ATI PN PHARMACOLOGY PROCTORED EXAM V7 2026/2027 - 400 VERIFIED QUESTIONS WITH
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V7 2026/2027 | 400Q Mixed A/B/C/D: A=101 B=90 C=99 D=110 | 2026/2027 - No
Repeat Edition
9 new versions - 100% unique questions - no repeat from previous PN Pharm file. Original 2026/2027 content, mixed keys.
1. [V7] Amoxicillin allergic reaction first? - Case 1 PN Pharm 2026/2027
A. Double dose
B. Give next dose
C. Take with milk
D. Stop drug, notify provider, assess airway - anaphylaxis risk
Answer: D
Rationale: Penicillin allergy stop drug, airway assessment. - Version 7 2026/2027
2. [V7] Acetaminophen max dose PN? - Case 2 PN Pharm 2026/2027
A. 3-4g/day adult max - liver toxicity >4g, avoid alcohol
B. 8g
C. 10g/day
D. No max
Answer: A
Rationale: Acetaminophen max 3-4g/day. - Version 7 2026/2027
3. [V7] Levothyroxine teaching? - Case 3 PN Pharm 2026/2027
A. Take with iron
B. Take 30-60 min before breakfast on empty stomach, same time daily
C. Take with milk
D. Take with food, at night
Answer: B
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 7 2026/2027
4. [V7] Lisinopril causes dry cough due to? - Case 4 PN Pharm 2026/2027
A. Histamine
B. K+ loss
C. Bradykinin accumulation in lungs - ACE inhibitor side effect
D. Na retention
Answer: C
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 7 2026/2027
5. [V7] Loperamide use? - Case 5 PN Pharm 2026/2027
A. Fever
B. Pain
C. Constipation
D. Diarrhea - anti-diarrheal, monitor fluid/electrolytes
Answer: D
Rationale: Loperamide anti-diarrheal. - Version 7 2026/2027
6. [V7] Fluoxetine (SSRI) onset? - Case 6 PN Pharm 2026/2027
A. No onset
B. Immediate
C. 2-4 weeks for full effect, watch for increased suicidal ideation early
D. 1 hour
Answer: C
Rationale: SSRI 2-4 weeks, black box suicide early. - Version 7 2026/2027
7. [V7] Atropine use? - Case 7 PN Pharm 2026/2027
A. Bradycardia symptomatic, organophosphate poisoning antidote
B. No use
C. Hypertension
D. Tachycardia
Answer: A
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 7 2026/2027
8. [V7] Omeprazole teaching? - Case 8 PN Pharm 2026/2027
A. No risk
B. Double dose
C. Take 30 min before breakfast, long-term risk fractures, low Mg2+
, D. Take with food always
Answer: C
Rationale: PPI before breakfast. - Version 7 2026/2027
9. [V7] Insulin lispro onset? - Case 9 PN Pharm 2026/2027
A. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
B. 2 hours
C. 6 hours
D. 12 hours
Answer: A
Rationale: Lispro rapid 15 min onset. - Version 7 2026/2027
10. [V7] Iron supplement teaching? - Case 10 PN Pharm 2026/2027
A. Take with OJ/Vit C on empty stomach, dark green stools normal, constipation
B. Take with antacid
C. No teaching
D. Take with milk
Answer: A
Rationale: Iron with Vit C, dark stools normal. - Version 7 2026/2027
11. [V7] Psyllium teaching? - Case 11 PN Pharm 2026/2027
A. Take with full glass water, may cause bloating, fiber
B. Take dry
C. No water
D. At bedtime only
Answer: A
Rationale: Psyllium needs water. - Version 7 2026/2027
12. [V7] Benzodiazepine overdose antidote? - Case 12 PN Pharm 2026/2027
A. Vitamin K
B. Protamine
C. Naloxone
D. Flumazenil
Answer: D
Rationale: Flumazenil reverses benzos, risk seizures. - Version 7 2026/2027
13. [V7] Hypoglycemia treatment conscious PN? - Case 13 PN Pharm 2026/2027
A. No treatment
B. Give insulin
C. 15g fast carb juice/glucose tabs, recheck 15 min, repeat if <70
D. Water
Answer: C
Rationale: Rule of 15 for hypo. - Version 7 2026/2027
