ATI Pharmacology 2026/2027 | ATI RN Pharmacology for Nursing
Edition 10.0 Study Guide, Pharmacology Exam Prep, Medication
Administration, Drug Classifications, Pharmacokinetics,
Pharmacodynamics, Adverse Effects, Drug Interactions, Dosage
Calculations, Practice Questions and Answers
Question 1: A nurse is preparing to administer a medication with a narrow
therapeutic index. Which action should the nurse prioritize?
A. Administer the medication with food to reduce GI upset
B. Monitor serum drug levels closely for toxicity
C. Double the dose if the client reports no effect
D. Withhold the medication if the client reports nausea
CORRECT ANSWER: B. Monitor serum drug levels closely for toxicity
Rationale: Medications with a narrow therapeutic index have a small margin
between therapeutic and toxic doses. Serum level monitoring is essential to
ensure efficacy while preventing toxicity. Administering with food, doubling
doses, or withholding based on nausea are not appropriate primary actions for
NTI drugs.
Question 2: A nurse is calculating a medication dose and converts 0.75 grams to
milligrams. How many milligrams should the nurse document?
A. 7.5 mg
B. 75 mg
C. 750 mg
D. 7,500 mg
CORRECT ANSWER: C. 750 mg
Rationale: To convert grams to milligrams, multiply by 1,000. Therefore, 0.75 g ×
1,000 = 750 mg. This conversion is fundamental to safe dosage calculation.
Question 3: A client asks the nurse why a prescribed medication is given
sublingually rather than orally. Which response by the nurse is most accurate?
A. "Sublingual medications are absorbed more slowly for sustained effect."
B. "Sublingual administration bypasses first-pass metabolism in the liver."
C. "Sublingual medications are less potent than oral forms."
D. "Sublingual administration allows for higher doses to be given safely."
,CORRECT ANSWER: B. "Sublingual administration bypasses first-pass
metabolism in the liver."
Rationale: Sublingual medications are absorbed directly into systemic circulation
through the oral mucosa, bypassing the hepatic first-pass effect. This results in
higher bioavailability and faster onset compared to oral administration.
Question 4: A nurse is reviewing a client's medication record and notes a
prescription for "trough level" monitoring. When should the nurse obtain the
blood specimen?
A. 30 minutes after the next dose is administered
B. Immediately before the next scheduled dose
C. Exactly 2 hours after the dose
D. At any random time during the dosing interval
CORRECT ANSWER: B. Immediately before the next scheduled dose
Rationale: A trough level measures the lowest concentration of drug in the
bloodstream and is drawn immediately before the next dose is due. This helps
determine if the dosage is adequate to maintain therapeutic levels throughout
the dosing interval.
Question 5: A nurse is preparing to administer an intramuscular injection to an
adult client with a BMI of 35. Which needle length should the nurse select?
A. 5/8 inch
B. 1 inch
C. 1½ inches
D. 3 inches
CORRECT ANSWER: C. 1½ inches
Rationale: For clients with increased adipose tissue, a longer needle (1½ inches) is
required to ensure the medication reaches muscle tissue rather than being
deposited in subcutaneous fat. Standard IM needles for adults are typically 1 to
1½ inches.
,Question 6: A nurse is teaching a client about a new prescription for a
transdermal patch. Which statement indicates the client understands the
instructions?
A. "I will apply the patch to the same spot each time."
B. "I will cut the patch in half if the dose feels too strong."
C. "I will rotate application sites with each new patch."
D. "I will apply a heating pad over the patch to increase absorption."
CORRECT ANSWER: C. "I will rotate application sites with each new patch."
Rationale: Transdermal patches should be applied to different sites with each
application to prevent skin irritation. Patches should never be cut, and heat
should not be applied over the patch as it can increase absorption and cause
toxicity.
Question 7: A nurse is preparing to administer a medication via a nasogastric
tube. Which action should the nurse take first?
