RN ATI Pharmacology 2026 Retake Proctored Exam | All NGN
Level 3 Study Guide
This professional nursing resource is a premier test bank designed for students
preparing for the RN ATI Pharmacology Content Mastery Series (CMS) Retake
Proctored Examination. It features high-yield practice questions, 100% verified
answers, and comprehensive clinical rationales meticulously aligned with the Next
Generation NCLEX (NGN) framework. Reviewing these materials will optimize your
clinical judgment regarding medication administration safety, critical drug interactions,
lab monitoring protocols, and specific antidotes to ensure a Level 3 proficiency score
on your retake assessment
SECTION 1: CARDIOVASCULAR MEDICATIONS (Questions
1–30)
1. A nurse is caring for a client who is receiving IV heparin. The client's aPTT is 95
seconds (control 30 seconds). Which of the following actions should the nurse take
first?
A. Continue the infusion at the current rate
B. Stop the infusion and notify the provider
C. Administer protamine sulfate
D. Increase the infusion rate
Correct Answer: B
Rationale: The therapeutic aPTT for heparin is 1.5 to 2.5 times the control value (45-75
seconds). An aPTT of 95 seconds is 3.2 times the control, indicating supratherapeutic
,anticoagulation. The nurse should stop the infusion and notify the provider. Protamine
sulfate (C) is the antidote but requires a provider order.
2. A nurse is teaching a client about warfarin therapy. Which of the following
statements by the client indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will use aspirin for headaches."
C. "I will keep my vitamin K intake consistent."
D. "I will stop taking the medication if I notice bruising."
Correct Answer: C
Rationale: Warfarin is a vitamin K antagonist. Clients should maintain a consistent intake
of vitamin K-rich foods (green leafy vegetables) to keep INR stable. Increasing intake (A)
would decrease effectiveness. Aspirin (B) increases bleeding risk. Stopping the medication
(D) without provider guidance is unsafe.
3. A nurse is administering digoxin to a client with heart failure. The client's apical
pulse is 54 bpm. Which of the following actions should the nurse take?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Administer the medication with food
D. Recheck the pulse in 30 minutes
Correct Answer: B
Rationale: Digoxin is withheld when the apical pulse is below 60 bpm in adults because
bradycardia increases the risk of digoxin toxicity and dysrhythmias. The nurse should hold
the dose and notify the provider.
,4. A nurse is caring for a client who has a new prescription for lisinopril. Which of
the following findings should the nurse report to the provider?
A. Dry cough
B. Blood pressure 110/70 mm Hg
C. Serum potassium 5.8 mEq/L
D. Heart rate 88 bpm
Correct Answer: C
Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by decreasing
aldosterone secretion. A potassium level of 5.8 mEq/L is elevated and should be reported.
A dry cough (A) is a common side effect but not an emergency. Blood pressure (B) and
heart rate (D) are within normal limits.
5. A nurse is preparing to administer metoprolol to a client. Which of the
following findings should the nurse assess before administration?
A. Respiratory rate
B. Apical pulse
C. Temperature
D. Oxygen saturation
Correct Answer: B
Rationale: Metoprolol is a beta-blocker that decreases heart rate. The nurse should assess
the apical pulse before administration. If the heart rate is below 60 bpm, the dose should
be held and the provider notified. Respiratory rate (A), temperature (C), and oxygen
saturation (D) are important but not specific to beta-blocker administration.
, 6. A client is prescribed furosemide. Which of the following laboratory values
should the nurse monitor?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum phosphorus
Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss (hypokalemia). Serum
potassium should be monitored closely. Calcium (B), magnesium (C), and phosphorus (D)
can be affected but potassium is the priority.
7. A nurse is administering spironolactone to a client with heart failure. Which of
the following findings indicates a therapeutic response?
A. Increased urine output
B. Decreased blood pressure
C. Weight loss
D. All of the above
Correct Answer: D
Rationale: Spironolactone is a potassium-sparing diuretic that promotes diuresis, reduces
fluid retention, and lowers blood pressure. Increased urine output (A), decreased blood
pressure (B), and weight loss (C) all indicate a therapeutic response.
8. A client is prescribed nitroglycerin sublingual. Which of the following
instructions should the nurse include?