14. [V7] Morphine side effects PN monitor? - Case 14 PN Pharm 2026/2027
A. No effects
B. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
C. Diarrhea
D. Tachycardia only
Answer: B
Rationale: Opioid side effects resp depression. - Version 7 2026/2027
15. [V7] Albuterol side effects? - Case 15 PN Pharm 2026/2027
A. Bradycardia
B. Weight gain
C. Tachycardia, tremor, nervousness - beta2 agonist
D. Cough always
Answer: C
Rationale: Albuterol tachycardia, tremor. - Version 7 2026/2027
16. [V7] Docusate use? - Case 16 PN Pharm 2026/2027
A. Stimulant
B. Fever
C. Pain
D. Stool softener - softens stool, needs fluids
Answer: D
Rationale: Docusate softener. - Version 7 2026/2027
17. [V7] Potassium chloride administration? - Case 17 PN Pharm 2026/2027
, A. IV push
B. Never IV push - dilute, give via pump, check kidney function, monitor EKG
C. No monitor
D. Give fast
Answer: B
Rationale: KCl never IV push, dilute. - Version 7 2026/2027
18. [V7] Metronidazole teaching? - Case 18 PN Pharm 2026/2027
A. Drink alcohol
B. No teaching
C. Avoid alcohol during and 48h after - disulfiram reaction nausea/vomiting
D. Take with alcohol
Answer: C
Rationale: Flagyl no alcohol disulfiram. - Version 7 2026/2027
19. [V7] Metformin and contrast dye - why hold? - Case 19 PN Pharm 2026/2027
A. Risk lactic acidosis if contrast-induced AKI - hold 48h before/after per protocol
B. Causes HTN
C. No reason
D. Causes hyperglycemia
Answer: A
Rationale: Hold metformin before contrast to prevent lactic acidosis with AKI. - Version 7 2026/2027
20. [V7] Acetaminophen overdose antidote? - Case 20 PN Pharm 2026/2027
A. Vitamin K
B. Naloxone
C. N-acetylcysteine (NAC) within 8 hours
D. Protamine
Answer: C
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 7 2026/2027
21. [V7] Ondansetron use? - Case 21 PN Pharm 2026/2027
A. Pain
B. Diarrhea
C. Fever
D. Nausea/vomiting - monitor QT, headache, constipation
Answer: D
Rationale: Zofran antiemetic QT risk. - Version 7 2026/2027
22. [V7] Opioid overdose antidote? - Case 22 PN Pharm 2026/2027
A. Flumazenil
B. Naloxone - may need repeat due to short half-life
C. Vitamin K
D. Protamine
Answer: B
Rationale: Naloxone opioid antagonist, monitor for re-sedation. - Version 7 2026/2027
23. [V7] PN role in blood transfusion? - Case 23 PN Pharm 2026/2027
A. Crossmatch
B. Order blood
C. Start transfusion
D. Monitor transfusion, vitals q15min, stop if reaction, notify RN/provider
Answer: D
Rationale: PN monitors transfusion, stops if reaction. - Version 7 2026/2027
24. [V7] Digoxin antidote? - Case 24 PN Pharm 2026/2027
A. Protamine
B. Naloxone
C. Vitamin K
D. Digoxin immune Fab (Digibind)
Answer: D
Rationale: Digibind binds digoxin in toxicity. - Version 7 2026/2027
25. [V7] Glargine (Lantus) rule? - Case 25 PN Pharm 2026/2027
A. Give with meals only
B. Mix with regular
C. Do not mix, given at same time daily, no peak - basal insulin
D. IV push
, Answer: C
Rationale: Glargine long-acting no mix, basal. - Version 7 2026/2027
26. [V7] Prednisone long-term side effects? - Case 26 PN Pharm 2026/2027
A. No effects
B. Weight gain, hyperglycemia, moon face, buffalo hump, osteoporosis, infection risk
C. Hypoglycemia
D. Weight loss
Answer: B
Rationale: Steroids cause Cushingoid appearance, hyperglycemia, osteoporosis. - Version 7 2026/2027
27. [V7] Epinephrine use in anaphylaxis? - Case 27 PN Pharm 2026/2027
A. Bradycardia only
B. No use
C. Hypotension only
D. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
Answer: D
Rationale: Epi first in anaphylaxis IM. - Version 7 2026/2027
