RN PHARMACOLOGY
ATI RN Pharmacology Proctored Exam 2023–2026
| NGN 140 Questions & Answers |
MOST TESTED QUESTIONS DISCUSSED.90% PASS
GUARANTEED NO RETAKE
Question 1
A nurse is preparing to administer IV morphine to a client with acute pulmonary
edema. Which of the following actions should the nurse take?
• Flush the IV line with heparin solution before administration
• Administer the medication at a rate of 5 mg per minute
• Monitor for decreased respiratory rate and hypotension
• Dilute the medication with dextrose 5% in water
Answer: Monitor for decreased respiratory rate and hypotension.
Rationale:
• Monitor for decreased RR and BP: Morphine causes respiratory
depression and vasodilation (reduces preload). These are therapeutic
effects but require close monitoring to prevent overdose.
• Flush with heparin: Not necessary; flush with normal saline.
• Rate 5 mg/min: Too rapid; give slowly over 1-5 minutes.
• Dilute with D5W: Compatible with normal saline or D5W, but monitoring
is most critical.
Question 2
A nurse is administering IV metoprolol to a client with acute myocardial
infarction. The client's heart rate drops to 48 beats/min and blood pressure is
88/52 mm Hg. Which of the following actions should the nurse take first?
• Continue the infusion as ordered
• Administer IV atropine
• Stop the infusion
, RN PHARMACOLOGY
• Notify the provider
Answer: Stop the infusion.
Rationale:
• Stop the infusion: Metoprolol is a beta-blocker that decreases HR and BP.
Severe bradycardia and hypotension require immediate discontinuation.
• Continue: Unsafe given vital signs.
• Administer atropine: May be needed after stopping, but not first action.
• Notify provider: Do after stopping infusion.
Question 3
A nurse is teaching a client who has a new prescription for warfarin after
mechanical heart valve replacement. Which of the following statements by the
client indicates understanding?
• "I will take ibuprofen if I get a headache"
• "I will eat spinach and kale daily to prevent bleeding"
• "I will have my INR checked regularly as scheduled"
• "I will stop taking warfarin if I notice bruising"
Answer: "I will have my INR checked regularly as scheduled."
Rationale:
• Regular INR: Essential to maintain therapeutic range (2.5-3.5 for
mechanical valves).
• Ibuprofen: Increases bleeding risk - avoid.
• Spinach/kale: High in vitamin K, counteracts warfarin - avoid large
changes.
• Stop if bruising: Do not stop; report bruising to provider.
Question 4
A nurse is reviewing the medication list of a client who will start linezolid for
vancomycin-resistant Enterococcus (VRE). Which of the following medications
should the nurse identify as a potential interaction?
, RN PHARMACOLOGY
• Acetaminophen
• Lisinopril
• Sertraline
• Metformin
Answer: Sertraline.
Rationale:
• Sertraline (SSRI): Linezolid is a weak MAOI; combined with SSRIs increases
risk of serotonin syndrome (agitation, hyperthermia, confusion).
• Acetaminophen, lisinopril, metformin: No significant interaction.
Question 5
A nurse is preparing to administer enoxaparin 40 mg subcutaneously to a client
after abdominal surgery. Which of the following actions should the nurse take?
• Expel the air bubble from the syringe before injection
• Massage the site after injection to promote absorption
• Administer the injection into the deltoid muscle
• Pinch a skin fold on the abdomen and insert the needle at a 90° angle
Answer: Pinch a skin fold on the abdomen and insert the needle at a 90° angle.
Rationale:
• Pinch and 90° angle: Correct technique for subcutaneous enoxaparin
administration into abdomen.
• Expel air bubble: Do not expel – air bubble ensures full dose delivery.
• Massage site: Do not massage – causes bruising/hematoma.
• Deltoid: Subcutaneous injections given in abdomen for enoxaparin.
Question 6
A nurse is caring for a client receiving a continuous heparin infusion. The client's
aPTT is 110 seconds (normal 25-35). The client has epistaxis. Which of the
following actions should the nurse take?
• Decrease the infusion rate by 50%
, RN PHARMACOLOGY
• Continue the infusion and monitor closely
• Stop the infusion and notify the provider immediately
• Administer vitamin K
Answer: Stop the infusion and notify the provider immediately.
Rationale:
• Stop and notify: Supratherapeutic aPTT (>2.5x normal) with bleeding
requires immediate discontinuation. Protamine sulfate may be ordered.
• Decrease rate: Inadequate given active bleeding.
• Continue: Unsafe.
• Vitamin K: Antidote for warfarin, not heparin.
Question 7
A nurse is teaching a client with osteoporosis about a new prescription for
risedronate. Which of the following instructions should the nurse include?
• Take the medication with orange juice to enhance absorption
• Remain sitting upright for 30 minutes after taking
• Take the medication immediately after breakfast
• Chew the tablet for faster absorption
Answer: Remain sitting upright for 30 minutes after taking.
Rationale:
• Upright position: Prevents esophageal irritation and ulceration.
• Orange juice: Take with plain water only.
• After breakfast: Take first thing in morning, 30 min before food/drink.
• Chew tablet: Swallow whole; chewing causes esophageal irritation.
Question 8
A nurse is assessing a client who has been taking carbamazepine for seizures for
3 months. Which of the following findings should the nurse report to the
provider immediately?