A. "Swallow the tablet with water."
Level 3 Study Guide
This professional nursing resource is a premier test bank designed for students
preparing for the RN ATI Pharmacology Content Mastery Series (CMS) Retake
Proctored Examination. It features high-yield practice questions, 100% verified
answers, and comprehensive clinical rationales meticulously aligned with the Next
Generation NCLEX (NGN) framework. Reviewing these materials will optimize your
clinical judgment regarding medication administration safety, critical drug interactions,
lab monitoring protocols, and specific antidotes to ensure a Level 3 proficiency score
on your retake assessment
SECTION 1: CARDIOVASCULAR MEDICATIONS (Questions
1–30)
1. A nurse is caring for a client who is receiving IV heparin. The client's aPTT is 95
seconds (control 30 seconds). Which of the following actions should the nurse take
first?
A. Continue the infusion at the current rate
B. Stop the infusion and notify the provider
C. Administer protamine sulfate
D. Increase the infusion rate
Correct Answer: B
Rationale: The therapeutic aPTT for heparin is 1.5 to 2.5 times the control value (45-75
seconds). An aPTT of 95 seconds is 3.2 times the control, indicating supratherapeutic
,anticoagulation. The nurse should stop the infusion and notify the provider. Protamine
sulfate (C) is the antidote but requires a provider order.
2. A nurse is teaching a client about warfarin therapy. Which of the following
statements by the client indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will use aspirin for headaches."
C. "I will keep my vitamin K intake consistent."
D. "I will stop taking the medication if I notice bruising."
Correct Answer: C
Rationale: Warfarin is a vitamin K antagonist. Clients should maintain a consistent intake
of vitamin K-rich foods (green leafy vegetables) to keep INR stable. Increasing intake (A)
would decrease effectiveness. Aspirin (B) increases bleeding risk. Stopping the medication
(D) without provider guidance is unsafe.
3. A nurse is administering digoxin to a client with heart failure. The client's apical
pulse is 54 bpm. Which of the following actions should the nurse take?
A. Administer the medication as ordered
B. Hold the medication and notify the provider
C. Administer the medication with food
D. Recheck the pulse in 30 minutes
Correct Answer: B
Rationale: Digoxin is withheld when the apical pulse is below 60 bpm in adults because
bradycardia increases the risk of digoxin toxicity and dysrhythmias. The nurse should hold
the dose and notify the provider.
,4. A nurse is caring for a client who has a new prescription for lisinopril. Which of
the following findings should the nurse report to the provider?
A. Dry cough
B. Blood pressure 110/70 mm Hg
C. Serum potassium 5.8 mEq/L
D. Heart rate 88 bpm
Correct Answer: C
Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia by decreasing
aldosterone secretion. A potassium level of 5.8 mEq/L is elevated and should be reported.
A dry cough (A) is a common side effect but not an emergency. Blood pressure (B) and
heart rate (D) are within normal limits.
5. A nurse is preparing to administer metoprolol to a client. Which of the
following findings should the nurse assess before administration?
A. Respiratory rate
B. Apical pulse
C. Temperature
D. Oxygen saturation
Correct Answer: B
Rationale: Metoprolol is a beta-blocker that decreases heart rate. The nurse should assess
the apical pulse before administration. If the heart rate is below 60 bpm, the dose should
be held and the provider notified. Respiratory rate (A), temperature (C), and oxygen
saturation (D) are important but not specific to beta-blocker administration.
, 6. A client is prescribed furosemide. Which of the following laboratory values
should the nurse monitor?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum phosphorus
Correct Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss (hypokalemia). Serum
potassium should be monitored closely. Calcium (B), magnesium (C), and phosphorus (D)
can be affected but potassium is the priority.
7. A nurse is administering spironolactone to a client with heart failure. Which of
the following findings indicates a therapeutic response?
A. Increased urine output
B. Decreased blood pressure
C. Weight loss
D. All of the above
Correct Answer: D
Rationale: Spironolactone is a potassium-sparing diuretic that promotes diuresis, reduces
fluid retention, and lowers blood pressure. Increased urine output (A), decreased blood
pressure (B), and weight loss (C) all indicate a therapeutic response.
8. A client is prescribed nitroglycerin sublingual. Which of the following
instructions should the nurse include?
A. "Swallow the tablet with water."
