ATI Pharmacology 2026/2027 | ACTUAL-Style Practice Questions &
Answers, RN Nursing Exam Prep, Drug Classifications, Medication
Administration, Dosage Calculations, Adverse Effects, and Detailed
Rationales
Question 1: A nurse is preparing to administer IV morphine sulfate 2 mg
to a post-operative client who reports pain rated 8/10. The client's
respiratory rate is 9 breaths per minute and SpO₂ is 94%. The provider
prescribed morphine for pain greater than 6/10. What is the nurse's
priority action before administering the medication?
A. Administer the morphine and monitor every 15 minutes
B. Reassess pain in 30 minutes before proceeding
C. Hold the medication and notify the provider of respiratory depression
D. Administer naloxone concurrently to prevent adverse effects
CORRECT ANSWER: C. Hold the medication and notify the provider of
respiratory depression
Rationale: The client's respiratory rate of 9 breaths/min is below the normal
threshold of 12 breaths/min, indicating opioid-induced respiratory
depression, which is a life-threatening complication of morphine.
Administering morphine could worsen respiratory status and lead to
respiratory arrest. The nurse must withhold the dose and notify the provider
immediately .
Question 2: A nurse is reviewing medications for a client recently
diagnosed with tuberculosis who has been prescribed isoniazid and
rifampin. Which statement by the nurse is most appropriate during
client education?
A. "Rifampin may cause yellowing of the eyes, which is harmless."
B. "You should notify your provider if you experience numbness or tingling
in your hands or feet."
C. "You can stop taking isoniazid if you feel better after a few weeks."
D. "Take the medications with food to increase absorption."
CORRECT ANSWER: B. "You should notify your provider if you
experience numbness or tingling in your hands or feet."
Rationale: Isoniazid can cause peripheral neuropathy due to vitamin B6
depletion, manifested by numbness or tingling in the extremities. Clients
must report these symptoms immediately. Rifampin causes harmless
,orange-red discoloration of body fluids, not yellowing of eyes. TB
medications require strict adherence to prevent resistance .
Question 3: A nurse is caring for a client with heart failure receiving
digoxin 0.125 mg daily. The client reports nausea, anorexia, and blurred
vision. Vital signs include HR 56 bpm and BP 118/76. Lab values show
potassium 3.1 mEq/L and digoxin level 2.2 ng/mL. What is the nurse's
priority intervention?
A. Document findings and reassess in 1 hour
B. Administer potassium supplements and continue digoxin
C. Notify the provider of digoxin toxicity and hold the dose
D. Encourage intake of potassium-rich foods and fluids
CORRECT ANSWER: C. Notify the provider of digoxin toxicity and hold
the dose
Rationale: A digoxin level greater than 2.0 ng/mL with symptoms such as
nausea, anorexia, bradycardia, and vision changes strongly indicates
digoxin toxicity. Hypokalemia further increases sensitivity to digoxin and the
risk of arrhythmias. The nurse should hold the medication and notify the
provider immediately .
Question 4: A nurse is caring for a client with hypertension who has
been prescribed lisinopril. On the third day of therapy, the client
develops a persistent, dry cough. Which response by the nurse is most
appropriate?
A. "This is a common side effect caused by bradykinin accumulation."
B. "You should double your dose to counteract this effect."
C. "This indicates you are allergic to the medication and should stop
immediately."
D. "This will resolve within 24 hours of starting the medication."
CORRECT ANSWER: A. "This is a common side effect caused by
bradykinin accumulation."
Rationale: ACE inhibitors like lisinopril commonly cause a dry, persistent
cough due to accumulation of bradykinin. This occurs in approximately 10-
20% of clients and may require switching to an angiotensin receptor
blocker (ARB). The cough is not an allergic reaction and does not resolve
spontaneously .
,Question 5: A client is prescribed metformin for type 2 diabetes
mellitus. Which mechanism of action best describes how this
medication works?
A. Stimulates insulin secretion from pancreatic beta cells
B. Decreases hepatic glucose production and improves insulin sensitivity
C. Inhibits alpha-glucosidase enzymes in the small intestine
D. Increases glucose reabsorption in the renal tubules
CORRECT ANSWER: B. Decreases hepatic glucose production and
improves insulin sensitivity
Rationale: Metformin is a biguanide that works primarily by decreasing
hepatic glucose production and improving peripheral insulin sensitivity.
Unlike sulfonylureas, it does not stimulate insulin secretion. It is often used
as a first-line agent for type 2 diabetes because it does not cause weight
gain or hypoglycemia when used alone .
Question 6: A client taking warfarin for atrial fibrillation asks the nurse
about alcohol consumption. Which statement is most accurate?