28. [V7] Ibuprofen contraindication? - Case 28 PN Pharm 2026/2027
A. No risk
B. Avoid in ulcer, GI bleed, kidney disease, pregnancy 3rd trimester, bleeding risk
C. Safe always
D. No contraindication
Answer: B
Rationale: NSAID contraindications GI bleed, renal. - Version 7 2026/2027
29. [V7] Furosemide expected side effect? - Case 29 PN Pharm 2026/2027
A. No side effects
B. Hyperkalemia
C. Hypokalemia, hypotension, dehydration - monitor K+, I&O;, BP
D. Hypernatremia
Answer: C
Rationale: Loop diuretic wastes K+ - monitor hypokalemia, give K+ rich foods. - Version 7 2026/2027
30. [V7] Warfarin antidote for bleeding? - Case 30 PN Pharm 2026/2027
A. Vitamin K + 4F-PCC for life-threatening
B. Calcium
C. Protamine
D. Naloxone
Answer: A
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 7 2026/2027
31. [V7] A client taking amlodipine reports ankle swelling. Best response? - Case 31 PN Pharm 2026/2027
A. Stop drug immediately
B. Take double dose
C. Ankle swelling common with amlodipine - elevate legs, notify provider if worsens, monitor BP
D. No action
Answer: C
Rationale: CCB amlodipine causes peripheral edema - elevate legs, monitor. - Version 7 2026/2027
32. [V7] Phenytoin teaching? - Case 32 PN Pharm 2026/2027
A. Skip doses
B. Double dose if missed
C. No hygiene
D. Good oral hygiene, avoid alcohol, therapeutic 10-20 mcg/mL, gum hyperplasia risk
Answer: D
Rationale: Phenytoin gum hyperplasia, hygiene. - Version 7 2026/2027
33. [V7] Montelukast when to take? - Case 33 PN Pharm 2026/2027
A. Morning only
B. Evening - asthma prophylaxis, not rescue
C. During attack only
D. No timing
Answer: B
Rationale: Montelukast evening daily, not rescue. - Version 7 2026/2027
34. [V7] LPN cannot do IV push - Case 34 PN Pharm 2026/2027
A. Can do IV push
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V7 2026/2027 | 400Q Mixed A/B/C/D: A=101 B=90 C=99 D=110 | 2026/2027 - No
Repeat Edition
9 new versions - 100% unique questions - no repeat from previous PN Pharm file. Original 2026/2027 content, mixed keys.
1. [V7] Amoxicillin allergic reaction first? - Case 1 PN Pharm 2026/2027
A. Double dose
B. Give next dose
C. Take with milk
D. Stop drug, notify provider, assess airway - anaphylaxis risk
Answer: D
Rationale: Penicillin allergy stop drug, airway assessment. - Version 7 2026/2027
2. [V7] Acetaminophen max dose PN? - Case 2 PN Pharm 2026/2027
A. 3-4g/day adult max - liver toxicity >4g, avoid alcohol
B. 8g
C. 10g/day
D. No max
Answer: A
Rationale: Acetaminophen max 3-4g/day. - Version 7 2026/2027
3. [V7] Levothyroxine teaching? - Case 3 PN Pharm 2026/2027
A. Take with iron
B. Take 30-60 min before breakfast on empty stomach, same time daily
C. Take with milk
D. Take with food, at night
Answer: B
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 7 2026/2027
4. [V7] Lisinopril causes dry cough due to? - Case 4 PN Pharm 2026/2027
A. Histamine
B. K+ loss
C. Bradykinin accumulation in lungs - ACE inhibitor side effect
D. Na retention
Answer: C
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 7 2026/2027
5. [V7] Loperamide use? - Case 5 PN Pharm 2026/2027
A. Fever
B. Pain
C. Constipation
D. Diarrhea - anti-diarrheal, monitor fluid/electrolytes
Answer: D
Rationale: Loperamide anti-diarrheal. - Version 7 2026/2027
6. [V7] Fluoxetine (SSRI) onset? - Case 6 PN Pharm 2026/2027
A. No onset
B. Immediate
C. 2-4 weeks for full effect, watch for increased suicidal ideation early
D. 1 hour
Answer: C
