ATI RN Pharmacology Retake Exam (2023) – NGN
Questions and Case Scenarios (ATI) (Guarantee
Pass)
SECTION I: BASIC PHARMACOLOGY PRINCIPLES & MEDICATION SAFETY
(Questions 1–25)
1. A nurse is teaching a client about pharmacokinetics. Which process describes
the movement of a medication from the bloodstream into body tissues?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: B
Rationale: Distribution is the movement of a medication from the
bloodstream into tissues and body fluids. Absorption is movement into the
bloodstream, metabolism is chemical alteration, and excretion removes the
medication. Understanding these phases is essential for predicting drug onset,
duration, and potential for toxicity.
2. Which organ is primarily responsible for medication metabolism?
A. Heart
B. Liver
C. Lungs
D. Spleen
Correct Answer: B
Rationale: The liver is the major site of medication metabolism through
cytochrome P450 enzymes, although other organs can contribute. Hepatic
impairment can prolong drug action and increase toxicity risk.
,3. A nurse should recognize that impaired renal function can cause which
medication-related problem?
A. Faster medication absorption
B. Increased medication excretion
C. Medication accumulation
D. Reduced medication distribution
Correct Answer: C
Rationale: The kidneys eliminate many medications. Reduced renal
function decreases clearance, causing accumulation and toxicity. Nurses must
monitor renal function tests (BUN, creatinine) and adjust dosages accordingly.
4. Which medication route generally produces the fastest systemic effect?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
Correct Answer: D
Rationale: IV medications enter the bloodstream directly and have
essentially immediate systemic availability. Oral medications undergo first-pass
metabolism, delaying onset.
5. A medication's therapeutic index primarily provides information about its:
A. Color
B. Safety margin
C. Route of administration
D. Absorption rate
Correct Answer: B
Rationale: The therapeutic index compares effective and toxic
concentrations, indicating how safely a medication can be administered. A narrow
therapeutic index (e.g., digoxin, warfarin) requires close monitoring.
,6. A nurse is preparing to administer a medication that has a long half-life of 4
days. How many times per day should the nurse expect to administer this
medication?
A. One
B. Two
C. Three
D. Four
Correct Answer: A
Rationale: Medications with long half-lives remain at therapeutic levels
between doses for extended periods. The nurse should expect to administer this
medication once daily.
7. A nurse is preparing to administer a medication via nasogastric tube. Which
action should the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify tube placement
C. Crush the medication
D. Administer the medication in divided doses
Correct Answer: B
Rationale: Verifying tube placement is the first priority to ensure the
medication is delivered to the stomach and not the lungs. Auscultation, pH
testing, or radiographic confirmation should be performed before administration.
8. A nurse is reviewing a medication order and notes the abbreviation "U" for
units. What is the appropriate action?
A. Administer as written
B. Clarify the order because "U" is a dangerous abbreviation
C. Assume it means milligrams
D. Double the dose
, Correct Answer: B
Rationale: "U" is a dangerous abbreviation that can be mistaken for "0" or
"4," leading to tenfold dosing errors. The nurse should clarify the order and write
"unit."
9. A client is prescribed a medication that is highly protein-bound. Which lab value
should the nurse monitor?
A. Albumin
B. Potassium
C. Creatinine
D. Hemoglobin
Correct Answer: A
Rationale: Low albumin means more free (unbound) drug is available,
increasing the risk of toxicity. Highly protein-bound drugs require monitoring of
albumin levels.
10. Which type of drug interaction occurs when one drug increases the effect of
another?
A. Antagonistic
B. Synergistic (potentiating)
C. Additive
D. Idiosyncratic
Correct Answer: B
Rationale: A synergistic (potentiating) interaction occurs when one drug
enhances or increases the effect of another drug. Additive means the combined
effect equals the sum of individual effects.
11. A nurse is teaching a client about the onset of action of a medication. What
does "onset" refer to?