A. Crush all medications together for efficiency
B. Verify tube placement before administration
C. Flush the tube with 10 mL of air
D. Mix medications with enteral feeding formula
CORRECT ANSWER: B. Verify tube placement before administration
Rationale: Verifying NG tube placement is the priority before administering any
medication to prevent inadvertent administration into the lungs. Placement
should be verified by pH testing of aspirate or x-ray confirmation per facility
policy.
Question 8: A client with severe liver disease is prescribed a medication that
undergoes extensive hepatic metabolism. The nurse should anticipate which
dosage adjustment?
A. Increased dose to compensate for impaired metabolism
B. Decreased dose to prevent drug accumulation and toxicity
C. No change in dose since metabolism is not affected
D. Administration via a different route only
, CORRECT ANSWER: B. Decreased dose to prevent drug accumulation and
toxicity
Rationale: Liver failure decreases the metabolism of drugs, leading to drug
accumulation and increased risk for toxicity. Providers typically reduce dosages or
lengthen dosing intervals for medications metabolized by the liver.
Question 9: A nurse is administering a medication that is 98% protein-bound.
The client has a serum albumin level of 2.5 g/dL. The nurse should monitor the
client for which effect?
A. Decreased therapeutic effect due to rapid excretion
B. Increased risk for medication toxicity
C. Delayed onset of action
D. Reduced absorption from the GI tract
CORRECT ANSWER: B. Increased risk for medication toxicity
Rationale: A low serum albumin level means fewer protein-binding sites are
available, leaving more free (active) drug in the bloodstream. This increases the
risk for toxicity even at therapeutic doses. Normal albumin is 3.5–5.0 g/dL.
Question 10: A nurse is preparing to administer 0.5 g of a medication. The
available tablets are 250 mg each. How many tablets should the nurse
administer?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets
D. 4 tablets
CORRECT ANSWER: C. 2 tablets
Rationale: Convert grams to milligrams: 0.5 g × 1,000 = 500 mg. Divide the
ordered dose by the available dose: 500 mg ÷ 250 mg = 2 tablets. This is a
fundamental dosage calculation.
Question 11: A nurse is reviewing a medication order that reads "AC." When
should the nurse administer this medication?
Edition 10.0 Study Guide, Pharmacology Exam Prep, Medication
Administration, Drug Classifications, Pharmacokinetics,
Pharmacodynamics, Adverse Effects, Drug Interactions, Dosage
Calculations, Practice Questions and Answers
Question 1: A nurse is preparing to administer a medication with a narrow
therapeutic index. Which action should the nurse prioritize?
A. Administer the medication with food to reduce GI upset
B. Monitor serum drug levels closely for toxicity
C. Double the dose if the client reports no effect
D. Withhold the medication if the client reports nausea
CORRECT ANSWER: B. Monitor serum drug levels closely for toxicity
Rationale: Medications with a narrow therapeutic index have a small margin
between therapeutic and toxic doses. Serum level monitoring is essential to
ensure efficacy while preventing toxicity. Administering with food, doubling
doses, or withholding based on nausea are not appropriate primary actions for
NTI drugs.
Question 2: A nurse is calculating a medication dose and converts 0.75 grams to
milligrams. How many milligrams should the nurse document?
A. 7.5 mg
B. 75 mg
C. 750 mg
D. 7,500 mg
CORRECT ANSWER: C. 750 mg
Rationale: To convert grams to milligrams, multiply by 1,000. Therefore, 0.75 g ×
1,000 = 750 mg. This conversion is fundamental to safe dosage calculation.
Question 3: A client asks the nurse why a prescribed medication is given
sublingually rather than orally. Which response by the nurse is most accurate?
A. "Sublingual medications are absorbed more slowly for sustained effect."
B. "Sublingual administration bypasses first-pass metabolism in the liver."
C. "Sublingual medications are less potent than oral forms."
D. "Sublingual administration allows for higher doses to be given safely."
,CORRECT ANSWER: B. "Sublingual administration bypasses first-pass
metabolism in the liver."
Rationale: Sublingual medications are absorbed directly into systemic circulation
through the oral mucosa, bypassing the hepatic first-pass effect. This results in
higher bioavailability and faster onset compared to oral administration.
