ATI RN Pharmacology 2025 NGN Exam
Review | 200 Practice Questions & Verified
Answers with Detailed Rationales | Latest
Pharmacology Study Guide for NCLEX RN
PDF
• This 200-question ATI RN Pharmacology 2025 NGN practice exam mirrors the
format and rigor of the actual NCLEX-RN, covering all high-yield pharmacology
topics tested in ATI assessments.
• Use this material by reading each question carefully, selecting your answer before
checking the correct option and EXPERT RATIONALE — this active recall method
maximizes retention and exam readiness.
ATI RN PHARMACOLOGY 2025 NGN EXAM REVIEW
200 Practice Questions with Verified Answers & Detailed EXPERT RATIONALE
1. A nurse is preparing to administer metformin to a client with type 2
diabetes. Which of the following findings should the nurse report to the
provider before giving the medication?
A. Fasting blood glucose of 180 mg/dL
B. HbA1c of 7.5%
C. Serum creatinine of 2.8 mg/dL
D. Blood pressure of 138/86 mmHg
E. Weight gain of 1 kg in one week
C. Serum creatinine of 2.8 mg/dL
EXPERT RATIONALE: Metformin is contraindicated in clients with renal impairment
(creatinine ≥1.5 mg/dL in males, ≥1.4 mg/dL in females) due to the risk of lactic acidosis.
The nurse must withhold the medication and notify the provider immediately.
,2. A nurse is educating a client prescribed warfarin. Which statement by the
client indicates a need for further teaching?
A. "I will have my INR checked regularly."
B. "I should avoid foods high in vitamin K."
C. "I can take ibuprofen for my headaches."
D. "I will report any unusual bruising immediately."
E. "I should wear a medical alert bracelet."
C. "I can take ibuprofen for my headaches."
EXPERT RATIONALE: NSAIDs such as ibuprofen potentiate the anticoagulant effect of
warfarin and increase the risk of bleeding. Clients should use acetaminophen for pain
relief instead.
3. A nurse is administering IV vancomycin. The client develops flushing,
erythema, and hypotension. What is the priority nursing action?
A. Discontinue the infusion and notify the provider
B. Administer diphenhydramine as ordered
C. Slow the infusion rate
D. Obtain an ECG immediately
E. Place the client in Trendelenburg position
C. Slow the infusion rate
EXPERT RATIONALE: The symptoms describe Red Man Syndrome, a non-immune-
mediated reaction caused by too-rapid infusion of vancomycin. The first action is to slow
the infusion rate. If symptoms persist, the infusion may be stopped and antihistamines
administered.
,4. A nurse is caring for a client receiving heparin infusion. The aPTT result is
120 seconds. What action should the nurse take?
A. Increase the heparin rate per protocol
B. Continue the infusion at the current rate
C. Decrease the heparin rate per protocol
D. Discontinue heparin and administer protamine sulfate
E. Draw a repeat aPTT in 6 hours
C. Decrease the heparin rate per protocol
EXPERT RATIONALE: The therapeutic aPTT for heparin therapy is 60–100 seconds (1.5–
2.5 times normal). An aPTT of 120 seconds is supratherapeutic, indicating the client is
over-anticoagulated. The nurse should reduce the infusion rate per the protocol to
prevent bleeding complications.
5. A client prescribed lithium reports nausea, tremors, and polyuria. The
serum lithium level is 1.8 mEq/L. What is the nurse's priority action?
A. Encourage the client to increase fluid intake
B. Administer an antiemetic as prescribed
C. Hold the next dose and notify the provider
D. Reassure the client these are expected side effects
E. Schedule a repeat lithium level in 12 hours
C. Hold the next dose and notify the provider
EXPERT RATIONALE: A lithium level of 1.8 mEq/L is above the therapeutic range of 0.6–
1.2 mEq/L, indicating early toxicity. Symptoms of nausea, tremors, and polyuria confirm
toxicity. The nurse must hold the dose and notify the provider promptly.
, 6. A nurse is preparing to administer digoxin to a client. Which assessment
finding requires the nurse to withhold the medication?
A. Blood pressure of 110/70 mmHg
B. Apical pulse of 54 beats per minute
C. Potassium level of 3.8 mEq/L
D. Digoxin level of 0.9 ng/mL
E. Respiratory rate of 16 breaths per minute
B. Apical pulse of 54 beats per minute
EXPERT RATIONALE: Digoxin should be withheld and the provider notified if the apical
pulse is below 60 beats per minute in an adult. Digoxin slows conduction through the AV
node and a low heart rate may indicate toxicity.
7. A nurse is caring for a client on isoniazid (INH) therapy for tuberculosis.
Which supplement should the nurse anticipate administering concurrently?
A. Vitamin C
B. Vitamin B12
C. Vitamin B6 (pyridoxine)
D. Folic acid
E. Vitamin D
C. Vitamin B6 (pyridoxine)
EXPERT RATIONALE: INH interferes with pyridoxine (vitamin B6) metabolism, which can
lead to peripheral neuropathy. Pyridoxine supplementation is routinely prescribed
alongside INH to prevent this complication.
8. A client is prescribed furosemide 40 mg IV. Which laboratory value is most
important to monitor?
