ATI RN Pharmacology Exam
Next Generation NCLEX (NGN) Format | 70 Questions | Study
Review Edition
Instructions: Read each question carefully. For standard multiple-choice questions,
select the single best answer. For Select All That Apply (SATA) questions, select all
correct answers. Answers and rationales follow each question.
Question 1
A client with heart failure is prescribed furosemide (Lasix). Which laboratory value
should the nurse monitor most closely?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum magnesium
Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes increased excretion of potassium
in the urine. Hypokalemia is a common and potentially dangerous adverse effect that
can lead to cardiac dysrhythmias. While sodium and magnesium may also be affected,
potassium depletion occurs most rapidly and poses the greatest immediate risk. The
nurse should monitor serum potassium levels closely and assess for signs of
hypokalemia such as muscle weakness, fatigue, and irregular heartbeat.
Question 2
A nurse is administering lisinopril (Zestril) to a client with hypertension. Which
instruction is most important for the nurse to include in the teaching plan?
A. Avoid potassium substitutes
B. Take the medication with food
C. Increase fluid intake to 3 L daily
D. Expect a dry cough as a side effect
,Correct Answer: A
Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia due to decreased
aldosterone production. Clients should be instructed to avoid potassium supplements
and salt substitutes, which often contain potassium chloride. While a dry cough is a
known side effect of ACE inhibitors, it is not life-threatening and does not require the
same level of precaution as preventing hyperkalemia. Taking the medication with food
is acceptable but not the most critical instruction.
Question 3
A client with atrial fibrillation is started on warfarin (Coumadin). The nurse
teaches the client about dietary consistency. Which food should the client be
instructed to consume in consistent amounts?
A. Green leafy vegetables
B. Dairy products
C. Citrus fruits
D. Red meat
Correct Answer: A
,Rationale: Green leafy vegetables such as spinach, kale, and broccoli are high in
vitamin K, which promotes hepatic synthesis of clotting factors II, VII, IX, and X.
Warfarin works by inhibiting vitamin K epoxide reductase, thereby reducing the
production of these clotting factors. Sudden increases in dietary vitamin K intake can
decrease the INR and increase the risk of thrombosis, while sudden decreases can
increase the INR and raise bleeding risk. The client should maintain a consistent intake
of vitamin K-rich foods rather than avoiding them entirely.
Question 4
A client is receiving intravenous heparin therapy. Which laboratory test result
indicates the heparin dose is therapeutic?
A. aPTT 1.5 to 2.5 times the control value
B. INR of 2 to 3
C. Platelet count greater than 300,000/mm3
D. Prothrombin time of 12 to 15 seconds
Correct Answer: A
Rationale: The activated partial thromboplastin time (aPTT) is the primary laboratory
test used to monitor heparin therapy. A therapeutic range for aPTT is 1.5 to 2.5 times
the laboratory control value, which corresponds to adequate anticoagulation without
excessive bleeding risk. INR is used to monitor warfarin, not heparin. Prothrombin
time is also associated with warfarin monitoring. Platelet count is monitored to detect
heparin-induced thrombocytopenia (HIT), but it does not indicate whether the
heparin dose is therapeutic.
Question 5
A nurse is caring for a client who is taking metoprolol (Lopressor). Which assessment
finding requires immediate intervention by the nurse?
A. Heart rate of 48 bpm
B. Blood pressure of 120/80 mmHg
C. Respiratory rate of 18 breaths/min
D. Temperature of 99.2 degrees F (37.3 degrees C)
Correct Answer: A
, Rationale: Metoprolol is a beta-1 selective adrenergic antagonist (beta-blocker) that
decreases heart rate, myocardial contractility, and cardiac output. A heart rate of 48
bpm indicates significant bradycardia, which is a serious adverse effect requiring
immediate intervention. The nurse should hold the medication, notify the provider,
and monitor the client closely. Blood pressure of 120/80 mmHg is within normal
limits. A respiratory rate of 18 and a temperature of 99.2 degrees F are within
acceptable ranges and do not indicate an acute problem.
Question 6
A client is prescribed atorvastatin (Lipitor). Which statement by the client indicates a
need for further teaching?