Question 4: A nurse is reviewing a client's medication record and notes a
prescription for "trough level" monitoring. When should the nurse obtain the
blood specimen?
A. 30 minutes after the next dose is administered
B. Immediately before the next scheduled dose
C. Exactly 2 hours after the dose
D. At any random time during the dosing interval
CORRECT ANSWER: B. Immediately before the next scheduled dose
Rationale: A trough level measures the lowest concentration of drug in the
bloodstream and is drawn immediately before the next dose is due. This helps
determine if the dosage is adequate to maintain therapeutic levels throughout
the dosing interval.
Question 5: A nurse is preparing to administer an intramuscular injection to an
adult client with a BMI of 35. Which needle length should the nurse select?
A. 5/8 inch
B. 1 inch
C. 1½ inches
D. 3 inches
CORRECT ANSWER: C. 1½ inches
Rationale: For clients with increased adipose tissue, a longer needle (1½ inches) is
required to ensure the medication reaches muscle tissue rather than being
deposited in subcutaneous fat. Standard IM needles for adults are typically 1 to
1½ inches.
,Question 6: A nurse is teaching a client about a new prescription for a
transdermal patch. Which statement indicates the client understands the
instructions?
A. "I will apply the patch to the same spot each time."
B. "I will cut the patch in half if the dose feels too strong."
C. "I will rotate application sites with each new patch."
D. "I will apply a heating pad over the patch to increase absorption."
CORRECT ANSWER: C. "I will rotate application sites with each new patch."
Rationale: Transdermal patches should be applied to different sites with each
application to prevent skin irritation. Patches should never be cut, and heat
should not be applied over the patch as it can increase absorption and cause
toxicity.
Question 7: A nurse is preparing to administer a medication via a nasogastric
tube. Which action should the nurse take first?
A. Crush all medications together for efficiency
B. Verify tube placement before administration
C. Flush the tube with 10 mL of air
D. Mix medications with enteral feeding formula
CORRECT ANSWER: B. Verify tube placement before administration
Rationale: Verifying NG tube placement is the priority before administering any
medication to prevent inadvertent administration into the lungs. Placement
should be verified by pH testing of aspirate or x-ray confirmation per facility
policy.
Question 8: A client with severe liver disease is prescribed a medication that
undergoes extensive hepatic metabolism. The nurse should anticipate which
dosage adjustment?
A. Increased dose to compensate for impaired metabolism
B. Decreased dose to prevent drug accumulation and toxicity
C. No change in dose since metabolism is not affected
D. Administration via a different route only
, CORRECT ANSWER: B. Decreased dose to prevent drug accumulation and
toxicity
Rationale: Liver failure decreases the metabolism of drugs, leading to drug
accumulation and increased risk for toxicity. Providers typically reduce dosages or
lengthen dosing intervals for medications metabolized by the liver.
Question 9: A nurse is administering a medication that is 98% protein-bound.
The client has a serum albumin level of 2.5 g/dL. The nurse should monitor the
client for which effect?
A. Decreased therapeutic effect due to rapid excretion
B. Increased risk for medication toxicity
C. Delayed onset of action
D. Reduced absorption from the GI tract
CORRECT ANSWER: B. Increased risk for medication toxicity
Rationale: A low serum albumin level means fewer protein-binding sites are
available, leaving more free (active) drug in the bloodstream. This increases the
risk for toxicity even at therapeutic doses. Normal albumin is 3.5–5.0 g/dL.
Question 10: A nurse is preparing to administer 0.5 g of a medication. The
available tablets are 250 mg each. How many tablets should the nurse
administer?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets
D. 4 tablets
CORRECT ANSWER: C. 2 tablets
Rationale: Convert grams to milligrams: 0.5 g × 1,000 = 500 mg. Divide the
ordered dose by the available dose: 500 mg ÷ 250 mg = 2 tablets. This is a
fundamental dosage calculation.
Question 11: A nurse is reviewing a medication order that reads "AC." When
should the nurse administer this medication?
