ATI PN Pharmacology – ATI Practical Nursing
Pharmacology Study Guide, Original Practice
Questions & Answers, Comprehensive ATI PN
Pharmacology Exam Preparation, Medication
Administration, Pharmacological Principles, Dosage
& Fluid Calculations, Drug Classifications, Drug
Interactions, Adverse Effects, Nursing Implications,
Patient Teaching, Cardiovascular, Respiratory,
Neurological, Endocrine, Gastrointestinal,
Reproductive, Musculoskeletal, Pain &
Inflammation, Immune & Infectious Medications &
Clinical Judgment
Question 1: A healthcare provider is reviewing the laboratory results of a
client who is prescribed lithium carbonate. Which serum lithium level
indicates that the client is at risk for severe toxicity?
A. 0.8 mEq/L
B. 1.2 mEq/L
C. 1.8 mEq/L
D. 2.5 mEq/L
CORRECT ANSWER: D. 2.5 mEq/L
Rationale: The therapeutic range for lithium is 0.8 to 1.2 mEq/L for acute mania and
0.6 to 1.0 mEq/L for maintenance. A level of 2.5 mEq/L is within the severe toxicity
range, which can cause seizures, renal failure, and coma. Levels above 2.0 mEq/L are
considered a medical emergency.
Question 2: A client receiving digoxin therapy reports nausea, vomiting, and
visual disturbances. Which medication should the nurse anticipate
administering to reverse these effects?
A. Protamine sulfate
B. Naloxone
C. Digoxin immune Fab
D. Flumazenil
CORRECT ANSWER: C. Digoxin immune Fab
Rationale: The client is exhibiting signs of digoxin toxicity. Digoxin immune Fab
(Digibind) is the specific antidote that binds to digoxin molecules, making them inactive
and allowing for renal excretion. Protamine sulfate reverses heparin, naloxone reverses
opioids, and flumazenil reverses benzodiazepines.
,Question 3: A client is prescribed warfarin for atrial fibrillation. Which
laboratory value is the primary indicator for monitoring the therapeutic effect
of this medication?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Platelet count
D. Bleeding time
CORRECT ANSWER: B. International normalized ratio (INR)
Rationale: Warfarin is a vitamin K antagonist that prolongs the prothrombin time (PT).
The INR is a standardized calculation of PT and is the primary monitoring tool to ensure
therapeutic anticoagulation (typically 2.0-3.0 for atrial fibrillation) and prevent bleeding
or clotting complications. aPTT monitors heparin therapy.
Question 4: A client is prescribed furosemide for heart failure. The nurse
should monitor for which electrolyte imbalance that is a common adverse
effect of this medication?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
CORRECT ANSWER: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption
in the ascending loop of Henle. This action also leads to increased excretion of
potassium, which can result in hypokalemia. Hypokalemia can predispose the client to
cardiac dysrhythmias, especially if they are also taking digoxin.
Question 5: A client is prescribed an selective serotonin reuptake inhibitor
(SSRI) for depression. The nurse should instruct the client to monitor for
which adverse effect that is most common during the first few weeks of
therapy?
A. Insomnia
B. Weight gain
C. Hypertensive crisis
D. Gastrointestinal distress
CORRECT ANSWER: D. Gastrointestinal distress
Rationale: SSRIs increase serotonin levels in the GI tract, which can cause nausea,
vomiting, diarrhea, and anorexia. These side effects are typically transient and often
resolve after 1-2 weeks of therapy. Hypertensive crisis is associated with MAOIs, while
insomnia and weight gain can occur but are not the most common initial adverse effect.
, Question 6: A client with a history of alcohol use disorder is prescribed
disulfiram. The nurse emphasizes the importance of avoiding which substance
to prevent a severe adverse reaction?
A. Caffeine
B. Acetaminophen
C. Mouthwash containing alcohol
D. Aspirin
CORRECT ANSWER: C. Mouthwash containing alcohol
Rationale: Disulfiram works by blocking the metabolism of alcohol, leading to an
accumulation of acetaldehyde. This causes a severe reaction characterized by flushing,
nausea, vomiting, and hypotension. Clients must avoid all alcohol-containing products,
including mouthwash, cough syrup, and cooking wines, to prevent this reaction.
Question 7: A client is prescribed albuterol via metered-dose inhaler (MDI) for
asthma. The nurse should instruct the client to wait how long before
administering a second puff of the same medication?
A. 1 minute
B. 3 minutes
C. 5 minutes
D. 10 minutes
CORRECT ANSWER: A. 1 minute
Rationale: When using an MDI, a 1-minute wait between puffs of the same
bronchodilator allows for maximal bronchodilation and better absorption of the second
dose. Waiting 1 to 2 minutes is the standard recommendation. Waiting longer is not
necessary, and waiting too short a time may reduce drug effectiveness.
Question 8: A client is receiving morphine sulfate via patient-controlled
analgesia (PCA) pump. The nurse notes a respiratory rate of 8 breaths/min
and pinpoint pupils. Which medication should the nurse prepare to
administer?
A. Atropine sulfate
B. Naloxone
C. Flumazenil
D. Epinephrine
CORRECT ANSWER: B. Naloxone
Rationale: The client is exhibiting signs of opioid toxicity, including respiratory
depression and miosis (pinpoint pupils). Naloxone (Narcan) is an opioid antagonist that
competes for opioid receptor sites, reversing these life-threatening effects. Flumazenil
reverses benzodiazepines, and atropine is used for bradycardia or cholinergic toxicity.