• Drowsiness
ATI RN Pharmacology Proctored Exam 2023–2026
| NGN 140 Questions & Answers |
MOST TESTED QUESTIONS DISCUSSED.90% PASS
GUARANTEED NO RETAKE
Question 1
A nurse is preparing to administer IV morphine to a client with acute pulmonary
edema. Which of the following actions should the nurse take?
• Flush the IV line with heparin solution before administration
• Administer the medication at a rate of 5 mg per minute
• Monitor for decreased respiratory rate and hypotension
• Dilute the medication with dextrose 5% in water
Answer: Monitor for decreased respiratory rate and hypotension.
Rationale:
• Monitor for decreased RR and BP: Morphine causes respiratory
depression and vasodilation (reduces preload). These are therapeutic
effects but require close monitoring to prevent overdose.
• Flush with heparin: Not necessary; flush with normal saline.
• Rate 5 mg/min: Too rapid; give slowly over 1-5 minutes.
• Dilute with D5W: Compatible with normal saline or D5W, but monitoring
is most critical.
Question 2
A nurse is administering IV metoprolol to a client with acute myocardial
infarction. The client's heart rate drops to 48 beats/min and blood pressure is
88/52 mm Hg. Which of the following actions should the nurse take first?
• Continue the infusion as ordered
• Administer IV atropine
• Stop the infusion
, RN PHARMACOLOGY
• Notify the provider
Answer: Stop the infusion.
Rationale:
• Stop the infusion: Metoprolol is a beta-blocker that decreases HR and BP.
Severe bradycardia and hypotension require immediate discontinuation.
• Continue: Unsafe given vital signs.
• Administer atropine: May be needed after stopping, but not first action.
• Notify provider: Do after stopping infusion.
Question 3
A nurse is teaching a client who has a new prescription for warfarin after
mechanical heart valve replacement. Which of the following statements by the
client indicates understanding?
• "I will take ibuprofen if I get a headache"
• "I will eat spinach and kale daily to prevent bleeding"
• "I will have my INR checked regularly as scheduled"
• "I will stop taking warfarin if I notice bruising"
Answer: "I will have my INR checked regularly as scheduled."
Rationale:
• Regular INR: Essential to maintain therapeutic range (2.5-3.5 for
mechanical valves).
• Ibuprofen: Increases bleeding risk - avoid.
• Spinach/kale: High in vitamin K, counteracts warfarin - avoid large
changes.
• Stop if bruising: Do not stop; report bruising to provider.
Question 4
A nurse is reviewing the medication list of a client who will start linezolid for
vancomycin-resistant Enterococcus (VRE). Which of the following medications
should the nurse identify as a potential interaction?
, RN PHARMACOLOGY
• Acetaminophen
• Lisinopril
• Sertraline
• Metformin
Answer: Sertraline.
Rationale:
• Sertraline (SSRI): Linezolid is a weak MAOI; combined with SSRIs increases
risk of serotonin syndrome (agitation, hyperthermia, confusion).
• Acetaminophen, lisinopril, metformin: No significant interaction.
Question 5
A nurse is preparing to administer enoxaparin 40 mg subcutaneously to a client
after abdominal surgery. Which of the following actions should the nurse take?
• Expel the air bubble from the syringe before injection
• Massage the site after injection to promote absorption
• Administer the injection into the deltoid muscle
• Pinch a skin fold on the abdomen and insert the needle at a 90° angle
Answer: Pinch a skin fold on the abdomen and insert the needle at a 90° angle.
Rationale:
• Pinch and 90° angle: Correct technique for subcutaneous enoxaparin
administration into abdomen.
• Expel air bubble: Do not expel – air bubble ensures full dose delivery.
• Massage site: Do not massage – causes bruising/hematoma.
• Deltoid: Subcutaneous injections given in abdomen for enoxaparin.
Question 6
A nurse is caring for a client receiving a continuous heparin infusion. The client's
aPTT is 110 seconds (normal 25-35). The client has epistaxis. Which of the
following actions should the nurse take?
• Decrease the infusion rate by 50%
, RN PHARMACOLOGY
• Continue the infusion and monitor closely
• Stop the infusion and notify the provider immediately
• Administer vitamin K
Answer: Stop the infusion and notify the provider immediately.
Rationale:
• Stop and notify: Supratherapeutic aPTT (>2.5x normal) with bleeding
requires immediate discontinuation. Protamine sulfate may be ordered.
• Decrease rate: Inadequate given active bleeding.
• Continue: Unsafe.
• Vitamin K: Antidote for warfarin, not heparin.
Question 7
A nurse is teaching a client with osteoporosis about a new prescription for
risedronate. Which of the following instructions should the nurse include?
• Take the medication with orange juice to enhance absorption
• Remain sitting upright for 30 minutes after taking
• Take the medication immediately after breakfast
• Chew the tablet for faster absorption
Answer: Remain sitting upright for 30 minutes after taking.
Rationale:
• Upright position: Prevents esophageal irritation and ulceration.
• Orange juice: Take with plain water only.
• After breakfast: Take first thing in morning, 30 min before food/drink.
• Chew tablet: Swallow whole; chewing causes esophageal irritation.
Question 8
A nurse is assessing a client who has been taking carbamazepine for seizures for
3 months. Which of the following findings should the nurse report to the
provider immediately?
• Drowsiness