Questions and Case Scenarios (ATI) (Guarantee
Pass)
SECTION I: BASIC PHARMACOLOGY PRINCIPLES & MEDICATION SAFETY
(Questions 1–25)
1. A nurse is teaching a client about pharmacokinetics. Which process describes
the movement of a medication from the bloodstream into body tissues?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: B
Rationale: Distribution is the movement of a medication from the
bloodstream into tissues and body fluids. Absorption is movement into the
bloodstream, metabolism is chemical alteration, and excretion removes the
medication. Understanding these phases is essential for predicting drug onset,
duration, and potential for toxicity.
2. Which organ is primarily responsible for medication metabolism?
A. Heart
B. Liver
C. Lungs
D. Spleen
Correct Answer: B
Rationale: The liver is the major site of medication metabolism through
cytochrome P450 enzymes, although other organs can contribute. Hepatic
impairment can prolong drug action and increase toxicity risk.
,3. A nurse should recognize that impaired renal function can cause which
medication-related problem?
A. Faster medication absorption
B. Increased medication excretion
C. Medication accumulation
D. Reduced medication distribution
Correct Answer: C
Rationale: The kidneys eliminate many medications. Reduced renal
function decreases clearance, causing accumulation and toxicity. Nurses must
monitor renal function tests (BUN, creatinine) and adjust dosages accordingly.
4. Which medication route generally produces the fastest systemic effect?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
Correct Answer: D
Rationale: IV medications enter the bloodstream directly and have
essentially immediate systemic availability. Oral medications undergo first-pass
metabolism, delaying onset.
5. A medication's therapeutic index primarily provides information about its:
A. Color
B. Safety margin
C. Route of administration
D. Absorption rate
Correct Answer: B
Rationale: The therapeutic index compares effective and toxic
concentrations, indicating how safely a medication can be administered. A narrow
therapeutic index (e.g., digoxin, warfarin) requires close monitoring.
,6. A nurse is preparing to administer a medication that has a long half-life of 4
days. How many times per day should the nurse expect to administer this
medication?
A. One
B. Two
C. Three
D. Four
Correct Answer: A
Rationale: Medications with long half-lives remain at therapeutic levels
between doses for extended periods. The nurse should expect to administer this
medication once daily.
7. A nurse is preparing to administer a medication via nasogastric tube. Which
action should the nurse take first?
A. Flush the tube with 30 mL of water
B. Verify tube placement
C. Crush the medication
D. Administer the medication in divided doses
Correct Answer: B
Rationale: Verifying tube placement is the first priority to ensure the
medication is delivered to the stomach and not the lungs. Auscultation, pH
testing, or radiographic confirmation should be performed before administration.
8. A nurse is reviewing a medication order and notes the abbreviation "U" for
units. What is the appropriate action?
A. Administer as written
B. Clarify the order because "U" is a dangerous abbreviation
C. Assume it means milligrams
D. Double the dose
, Correct Answer: B
Rationale: "U" is a dangerous abbreviation that can be mistaken for "0" or
"4," leading to tenfold dosing errors. The nurse should clarify the order and write
"unit."
9. A client is prescribed a medication that is highly protein-bound. Which lab value
should the nurse monitor?
A. Albumin
B. Potassium
C. Creatinine
D. Hemoglobin
Correct Answer: A
Rationale: Low albumin means more free (unbound) drug is available,
increasing the risk of toxicity. Highly protein-bound drugs require monitoring of
albumin levels.
10. Which type of drug interaction occurs when one drug increases the effect of
another?
A. Antagonistic
B. Synergistic (potentiating)
C. Additive
D. Idiosyncratic
Correct Answer: B
Rationale: A synergistic (potentiating) interaction occurs when one drug
enhances or increases the effect of another drug. Additive means the combined
effect equals the sum of individual effects.
11. A nurse is teaching a client about the onset of action of a medication. What
does "onset" refer to?