A. Alcohol has no effect on warfarin metabolism
B. Occasional alcohol consumption is safe; chronic use may increase
anticoagulation effect
C. Alcohol should be completely avoided as it always decreases warfarin
effectiveness
D. Moderate alcohol consumption enhances warfarin's therapeutic effect
CORRECT ANSWER: B. Occasional alcohol consumption is safe;
chronic use may increase anticoagulation effect
Rationale: Warfarin is metabolized by the liver via cytochrome P450
enzymes. Chronic alcohol consumption can induce hepatic enzymes,
potentially increasing warfarin metabolism and decreasing its
anticoagulant effect; however, acute alcohol ingestion may inhibit
metabolism and increase anticoagulation effects. Clients should be
counseled about consistent alcohol consumption patterns and the need
for INR monitoring .
Question 7: A client is prescribed cephalexin for a respiratory tract
infection. Which assessment finding would contraindicate this
medication?
, A. History of seasonal allergies treated with antihistamines
B. History of penicillin anaphylaxis
C. Mild gastrointestinal upset with dairy products
D. Current use of acetaminophen for pain management
CORRECT ANSWER: B. History of penicillin anaphylaxis
Rationale: Cephalosporins have a 1-3% cross-reactivity with penicillins,
particularly if the client has experienced anaphylaxis to penicillins. A
history of penicillin anaphylaxis is a significant contraindication and
cephalosporins should be avoided or used with extreme caution. The other
options do not represent contraindications .
Question 8: A nurse administers morphine intravenously to a client with
severe post-operative pain. Which adverse effect requires immediate
nursing intervention?
A. Mild drowsiness and dry mouth
B. Constipation and urinary retention
C. Respiratory depression with decreased oxygen saturation
D. Flushing and mild tachycardia
CORRECT ANSWER: C. Respiratory depression with decreased oxygen
saturation
Rationale: Respiratory depression is the most life-threatening adverse
effect of opioid analgesics like morphine. The nurse must monitor
respiratory rate and oxygen saturation closely. Constipation, urinary
retention, and mild drowsiness are common but not immediately life-
threatening .
Question 9: A nurse is teaching a client about the use of an albuterol
inhaler for exercise-induced bronchospasm. Which instruction should
the nurse include?
A. Take the medication 30 minutes after exercise
B. This medication is for long-term control of asthma
C. Limit fluid intake while taking this medication
D. Wait 1 minute between inhalations of the same medication
CORRECT ANSWER: D. Wait 1 minute between inhalations of the same
medication
Answers, RN Nursing Exam Prep, Drug Classifications, Medication
Administration, Dosage Calculations, Adverse Effects, and Detailed
Rationales
Question 1: A nurse is preparing to administer IV morphine sulfate 2 mg
to a post-operative client who reports pain rated 8/10. The client's
respiratory rate is 9 breaths per minute and SpO₂ is 94%. The provider
prescribed morphine for pain greater than 6/10. What is the nurse's
priority action before administering the medication?
A. Administer the morphine and monitor every 15 minutes
B. Reassess pain in 30 minutes before proceeding
C. Hold the medication and notify the provider of respiratory depression
D. Administer naloxone concurrently to prevent adverse effects
CORRECT ANSWER: C. Hold the medication and notify the provider of
respiratory depression
Rationale: The client's respiratory rate of 9 breaths/min is below the normal
threshold of 12 breaths/min, indicating opioid-induced respiratory
depression, which is a life-threatening complication of morphine.
Administering morphine could worsen respiratory status and lead to
respiratory arrest. The nurse must withhold the dose and notify the provider
immediately .
Question 2: A nurse is reviewing medications for a client recently
diagnosed with tuberculosis who has been prescribed isoniazid and
rifampin. Which statement by the nurse is most appropriate during
client education?
A. "Rifampin may cause yellowing of the eyes, which is harmless."
B. "You should notify your provider if you experience numbness or tingling
in your hands or feet."
C. "You can stop taking isoniazid if you feel better after a few weeks."
D. "Take the medications with food to increase absorption."
CORRECT ANSWER: B. "You should notify your provider if you
experience numbness or tingling in your hands or feet."
Rationale: Isoniazid can cause peripheral neuropathy due to vitamin B6
depletion, manifested by numbness or tingling in the extremities. Clients
must report these symptoms immediately. Rifampin causes harmless
,orange-red discoloration of body fluids, not yellowing of eyes. TB
medications require strict adherence to prevent resistance .
Question 3: A nurse is caring for a client with heart failure receiving
digoxin 0.125 mg daily. The client reports nausea, anorexia, and blurred
vision. Vital signs include HR 56 bpm and BP 118/76. Lab values show
potassium 3.1 mEq/L and digoxin level 2.2 ng/mL. What is the nurse's
priority intervention?
