ATI PN Pharmacology 2026 Proctored
Exam Package | Actual and Retake
Versions
Section 1: Medication Administration & Safety (Q1–Q20)
Q1. A nurse is preparing to administer digoxin to a client. Which of the following findings
should the nurse report before administering the medication?
A. Heart rate 58/min
B. Potassium 3.2 mEq/L
C. Blood pressure 118/76 mm Hg
D. Respiratory rate 18/min
CORRECT: B
Rationale: Hypokalemia increases the risk of digoxin toxicity. Digoxin should be held and the
provider notified for potassium below 3.5 mEq/L. Heart rate below 60/min is also a hold
parameter, but 58/min alone requires assessment; potassium 3.2 is the priority lab abnormality.
Q2. A nurse is preparing to administer a subcutaneous injection of insulin. Which of the
following actions should the nurse take?
A. Use a 1-inch needle at 90 degrees
B. Aspirate before injecting
C. Rotate injection sites within the same anatomical region
D. Massage the site vigorously after injection
CORRECT: C
Rationale: Rotating sites within one region prevents lipohypertrophy and ensures consistent
absorption. Aspiration is not required for insulin. Massaging can alter absorption. Needle length
and angle depend on client size and syringe type.
Q3. Which of the following are appropriate nursing actions when administering a medication
via nasogastric tube? (SATA)
,A. Verify tube placement before administration
B. Crush enteric-coated tablets for easier administration
C. Flush with 15–30 mL of water before and after
D. Mix medication with enteral feeding formula
E. Position client upright during administration
CORRECT: A, C, E
Rationale: Verify placement, flush before/after, and keep client upright to prevent
aspiration. Enteric-coated and extended-release forms should not be crushed. Medications
should not be mixed with formula unless specified.
Q4. A nurse is reviewing a client's medication administration record and notes an order for
"morphine sulfate 2 mg IV every 2 hours PRN." Which of the following is the nurse's priority
action?
A. Administer the medication as ordered
B. Verify the order with the provider because IV morphine dosing is unusual
C. Hold the medication and document refusal
D. Administer half the dose
CORRECT: B
Rationale: IV morphine is typically ordered in mg doses, but the nurse should verify any
unclear or potentially unsafe order. The priority is client safety through verification. Note: the
order as written is not inherently wrong; however, when in doubt, clarify.
Q5. A nurse is teaching a client about using a metered-dose inhaler (MDI) with a spacer.
Which statement indicates understanding?
A. "I will shake the inhaler and breathe out fully before activating it."
B. "I will inhale rapidly and forcefully."
C. "I will use the inhaler without a spacer for better delivery."
D. "I will take two puffs 1 minute apart without waiting."
CORRECT: A
Rationale: Shake the inhaler, exhale fully, then activate and inhale slowly and deeply. Rapid
inhalation reduces drug delivery. A spacer improves delivery. Waiting 1–2 minutes between
puffs is recommended.
,Q6. A nurse is preparing to administer a medication that is on the high-alert list. Which of the
following actions is required?
A. Independent double-check with a second nurse
B. Administration by the prescriber only
C. Administration without a pump
D. Documentation after the shift
CORRECT: A
Rationale: High-alert medications require an independent double-check to reduce the risk
of serious errors. Administration is within nursing scope with proper verification.
Q7. A nurse is administering an oral medication to a client who has difficulty swallowing.
Which action is appropriate?
A. Crush all medications and mix with applesauce
B. Place medication in the back of the mouth and offer water
C. Have the client lie flat during administration
D. Administer with a straw
CORRECT: B
Rationale: Placing medication at the back of the mouth and offering water facilitates
swallowing. Not all medications can be crushed. Lying flat increases aspiration risk.
Q8. A nurse is calculating a pediatric dose. The child weighs 22 lb. The ordered dose is 10
mg/kg/day divided every 12 hours. How many mg per dose should the nurse administer?
(Round to the nearest tenth.)
A. 50 mg
B. 100 mg
C. 25 mg
D. 10 mg
CORRECT: A
Rationale: 22 lb ÷ 2.2 = 10 kg. 10 mg/kg/day × 10 kg = 100 mg/day ÷ 2 doses = 50 mg/dose.
, Q9. Which of the following are correct rights of medication administration? (SATA)
A. Right client
B. Right medication
C. Right dose
D. Right route
E. Right time
F. Right documentation
CORRECT: A, B, C, D, E, F
Rationale: All are components of the rights of medication administration. Some frameworks
also include right reason and right to refuse.
Q10. A nurse is administering a medication via IM injection to an adult. Which site is
preferred for large-volume injections?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Vastus lateralis
CORRECT: B
Rationale: The ventrogluteal site is preferred for IM injections in adults because it is free of
major nerves and blood vessels and can accommodate larger volumes. Deltoid is used for small
volumes. Dorsogluteal is avoided due to sciatic nerve risk.
Q11. A nurse is preparing to administer a medication through a central venous catheter.
Which action is priority?
A. Use sterile technique
B. Flush with air
C. Administer rapidly
D. Use a peripheral needle
CORRECT: A
Rationale: Sterile technique is essential for central line access to prevent bloodstream
infections.
