ATI NR 203 PHARM FINAL REVIEW ACTUAL
PRACTICE EXAM WITH WELL ELABORATED AND
MOST TESTED REAL PRACTICE QUESTIONS AND
100% CORRECT VERIFIED ANSWERS WITH
DETAILED RATIONALES PLUS EXPERT ANSWER KEY
2026-2027 Q&A 100% GUARANTEED PASS A+ INSTANT
DOWNLOAD PDF
1. A nurse is caring for a client who has alcohol use disorder and is admitted with
lower extremity fractures following a motor-vehicle crash. A few hours after
admission, the client develops restlessness and tremors. Which of the following
medications should the nurse anticipate administering to the client first?
A. Haloperidol
B. Chlordiazepoxide
C. Lorazepam
D. Naltrexone
Rationale: Chlordiazepoxide is a benzodiazepine used to manage acute alcohol
withdrawal symptoms, including restlessness and tremors. It helps prevent
progression to severe withdrawal complications such as seizures and delirium
tremens. Haloperidol is an antipsychotic and is not first-line for withdrawal.
Lorazepam may be used but chlordiazepoxide is the preferred agent for acute
withdrawal management. Naltrexone is used for maintenance of alcohol
abstinence, not acute withdrawal.
2. A nurse is reinforcing teaching with a client who has postmenopausal
osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the
following statements by the client indicates an understanding of the teaching?
,A. "I will need to depress the side arms to initially activate the pump."
B. "I will need to depress the side arms to initially activate the pump."
C. "I should take this medication with a full glass of milk."
D. "I will inject this medication into my abdomen daily."
Rationale: Intranasal calcitonin-salmon requires priming the pump by depressing
the side arms before the first use. This ensures the correct dose is delivered. It is
not taken with milk, as that would interfere with calcium regulation therapy. It is
administered intranasally, not injected.
3. A nurse is reinforcing discharge teaching about lithium toxicity with a client who
has a new prescription for lithium. Which of the following statements by the client
indicates an understanding of the teaching?
A. "I can develop lithium toxicity if I experience vomiting or diarrhea."
B. "I should increase my sodium intake while taking this medication."
C. "I will take this medication with food to prevent toxicity."
D. "I can stop taking this medication once my mood stabilizes."
Rationale: Vomiting and diarrhea can lead to dehydration and sodium depletion,
which increases lithium reabsorption and can precipitate toxicity. Clients should
maintain adequate sodium and fluid intake. Lithium should not be stopped
abruptly. Taking it with food helps with GI upset but does not prevent toxicity.
4. A nurse is administering insulin glargine 10 units subcutaneously at 0730 to an
adolescent client who has type 1 diabetes mellitus. The nurse should anticipate
onset of action of the insulin at which of the following times?
A. 0745
B. 0745
C. 0800
D. 1200
Rationale: Insulin glargine is a long-acting insulin with an onset of action of
approximately 1 to 2 hours. Administered at 0730, the onset would be around 0745
,to 0830. It has no peak and a duration of 24 hours. This is in contrast to rapid-
acting insulins like lispro, which have an onset of 15 minutes.
5. A nurse is preparing to administer ampicillin 500 mg in 50 mL dextrose 5% in
water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10
gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?
(Round the answer to the nearest whole number.)
A. 25 gtt/min
B. 33 gtt/min
C. 40 gtt/min
D. 50 gtt/min
Rationale: To calculate gtt/min: (Volume in mL × Drop factor) ÷ Time in minutes
= (50 mL × 10 gtt/mL) ÷ 15 min = 500 ÷ 15 = 33.3, rounded to 33 gtt/min. This
ensures the medication infuses over the prescribed 15-minute period.
6. A nurse is reviewing the medical record of a client who is experiencing an acute
migraine attack and has a new prescription for sumatriptan. Which of the
following findings indicates a contraindication to sumatriptan?
A. History of hypertension
B. Coronary artery disease
C. History of migraine with aura
D. Nausea and vomiting
Rationale: Sumatriptan is a triptan used for acute migraine treatment. It causes
vasoconstriction and is contraindicated in clients with coronary artery disease,
uncontrolled hypertension, and other cardiovascular conditions due to the risk of
coronary vasospasm. Nausea is a common migraine symptom, not a
contraindication.
, 7. A nurse is caring for a client who has schizophrenia and is prescribed
haloperidol. Which adverse effect should the nurse identify as an extrapyramidal
symptom (EPS)?
A. Orthostatic hypotension
B. Acute dystonia
C. Hyperglycemia
D. Constipation
Rationale: Acute dystonia is an extrapyramidal symptom characterized by painful
muscle spasms, torticollis, and abnormal movements. It is associated with
antipsychotic medications such as haloperidol. Anticholinergic medications like
benztropine may be prescribed to treat acute dystonia. Orthostatic hypotension is a
cardiovascular effect, not EPS. Hyperglycemia is a metabolic effect. Constipation
is an anticholinergic effect.
8. A client taking clozapine reports having a sore throat and fever. Which action
should the nurse take first?
A. Administer the next dose with food
B. Encourage increased fluid intake
C. Hold the medication and notify the provider immediately
D. Reassure the client that this is a common side effect
Rationale: Clozapine can cause severe neutropenia and agranulocytosis. A sore
throat and fever may indicate infection secondary to neutropenia. The nurse should
hold the medication and notify the provider immediately for a CBC with
differential. This is a medical emergency requiring prompt intervention.
