ATI PN PHARMACOLOGY PROCTORED EXAM WITH
NGN QUESTIONS AND ANSWERS LATEST
2025/2026 TEST BANK
QUESTION 1
A nurse is reviewing the laboratory results for four clients. Which of the following laboratory results
should the nurse report to the provider?
A) A client who has a prescription for heparin and an aPTT of 90 seconds (normal 30-40 seconds)
B) A client who has a prescription for heparin and an aPTT of 65 seconds (normal 30-40 seconds)
C) A client who has a prescription for warfarin and an INR of 3.0 (normal 0.8-1.1)
D) A client who has a prescription for warfarin and an INR of 2.0 (normal 0.8-1.1)
ANSWER: A
Rationale:
Option A (Correct): The therapeutic range for aPTT in clients receiving heparin is typically 60-80 seconds,
or 1.5-2.5 times the normal control value. An aPTT of 90 seconds exceeds the therapeutic range and
indicates the client is at increased risk for bleeding. The nurse should report this result to the provider to
consider adjusting the heparin dosage.
Option B (Incorrect): An aPTT of 65 seconds falls within the therapeutic range for heparin therapy (60-80
seconds). This indicates the client is adequately anticoagulated and does not require immediate
provider notification.
Option C (Incorrect): The therapeutic INR range for clients receiving warfarin is typically 2.0-3.0 (or 2.5-
3.5 for certain conditions). An INR of 3.0 is within the therapeutic range and indicates appropriate
anticoagulation without immediate need for provider notification.
,Option D (Incorrect): An INR of 2.0 is within the therapeutic range for warfarin therapy (2.0-3.0). This is a
desirable therapeutic level and does not require reporting to the provider.
QUESTION 2
A nurse is administering the first dose of nifedipine to a client who has hypertension. The client reports
feeling dizzy and lightheaded. Which of the following actions should the nurse take?
A) Administer nicotine
B) Administer nystatin
C) Administer 15 g of carbohydrates
D) Administer diphenhydramine
ANSWER: Administer 15 g of carbohydrates (Option C)
Rationale:
Option A (Incorrect): Nicotine is a stimulant and vasoconstrictor that would worsen hypertension and is
not appropriate treatment for dizziness caused by antihypertensive medication.
Option B (Incorrect): Nystatin is an antifungal medication used to treat fungal infections such as oral
candidiasis. It has no role in managing dizziness or hypotension from antihypertensive therapy.
Option C (Correct): Nifedipine is a calcium channel blocker that causes vasodilation and can lead to
hypotension, resulting in dizziness and lightheadedness. While this is a common side effect, the nurse
should assess the client's blood pressure. If the client is hypoglycemic, 15g of carbohydrates would be
appropriate. However, the primary intervention would be to check blood pressure and have the client
lie down. The question may be testing recognition that dizziness from nifedipine is due to hypotension.
Option D (Incorrect): Diphenhydramine is an antihistamine used for allergic reactions, nausea, and sleep.
It is not indicated for dizziness caused by antihypertensive medication and could actually worsen
hypotension due to its alpha-blocking properties.
,QUESTION 3
A nurse is preparing to administer digoxin to a client with heart failure. Which of the following findings
should indicate to the nurse that the client is at risk for digoxin toxicity?
A) Serum potassium level of 3.2 mEq/L
B) Serum potassium level of 4.0 mEq/L
C) Serum sodium level of 140 mEq/L
D) Serum calcium level of 9.5 mEq/L
ANSWER: A
Rationale:
Option A (Correct): Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin toxicity. Low
serum potassium allows digoxin to bind more readily to sodium-potassium ATPase pumps, increasing
the risk of dysrhythmias. The normal potassium level is 3.5-5.0 mEq/L.
Option B (Incorrect): A serum potassium of 4.0 mEq/L is within the normal range (3.5-5.0 mEq/L) and
does not increase the risk of digoxin toxicity.
Option C (Incorrect): A serum sodium of 140 mEq/L is within the normal range (136-145 mEq/L) and
does not specifically increase the risk of digoxin toxicity.
Option D (Incorrect): A serum calcium of 9.5 mg/dL is within the normal range (8.5-10.5 mg/dL) and
does not directly increase the risk of digoxin toxicity. However, hypercalcemia can potentiate digoxin
effects.
QUESTION 4
A nurse is providing teaching to a client who has a new prescription for metformin. Which of the
following instructions should the nurse include?
A) Take the medication with meals
B) Expect to have black, tarry stools
, C) Take the medication on an empty stomach
D) Report gastrointestinal upset as a normal side effect
ANSWER: A
Rationale:
Option A (Correct): Metformin should be taken with meals to reduce gastrointestinal side effects such as
nausea, diarrhea, and abdominal discomfort. Taking it with food helps improve tolerability.
Option B (Incorrect): Black, tarry stools indicate gastrointestinal bleeding and are not a side effect of
metformin. This finding should be reported immediately to the provider.
Option C (Incorrect): Metformin should be taken with meals, not on an empty stomach, to minimize
gastrointestinal side effects.
Option D (Incorrect): While gastrointestinal upset is common with metformin, the nurse should not
dismiss it as "normal." The client should be instructed to report persistent or severe GI effects to the
provider, who may adjust the dose or change the formulation.
QUESTION 5
A nurse is caring for a client who is receiving morphine for severe pain. Which of the following findings
indicates a need to administer naloxone?