Rationale: SSRI 2-4 weeks, black box suicide early. - Version 7 2026/2027
7. [V7] Atropine use? - Case 7 PN Pharm 2026/2027
A. Bradycardia symptomatic, organophosphate poisoning antidote
B. No use
C. Hypertension
D. Tachycardia
Answer: A
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 7 2026/2027
8. [V7] Omeprazole teaching? - Case 8 PN Pharm 2026/2027
A. No risk
B. Double dose
C. Take 30 min before breakfast, long-term risk fractures, low Mg2+
, D. Take with food always
Answer: C
Rationale: PPI before breakfast. - Version 7 2026/2027
9. [V7] Insulin lispro onset? - Case 9 PN Pharm 2026/2027
A. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
B. 2 hours
C. 6 hours
D. 12 hours
Answer: A
Rationale: Lispro rapid 15 min onset. - Version 7 2026/2027
10. [V7] Iron supplement teaching? - Case 10 PN Pharm 2026/2027
A. Take with OJ/Vit C on empty stomach, dark green stools normal, constipation
B. Take with antacid
C. No teaching
D. Take with milk
Answer: A
Rationale: Iron with Vit C, dark stools normal. - Version 7 2026/2027
11. [V7] Psyllium teaching? - Case 11 PN Pharm 2026/2027
A. Take with full glass water, may cause bloating, fiber
B. Take dry
C. No water
D. At bedtime only
Answer: A
Rationale: Psyllium needs water. - Version 7 2026/2027
12. [V7] Benzodiazepine overdose antidote? - Case 12 PN Pharm 2026/2027
A. Vitamin K
B. Protamine
C. Naloxone
D. Flumazenil
Answer: D
Rationale: Flumazenil reverses benzos, risk seizures. - Version 7 2026/2027
13. [V7] Hypoglycemia treatment conscious PN? - Case 13 PN Pharm 2026/2027
A. No treatment
B. Give insulin
C. 15g fast carb juice/glucose tabs, recheck 15 min, repeat if <70
D. Water
Answer: C
Rationale: Rule of 15 for hypo. - Version 7 2026/2027
14. [V7] Morphine side effects PN monitor? - Case 14 PN Pharm 2026/2027
A. No effects
B. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
C. Diarrhea
D. Tachycardia only
Answer: B
Rationale: Opioid side effects resp depression. - Version 7 2026/2027
15. [V7] Albuterol side effects? - Case 15 PN Pharm 2026/2027
A. Bradycardia
B. Weight gain
C. Tachycardia, tremor, nervousness - beta2 agonist
D. Cough always
Answer: C
Rationale: Albuterol tachycardia, tremor. - Version 7 2026/2027
16. [V7] Docusate use? - Case 16 PN Pharm 2026/2027
A. Stimulant
B. Fever
C. Pain
D. Stool softener - softens stool, needs fluids
Answer: D
Rationale: Docusate softener. - Version 7 2026/2027
17. [V7] Potassium chloride administration? - Case 17 PN Pharm 2026/2027
, A. IV push
B. Never IV push - dilute, give via pump, check kidney function, monitor EKG
C. No monitor
D. Give fast
Answer: B
Rationale: KCl never IV push, dilute. - Version 7 2026/2027
18. [V7] Metronidazole teaching? - Case 18 PN Pharm 2026/2027
A. Drink alcohol
B. No teaching
C. Avoid alcohol during and 48h after - disulfiram reaction nausea/vomiting
D. Take with alcohol
Answer: C
Rationale: Flagyl no alcohol disulfiram. - Version 7 2026/2027
19. [V7] Metformin and contrast dye - why hold? - Case 19 PN Pharm 2026/2027
A. Risk lactic acidosis if contrast-induced AKI - hold 48h before/after per protocol
B. Causes HTN
C. No reason
D. Causes hyperglycemia
Answer: A
Rationale: Hold metformin before contrast to prevent lactic acidosis with AKI. - Version 7 2026/2027
20. [V7] Acetaminophen overdose antidote? - Case 20 PN Pharm 2026/2027
A. Vitamin K
B. Naloxone
C. N-acetylcysteine (NAC) within 8 hours
D. Protamine
Answer: C
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 7 2026/2027
21. [V7] Ondansetron use? - Case 21 PN Pharm 2026/2027