A. "I will take this medication in the morning with breakfast."
B. "I will report any unexplained muscle pain to my provider."
C. "I will avoid drinking large amounts of grapefruit juice."
D. "I will continue following a low-fat diet while taking this medication."
Correct Answer: A
Next Generation NCLEX (NGN) Format | 70 Questions | Study
Review Edition
Instructions: Read each question carefully. For standard multiple-choice questions,
select the single best answer. For Select All That Apply (SATA) questions, select all
correct answers. Answers and rationales follow each question.
Question 1
A client with heart failure is prescribed furosemide (Lasix). Which laboratory value
should the nurse monitor most closely?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum magnesium
Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes increased excretion of potassium
in the urine. Hypokalemia is a common and potentially dangerous adverse effect that
can lead to cardiac dysrhythmias. While sodium and magnesium may also be affected,
potassium depletion occurs most rapidly and poses the greatest immediate risk. The
nurse should monitor serum potassium levels closely and assess for signs of
hypokalemia such as muscle weakness, fatigue, and irregular heartbeat.
Question 2
A nurse is administering lisinopril (Zestril) to a client with hypertension. Which
instruction is most important for the nurse to include in the teaching plan?
A. Avoid potassium substitutes
B. Take the medication with food
C. Increase fluid intake to 3 L daily
D. Expect a dry cough as a side effect
,Correct Answer: A
Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia due to decreased
aldosterone production. Clients should be instructed to avoid potassium supplements
and salt substitutes, which often contain potassium chloride. While a dry cough is a
known side effect of ACE inhibitors, it is not life-threatening and does not require the
same level of precaution as preventing hyperkalemia. Taking the medication with food
is acceptable but not the most critical instruction.
Question 3
A client with atrial fibrillation is started on warfarin (Coumadin). The nurse
teaches the client about dietary consistency. Which food should the client be
instructed to consume in consistent amounts?
A. Green leafy vegetables
B. Dairy products
C. Citrus fruits
D. Red meat
Correct Answer: A
,Rationale: Green leafy vegetables such as spinach, kale, and broccoli are high in
vitamin K, which promotes hepatic synthesis of clotting factors II, VII, IX, and X.
Warfarin works by inhibiting vitamin K epoxide reductase, thereby reducing the
production of these clotting factors. Sudden increases in dietary vitamin K intake can
decrease the INR and increase the risk of thrombosis, while sudden decreases can
increase the INR and raise bleeding risk. The client should maintain a consistent intake
of vitamin K-rich foods rather than avoiding them entirely.
Question 4
A client is receiving intravenous heparin therapy. Which laboratory test result
indicates the heparin dose is therapeutic?
A. aPTT 1.5 to 2.5 times the control value
B. INR of 2 to 3
C. Platelet count greater than 300,000/mm3
D. Prothrombin time of 12 to 15 seconds
Correct Answer: A
Rationale: The activated partial thromboplastin time (aPTT) is the primary laboratory
test used to monitor heparin therapy. A therapeutic range for aPTT is 1.5 to 2.5 times
the laboratory control value, which corresponds to adequate anticoagulation without
excessive bleeding risk. INR is used to monitor warfarin, not heparin. Prothrombin
time is also associated with warfarin monitoring. Platelet count is monitored to detect
heparin-induced thrombocytopenia (HIT), but it does not indicate whether the
heparin dose is therapeutic.
Question 5
A nurse is caring for a client who is taking metoprolol (Lopressor). Which assessment
finding requires immediate intervention by the nurse?
A. Heart rate of 48 bpm
B. Blood pressure of 120/80 mmHg
C. Respiratory rate of 18 breaths/min
D. Temperature of 99.2 degrees F (37.3 degrees C)
Correct Answer: A
, Rationale: Metoprolol is a beta-1 selective adrenergic antagonist (beta-blocker) that
decreases heart rate, myocardial contractility, and cardiac output. A heart rate of 48
bpm indicates significant bradycardia, which is a serious adverse effect requiring
immediate intervention. The nurse should hold the medication, notify the provider,
and monitor the client closely. Blood pressure of 120/80 mmHg is within normal
limits. A respiratory rate of 18 and a temperature of 99.2 degrees F are within
acceptable ranges and do not indicate an acute problem.
Question 6
A client is prescribed atorvastatin (Lipitor). Which statement by the client indicates a
need for further teaching?
A. "I will take this medication in the morning with breakfast."
B. "I will report any unexplained muscle pain to my provider."
C. "I will avoid drinking large amounts of grapefruit juice."
D. "I will continue following a low-fat diet while taking this medication."
Correct Answer: A