A) Respiratory rate of 8/min
B) Blood pressure of 140/90 mmHg
C) Pain rating of 7 on a 0-10 scale
D) Pupil size of 4 mm
ANSWER: A
Rationale:
NGN QUESTIONS AND ANSWERS LATEST
2025/2026 TEST BANK
QUESTION 1
A nurse is reviewing the laboratory results for four clients. Which of the following laboratory results
should the nurse report to the provider?
A) A client who has a prescription for heparin and an aPTT of 90 seconds (normal 30-40 seconds)
B) A client who has a prescription for heparin and an aPTT of 65 seconds (normal 30-40 seconds)
C) A client who has a prescription for warfarin and an INR of 3.0 (normal 0.8-1.1)
D) A client who has a prescription for warfarin and an INR of 2.0 (normal 0.8-1.1)
ANSWER: A
Rationale:
Option A (Correct): The therapeutic range for aPTT in clients receiving heparin is typically 60-80 seconds,
or 1.5-2.5 times the normal control value. An aPTT of 90 seconds exceeds the therapeutic range and
indicates the client is at increased risk for bleeding. The nurse should report this result to the provider to
consider adjusting the heparin dosage.
Option B (Incorrect): An aPTT of 65 seconds falls within the therapeutic range for heparin therapy (60-80
seconds). This indicates the client is adequately anticoagulated and does not require immediate
provider notification.
Option C (Incorrect): The therapeutic INR range for clients receiving warfarin is typically 2.0-3.0 (or 2.5-
3.5 for certain conditions). An INR of 3.0 is within the therapeutic range and indicates appropriate
anticoagulation without immediate need for provider notification.
,Option D (Incorrect): An INR of 2.0 is within the therapeutic range for warfarin therapy (2.0-3.0). This is a
desirable therapeutic level and does not require reporting to the provider.
QUESTION 2
A nurse is administering the first dose of nifedipine to a client who has hypertension. The client reports
feeling dizzy and lightheaded. Which of the following actions should the nurse take?
A) Administer nicotine
B) Administer nystatin
C) Administer 15 g of carbohydrates
D) Administer diphenhydramine
ANSWER: Administer 15 g of carbohydrates (Option C)
Rationale:
Option A (Incorrect): Nicotine is a stimulant and vasoconstrictor that would worsen hypertension and is
not appropriate treatment for dizziness caused by antihypertensive medication.
Option B (Incorrect): Nystatin is an antifungal medication used to treat fungal infections such as oral
candidiasis. It has no role in managing dizziness or hypotension from antihypertensive therapy.
Option C (Correct): Nifedipine is a calcium channel blocker that causes vasodilation and can lead to
hypotension, resulting in dizziness and lightheadedness. While this is a common side effect, the nurse
should assess the client's blood pressure. If the client is hypoglycemic, 15g of carbohydrates would be
appropriate. However, the primary intervention would be to check blood pressure and have the client
lie down. The question may be testing recognition that dizziness from nifedipine is due to hypotension.
Option D (Incorrect): Diphenhydramine is an antihistamine used for allergic reactions, nausea, and sleep.
It is not indicated for dizziness caused by antihypertensive medication and could actually worsen
hypotension due to its alpha-blocking properties.
,QUESTION 3
A nurse is preparing to administer digoxin to a client with heart failure. Which of the following findings
should indicate to the nurse that the client is at risk for digoxin toxicity?
A) Serum potassium level of 3.2 mEq/L
B) Serum potassium level of 4.0 mEq/L
C) Serum sodium level of 140 mEq/L
D) Serum calcium level of 9.5 mEq/L
ANSWER: A
Rationale:
Option A (Correct): Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin toxicity. Low
serum potassium allows digoxin to bind more readily to sodium-potassium ATPase pumps, increasing
the risk of dysrhythmias. The normal potassium level is 3.5-5.0 mEq/L.
Option B (Incorrect): A serum potassium of 4.0 mEq/L is within the normal range (3.5-5.0 mEq/L) and
does not increase the risk of digoxin toxicity.
Option C (Incorrect): A serum sodium of 140 mEq/L is within the normal range (136-145 mEq/L) and
does not specifically increase the risk of digoxin toxicity.
Option D (Incorrect): A serum calcium of 9.5 mg/dL is within the normal range (8.5-10.5 mg/dL) and
does not directly increase the risk of digoxin toxicity. However, hypercalcemia can potentiate digoxin
effects.
QUESTION 4
A nurse is providing teaching to a client who has a new prescription for metformin. Which of the
following instructions should the nurse include?
A) Take the medication with meals
B) Expect to have black, tarry stools
, C) Take the medication on an empty stomach
D) Report gastrointestinal upset as a normal side effect
ANSWER: A
Rationale:
Option A (Correct): Metformin should be taken with meals to reduce gastrointestinal side effects such as
nausea, diarrhea, and abdominal discomfort. Taking it with food helps improve tolerability.
Option B (Incorrect): Black, tarry stools indicate gastrointestinal bleeding and are not a side effect of
metformin. This finding should be reported immediately to the provider.
Option C (Incorrect): Metformin should be taken with meals, not on an empty stomach, to minimize
gastrointestinal side effects.
Option D (Incorrect): While gastrointestinal upset is common with metformin, the nurse should not
dismiss it as "normal." The client should be instructed to report persistent or severe GI effects to the
provider, who may adjust the dose or change the formulation.
QUESTION 5
A nurse is caring for a client who is receiving morphine for severe pain. Which of the following findings
indicates a need to administer naloxone?
A) Respiratory rate of 8/min
B) Blood pressure of 140/90 mmHg
C) Pain rating of 7 on a 0-10 scale
D) Pupil size of 4 mm
ANSWER: A
Rationale:
