ATI PN Pharmacology 2026 Proctored Exam
Comprising NGN and All Questions and
Answers----Questions 1–200 with detailed
rationales | 100% Pass Guaranteed | Graded A+
1. A nurse is preparing to administer medication to a client. Which of the
following actions should the nurse take first when verifying the
medication order?
A. Review the medication's mechanism of action in a reference guide
B. Ask the client if they have taken this medication before
C. Check the client's insurance coverage for the medication
D. Compare the medication label with the MAR at the bedside
ANS: D
Explanation: The Three Medication Checks require the nurse to compare the
MAR with the medication label three times: when removing from storage, when
preparing, and at bedside before administration. The bedside check is the final
safety verification ensuring the correct medication reaches the client. Checking
insurance (C), asking about prior use (B), or reviewing mechanism of action (A)
do not directly verify the accuracy of the specific medication order being
administered .
2. Which of the following actions is essential when using the Z-track method
for intramuscular injection?
A. Inject the medication slowly over 30 seconds after releasing the skin
B. Massage the injection site vigorously for 60 seconds after removing the
needle
C. Insert the needle at a 45-degree angle into the subcutaneous tissue
1
,D. Pull the skin laterally before inserting the needle and hold until after injection
and needle removal
ANS: D
Explanation: The Z-track method requires pulling the skin laterally before
needle insertion and maintaining that displacement throughout injection and
needle withdrawal, which creates a zigzag path that seals the medication within
muscle tissue and prevents leakage into subcutaneous tissue. Massaging the site
(B) would force medication into subcutaneous tissue, defeating the purpose. A
45-degree angle (C) is used for subcutaneous injections, not IM Z-track, which
uses a 90-degree angle .
3. A client is prescribed a medication that undergoes significant first-pass
metabolism. The nurse understands that which route of administration
would bypass this effect?
A. Sublingual (SL) administration
B. Oral (PO) administration with enteric-coated tablets
C. Intramuscular (IM) administration in the deltoid
D. Rectal administration via suppository
ANS: A
Explanation: Sublingual administration allows medication to be absorbed
directly through the oral mucosa into the systemic circulation, completely
bypassing hepatic first-pass metabolism. Enteric-coated oral tablets (B) still
undergo first-pass metabolism. Rectal administration (D) partially bypasses first-
pass metabolism but approximately 50% still reaches the liver. IM administration
(C) bypasses first-pass metabolism but SL is specifically designed to avoid it
entirely .
2
, 4. A nurse is verifying a client's identity before medication administration.
Which of the following meets the standard for client identification using
two identifiers?
A. Verifying the client's room number and date of admission
B. Checking the client's armband name and asking the client to state their name
and date of birth
C. Asking the client to state their diagnosis and verifying their medication
allergies
D. Comparing the client's facial appearance with the photo on the MAR and
confirming their room number
ANS: B
Explanation: Joint Commission standards require two unique identifiers for
client verification; acceptable identifiers include the client's name on the
armband and the client verbally stating their name and date of birth. Room
numbers (A, D) are not acceptable identifiers because they can change and are
not unique to the individual. Diagnosis and allergy information (C) are clinical
data, not unique personal identifiers .
5. A nurse is preparing to administer cephalexin 500 mg PO every 6 hours.
The pharmacy supplies cephalexin oral suspension 250 mg/5 mL. How
many mL will the nurse administer per dose?
A. 5 mL
B. 10 mL
C. 15 mL
D. 20 mL
ANS: B
Explanation: Use the formula: (Desired Dose / Dose on Hand) × Volume = (500
mg / 250 mg) × 5 mL = 2 × 5 mL = 10 mL. The nurse must verify the concentration
on the label and use a calibrated oral syringe or medicine cup for accuracy .
3
, 6. A client is prescribed heparin 5,000 units subcutaneous every 12 hours.
The vial available is heparin 20,000 units/mL. How many mL should the
nurse administer?
A. 0.15 mL
B. 0.25 mL
C. 0.5 mL
D. 1 mL
ANS: B
Explanation: Calculation: 5,000 units ÷ 20,000 units/mL = 0.25 mL. Heparin is a
high-alert anticoagulant requiring independent double-check per institutional
policy. A volume of 0.25 mL is appropriate for subcutaneous injection (abdomen
preferred, avoiding the umbilicus) .
7. An IV infusion of 0.9% NaCl is prescribed at 125 mL/hr. The drop factor is
15 gtt/mL. How many gtt/min will the nurse set the IV flow rate? (Round
to the nearest whole number.)
A. 21 gtt/min
B. 31 gtt/min
C. 41 gtt/min
D. 51 gtt/min
ANS: B
Explanation: Formula: (Total mL / Total minutes) × Drop Factor = (125 mL / 60
min) × 15 gtt/mL = 2.083 × 15 = 31.25 → 31 gtt/min. The nurse must monitor the
IV site for infiltration and verify pump settings or manually regulate drops .
