ATI Pharmacology Proctored Exam – Actual Questions
with Detailed Clinical Rationales (300+ questions and
answers with rationales)
Questions 1–50: Cardiovascular & Hematologic Medications
1. A nurse is assessing a client who has started lisinopril. Which finding
requires immediate attention?
A. Dry cough
B. Potassium 5.8 mEq/L
C. Blood pressure 118/72 mm Hg
D. Mild fatigue
Answer: B
Rationale: ACE inhibitors can cause hyperkalemia. A potassium of 5.8
mEq/L increases the risk for potentially serious cardiac dysrhythmias.
2. Which instruction should the nurse give a client taking lisinopril?
A. Increase potassium-containing salt substitutes.
B. Report swelling of the face or tongue.
C. Stop the medication when blood pressure normalizes.
D. Take an NSAID routinely for headaches.
Answer: B
Rationale: Facial, tongue, or throat swelling can indicate angioedema, a
potentially life-threatening adverse effect requiring immediate
evaluation.
3. A client taking furosemide is at greatest risk for which electrolyte
imbalance?
A. Hyperkalemia
B. Hypercalcemia
,C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Furosemide is a loop diuretic that increases urinary
potassium loss.
4. Which assessment is most important before administering digoxin?
A. Respiratory rate
B. Apical pulse
C. Temperature
D. Bowel sounds
Answer: B
Rationale: Digoxin slows cardiac conduction. The nurse should assess
the apical pulse and follow the prescribed parameters for withholding
the medication.
5. Which finding may indicate digoxin toxicity?
A. Increased appetite
B. Yellow-green visual disturbances
C. Increased urine output
D. Hypertension
Answer: B
Rationale: Visual changes, nausea, vomiting, anorexia, and
dysrhythmias are classic manifestations associated with digoxin toxicity.
6. A client taking warfarin should receive which laboratory test
routinely?
A. aPTT
B. INR
C. Troponin
D. BNP
,Answer: B
Rationale: INR is used to monitor the anticoagulant effect of warfarin
and guide dosing.
7. Which medication reverses the anticoagulant effect of heparin?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: B
Rationale: Protamine sulfate is the reversal agent for unfractionated
heparin.
8. Which medication is commonly used to reverse excessive warfarin
anticoagulation?
A. Vitamin K
B. Protamine
C. Flumazenil
D. Atropine
Answer: A
Rationale: Vitamin K promotes production of clotting factors and
reverses warfarin's anticoagulant effect.
9. A client taking atorvastatin should report which finding?
A. Muscle pain and weakness
B. Mild thirst
C. Occasional sneezing
D. Increased appetite
Answer: A
Rationale: Unexplained muscle pain or weakness can indicate statin-
associated muscle injury, including potentially serious rhabdomyolysis.
, 10. Which instruction is appropriate for a client taking nitroglycerin
sublingually?
A. Swallow the tablet whole.
B. Place the tablet under the tongue.
C. Take it only after eating.
D. Store tablets in a weekly pill organizer.
Answer: B
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid
absorption. Proper storage in the original container is important
because the medication is sensitive to environmental conditions.
11. Which adverse effect is expected with nitroglycerin?
A. Headache
B. Severe constipation
C. Hyperglycemia
D. Urinary retention
Answer: A
Rationale: Vasodilation commonly produces headache, flushing,
dizziness, and hypotension.
12. A client taking metoprolol should be monitored for which effect?
A. Tachycardia
B. Bradycardia
C. Hyperthermia
D. Polyuria
Answer: B
Rationale: Beta blockers decrease heart rate and blood pressure and
can cause symptomatic bradycardia.
13. Which finding is particularly important to monitor in a client taking
a beta blocker who also has diabetes?
with Detailed Clinical Rationales (300+ questions and
answers with rationales)
Questions 1–50: Cardiovascular & Hematologic Medications
1. A nurse is assessing a client who has started lisinopril. Which finding
requires immediate attention?
A. Dry cough
B. Potassium 5.8 mEq/L
C. Blood pressure 118/72 mm Hg
D. Mild fatigue
Answer: B
Rationale: ACE inhibitors can cause hyperkalemia. A potassium of 5.8
mEq/L increases the risk for potentially serious cardiac dysrhythmias.
2. Which instruction should the nurse give a client taking lisinopril?
A. Increase potassium-containing salt substitutes.
B. Report swelling of the face or tongue.
C. Stop the medication when blood pressure normalizes.
D. Take an NSAID routinely for headaches.
Answer: B
Rationale: Facial, tongue, or throat swelling can indicate angioedema, a
potentially life-threatening adverse effect requiring immediate
evaluation.
3. A client taking furosemide is at greatest risk for which electrolyte
imbalance?
A. Hyperkalemia
B. Hypercalcemia
,C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Furosemide is a loop diuretic that increases urinary
potassium loss.
4. Which assessment is most important before administering digoxin?
A. Respiratory rate
B. Apical pulse
C. Temperature
D. Bowel sounds
Answer: B
Rationale: Digoxin slows cardiac conduction. The nurse should assess
the apical pulse and follow the prescribed parameters for withholding
the medication.
5. Which finding may indicate digoxin toxicity?
A. Increased appetite
B. Yellow-green visual disturbances
C. Increased urine output
D. Hypertension
Answer: B
Rationale: Visual changes, nausea, vomiting, anorexia, and
dysrhythmias are classic manifestations associated with digoxin toxicity.
6. A client taking warfarin should receive which laboratory test
routinely?
A. aPTT
B. INR
C. Troponin
D. BNP
,Answer: B
Rationale: INR is used to monitor the anticoagulant effect of warfarin
and guide dosing.
7. Which medication reverses the anticoagulant effect of heparin?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: B
Rationale: Protamine sulfate is the reversal agent for unfractionated
heparin.
8. Which medication is commonly used to reverse excessive warfarin
anticoagulation?
A. Vitamin K
B. Protamine
C. Flumazenil
D. Atropine
Answer: A
Rationale: Vitamin K promotes production of clotting factors and
reverses warfarin's anticoagulant effect.
9. A client taking atorvastatin should report which finding?
A. Muscle pain and weakness
B. Mild thirst
C. Occasional sneezing
D. Increased appetite
Answer: A
Rationale: Unexplained muscle pain or weakness can indicate statin-
associated muscle injury, including potentially serious rhabdomyolysis.
, 10. Which instruction is appropriate for a client taking nitroglycerin
sublingually?
A. Swallow the tablet whole.
B. Place the tablet under the tongue.
C. Take it only after eating.
D. Store tablets in a weekly pill organizer.
Answer: B
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid
absorption. Proper storage in the original container is important
because the medication is sensitive to environmental conditions.
11. Which adverse effect is expected with nitroglycerin?
A. Headache
B. Severe constipation
C. Hyperglycemia
D. Urinary retention
Answer: A
Rationale: Vasodilation commonly produces headache, flushing,
dizziness, and hypotension.
12. A client taking metoprolol should be monitored for which effect?
A. Tachycardia
B. Bradycardia
C. Hyperthermia
D. Polyuria
Answer: B
Rationale: Beta blockers decrease heart rate and blood pressure and
can cause symptomatic bradycardia.
13. Which finding is particularly important to monitor in a client taking
a beta blocker who also has diabetes?