A. Document findings and reassess in 1 hour
B. Administer potassium supplements and continue digoxin
C. Notify the provider of digoxin toxicity and hold the dose
D. Encourage intake of potassium-rich foods and fluids
CORRECT ANSWER: C. Notify the provider of digoxin toxicity and hold
the dose
Rationale: A digoxin level greater than 2.0 ng/mL with symptoms such as
nausea, anorexia, bradycardia, and vision changes strongly indicates
digoxin toxicity. Hypokalemia further increases sensitivity to digoxin and the
risk of arrhythmias. The nurse should hold the medication and notify the
provider immediately .
Question 4: A nurse is caring for a client with hypertension who has
been prescribed lisinopril. On the third day of therapy, the client
develops a persistent, dry cough. Which response by the nurse is most
appropriate?
A. "This is a common side effect caused by bradykinin accumulation."
B. "You should double your dose to counteract this effect."
C. "This indicates you are allergic to the medication and should stop
immediately."
D. "This will resolve within 24 hours of starting the medication."
CORRECT ANSWER: A. "This is a common side effect caused by
bradykinin accumulation."
Rationale: ACE inhibitors like lisinopril commonly cause a dry, persistent
cough due to accumulation of bradykinin. This occurs in approximately 10-
20% of clients and may require switching to an angiotensin receptor
blocker (ARB). The cough is not an allergic reaction and does not resolve
spontaneously .
,Question 5: A client is prescribed metformin for type 2 diabetes
mellitus. Which mechanism of action best describes how this
medication works?
A. Stimulates insulin secretion from pancreatic beta cells
B. Decreases hepatic glucose production and improves insulin sensitivity
C. Inhibits alpha-glucosidase enzymes in the small intestine
D. Increases glucose reabsorption in the renal tubules
CORRECT ANSWER: B. Decreases hepatic glucose production and
improves insulin sensitivity
Rationale: Metformin is a biguanide that works primarily by decreasing
hepatic glucose production and improving peripheral insulin sensitivity.
Unlike sulfonylureas, it does not stimulate insulin secretion. It is often used
as a first-line agent for type 2 diabetes because it does not cause weight
gain or hypoglycemia when used alone .
Question 6: A client taking warfarin for atrial fibrillation asks the nurse
about alcohol consumption. Which statement is most accurate?
A. Alcohol has no effect on warfarin metabolism
B. Occasional alcohol consumption is safe; chronic use may increase
anticoagulation effect
C. Alcohol should be completely avoided as it always decreases warfarin
effectiveness
D. Moderate alcohol consumption enhances warfarin's therapeutic effect
CORRECT ANSWER: B. Occasional alcohol consumption is safe;
chronic use may increase anticoagulation effect
Rationale: Warfarin is metabolized by the liver via cytochrome P450
enzymes. Chronic alcohol consumption can induce hepatic enzymes,
potentially increasing warfarin metabolism and decreasing its
anticoagulant effect; however, acute alcohol ingestion may inhibit
metabolism and increase anticoagulation effects. Clients should be
counseled about consistent alcohol consumption patterns and the need
for INR monitoring .
Question 7: A client is prescribed cephalexin for a respiratory tract
infection. Which assessment finding would contraindicate this
medication?
, A. History of seasonal allergies treated with antihistamines
B. History of penicillin anaphylaxis
C. Mild gastrointestinal upset with dairy products
D. Current use of acetaminophen for pain management
CORRECT ANSWER: B. History of penicillin anaphylaxis
Rationale: Cephalosporins have a 1-3% cross-reactivity with penicillins,
particularly if the client has experienced anaphylaxis to penicillins. A
history of penicillin anaphylaxis is a significant contraindication and
cephalosporins should be avoided or used with extreme caution. The other
options do not represent contraindications .
Question 8: A nurse administers morphine intravenously to a client with
severe post-operative pain. Which adverse effect requires immediate
nursing intervention?
A. Mild drowsiness and dry mouth
B. Constipation and urinary retention
C. Respiratory depression with decreased oxygen saturation
D. Flushing and mild tachycardia
CORRECT ANSWER: C. Respiratory depression with decreased oxygen
saturation
Rationale: Respiratory depression is the most life-threatening adverse
effect of opioid analgesics like morphine. The nurse must monitor
respiratory rate and oxygen saturation closely. Constipation, urinary
retention, and mild drowsiness are common but not immediately life-
threatening .
Question 9: A nurse is teaching a client about the use of an albuterol
inhaler for exercise-induced bronchospasm. Which instruction should
the nurse include?
A. Take the medication 30 minutes after exercise
B. This medication is for long-term control of asthma
C. Limit fluid intake while taking this medication
D. Wait 1 minute between inhalations of the same medication
CORRECT ANSWER: D. Wait 1 minute between inhalations of the same
medication