4
Comprising NGN and All Questions and
Answers----Questions 1–200 with detailed
rationales | 100% Pass Guaranteed | Graded A+
1. A nurse is preparing to administer medication to a client. Which of the
following actions should the nurse take first when verifying the
medication order?
A. Review the medication's mechanism of action in a reference guide
B. Ask the client if they have taken this medication before
C. Check the client's insurance coverage for the medication
D. Compare the medication label with the MAR at the bedside
ANS: D
Explanation: The Three Medication Checks require the nurse to compare the
MAR with the medication label three times: when removing from storage, when
preparing, and at bedside before administration. The bedside check is the final
safety verification ensuring the correct medication reaches the client. Checking
insurance (C), asking about prior use (B), or reviewing mechanism of action (A)
do not directly verify the accuracy of the specific medication order being
administered .
2. Which of the following actions is essential when using the Z-track method
for intramuscular injection?
A. Inject the medication slowly over 30 seconds after releasing the skin
B. Massage the injection site vigorously for 60 seconds after removing the
needle
C. Insert the needle at a 45-degree angle into the subcutaneous tissue
1
,D. Pull the skin laterally before inserting the needle and hold until after injection
and needle removal
ANS: D
Explanation: The Z-track method requires pulling the skin laterally before
needle insertion and maintaining that displacement throughout injection and
needle withdrawal, which creates a zigzag path that seals the medication within
muscle tissue and prevents leakage into subcutaneous tissue. Massaging the site
(B) would force medication into subcutaneous tissue, defeating the purpose. A
45-degree angle (C) is used for subcutaneous injections, not IM Z-track, which
uses a 90-degree angle .
3. A client is prescribed a medication that undergoes significant first-pass
metabolism. The nurse understands that which route of administration
would bypass this effect?
A. Sublingual (SL) administration
B. Oral (PO) administration with enteric-coated tablets
C. Intramuscular (IM) administration in the deltoid
D. Rectal administration via suppository
ANS: A
Explanation: Sublingual administration allows medication to be absorbed
directly through the oral mucosa into the systemic circulation, completely
bypassing hepatic first-pass metabolism. Enteric-coated oral tablets (B) still
undergo first-pass metabolism. Rectal administration (D) partially bypasses first-
pass metabolism but approximately 50% still reaches the liver. IM administration
(C) bypasses first-pass metabolism but SL is specifically designed to avoid it
entirely .
2
, 4. A nurse is verifying a client's identity before medication administration.
Which of the following meets the standard for client identification using
two identifiers?
A. Verifying the client's room number and date of admission
B. Checking the client's armband name and asking the client to state their name
and date of birth
C. Asking the client to state their diagnosis and verifying their medication
allergies
D. Comparing the client's facial appearance with the photo on the MAR and
confirming their room number
ANS: B
Explanation: Joint Commission standards require two unique identifiers for
client verification; acceptable identifiers include the client's name on the
armband and the client verbally stating their name and date of birth. Room
numbers (A, D) are not acceptable identifiers because they can change and are
not unique to the individual. Diagnosis and allergy information (C) are clinical
data, not unique personal identifiers .
5. A nurse is preparing to administer cephalexin 500 mg PO every 6 hours.
The pharmacy supplies cephalexin oral suspension 250 mg/5 mL. How
many mL will the nurse administer per dose?
A. 5 mL
B. 10 mL
C. 15 mL
D. 20 mL
ANS: B
Explanation: Use the formula: (Desired Dose / Dose on Hand) × Volume = (500
mg / 250 mg) × 5 mL = 2 × 5 mL = 10 mL. The nurse must verify the concentration
on the label and use a calibrated oral syringe or medicine cup for accuracy .
3
, 6. A client is prescribed heparin 5,000 units subcutaneous every 12 hours.
The vial available is heparin 20,000 units/mL. How many mL should the
nurse administer?
A. 0.15 mL
B. 0.25 mL
C. 0.5 mL
D. 1 mL
ANS: B
Explanation: Calculation: 5,000 units ÷ 20,000 units/mL = 0.25 mL. Heparin is a
high-alert anticoagulant requiring independent double-check per institutional
policy. A volume of 0.25 mL is appropriate for subcutaneous injection (abdomen
preferred, avoiding the umbilicus) .
7. An IV infusion of 0.9% NaCl is prescribed at 125 mL/hr. The drop factor is
15 gtt/mL. How many gtt/min will the nurse set the IV flow rate? (Round
to the nearest whole number.)
A. 21 gtt/min
B. 31 gtt/min
C. 41 gtt/min
D. 51 gtt/min
ANS: B
Explanation: Formula: (Total mL / Total minutes) × Drop Factor = (125 mL / 60
min) × 15 gtt/mL = 2.083 × 15 = 31.25 → 31 gtt/min. The nurse must monitor the
IV site for infiltration and verify pump settings or manually regulate drops .
4
