ATI PN PHARMACOLOGY PROCTORED EXAM
WITH NGN 2026-2027 QUESTIONS AND
ANSWERS WITH RATIONALES LEVEL 3 GUIDE
This comprehensive question test bank delivers
highly targeted, Next-Generation NCLEX (NGN)
style multiple-choice questions designed to
mirror the exact blueprint of the ATI PN
Pharmacology Proctored Exam. Each premium
question is immediately paired with its correct
answer and an in-depth, bolded clinical
rationale to maximize active learning and
concept retention. It serves as the ultimate
high-yield study tool for practical nursing
students aiming to achieve a Level 3 proficiency
and pass the NCLEX-PN on their first attempt.
1. A nurse is preparing to administer insulin glargine and regular
insulin to a client who has diabetes mellitus. Which of the following
actions should the nurse take?
A. Draw up the insulin glargine first, then the regular insulin in the same
syringe.
B. Draw up the regular insulin first, then the insulin glargine in the same
syringe.
,C. Prepare two separate injections, administering them at different sites.
D. Mix both insulins together in a single vial before drawing up the dose.
Answer: C
Rationale: Regular insulin can be mixed with intermediate-acting insulins
like NPH. However, long-acting insulins such as insulin glargine
(Lantus) have a low pH and must never be mixed in the same syringe
with any other insulin because doing so will alter its absorption rate and
cause precipitation. The nurse must prepare them as two separate
injections.
2. A nurse is reviewing the laboratory results of a client who is taking
furosemide daily. Which of the following laboratory values should the
nurse report to the provider immediately?
A. Sodium 138 mEq/L
B. Potassium 3.1 mEq/L
C. Calcium 9.2 mg/dL
D. Fasting blood glucose 105 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that causes the kidneys to excrete
water, sodium, and potassium. A potassium level of 3.1 mEq/L indicates
hypokalemia (normal range: 3.5 to 5.0 mEq/L), which can cause lethal
cardiac dysrhythmias. The other values fall within normal physiological
parameters.
3. A practical nurse is reinforcing teaching with a client who has a
new prescription for spironolactone. Which of the following dietary
instructions should the nurse include?
A. Increase your intake of bananas and orange juice.
B. Avoid the use of salt substitutes containing potassium chloride.
C. Consume at least three servings of dairy products daily.
D. Limit your intake of dark leafy green vegetables.
,Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that blocks
aldosterone, causing the body to retain potassium while excreting water
and sodium. Using salt substitutes, which are rich in potassium
chloride, puts the client at severe risk for life-threatening
hyperkalemia. Clients should be taught to maintain a moderate, consistent
intake of potassium rather than increasing it.
4. A nurse is monitoring a client who is receiving a continuous
intravenous heparin infusion for a deep vein thrombosis. Which of the
following laboratory values should the nurse monitor to adjust the
dosage?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Answer: C
Rationale: The activated partial thromboplastin time (aPTT) is the
primary laboratory test used to monitor and adjust therapeutic
dosages of heparin. Prothrombin time (PT) and International Normalized
Ratio (INR) are used to monitor oral warfarin therapy. While platelet counts
are monitored to check for heparin-induced thrombocytopenia (HIT), they
are not used to titrate the infusion rate.
5. A nurse is preparing to administer morphine sulfate 4 mg IV bolus
to a postoperative client. Which of the following assessments is the
nurse's priority before administering the medication?
A. Blood pressure
B. Respiratory rate
C. Pain scale score
D. Urine output over the past 4 hours
, Answer: B
Rationale: While all options are important components of postoperative
nursing care, the absolute priority before administering an opioid
analgesic like morphine is assessing the respiratory rate because
opioids depress the central nervous system. If the respiratory rate is
lower than 12 breaths per minute, the dose must be held and the provider
notified to prevent respiratory arrest.
6. A nurse is caring for a client who is experiencing severe respiratory
depression after receiving an overdose of intravenous
hydromorphone. Which of the following medications should the nurse
prepare to administer?
A. Flumazenil
B. Protamine sulfate
C. Acetylcysteine
D. Naloxone
Answer: D
Rationale: Naloxone is the specific opioid antagonist used to reverse
opioid-induced respiratory depression and central nervous system
toxicity. Flumazenil is the reversal agent for benzodiazepines, protamine
sulfate reverses heparin, and acetylcysteine is the antidote for
acetaminophen toxicity.
7. A nurse is reinforcing teaching with a client who has a new
prescription for oral warfarin. Which of the following statements by
the client indicates an understanding of the teaching?
A. "I should drink green tea every morning to help thin my blood."
B. "I will eat a large spinach salad every day for lunch to stay healthy."
C. "I need to keep my intake of green leafy vegetables consistent from day
to day."