Review | 200 Practice Questions & Verified
Answers with Detailed Rationales | Latest
Pharmacology Study Guide for NCLEX RN
• This 200-question ATI RN Pharmacology 2025 NGN practice exam mirrors the
format and rigor of the actual NCLEX-RN, covering all high-yield pharmacology
topics tested in ATI assessments.
• Use this material by reading each question carefully, selecting your answer before
checking the correct option and EXPERT RATIONALE — this active recall method
maximizes retention and exam readiness.
ATI RN PHARMACOLOGY 2025 NGN EXAM REVIEW
200 Practice Questions with Verified Answers & Detailed EXPERT RATIONALE
1. A nurse is preparing to administer metformin to a client with type 2
diabetes. Which of the following findings should the nurse report to the
provider before giving the medication?
A. Fasting blood glucose of 180 mg/dL
B. HbA1c of 7.5%
C. Serum creatinine of 2.8 mg/dL
D. Blood pressure of 138/86 mmHg
E. Weight gain of 1 kg in one week
C. Serum creatinine of 2.8 mg/dL
EXPERT RATIONALE: Metformin is contraindicated in clients with renal impairment
(creatinine ≥1.5 mg/dL in males, ≥1.4 mg/dL in females) due to the risk of lactic acidosis.
The nurse must withhold the medication and notify the provider immediately.
,2. A nurse is educating a client prescribed warfarin. Which statement by the
client indicates a need for further teaching?
A. "I will have my INR checked regularly."
B. "I should avoid foods high in vitamin K."
C. "I can take ibuprofen for my headaches."
D. "I will report any unusual bruising immediately."
E. "I should wear a medical alert bracelet."
C. "I can take ibuprofen for my headaches."
EXPERT RATIONALE: NSAIDs such as ibuprofen potentiate the anticoagulant effect of
warfarin and increase the risk of bleeding. Clients should use acetaminophen for pain
relief instead.
3. A nurse is administering IV vancomycin. The client develops flushing,
erythema, and hypotension. What is the priority nursing action?
A. Discontinue the infusion and notify the provider
B. Administer diphenhydramine as ordered
C. Slow the infusion rate
D. Obtain an ECG immediately
E. Place the client in Trendelenburg position
C. Slow the infusion rate
EXPERT RATIONALE: The symptoms describe Red Man Syndrome, a non-immune-
mediated reaction caused by too-rapid infusion of vancomycin. The first action is to slow
the infusion rate. If symptoms persist, the infusion may be stopped and antihistamines
administered.
,4. A nurse is caring for a client receiving heparin infusion. The aPTT result is
120 seconds. What action should the nurse take?
A. Increase the heparin rate per protocol
B. Continue the infusion at the current rate
C. Decrease the heparin rate per protocol
D. Discontinue heparin and administer protamine sulfate
E. Draw a repeat aPTT in 6 hours
C. Decrease the heparin rate per protocol
EXPERT RATIONALE: The therapeutic aPTT for heparin therapy is 60–100 seconds (1.5–
2.5 times normal). An aPTT of 120 seconds is supratherapeutic, indicating the client is
over-anticoagulated. The nurse should reduce the infusion rate per the protocol to
prevent bleeding complications.
5. A client prescribed lithium reports nausea, tremors, and polyuria. The
serum lithium level is 1.8 mEq/L. What is the nurse's priority action?
A. Encourage the client to increase fluid intake
B. Administer an antiemetic as prescribed
C. Hold the next dose and notify the provider
D. Reassure the client these are expected side effects
E. Schedule a repeat lithium level in 12 hours
C. Hold the next dose and notify the provider
EXPERT RATIONALE: A lithium level of 1.8 mEq/L is above the therapeutic range of 0.6–
1.2 mEq/L, indicating early toxicity. Symptoms of nausea, tremors, and polyuria confirm
toxicity. The nurse must hold the dose and notify the provider promptly.
, 6. A nurse is preparing to administer digoxin to a client. Which assessment
finding requires the nurse to withhold the medication?
A. Blood pressure of 110/70 mmHg
B. Apical pulse of 54 beats per minute
C. Potassium level of 3.8 mEq/L
D. Digoxin level of 0.9 ng/mL
E. Respiratory rate of 16 breaths per minute
B. Apical pulse of 54 beats per minute
EXPERT RATIONALE: Digoxin should be withheld and the provider notified if the apical
pulse is below 60 beats per minute in an adult. Digoxin slows conduction through the AV
node and a low heart rate may indicate toxicity.
7. A nurse is caring for a client on isoniazid (INH) therapy for tuberculosis.
Which supplement should the nurse anticipate administering concurrently?
A. Vitamin C
B. Vitamin B12
C. Vitamin B6 (pyridoxine)
D. Folic acid
E. Vitamin D
C. Vitamin B6 (pyridoxine)
EXPERT RATIONALE: INH interferes with pyridoxine (vitamin B6) metabolism, which can
lead to peripheral neuropathy. Pyridoxine supplementation is routinely prescribed
alongside INH to prevent this complication.
8. A client is prescribed furosemide 40 mg IV. Which laboratory value is most
important to monitor?
