ATI RN Pharmacology Proctored Exam
2026 Level 3 with NGN 200 Questions
and Answers with Rationale
SECTION 1: SAFE MEDICATION ADMINISTRATION & DRUG
CALCULATIONS (Q1-30)
Q1
A nurse is preparing to administer a medication to a client. Which action is most critical
to ensure patient safety?
A) Assess the patient's pain level
B) Verify the patient's identity using two identifiers
C) Review the patient's laboratory results
D) Educate the patient about the medication
,Rationale: Verifying patient identity using two identifiers (e.g., name and date of birth) is
the most critical safety step to prevent medication errors. This is part of the "right patient"
in the rights of medication administration .
Q2
A nurse is preparing to administer a controlled substance (hydromorphone) via unit-
dose packet. The client refuses the medication after it has been opened. Which action
should the nurse take?
A) Return the medication to the medication cart unopened
B) Dispose of the medication with a second nurse as a witness
C) Save the medication for the client to take later
D) Document refusal and keep medication at bedside
Rationale: If a client refuses a controlled substance after it has been prepared, it must be
wasted and witnessed by another nurse to comply with legal regulations for controlled
substances .
Q3
A nurse is reviewing a medication order that reads: "Digoxin 0.25 mg PO daily." Which
component of the medication order is missing?
A) Route
B) Dose
C) Frequency
D) Time of administration
,Rationale: A complete medication order must include: client name, date/time, drug name,
dose, route, frequency, and signature of prescriber. This order is missing the specific time
of administration .
Q4
A nurse is preparing to administer an IM injection to an adult client. Which needle size is
most appropriate?
A) 25 gauge, ½ inch
B) 22 gauge, 1½ inch
C) 18 gauge, 2 inch
D) 30 gauge, ⅔ inch
Rationale: IM injections typically use a 22-25 gauge needle that is 1-1½ inches long,
depending on the patient's muscle mass and the injection site .
Q5
A nurse is preparing to administer an intradermal injection. At what angle should the
needle be inserted?
A) 5- to 15-degree angle
B) 45-degree angle
C) 90-degree angle
D) 30-degree angle
, Rationale: Intradermal injections are given at a 5- to 15-degree angle, just below the
epidermis. A small wheal should appear if placed correctly .
Q6
A nurse is preparing to administer a subcutaneous injection. Which technique is correct?
A) Insert the needle at a 45- to 90-degree angle
B) Aspirate before injection to check for blood return
C) Massage the site after injection to promote absorption
D) Use a 1-inch needle for subcutaneous injections
Rationale: Subcutaneous injections are typically given at a 45- to 90-degree angle
depending on the amount of subcutaneous tissue .
Q7
A client's prescription reads "Ondansetron 4 mg PRN." Which information is missing
from this order?
A) The route of administration
B) The dose of the medication
C) The indication for use
D) The frequency of administration
Rationale: PRN prescriptions should include an indication for use. The nurse should clarify
with the provider what symptoms the ondansetron is intended to treat .
2026 Level 3 with NGN 200 Questions
and Answers with Rationale
SECTION 1: SAFE MEDICATION ADMINISTRATION & DRUG
CALCULATIONS (Q1-30)
Q1
A nurse is preparing to administer a medication to a client. Which action is most critical
to ensure patient safety?
A) Assess the patient's pain level
B) Verify the patient's identity using two identifiers
C) Review the patient's laboratory results
D) Educate the patient about the medication
,Rationale: Verifying patient identity using two identifiers (e.g., name and date of birth) is
the most critical safety step to prevent medication errors. This is part of the "right patient"
in the rights of medication administration .
Q2
A nurse is preparing to administer a controlled substance (hydromorphone) via unit-
dose packet. The client refuses the medication after it has been opened. Which action
should the nurse take?
A) Return the medication to the medication cart unopened
B) Dispose of the medication with a second nurse as a witness
C) Save the medication for the client to take later
D) Document refusal and keep medication at bedside
Rationale: If a client refuses a controlled substance after it has been prepared, it must be
wasted and witnessed by another nurse to comply with legal regulations for controlled
substances .
Q3
A nurse is reviewing a medication order that reads: "Digoxin 0.25 mg PO daily." Which
component of the medication order is missing?
A) Route
B) Dose
C) Frequency
D) Time of administration
,Rationale: A complete medication order must include: client name, date/time, drug name,
dose, route, frequency, and signature of prescriber. This order is missing the specific time
of administration .
Q4
A nurse is preparing to administer an IM injection to an adult client. Which needle size is
most appropriate?
A) 25 gauge, ½ inch
B) 22 gauge, 1½ inch
C) 18 gauge, 2 inch
D) 30 gauge, ⅔ inch
Rationale: IM injections typically use a 22-25 gauge needle that is 1-1½ inches long,
depending on the patient's muscle mass and the injection site .
Q5
A nurse is preparing to administer an intradermal injection. At what angle should the
needle be inserted?
A) 5- to 15-degree angle
B) 45-degree angle
C) 90-degree angle
D) 30-degree angle
, Rationale: Intradermal injections are given at a 5- to 15-degree angle, just below the
epidermis. A small wheal should appear if placed correctly .
Q6
A nurse is preparing to administer a subcutaneous injection. Which technique is correct?
A) Insert the needle at a 45- to 90-degree angle
B) Aspirate before injection to check for blood return
C) Massage the site after injection to promote absorption
D) Use a 1-inch needle for subcutaneous injections
Rationale: Subcutaneous injections are typically given at a 45- to 90-degree angle
depending on the amount of subcutaneous tissue .
Q7
A client's prescription reads "Ondansetron 4 mg PRN." Which information is missing
from this order?
A) The route of administration
B) The dose of the medication
C) The indication for use
D) The frequency of administration
Rationale: PRN prescriptions should include an indication for use. The nurse should clarify
with the provider what symptoms the ondansetron is intended to treat .