D. "I will completely avoid eating any foods that contain Vitamin K."
WITH NGN 2026-2027 QUESTIONS AND
ANSWERS WITH RATIONALES LEVEL 3 GUIDE
This comprehensive question test bank delivers
highly targeted, Next-Generation NCLEX (NGN)
style multiple-choice questions designed to
mirror the exact blueprint of the ATI PN
Pharmacology Proctored Exam. Each premium
question is immediately paired with its correct
answer and an in-depth, bolded clinical
rationale to maximize active learning and
concept retention. It serves as the ultimate
high-yield study tool for practical nursing
students aiming to achieve a Level 3 proficiency
and pass the NCLEX-PN on their first attempt.
1. A nurse is preparing to administer insulin glargine and regular
insulin to a client who has diabetes mellitus. Which of the following
actions should the nurse take?
A. Draw up the insulin glargine first, then the regular insulin in the same
syringe.
B. Draw up the regular insulin first, then the insulin glargine in the same
syringe.
,C. Prepare two separate injections, administering them at different sites.
D. Mix both insulins together in a single vial before drawing up the dose.
Answer: C
Rationale: Regular insulin can be mixed with intermediate-acting insulins
like NPH. However, long-acting insulins such as insulin glargine
(Lantus) have a low pH and must never be mixed in the same syringe
with any other insulin because doing so will alter its absorption rate and
cause precipitation. The nurse must prepare them as two separate
injections.
2. A nurse is reviewing the laboratory results of a client who is taking
furosemide daily. Which of the following laboratory values should the
nurse report to the provider immediately?
A. Sodium 138 mEq/L
B. Potassium 3.1 mEq/L
C. Calcium 9.2 mg/dL
D. Fasting blood glucose 105 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that causes the kidneys to excrete
water, sodium, and potassium. A potassium level of 3.1 mEq/L indicates
hypokalemia (normal range: 3.5 to 5.0 mEq/L), which can cause lethal
cardiac dysrhythmias. The other values fall within normal physiological
parameters.
3. A practical nurse is reinforcing teaching with a client who has a
new prescription for spironolactone. Which of the following dietary
instructions should the nurse include?
A. Increase your intake of bananas and orange juice.
B. Avoid the use of salt substitutes containing potassium chloride.
C. Consume at least three servings of dairy products daily.
D. Limit your intake of dark leafy green vegetables.
,Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that blocks
aldosterone, causing the body to retain potassium while excreting water
and sodium. Using salt substitutes, which are rich in potassium
chloride, puts the client at severe risk for life-threatening
hyperkalemia. Clients should be taught to maintain a moderate, consistent
intake of potassium rather than increasing it.
4. A nurse is monitoring a client who is receiving a continuous
intravenous heparin infusion for a deep vein thrombosis. Which of the
following laboratory values should the nurse monitor to adjust the
dosage?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Answer: C
Rationale: The activated partial thromboplastin time (aPTT) is the
primary laboratory test used to monitor and adjust therapeutic
dosages of heparin. Prothrombin time (PT) and International Normalized
Ratio (INR) are used to monitor oral warfarin therapy. While platelet counts
are monitored to check for heparin-induced thrombocytopenia (HIT), they
are not used to titrate the infusion rate.
5. A nurse is preparing to administer morphine sulfate 4 mg IV bolus
to a postoperative client. Which of the following assessments is the
nurse's priority before administering the medication?
A. Blood pressure
B. Respiratory rate
C. Pain scale score
D. Urine output over the past 4 hours
, Answer: B
Rationale: While all options are important components of postoperative
nursing care, the absolute priority before administering an opioid
analgesic like morphine is assessing the respiratory rate because
opioids depress the central nervous system. If the respiratory rate is
lower than 12 breaths per minute, the dose must be held and the provider
notified to prevent respiratory arrest.
6. A nurse is caring for a client who is experiencing severe respiratory
depression after receiving an overdose of intravenous
hydromorphone. Which of the following medications should the nurse
prepare to administer?
A. Flumazenil
B. Protamine sulfate
C. Acetylcysteine
D. Naloxone
Answer: D
Rationale: Naloxone is the specific opioid antagonist used to reverse
opioid-induced respiratory depression and central nervous system
toxicity. Flumazenil is the reversal agent for benzodiazepines, protamine
sulfate reverses heparin, and acetylcysteine is the antidote for
acetaminophen toxicity.
7. A nurse is reinforcing teaching with a client who has a new
prescription for oral warfarin. Which of the following statements by
the client indicates an understanding of the teaching?
A. "I should drink green tea every morning to help thin my blood."
B. "I will eat a large spinach salad every day for lunch to stay healthy."
C. "I need to keep my intake of green leafy vegetables consistent from day
to day."
D. "I will completely avoid eating any foods that contain Vitamin K."
