and chest are bright red. What is the
priority action?
A. Administer epinephrine.
B. Slow the infusion rate.
C. Stop the infusion and document the allergy.
D. Apply cold compresses to the chest.
Answer: B. SLOW THE INFUSION RATE
Rationale: "Red Man Syndrome" is a rate-related infusion reaction,
not a true allergy. Slowing the rate usually resolves the flushing and
hypotension.
10. Which medication is the treatment of choice for an acute
asthma attack?
, A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Answer: B. ALBUTEROL
Rationale: Albuterol is a short-acting beta2-agonist (SABA) that
provides rapid bronchodilation. Fluticasone is for long-term
prevention.
11. A nurse is caring for a patient on Warfarin. The patient has an
INR of 5.2 but no signs of bleeding. Which medication should the
nurse anticipate?
A. Protamine sulfate
B. Vitamin K
C. Epoetin alfa
D. Enoxaparin
Answer: B. VITAMIN K
Rationale: Vitamin K is the antagonist for warfarin. For high INRs
without bleeding, the dose is usually held and Vitamin K may be
given.
12. A patient is prescribed Spironolactone. Which food should the
nurse tell the patient to avoid?
A. Apples
B. Bananas
C. White bread
D. Green beans
Answer: B. BANANAS
Rationale: Spironolactone is a potassium-sparing diuretic. Consuming
high-potassium foods like bananas increases the risk of
hyperkalemia.
13. What is the primary adverse effect of ACE inhibitors like
Lisinopril that often leads to treatment discontinuation?
A. Yellow vision
B. Dry, nonproductive cough
C. Constipation
D. Weight gain
Answer: B. DRY, NONPRODUCTIVE COUGH
