ATI RN Pharmacology
Proctored Exam 2026/2027
70 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 High-Alert Medications
2 Dosage Calculations
3 Cardiovascular Medications
4 Psychiatric Medications
5 Endocrine Medications
6 Anti-infectives
7 Analgesics
8 Gastrointestinal Medications
Page 1
,Q1
A nurse is preparing to administer insulin. Which action reflects the high-alert status of
this medication?
A) Verify the dose with a second nurse only for IV insulin
B) *Have a second nurse independently verify the dose and pump
CORRECT
settings
C) Administer the dose without a time-out
D) Store insulin at room temperature indefinitely
Rationale
Insulin is a high-alert medication requiring independent double-check to prevent serious
harm.
Q2
A client receiving heparin develops signs of bleeding. Which medication should the
nurse anticipate administering?
A) Vitamin K
B) Fresh frozen plasma
C) Idarucizumab
D) *Protamine sulfate CORRECT
Rationale
Protamine sulfate is the antidote for heparin. Vitamin K reverses warfarin.
Q3
A client taking digoxin reports nausea and visual changes. The digoxin level is 2.8
ng/mL. Which action should the nurse take first?
A) *Hold the digoxin and notify the provider CORRECT
B) Administer the next dose as ordered
C) Increase the dose
Page 2
, D) Encourage potassium-rich foods
Rationale
Therapeutic digoxin range is 0.5–2 ng/mL; 2.8 indicates toxicity. Hold and notify.
Q4
A client is found unresponsive with pinpoint pupils and a respiratory rate of 6
breaths/min. Which medication should the nurse prepare to administer?
A) Flumazenil
B) Atropine
C) *Naloxone CORRECT
D) Protamine sulfate
Rationale
Pinpoint pupils and respiratory depression indicate opioid overdose; naloxone is the
antidote.
Q5
A nurse is reviewing the INR for a client taking warfarin. Which value indicates a
therapeutic response for atrial fibrillation?
A) 0.8
B) *2.5 CORRECT
C) 4.5
D) 6.0
Rationale
Therapeutic INR for atrial fibrillation is 2.0–3.0. Values >4 increase bleeding risk.
Page 3
Proctored Exam 2026/2027
70 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 High-Alert Medications
2 Dosage Calculations
3 Cardiovascular Medications
4 Psychiatric Medications
5 Endocrine Medications
6 Anti-infectives
7 Analgesics
8 Gastrointestinal Medications
Page 1
,Q1
A nurse is preparing to administer insulin. Which action reflects the high-alert status of
this medication?
A) Verify the dose with a second nurse only for IV insulin
B) *Have a second nurse independently verify the dose and pump
CORRECT
settings
C) Administer the dose without a time-out
D) Store insulin at room temperature indefinitely
Rationale
Insulin is a high-alert medication requiring independent double-check to prevent serious
harm.
Q2
A client receiving heparin develops signs of bleeding. Which medication should the
nurse anticipate administering?
A) Vitamin K
B) Fresh frozen plasma
C) Idarucizumab
D) *Protamine sulfate CORRECT
Rationale
Protamine sulfate is the antidote for heparin. Vitamin K reverses warfarin.
Q3
A client taking digoxin reports nausea and visual changes. The digoxin level is 2.8
ng/mL. Which action should the nurse take first?
A) *Hold the digoxin and notify the provider CORRECT
B) Administer the next dose as ordered
C) Increase the dose
Page 2
, D) Encourage potassium-rich foods
Rationale
Therapeutic digoxin range is 0.5–2 ng/mL; 2.8 indicates toxicity. Hold and notify.
Q4
A client is found unresponsive with pinpoint pupils and a respiratory rate of 6
breaths/min. Which medication should the nurse prepare to administer?
A) Flumazenil
B) Atropine
C) *Naloxone CORRECT
D) Protamine sulfate
Rationale
Pinpoint pupils and respiratory depression indicate opioid overdose; naloxone is the
antidote.
Q5
A nurse is reviewing the INR for a client taking warfarin. Which value indicates a
therapeutic response for atrial fibrillation?
A) 0.8
B) *2.5 CORRECT
C) 4.5
D) 6.0
Rationale
Therapeutic INR for atrial fibrillation is 2.0–3.0. Values >4 increase bleeding risk.
Page 3
