ATI PN PHARMACOLOGY 2026 PROCTORED EXAM LEVEL 3 WITH QUESTIONS – 60 ATI-STYLE
PRACTICE QUESTIONS AND DETAILED RATIONALES
Core Domains
Cardiovascular and Hematologic Pharmacology
Antimicrobial and Anti-Infective Pharmacology
Endocrine Pharmacology
Central Nervous System Pharmacology
Gastrointestinal and Respiratory Pharmacology
Pharmacokinetics and Pharmacodynamics
Medication Safety and Administration
Introduction
This comprehensive assessment is designed to evaluate the practical nursing student's mastery of
pharmacologic principles essential for safe, effective medication administration. It assesses the
candidate's ability to apply clinical judgment, prioritize patient safety, and integrate
pharmacokinetic and pharmacodynamic concepts with evidence-based nursing interventions. The
exam utilizes multiple-choice and scenario-based questions mirroring the ATI PN Pharmacology
Proctored Exam format. Emphasis is placed on recognizing adverse effects, monitoring parameters,
,patient teaching, and clinical decision-making across diverse medication classes. Success
demonstrates readiness for safe medication administration in professional nursing practice.
Section One: Cardiovascular and Hematologic Pharmacology (Questions 1–15)
1. A PN is caring for a client who is receiving digoxin (Lanoxin). Which assessment finding should
the PN report to the provider immediately?
A) Apical pulse of 62 beats per minute
B) Serum potassium level of 4.2 mEq/L
🟢 C) Nausea and visual disturbances with yellow halos around lights
D) Blood pressure of 130/80 mm Hg
🔴 RATIONALE: Nausea and visual disturbances (yellow-green halos) are classic signs of digoxin
toxicity. The therapeutic digoxin level is 0.8–2.0 ng/mL. Hypokalemia increases toxicity risk. A
pulse of 62 bpm is acceptable (hold if <60). Nausea with visual changes requires immediate
provider notification.
2. A PN is reinforcing teaching with a client who has a new prescription for warfarin (Coumadin).
Which statement by the client indicates a need for further teaching?
A) "I will eat the same amount of green leafy vegetables every week."
B) "I will use a soft toothbrush and electric razor."
🟢 C) "I can take ibuprofen for headaches because it is over-the-counter."
D) "I will have my INR checked regularly."
, 🔴 RATIONALE: Ibuprofen (NSAID) increases bleeding risk and should be avoided while taking
warfarin. Consistent vitamin K intake (green leafy vegetables) helps maintain stable INR. Soft
toothbrush/electric razor reduce bleeding risk. INR monitoring is essential.
3. A client is receiving a continuous heparin infusion. The PN notes a sudden drop in platelet
count from 250,000/mm³ to 90,000/mm³. Which action should the PN take first?
A) Administer protamine sulfate as ordered.
🟢 B) Stop the heparin infusion.
C) Increase the heparin rate to prevent clotting.
D) Obtain aPTT and INR levels.
🔴 RATIONALE: This platelet drop suggests heparin-induced thrombocytopenia (HIT), a life-
threatening prothrombotic condition. Heparin must be stopped immediately. Protamine sulfate
is for bleeding reversal, not HIT. aPTT monitoring is secondary.
4. A PN is preparing to administer furosemide (Lasix) 40 mg IV push. Which laboratory value
should the PN review before administration?
A) Serum creatinine
🟢 B) Serum potassium
C) Serum sodium
D) Hemoglobin
🔴 RATIONALE: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
increases the risk of cardiac arrhythmias, especially in clients taking digoxin. The PN should
PRACTICE QUESTIONS AND DETAILED RATIONALES
Core Domains
Cardiovascular and Hematologic Pharmacology
Antimicrobial and Anti-Infective Pharmacology
Endocrine Pharmacology
Central Nervous System Pharmacology
Gastrointestinal and Respiratory Pharmacology
Pharmacokinetics and Pharmacodynamics
Medication Safety and Administration
Introduction
This comprehensive assessment is designed to evaluate the practical nursing student's mastery of
pharmacologic principles essential for safe, effective medication administration. It assesses the
candidate's ability to apply clinical judgment, prioritize patient safety, and integrate
pharmacokinetic and pharmacodynamic concepts with evidence-based nursing interventions. The
exam utilizes multiple-choice and scenario-based questions mirroring the ATI PN Pharmacology
Proctored Exam format. Emphasis is placed on recognizing adverse effects, monitoring parameters,
,patient teaching, and clinical decision-making across diverse medication classes. Success
demonstrates readiness for safe medication administration in professional nursing practice.
Section One: Cardiovascular and Hematologic Pharmacology (Questions 1–15)
1. A PN is caring for a client who is receiving digoxin (Lanoxin). Which assessment finding should
the PN report to the provider immediately?
A) Apical pulse of 62 beats per minute
B) Serum potassium level of 4.2 mEq/L
🟢 C) Nausea and visual disturbances with yellow halos around lights
D) Blood pressure of 130/80 mm Hg
🔴 RATIONALE: Nausea and visual disturbances (yellow-green halos) are classic signs of digoxin
toxicity. The therapeutic digoxin level is 0.8–2.0 ng/mL. Hypokalemia increases toxicity risk. A
pulse of 62 bpm is acceptable (hold if <60). Nausea with visual changes requires immediate
provider notification.
2. A PN is reinforcing teaching with a client who has a new prescription for warfarin (Coumadin).
Which statement by the client indicates a need for further teaching?
A) "I will eat the same amount of green leafy vegetables every week."
B) "I will use a soft toothbrush and electric razor."
🟢 C) "I can take ibuprofen for headaches because it is over-the-counter."
D) "I will have my INR checked regularly."
, 🔴 RATIONALE: Ibuprofen (NSAID) increases bleeding risk and should be avoided while taking
warfarin. Consistent vitamin K intake (green leafy vegetables) helps maintain stable INR. Soft
toothbrush/electric razor reduce bleeding risk. INR monitoring is essential.
3. A client is receiving a continuous heparin infusion. The PN notes a sudden drop in platelet
count from 250,000/mm³ to 90,000/mm³. Which action should the PN take first?
A) Administer protamine sulfate as ordered.
🟢 B) Stop the heparin infusion.
C) Increase the heparin rate to prevent clotting.
D) Obtain aPTT and INR levels.
🔴 RATIONALE: This platelet drop suggests heparin-induced thrombocytopenia (HIT), a life-
threatening prothrombotic condition. Heparin must be stopped immediately. Protamine sulfate
is for bleeding reversal, not HIT. aPTT monitoring is secondary.
4. A PN is preparing to administer furosemide (Lasix) 40 mg IV push. Which laboratory value
should the PN review before administration?
A) Serum creatinine
🟢 B) Serum potassium
C) Serum sodium
D) Hemoglobin
🔴 RATIONALE: Furosemide is a loop diuretic that causes potassium wasting. Hypokalemia
increases the risk of cardiac arrhythmias, especially in clients taking digoxin. The PN should