9. Which instruction is most important for a client beginning paroxetine therapy?
A. Stop the medication when symptoms improve
B. Expect immediate relief after the first dose
C. Do not discontinue the medication abruptly
D. Restrict dietary sodium
PRACTICE EXAM WITH WELL ELABORATED AND
MOST TESTED REAL PRACTICE QUESTIONS AND
100% CORRECT VERIFIED ANSWERS WITH
DETAILED RATIONALES PLUS EXPERT ANSWER KEY
2026-2027 Q&A 100% GUARANTEED PASS A+ INSTANT
DOWNLOAD PDF
1. A nurse is caring for a client who has alcohol use disorder and is admitted with
lower extremity fractures following a motor-vehicle crash. A few hours after
admission, the client develops restlessness and tremors. Which of the following
medications should the nurse anticipate administering to the client first?
A. Haloperidol
B. Chlordiazepoxide
C. Lorazepam
D. Naltrexone
Rationale: Chlordiazepoxide is a benzodiazepine used to manage acute alcohol
withdrawal symptoms, including restlessness and tremors. It helps prevent
progression to severe withdrawal complications such as seizures and delirium
tremens. Haloperidol is an antipsychotic and is not first-line for withdrawal.
Lorazepam may be used but chlordiazepoxide is the preferred agent for acute
withdrawal management. Naltrexone is used for maintenance of alcohol
abstinence, not acute withdrawal.
2. A nurse is reinforcing teaching with a client who has postmenopausal
osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the
following statements by the client indicates an understanding of the teaching?
,A. "I will need to depress the side arms to initially activate the pump."
B. "I will need to depress the side arms to initially activate the pump."
C. "I should take this medication with a full glass of milk."
D. "I will inject this medication into my abdomen daily."
Rationale: Intranasal calcitonin-salmon requires priming the pump by depressing
the side arms before the first use. This ensures the correct dose is delivered. It is
not taken with milk, as that would interfere with calcium regulation therapy. It is
administered intranasally, not injected.
3. A nurse is reinforcing discharge teaching about lithium toxicity with a client who
has a new prescription for lithium. Which of the following statements by the client
indicates an understanding of the teaching?
A. "I can develop lithium toxicity if I experience vomiting or diarrhea."
B. "I should increase my sodium intake while taking this medication."
C. "I will take this medication with food to prevent toxicity."
D. "I can stop taking this medication once my mood stabilizes."
Rationale: Vomiting and diarrhea can lead to dehydration and sodium depletion,
which increases lithium reabsorption and can precipitate toxicity. Clients should
maintain adequate sodium and fluid intake. Lithium should not be stopped
abruptly. Taking it with food helps with GI upset but does not prevent toxicity.
4. A nurse is administering insulin glargine 10 units subcutaneously at 0730 to an
adolescent client who has type 1 diabetes mellitus. The nurse should anticipate
onset of action of the insulin at which of the following times?
A. 0745
B. 0745
C. 0800
D. 1200
Rationale: Insulin glargine is a long-acting insulin with an onset of action of
approximately 1 to 2 hours. Administered at 0730, the onset would be around 0745
,to 0830. It has no peak and a duration of 24 hours. This is in contrast to rapid-
acting insulins like lispro, which have an onset of 15 minutes.
5. A nurse is preparing to administer ampicillin 500 mg in 50 mL dextrose 5% in
water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10
gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?
(Round the answer to the nearest whole number.)
A. 25 gtt/min
B. 33 gtt/min
C. 40 gtt/min
D. 50 gtt/min
Rationale: To calculate gtt/min: (Volume in mL × Drop factor) ÷ Time in minutes
= (50 mL × 10 gtt/mL) ÷ 15 min = 500 ÷ 15 = 33.3, rounded to 33 gtt/min. This
ensures the medication infuses over the prescribed 15-minute period.
6. A nurse is reviewing the medical record of a client who is experiencing an acute
migraine attack and has a new prescription for sumatriptan. Which of the
following findings indicates a contraindication to sumatriptan?
A. History of hypertension
B. Coronary artery disease
C. History of migraine with aura
D. Nausea and vomiting
Rationale: Sumatriptan is a triptan used for acute migraine treatment. It causes
vasoconstriction and is contraindicated in clients with coronary artery disease,
uncontrolled hypertension, and other cardiovascular conditions due to the risk of
coronary vasospasm. Nausea is a common migraine symptom, not a
contraindication.
, 7. A nurse is caring for a client who has schizophrenia and is prescribed
haloperidol. Which adverse effect should the nurse identify as an extrapyramidal
symptom (EPS)?
A. Orthostatic hypotension
B. Acute dystonia
C. Hyperglycemia
D. Constipation
Rationale: Acute dystonia is an extrapyramidal symptom characterized by painful
muscle spasms, torticollis, and abnormal movements. It is associated with
antipsychotic medications such as haloperidol. Anticholinergic medications like
benztropine may be prescribed to treat acute dystonia. Orthostatic hypotension is a
cardiovascular effect, not EPS. Hyperglycemia is a metabolic effect. Constipation
is an anticholinergic effect.
8. A client taking clozapine reports having a sore throat and fever. Which action
should the nurse take first?
A. Administer the next dose with food
B. Encourage increased fluid intake
C. Hold the medication and notify the provider immediately
D. Reassure the client that this is a common side effect
Rationale: Clozapine can cause severe neutropenia and agranulocytosis. A sore
throat and fever may indicate infection secondary to neutropenia. The nurse should
hold the medication and notify the provider immediately for a CBC with
differential. This is a medical emergency requiring prompt intervention.
9. Which instruction is most important for a client beginning paroxetine therapy?
A. Stop the medication when symptoms improve
B. Expect immediate relief after the first dose
C. Do not discontinue the medication abruptly
D. Restrict dietary sodium
