ATI PHARMACOLOGY PROCTORED EXAM
2026 – COMPLETE TEST BUNDLE 150 Practice
Questions with Answers & Detailed Rationales
📋 EXAM OVERVIEW
| Detail | Information |
|:|:|
| Exam | ATI RN/PN Pharmacology Proctored Exam (CMS) |
| Latest Version | |
| Format | Multiple-choice, Select All That Apply, NGN-style case studies |
| Question Count | 60–75 questions per exam version |
| Key Topics | Cardiovascular, Endocrine, Neurological, Psychiatric, Antibiotics, Pain
Management, Respiratory, GI, Fluid & Electrolytes, Medication Safety |
| Passing Score | Varies by nursing program (typically Level 1 or 2 proficiency) |
SECTION 1: CARDIOVASCULAR & ANTICOAGULANT PHARMACOLOGY (Questions 1–20)
QUESTION 1
A nurse is preparing to administer digoxin to a client with heart failure. Which assessment
finding requires withholding the medication?
A) Potassium level 4.0 mEq/L
B) Apical pulse 54/min
C) Blood pressure 118/76 mmHg
D) Respiratory rate 16/min
Correct Answer: B
Rationale: Digoxin should be withheld if the apical pulse is less than 60/min in an adult. Digoxin
slows the heart rate, and bradycardia is a sign of digoxin toxicity. The normal potassium range is
3.5–5.0 mEq/L, so 4.0 mEq/L is within normal limits and would not require withholding.
QUESTION 2
,A patient is receiving IV heparin for a deep vein thrombosis. Which laboratory value should the
nurse monitor most closely?
A) PT/INR
B) aPTT
C) Platelet count
D) Serum potassium
Correct Answer: B
Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
The therapeutic range is typically 1.5–2.5 times the control value. PT/INR is monitored for
warfarin therapy.
QUESTION 3
A nurse is providing teaching to a client prescribed warfarin. Which statement by the client
indicates a need for further teaching?
A) "I will avoid eating large amounts of green leafy vegetables."
B) "I will report any unusual bleeding to my provider."
C) "I will take ibuprofen for my headaches."
D) "I will wear a medical alert bracelet."
Correct Answer: C
Rationale: Ibuprofen (an NSAID) increases the risk of bleeding when taken with warfarin.
Patients on warfarin should avoid NSAIDs and use alternative pain relief such as
acetaminophen. Green leafy vegetables contain vitamin K, which can antagonize warfarin, so
they should be consumed in consistent amounts. Medical alert bracelets are recommended.
QUESTION 4
A client is prescribed clopidogrel (Plavix) after a stent placement. The nurse understands that
this medication works by:
A) Inhibiting platelet aggregation
B) Blocking vitamin K synthesis
C) Inhibiting thrombin
D) Dissolving existing clots
Correct Answer: A
,Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation by irreversibly
blocking the P2Y12 receptor on platelets. This prevents platelet activation and reduces the risk
of stent thrombosis.
QUESTION 5
A nurse is caring for a client receiving a continuous heparin infusion. Which finding indicates the
client is experiencing a complication of heparin therapy?
A) aPTT of 60 seconds
B) Platelet count of 80,000/mm³
C) INR of 2.5
D) Hemoglobin of 13 g/dL
Correct Answer: B
Rationale: A platelet count of 80,000/mm³ is below normal (150,000–400,000) and may indicate
heparin-induced thrombocytopenia (HIT), a serious complication of heparin therapy. HIT
requires immediate discontinuation of heparin. The other values are within acceptable ranges.
QUESTION 6
A patient with heart failure is prescribed furosemide (Lasix). Which laboratory value should the
nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia is a
common and potentially dangerous side effect that can lead to cardiac arrhythmias.
QUESTION 7
A nurse is teaching a client about the use of sublingual nitroglycerin for angina. Which
instruction should the nurse include?
A) "Take one tablet every 15 minutes for up to three doses."
B) "Swallow the tablet with a full glass of water."
C) "Take the tablet at the first sign of chest pain."
, D) "Store the tablets in the refrigerator."
Correct Answer: C
Rationale: Nitroglycerin should be taken at the first sign of chest pain. The standard protocol is
to take one tablet sublingually every 5 minutes for up to three doses. If pain persists after three
tablets, seek emergency care. Tablets should be stored in their original container away from
light and moisture.
QUESTION 8
A client is prescribed amiodarone for a cardiac arrhythmia. Which adverse effect should the
nurse monitor for?
A) Pulmonary toxicity
B) Nephrotoxicity
C) Hepatotoxicity
D) Ototoxicity
Correct Answer: A
Rationale: Amiodarone can cause pulmonary toxicity, including interstitial pneumonitis and
pulmonary fibrosis. Patients should be monitored for signs such as cough, dyspnea, and
decreased exercise tolerance. Regular monitoring of pulmonary function is recommended.
QUESTION 9
A nurse is administering lisinopril to a client with hypertension. Which adverse effect is
associated with this medication?
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) All of the above
Correct Answer: D
Rationale: Lisinopril (an ACE inhibitor) is associated with a dry cough (due to bradykinin
accumulation), hyperkalemia, and angioedema. Patients should be monitored for these adverse
effects.