A. Pain
B. Diarrhea
C. Fever
D. Nausea/vomiting - monitor QT, headache, constipation
Answer: D
Rationale: Zofran antiemetic QT risk. - Version 7 2026/2027
22. [V7] Opioid overdose antidote? - Case 22 PN Pharm 2026/2027
A. Flumazenil
B. Naloxone - may need repeat due to short half-life
C. Vitamin K
D. Protamine
Answer: B
Rationale: Naloxone opioid antagonist, monitor for re-sedation. - Version 7 2026/2027
23. [V7] PN role in blood transfusion? - Case 23 PN Pharm 2026/2027
A. Crossmatch
B. Order blood
C. Start transfusion
D. Monitor transfusion, vitals q15min, stop if reaction, notify RN/provider
Answer: D
Rationale: PN monitors transfusion, stops if reaction. - Version 7 2026/2027
24. [V7] Digoxin antidote? - Case 24 PN Pharm 2026/2027
A. Protamine
B. Naloxone
C. Vitamin K
D. Digoxin immune Fab (Digibind)
Answer: D
Rationale: Digibind binds digoxin in toxicity. - Version 7 2026/2027
25. [V7] Glargine (Lantus) rule? - Case 25 PN Pharm 2026/2027
A. Give with meals only
B. Mix with regular
C. Do not mix, given at same time daily, no peak - basal insulin
D. IV push
, Answer: C
Rationale: Glargine long-acting no mix, basal. - Version 7 2026/2027
26. [V7] Prednisone long-term side effects? - Case 26 PN Pharm 2026/2027
A. No effects
B. Weight gain, hyperglycemia, moon face, buffalo hump, osteoporosis, infection risk
C. Hypoglycemia
D. Weight loss
Answer: B
Rationale: Steroids cause Cushingoid appearance, hyperglycemia, osteoporosis. - Version 7 2026/2027
27. [V7] Epinephrine use in anaphylaxis? - Case 27 PN Pharm 2026/2027
A. Bradycardia only
B. No use
C. Hypotension only
D. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
Answer: D
Rationale: Epi first in anaphylaxis IM. - Version 7 2026/2027
28. [V7] Ibuprofen contraindication? - Case 28 PN Pharm 2026/2027
A. No risk
B. Avoid in ulcer, GI bleed, kidney disease, pregnancy 3rd trimester, bleeding risk
C. Safe always
D. No contraindication
Answer: B
Rationale: NSAID contraindications GI bleed, renal. - Version 7 2026/2027
29. [V7] Furosemide expected side effect? - Case 29 PN Pharm 2026/2027
A. No side effects
B. Hyperkalemia
C. Hypokalemia, hypotension, dehydration - monitor K+, I&O;, BP
D. Hypernatremia
Answer: C
Rationale: Loop diuretic wastes K+ - monitor hypokalemia, give K+ rich foods. - Version 7 2026/2027
30. [V7] Warfarin antidote for bleeding? - Case 30 PN Pharm 2026/2027
A. Vitamin K + 4F-PCC for life-threatening
B. Calcium
C. Protamine
D. Naloxone
Answer: A
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 7 2026/2027
31. [V7] A client taking amlodipine reports ankle swelling. Best response? - Case 31 PN Pharm 2026/2027
A. Stop drug immediately
B. Take double dose
C. Ankle swelling common with amlodipine - elevate legs, notify provider if worsens, monitor BP
D. No action
Answer: C
Rationale: CCB amlodipine causes peripheral edema - elevate legs, monitor. - Version 7 2026/2027
32. [V7] Phenytoin teaching? - Case 32 PN Pharm 2026/2027
A. Skip doses
B. Double dose if missed
C. No hygiene
D. Good oral hygiene, avoid alcohol, therapeutic 10-20 mcg/mL, gum hyperplasia risk
Answer: D
Rationale: Phenytoin gum hyperplasia, hygiene. - Version 7 2026/2027
33. [V7] Montelukast when to take? - Case 33 PN Pharm 2026/2027
A. Morning only
B. Evening - asthma prophylaxis, not rescue
C. During attack only
D. No timing
Answer: B
Rationale: Montelukast evening daily, not rescue. - Version 7 2026/2027
34. [V7] LPN cannot do IV push - Case 34 PN Pharm 2026/2027
A. Can do IV push
