ATI RN Pharmacology 2026 Proctored Exam100
Questions and Answers |2026 Updates |With
Complete Solutions
Introduction
This comprehensive practice examination has been designed to mirror the format,
content, and clinical judgment emphasis of the ATI RN Pharmacology 2026
Proctored Exam. The questions are drawn directly from the high-yield concepts
outlined in the preceding study guide, including laboratory monitoring,
pharmacokinetics, high-alert drug classes, safety and legal principles, dosage
calculations, and NGN-style clinical judgment scenarios.
Each question is presented in multiple-choice format (A, B, C, D), with the Correct
Answer clearly indicated and a detailed rationale explaining why the answer is
correct and why the distractors are incorrect. Questions are sequenced to cover all
major content areas without duplication, ensuring a thorough and efficient last-
minute review. Use this set to identify knowledge gaps, reinforce priority concepts,
and build confidence before exam day.
SECTION 1: Laboratory Monitoring & Priority Safety
Checks (Questions 1–15)
1. A nurse is preparing to administer warfarin to a client. Which laboratory
value should the nurse review prior to administration?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Correct Answer: B
,Rationale: Warfarin is monitored using PT/INR. The therapeutic INR is typically
2–3. aPTT monitors heparin. Platelet count and hemoglobin are important but do
not directly guide warfarin dosing.
2. A nurse is caring for a client receiving heparin infusion. The aPTT is 110
seconds. Which action should the nurse take first?
A. Increase the infusion rate
B. Continue the infusion as ordered
C. Hold the infusion and notify the provider
D. Administer vitamin K
Correct Answer: C
Rationale: Therapeutic aPTT is 1.5–2.5 times the control (approximately 60–80
seconds). An aPTT of 110 seconds indicates excessive anticoagulation. The nurse
should hold the infusion and notify the provider. Vitamin K is the antidote for
warfarin, not heparin.
3. A nurse is administering digoxin to a client. The apical pulse is 56
beats/min. Which action should the nurse take?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Administer the medication and recheck in 1 hour
D. Give half the dose
Correct Answer: B
Rationale: Digoxin should be held if the apical pulse is less than 60 beats/min in
adults. The nurse should hold the dose and notify the provider. Administering
digoxin with bradycardia increases the risk of toxicity and dysrhythmias.
4. A nurse is reviewing laboratory results for a client receiving vancomycin.
Which value requires immediate intervention?
,A. BUN 18 mg/dL
B. Creatinine 2.8 mg/dL
C. WBC 8,000/mm³
D. Hemoglobin 13 g/dL
Correct Answer: B
Rationale: Vancomycin is nephrotoxic. A creatinine of 2.8 mg/dL indicates
significant renal impairment and increases the risk of toxicity. The nurse should
notify the provider. BUN, WBC, and hemoglobin are within normal limits.
5. A nurse is caring for a client taking metformin. Which laboratory value
should the nurse monitor most closely?
A. Serum potassium
B. Renal function (eGFR)
C. INR
D. Thyroid-stimulating hormone
Correct Answer: B
Rationale: Metformin is contraindicated in renal impairment due to the risk of
lactic acidosis. Renal function should be monitored closely. Potassium is more
relevant for diuretics and ACE inhibitors. INR relates to warfarin, and TSH relates
to thyroid medications.
6. A nurse is administering lisinopril to a client. Which laboratory value
should the nurse monitor?
A. Serum potassium
B. Serum sodium
C. Platelet count
D. INR
Correct Answer: A
, Rationale: ACE inhibitors such as lisinopril can cause hyperkalemia. Potassium
levels should be monitored closely. Sodium, platelets, and INR are not the primary
concerns with ACE inhibitors.
7. A nurse is caring for a client receiving warfarin. The INR is 5.5 with no
signs of bleeding. Which action should the nurse anticipate?
A. Administer protamine sulfate
B. Administer vitamin K
C. Increase the warfarin dose
D. Continue the current dose
Correct Answer: B
Rationale: An INR greater than 5 without bleeding requires administration of
vitamin K (phytonadione). Protamine sulfate is the antidote for heparin. Increasing
the dose would worsen the coagulopathy.
8. A nurse is preparing to administer metoprolol. The client's heart rate is 52
beats/min and blood pressure is 88/56 mm Hg. Which action should the nurse
take?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Administer the medication and monitor closely
D. Give half the dose
Correct Answer: B
Rationale: Beta-blockers such as metoprolol should be held if the heart rate is less
than 60 beats/min or systolic BP is less than 90 mm Hg. The nurse should hold the
dose and notify the provider.
9. A nurse is reviewing the medication list for a client with a history of heart
failure. Which medication requires monitoring of potassium levels?