Pharmacology Study Guide, Original Practice
Questions & Answers, Comprehensive ATI PN
Pharmacology Exam Preparation, Medication
Administration, Pharmacological Principles, Dosage
& Fluid Calculations, Drug Classifications, Drug
Interactions, Adverse Effects, Nursing Implications,
Patient Teaching, Cardiovascular, Respiratory,
Neurological, Endocrine, Gastrointestinal,
Reproductive, Musculoskeletal, Pain &
Inflammation, Immune & Infectious Medications &
Clinical Judgment
Question 1: A healthcare provider is reviewing the laboratory results of a
client who is prescribed lithium carbonate. Which serum lithium level
indicates that the client is at risk for severe toxicity?
A. 0.8 mEq/L
B. 1.2 mEq/L
C. 1.8 mEq/L
D. 2.5 mEq/L
CORRECT ANSWER: D. 2.5 mEq/L
Rationale: The therapeutic range for lithium is 0.8 to 1.2 mEq/L for acute mania and
0.6 to 1.0 mEq/L for maintenance. A level of 2.5 mEq/L is within the severe toxicity
range, which can cause seizures, renal failure, and coma. Levels above 2.0 mEq/L are
considered a medical emergency.
Question 2: A client receiving digoxin therapy reports nausea, vomiting, and
visual disturbances. Which medication should the nurse anticipate
administering to reverse these effects?
A. Protamine sulfate
B. Naloxone
C. Digoxin immune Fab
D. Flumazenil
CORRECT ANSWER: C. Digoxin immune Fab
Rationale: The client is exhibiting signs of digoxin toxicity. Digoxin immune Fab
(Digibind) is the specific antidote that binds to digoxin molecules, making them inactive
and allowing for renal excretion. Protamine sulfate reverses heparin, naloxone reverses
opioids, and flumazenil reverses benzodiazepines.
,Question 3: A client is prescribed warfarin for atrial fibrillation. Which
laboratory value is the primary indicator for monitoring the therapeutic effect
of this medication?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Platelet count
D. Bleeding time
CORRECT ANSWER: B. International normalized ratio (INR)
Rationale: Warfarin is a vitamin K antagonist that prolongs the prothrombin time (PT).
The INR is a standardized calculation of PT and is the primary monitoring tool to ensure
therapeutic anticoagulation (typically 2.0-3.0 for atrial fibrillation) and prevent bleeding
or clotting complications. aPTT monitors heparin therapy.
Question 4: A client is prescribed furosemide for heart failure. The nurse
should monitor for which electrolyte imbalance that is a common adverse
effect of this medication?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
CORRECT ANSWER: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption
in the ascending loop of Henle. This action also leads to increased excretion of
potassium, which can result in hypokalemia. Hypokalemia can predispose the client to
cardiac dysrhythmias, especially if they are also taking digoxin.
Question 5: A client is prescribed an selective serotonin reuptake inhibitor
(SSRI) for depression. The nurse should instruct the client to monitor for
which adverse effect that is most common during the first few weeks of
therapy?
A. Insomnia
B. Weight gain
C. Hypertensive crisis
D. Gastrointestinal distress
CORRECT ANSWER: D. Gastrointestinal distress
Rationale: SSRIs increase serotonin levels in the GI tract, which can cause nausea,
vomiting, diarrhea, and anorexia. These side effects are typically transient and often
resolve after 1-2 weeks of therapy. Hypertensive crisis is associated with MAOIs, while
insomnia and weight gain can occur but are not the most common initial adverse effect.
, Question 6: A client with a history of alcohol use disorder is prescribed
disulfiram. The nurse emphasizes the importance of avoiding which substance
to prevent a severe adverse reaction?
A. Caffeine
B. Acetaminophen
C. Mouthwash containing alcohol
D. Aspirin
CORRECT ANSWER: C. Mouthwash containing alcohol
Rationale: Disulfiram works by blocking the metabolism of alcohol, leading to an
accumulation of acetaldehyde. This causes a severe reaction characterized by flushing,
nausea, vomiting, and hypotension. Clients must avoid all alcohol-containing products,
including mouthwash, cough syrup, and cooking wines, to prevent this reaction.
Question 7: A client is prescribed albuterol via metered-dose inhaler (MDI) for
asthma. The nurse should instruct the client to wait how long before
administering a second puff of the same medication?
A. 1 minute
B. 3 minutes
C. 5 minutes
D. 10 minutes
CORRECT ANSWER: A. 1 minute
Rationale: When using an MDI, a 1-minute wait between puffs of the same
bronchodilator allows for maximal bronchodilation and better absorption of the second
dose. Waiting 1 to 2 minutes is the standard recommendation. Waiting longer is not
necessary, and waiting too short a time may reduce drug effectiveness.
Question 8: A client is receiving morphine sulfate via patient-controlled
analgesia (PCA) pump. The nurse notes a respiratory rate of 8 breaths/min
and pinpoint pupils. Which medication should the nurse prepare to
administer?
A. Atropine sulfate
B. Naloxone
C. Flumazenil
D. Epinephrine
CORRECT ANSWER: B. Naloxone
Rationale: The client is exhibiting signs of opioid toxicity, including respiratory
depression and miosis (pinpoint pupils). Naloxone (Narcan) is an opioid antagonist that
competes for opioid receptor sites, reversing these life-threatening effects. Flumazenil
reverses benzodiazepines, and atropine is used for bradycardia or cholinergic toxicity.
