2026 ATI RN Pharmacology Practice
Exam Questions with Answers and
Detailed Rationales
Question 1.
A nurse is caring for a client who is receiving IV heparin for a
pulmonary embolism. Which laboratory result should the
nurse report immediately?
A. Hemoglobin 12.8 g/dL
B. Platelet count 82,000/mm³
C. aPTT 68 seconds
D. INR 1.2
Answer: B. Platelet count 82,000/mm³
The most concerning finding is thrombocytopenia, which may
indicate heparin-induced thrombocytopenia (HIT), a
potentially life-threatening immune-mediated reaction
associated with thrombosis. The nurse should stop heparin
and notify the provider according to protocol. The aPTT is
expected to be elevated during therapeutic unfractionated
heparin therapy.
Question 2.
,A client taking warfarin is prescribed trimethoprim-
sulfamethoxazole for a urinary tract infection. Which action
should the nurse anticipate?
A. Administer both medications as prescribed
B. Increase the client's vitamin K intake
C. Monitor the INR more frequently
D. Administer protamine sulfate prophylactically
Answer: C. Monitor the client's INR more frequently
Trimethoprim-sulfamethoxazole can increase the
anticoagulant effect of warfarin and significantly raise the risk
of bleeding. Increased INR monitoring is appropriate, and the
prescriber may need to adjust the warfarin dose. Protamine
sulfate reverses heparin, not warfarin.
Question 3.
A nurse is administering digoxin to a client with heart failure.
Which finding requires the nurse to withhold the medication?
A. Apical pulse 54/min
B. Blood pressure 128/74 mm Hg
C. Potassium 4.2 mEq/L
D. Respiratory rate 18/min
Answer: A. Apical pulse 54/min
Digoxin can cause bradycardia by slowing atrioventricular
conduction. The nurse should generally withhold digoxin in an
adult when the apical pulse is below 60/min and notify the
,provider. Hypokalemia increases digoxin toxicity risk, but the
potassium value is currently normal.
Question 4.
A client receiving digoxin reports nausea, anorexia, and
seeing yellow-green halos around lights. Which additional
finding most strongly increases the nurse's suspicion of
digoxin toxicity?
A. Serum potassium 3.0 mEq/L
B. Serum sodium 140 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.0 mg/dL
Answer: A. Serum potassium 3.0 mEq/L
Hypokalemia increases the sensitivity of cardiac tissue to
digoxin and significantly increases the risk of toxicity.
Gastrointestinal symptoms and visual disturbances are classic
manifestations of digoxin toxicity. The nurse should notify the
provider and anticipate withholding digoxin.
Question 5.
A client taking lisinopril develops swelling of the lips and
tongue and difficulty breathing. Which action should the
nurse take first?
A. Administer the next scheduled dose
B. Place the client in a supine position
, C. Activate emergency response measures
D. Encourage oral fluids
Answer: C. Activate emergency response measures
Angioedema is a potentially life-threatening adverse effect of
ACE inhibitors that can rapidly obstruct the airway. The
medication should be discontinued, and emergency airway
management should be initiated. The nurse's priority is
maintaining airway and breathing.
Question 6 — Difficulty: Hard
A client taking spironolactone is prescribed a potassium
supplement. Which action should the nurse take?
A. Administer both medications
B. Hold the potassium supplement and notify the provider
C. Administer the potassium with orange juice
D. Give the potassium only at bedtime
Answer: B. Hold the potassium supplement and notify the
provider
Spironolactone is a potassium-sparing diuretic. Concurrent
potassium supplementation increases the risk of
hyperkalemia, which can cause potentially fatal cardiac
dysrhythmias. The prescription should be clarified before
administration.
Question 7 — Difficulty: Hard
Exam Questions with Answers and
Detailed Rationales
Question 1.
A nurse is caring for a client who is receiving IV heparin for a
pulmonary embolism. Which laboratory result should the
nurse report immediately?
A. Hemoglobin 12.8 g/dL
B. Platelet count 82,000/mm³
C. aPTT 68 seconds
D. INR 1.2
Answer: B. Platelet count 82,000/mm³
The most concerning finding is thrombocytopenia, which may
indicate heparin-induced thrombocytopenia (HIT), a
potentially life-threatening immune-mediated reaction
associated with thrombosis. The nurse should stop heparin
and notify the provider according to protocol. The aPTT is
expected to be elevated during therapeutic unfractionated
heparin therapy.
Question 2.
,A client taking warfarin is prescribed trimethoprim-
sulfamethoxazole for a urinary tract infection. Which action
should the nurse anticipate?
A. Administer both medications as prescribed
B. Increase the client's vitamin K intake
C. Monitor the INR more frequently
D. Administer protamine sulfate prophylactically
Answer: C. Monitor the client's INR more frequently
Trimethoprim-sulfamethoxazole can increase the
anticoagulant effect of warfarin and significantly raise the risk
of bleeding. Increased INR monitoring is appropriate, and the
prescriber may need to adjust the warfarin dose. Protamine
sulfate reverses heparin, not warfarin.
Question 3.
A nurse is administering digoxin to a client with heart failure.
Which finding requires the nurse to withhold the medication?
A. Apical pulse 54/min
B. Blood pressure 128/74 mm Hg
C. Potassium 4.2 mEq/L
D. Respiratory rate 18/min
Answer: A. Apical pulse 54/min
Digoxin can cause bradycardia by slowing atrioventricular
conduction. The nurse should generally withhold digoxin in an
adult when the apical pulse is below 60/min and notify the
,provider. Hypokalemia increases digoxin toxicity risk, but the
potassium value is currently normal.
Question 4.
A client receiving digoxin reports nausea, anorexia, and
seeing yellow-green halos around lights. Which additional
finding most strongly increases the nurse's suspicion of
digoxin toxicity?
A. Serum potassium 3.0 mEq/L
B. Serum sodium 140 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.0 mg/dL
Answer: A. Serum potassium 3.0 mEq/L
Hypokalemia increases the sensitivity of cardiac tissue to
digoxin and significantly increases the risk of toxicity.
Gastrointestinal symptoms and visual disturbances are classic
manifestations of digoxin toxicity. The nurse should notify the
provider and anticipate withholding digoxin.
Question 5.
A client taking lisinopril develops swelling of the lips and
tongue and difficulty breathing. Which action should the
nurse take first?
A. Administer the next scheduled dose
B. Place the client in a supine position
, C. Activate emergency response measures
D. Encourage oral fluids
Answer: C. Activate emergency response measures
Angioedema is a potentially life-threatening adverse effect of
ACE inhibitors that can rapidly obstruct the airway. The
medication should be discontinued, and emergency airway
management should be initiated. The nurse's priority is
maintaining airway and breathing.
Question 6 — Difficulty: Hard
A client taking spironolactone is prescribed a potassium
supplement. Which action should the nurse take?
A. Administer both medications
B. Hold the potassium supplement and notify the provider
C. Administer the potassium with orange juice
D. Give the potassium only at bedtime
Answer: B. Hold the potassium supplement and notify the
provider
Spironolactone is a potassium-sparing diuretic. Concurrent
potassium supplementation increases the risk of
hyperkalemia, which can cause potentially fatal cardiac
dysrhythmias. The prescription should be clarified before
administration.
Question 7 — Difficulty: Hard