QUESTION 10
2026 – COMPLETE TEST BUNDLE 150 Practice
Questions with Answers & Detailed Rationales
📋 EXAM OVERVIEW
| Detail | Information |
|:|:|
| Exam | ATI RN/PN Pharmacology Proctored Exam (CMS) |
| Latest Version | |
| Format | Multiple-choice, Select All That Apply, NGN-style case studies |
| Question Count | 60–75 questions per exam version |
| Key Topics | Cardiovascular, Endocrine, Neurological, Psychiatric, Antibiotics, Pain
Management, Respiratory, GI, Fluid & Electrolytes, Medication Safety |
| Passing Score | Varies by nursing program (typically Level 1 or 2 proficiency) |
SECTION 1: CARDIOVASCULAR & ANTICOAGULANT PHARMACOLOGY (Questions 1–20)
QUESTION 1
A nurse is preparing to administer digoxin to a client with heart failure. Which assessment
finding requires withholding the medication?
A) Potassium level 4.0 mEq/L
B) Apical pulse 54/min
C) Blood pressure 118/76 mmHg
D) Respiratory rate 16/min
Correct Answer: B
Rationale: Digoxin should be withheld if the apical pulse is less than 60/min in an adult. Digoxin
slows the heart rate, and bradycardia is a sign of digoxin toxicity. The normal potassium range is
3.5–5.0 mEq/L, so 4.0 mEq/L is within normal limits and would not require withholding.
QUESTION 2
,A patient is receiving IV heparin for a deep vein thrombosis. Which laboratory value should the
nurse monitor most closely?
A) PT/INR
B) aPTT
C) Platelet count
D) Serum potassium
Correct Answer: B
Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
The therapeutic range is typically 1.5–2.5 times the control value. PT/INR is monitored for
warfarin therapy.
QUESTION 3
A nurse is providing teaching to a client prescribed warfarin. Which statement by the client
indicates a need for further teaching?
A) "I will avoid eating large amounts of green leafy vegetables."
B) "I will report any unusual bleeding to my provider."
C) "I will take ibuprofen for my headaches."
D) "I will wear a medical alert bracelet."
Correct Answer: C
Rationale: Ibuprofen (an NSAID) increases the risk of bleeding when taken with warfarin.
Patients on warfarin should avoid NSAIDs and use alternative pain relief such as
acetaminophen. Green leafy vegetables contain vitamin K, which can antagonize warfarin, so
they should be consumed in consistent amounts. Medical alert bracelets are recommended.
QUESTION 4
A client is prescribed clopidogrel (Plavix) after a stent placement. The nurse understands that
this medication works by:
A) Inhibiting platelet aggregation
B) Blocking vitamin K synthesis
C) Inhibiting thrombin
D) Dissolving existing clots
Correct Answer: A
,Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation by irreversibly
blocking the P2Y12 receptor on platelets. This prevents platelet activation and reduces the risk
of stent thrombosis.
QUESTION 5
A nurse is caring for a client receiving a continuous heparin infusion. Which finding indicates the
client is experiencing a complication of heparin therapy?
A) aPTT of 60 seconds
B) Platelet count of 80,000/mm³
C) INR of 2.5
D) Hemoglobin of 13 g/dL
Correct Answer: B
Rationale: A platelet count of 80,000/mm³ is below normal (150,000–400,000) and may indicate
heparin-induced thrombocytopenia (HIT), a serious complication of heparin therapy. HIT
requires immediate discontinuation of heparin. The other values are within acceptable ranges.
QUESTION 6
A patient with heart failure is prescribed furosemide (Lasix). Which laboratory value should the
nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia is a
common and potentially dangerous side effect that can lead to cardiac arrhythmias.
QUESTION 7
A nurse is teaching a client about the use of sublingual nitroglycerin for angina. Which
instruction should the nurse include?
A) "Take one tablet every 15 minutes for up to three doses."
B) "Swallow the tablet with a full glass of water."
C) "Take the tablet at the first sign of chest pain."
, D) "Store the tablets in the refrigerator."
Correct Answer: C
Rationale: Nitroglycerin should be taken at the first sign of chest pain. The standard protocol is
to take one tablet sublingually every 5 minutes for up to three doses. If pain persists after three
tablets, seek emergency care. Tablets should be stored in their original container away from
light and moisture.
QUESTION 8
A client is prescribed amiodarone for a cardiac arrhythmia. Which adverse effect should the
nurse monitor for?
A) Pulmonary toxicity
B) Nephrotoxicity
C) Hepatotoxicity
D) Ototoxicity
Correct Answer: A
Rationale: Amiodarone can cause pulmonary toxicity, including interstitial pneumonitis and
pulmonary fibrosis. Patients should be monitored for signs such as cough, dyspnea, and
decreased exercise tolerance. Regular monitoring of pulmonary function is recommended.
QUESTION 9
A nurse is administering lisinopril to a client with hypertension. Which adverse effect is
associated with this medication?
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) All of the above
Correct Answer: D
Rationale: Lisinopril (an ACE inhibitor) is associated with a dry cough (due to bradykinin
accumulation), hyperkalemia, and angioedema. Patients should be monitored for these adverse
effects.
QUESTION 10