Exam Package | Actual and Retake
Versions
Section 1: Medication Administration & Safety (Q1–Q20)
Q1. A nurse is preparing to administer digoxin to a client. Which of the following findings
should the nurse report before administering the medication?
A. Heart rate 58/min
B. Potassium 3.2 mEq/L
C. Blood pressure 118/76 mm Hg
D. Respiratory rate 18/min
CORRECT: B
Rationale: Hypokalemia increases the risk of digoxin toxicity. Digoxin should be held and the
provider notified for potassium below 3.5 mEq/L. Heart rate below 60/min is also a hold
parameter, but 58/min alone requires assessment; potassium 3.2 is the priority lab abnormality.
Q2. A nurse is preparing to administer a subcutaneous injection of insulin. Which of the
following actions should the nurse take?
A. Use a 1-inch needle at 90 degrees
B. Aspirate before injecting
C. Rotate injection sites within the same anatomical region
D. Massage the site vigorously after injection
CORRECT: C
Rationale: Rotating sites within one region prevents lipohypertrophy and ensures consistent
absorption. Aspiration is not required for insulin. Massaging can alter absorption. Needle length
and angle depend on client size and syringe type.
Q3. Which of the following are appropriate nursing actions when administering a medication
via nasogastric tube? (SATA)
,A. Verify tube placement before administration
B. Crush enteric-coated tablets for easier administration
C. Flush with 15–30 mL of water before and after
D. Mix medication with enteral feeding formula
E. Position client upright during administration
CORRECT: A, C, E
Rationale: Verify placement, flush before/after, and keep client upright to prevent
aspiration. Enteric-coated and extended-release forms should not be crushed. Medications
should not be mixed with formula unless specified.
Q4. A nurse is reviewing a client's medication administration record and notes an order for
"morphine sulfate 2 mg IV every 2 hours PRN." Which of the following is the nurse's priority
action?
A. Administer the medication as ordered
B. Verify the order with the provider because IV morphine dosing is unusual
C. Hold the medication and document refusal
D. Administer half the dose
CORRECT: B
Rationale: IV morphine is typically ordered in mg doses, but the nurse should verify any
unclear or potentially unsafe order. The priority is client safety through verification. Note: the
order as written is not inherently wrong; however, when in doubt, clarify.
Q5. A nurse is teaching a client about using a metered-dose inhaler (MDI) with a spacer.
Which statement indicates understanding?
A. "I will shake the inhaler and breathe out fully before activating it."
B. "I will inhale rapidly and forcefully."
C. "I will use the inhaler without a spacer for better delivery."
D. "I will take two puffs 1 minute apart without waiting."
CORRECT: A
Rationale: Shake the inhaler, exhale fully, then activate and inhale slowly and deeply. Rapid
inhalation reduces drug delivery. A spacer improves delivery. Waiting 1–2 minutes between
puffs is recommended.
,Q6. A nurse is preparing to administer a medication that is on the high-alert list. Which of the
following actions is required?
A. Independent double-check with a second nurse
B. Administration by the prescriber only
C. Administration without a pump
D. Documentation after the shift
CORRECT: A
Rationale: High-alert medications require an independent double-check to reduce the risk
of serious errors. Administration is within nursing scope with proper verification.
Q7. A nurse is administering an oral medication to a client who has difficulty swallowing.
Which action is appropriate?
A. Crush all medications and mix with applesauce
B. Place medication in the back of the mouth and offer water
C. Have the client lie flat during administration
D. Administer with a straw
CORRECT: B
Rationale: Placing medication at the back of the mouth and offering water facilitates
swallowing. Not all medications can be crushed. Lying flat increases aspiration risk.
Q8. A nurse is calculating a pediatric dose. The child weighs 22 lb. The ordered dose is 10
mg/kg/day divided every 12 hours. How many mg per dose should the nurse administer?
(Round to the nearest tenth.)
A. 50 mg
B. 100 mg
C. 25 mg
D. 10 mg
CORRECT: A
Rationale: 22 lb ÷ 2.2 = 10 kg. 10 mg/kg/day × 10 kg = 100 mg/day ÷ 2 doses = 50 mg/dose.
, Q9. Which of the following are correct rights of medication administration? (SATA)
A. Right client
B. Right medication
C. Right dose
D. Right route
E. Right time
F. Right documentation
CORRECT: A, B, C, D, E, F
Rationale: All are components of the rights of medication administration. Some frameworks
also include right reason and right to refuse.
Q10. A nurse is administering a medication via IM injection to an adult. Which site is
preferred for large-volume injections?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Vastus lateralis
CORRECT: B
Rationale: The ventrogluteal site is preferred for IM injections in adults because it is free of
major nerves and blood vessels and can accommodate larger volumes. Deltoid is used for small
volumes. Dorsogluteal is avoided due to sciatic nerve risk.
Q11. A nurse is preparing to administer a medication through a central venous catheter.
Which action is priority?
A. Use sterile technique
B. Flush with air
C. Administer rapidly
D. Use a peripheral needle
CORRECT: A
Rationale: Sterile technique is essential for central line access to prevent bloodstream
infections.