Questions and Answers |2026 Updates |With
Complete Solutions
Introduction
This comprehensive practice examination has been designed to mirror the format,
content, and clinical judgment emphasis of the ATI RN Pharmacology 2026
Proctored Exam. The questions are drawn directly from the high-yield concepts
outlined in the preceding study guide, including laboratory monitoring,
pharmacokinetics, high-alert drug classes, safety and legal principles, dosage
calculations, and NGN-style clinical judgment scenarios.
Each question is presented in multiple-choice format (A, B, C, D), with the Correct
Answer clearly indicated and a detailed rationale explaining why the answer is
correct and why the distractors are incorrect. Questions are sequenced to cover all
major content areas without duplication, ensuring a thorough and efficient last-
minute review. Use this set to identify knowledge gaps, reinforce priority concepts,
and build confidence before exam day.
SECTION 1: Laboratory Monitoring & Priority Safety
Checks (Questions 1–15)
1. A nurse is preparing to administer warfarin to a client. Which laboratory
value should the nurse review prior to administration?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Correct Answer: B
,Rationale: Warfarin is monitored using PT/INR. The therapeutic INR is typically
2–3. aPTT monitors heparin. Platelet count and hemoglobin are important but do
not directly guide warfarin dosing.
2. A nurse is caring for a client receiving heparin infusion. The aPTT is 110
seconds. Which action should the nurse take first?
A. Increase the infusion rate
B. Continue the infusion as ordered
C. Hold the infusion and notify the provider
D. Administer vitamin K
Correct Answer: C
Rationale: Therapeutic aPTT is 1.5–2.5 times the control (approximately 60–80
seconds). An aPTT of 110 seconds indicates excessive anticoagulation. The nurse
should hold the infusion and notify the provider. Vitamin K is the antidote for
warfarin, not heparin.
3. A nurse is administering digoxin to a client. The apical pulse is 56
beats/min. Which action should the nurse take?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Administer the medication and recheck in 1 hour
D. Give half the dose
Correct Answer: B
Rationale: Digoxin should be held if the apical pulse is less than 60 beats/min in
adults. The nurse should hold the dose and notify the provider. Administering
digoxin with bradycardia increases the risk of toxicity and dysrhythmias.
4. A nurse is reviewing laboratory results for a client receiving vancomycin.
Which value requires immediate intervention?
,A. BUN 18 mg/dL
B. Creatinine 2.8 mg/dL
C. WBC 8,000/mm³
D. Hemoglobin 13 g/dL
Correct Answer: B
Rationale: Vancomycin is nephrotoxic. A creatinine of 2.8 mg/dL indicates
significant renal impairment and increases the risk of toxicity. The nurse should
notify the provider. BUN, WBC, and hemoglobin are within normal limits.
5. A nurse is caring for a client taking metformin. Which laboratory value
should the nurse monitor most closely?
A. Serum potassium
B. Renal function (eGFR)
C. INR
D. Thyroid-stimulating hormone
Correct Answer: B
Rationale: Metformin is contraindicated in renal impairment due to the risk of
lactic acidosis. Renal function should be monitored closely. Potassium is more
relevant for diuretics and ACE inhibitors. INR relates to warfarin, and TSH relates
to thyroid medications.
6. A nurse is administering lisinopril to a client. Which laboratory value
should the nurse monitor?
A. Serum potassium
B. Serum sodium
C. Platelet count
D. INR
Correct Answer: A
, Rationale: ACE inhibitors such as lisinopril can cause hyperkalemia. Potassium
levels should be monitored closely. Sodium, platelets, and INR are not the primary
concerns with ACE inhibitors.
7. A nurse is caring for a client receiving warfarin. The INR is 5.5 with no
signs of bleeding. Which action should the nurse anticipate?
A. Administer protamine sulfate
B. Administer vitamin K
C. Increase the warfarin dose
D. Continue the current dose
Correct Answer: B
Rationale: An INR greater than 5 without bleeding requires administration of
vitamin K (phytonadione). Protamine sulfate is the antidote for heparin. Increasing
the dose would worsen the coagulopathy.
8. A nurse is preparing to administer metoprolol. The client's heart rate is 52
beats/min and blood pressure is 88/56 mm Hg. Which action should the nurse
take?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Administer the medication and monitor closely
D. Give half the dose
Correct Answer: B
Rationale: Beta-blockers such as metoprolol should be held if the heart rate is less
than 60 beats/min or systolic BP is less than 90 mm Hg. The nurse should hold the
dose and notify the provider.
9. A nurse is reviewing the medication list for a client with a history of heart
failure. Which medication requires monitoring of potassium levels?
