ATI PN PHARMACOLOGY ATI PN Pharmacology 2026
Proctored Exam Comprising NGN and All Questions
and Answers
Correct answer • Full rationale • Why each option is right or wrong • Test-taking tip
How to use this key
• Start with the Quick Answer Grid to score yourself, then study every rationale—including the ones you
answered correctly. ATI questions often recycle the same concept in a new scenario.
• Each question is reprinted with its options so the key can be studied on its own.
• “Option-by-option analysis” explains why each correct choice is correct and exactly why each distractor is
wrong. Learning the distractors is the fastest way to raise your score.
• Scoring guide (approximate): 90%+ (162+) excellent; 80–89% (144–161) strong; 70–79% (126–143) review
weak systems; below 70% re-study the high-yield tips and retake.
,Quick Answer Grid
1 C 37 B, D, E, F 73 A 109 A 145 B
2 B 38 B 74 D 110 A 146 A
3 A, B, C, F 39 B 75 A 111 D 147 D
4 A 40 A 76 B 112 A 148 B
5 B 41 D 77 A, B, C, D 113 A 149 D
6 B 42 D 78 B, C, D, E, F 114 D 150 A, B, C, D
7 B 43 C, D, E, F 79 B 115 B 151 B
8 B, C, E, F 44 D 80 A 116 B 152 B
9 B 45 A 81 A 117 D 153 A
10 C 46 B 82 D 118 A, B, E, F 154 A
11 B, C, D, F 47 A, B, C, E 83 A 119 B 155 A
12 B 48 C 84 D 120 A 156 A
13 D 49 B, C, D, E 85 B, C, D, F 121 B 157 C
14 A, B, C, D 50 A 86 C 122 C 158 A, D, E
15 C 51 B 87 A 123 C 159 C
16 A, B, E, F 52 B 88 C 124 D 160 C
17 D 53 B 89 B 125 A 161 C
18 C 54 C 90 C, D, E, F 126 D 162 B
19 B 55 B, C, D, F 91 D 127 A 163 B
20 A 56 B 92 D 128 B, C, D, F 164 D
21 A, C, E, F 57 A 93 A 129 B, C, D, E, F 165 D
22 B 58 B 94 A, B, C, E 130 A 166 B
23 C 59 A 95 B 131 A 167 B
24 C 60 A, B, C, F 96 C 132 C 168 C
25 B 61 A 97 A 133 A 169 A, B, D
26 A, B, C, D 62 D 98 D 134 C 170 D
27 D 63 D 99 A, B, D, E 135 D 171 D
28 A 64 A, B, E, F 100 A 136 D 172 B
29 B 65 C 101 A 137 C, E, F 173 C
30 D 66 D 102 B 138 C 174 C
31 C 67 C 103 A 139 C 175 D
32 B, C, D, E 68 A 104 C 140 D 176 C
,33 B 69 D 105 B, C, E, F 141 A, D, E, F 177 D
34 C 70 B 106 A, C, D, F 142 A 178 A, B, D, E
35 B 71 A 107 A 143 C 179 A
36 B 72 B, C, D, F 108 B 144 A 180 C, D, E, F
, ATI PN Pharmacology 2026 — Answer Key & Rationales
Question 1 Multiple Choice | Pharmacological Principles & Safe Medication Administration
A practical nurse (PN) is preparing to administer digoxin 0.125 mg PO to an adult client with chronic heart
failure. The nurse counts an apical pulse of 54/min for one full minute. The client denies dizziness and the
blood pressure is 118/72 mm Hg. Which action should the nurse take?
A. Administer half of the prescribed dose and document the finding.
B. Administer the medication with a potassium supplement to prevent toxicity.
C. Withhold the medication, document the apical rate, and notify the provider.
D. Administer the medication and recheck the apical pulse in 1 hour.
CORRECT ANSWER: C
Rationale
Digoxin increases myocardial contractility (positive inotrope) while slowing the heart rate (negative
chronotrope) and AV conduction (negative dromotrope). Because of its narrow therapeutic index (0.5–2.0
ng/mL; many references target 0.5–1.0 ng/mL in heart failure), the nurse always takes a full-minute apical
pulse before administration. Hold parameters: adults < 60/min, children < 70/min, infants < 90–110/min. A
rate of 54/min means the drug must be withheld, the finding documented, and the provider notified. Absence
of symptoms does not change the action—the parameter, not the symptom, drives the decision.
Option-by-option analysis
✘ A. Administer half of the prescribed dose and document the finding. — Incorrect. Altering a dose is a
prescriptive decision outside the PN scope. A partial dose is still a medication error and still slows the
heart.
✘ B. Administer the medication with a potassium supplement to prevent toxicity. — Incorrect. Potassium is
only given when prescribed and when the level is known to be low. It does not make digoxin safe to
give when the heart rate is already below the hold parameter.
✔ C. Withhold the medication, document the apical rate, and notify the provider. — Correct. Digoxin slows
conduction through the AV node (negative chronotrope). The standard hold parameter for adults is an
apical pulse below 60/min. The nurse withholds, documents the reason, and reports so the provider
can check a digoxin level, potassium, and decide on further dosing.
✘ D. Administer the medication and recheck the apical pulse in 1 hour. — Incorrect. Giving digoxin to an
adult with an apical rate below 60/min can deepen bradycardia and precipitate heart block. Rechecking
after the dose does not undo the risk that already occurred.
High-yield tip: Digoxin = always count an APICAL pulse for a FULL minute. Below 60 (adult) → hold, document,
report.
Answer Key • Page 4
Proctored Exam Comprising NGN and All Questions
and Answers
Correct answer • Full rationale • Why each option is right or wrong • Test-taking tip
How to use this key
• Start with the Quick Answer Grid to score yourself, then study every rationale—including the ones you
answered correctly. ATI questions often recycle the same concept in a new scenario.
• Each question is reprinted with its options so the key can be studied on its own.
• “Option-by-option analysis” explains why each correct choice is correct and exactly why each distractor is
wrong. Learning the distractors is the fastest way to raise your score.
• Scoring guide (approximate): 90%+ (162+) excellent; 80–89% (144–161) strong; 70–79% (126–143) review
weak systems; below 70% re-study the high-yield tips and retake.
,Quick Answer Grid
1 C 37 B, D, E, F 73 A 109 A 145 B
2 B 38 B 74 D 110 A 146 A
3 A, B, C, F 39 B 75 A 111 D 147 D
4 A 40 A 76 B 112 A 148 B
5 B 41 D 77 A, B, C, D 113 A 149 D
6 B 42 D 78 B, C, D, E, F 114 D 150 A, B, C, D
7 B 43 C, D, E, F 79 B 115 B 151 B
8 B, C, E, F 44 D 80 A 116 B 152 B
9 B 45 A 81 A 117 D 153 A
10 C 46 B 82 D 118 A, B, E, F 154 A
11 B, C, D, F 47 A, B, C, E 83 A 119 B 155 A
12 B 48 C 84 D 120 A 156 A
13 D 49 B, C, D, E 85 B, C, D, F 121 B 157 C
14 A, B, C, D 50 A 86 C 122 C 158 A, D, E
15 C 51 B 87 A 123 C 159 C
16 A, B, E, F 52 B 88 C 124 D 160 C
17 D 53 B 89 B 125 A 161 C
18 C 54 C 90 C, D, E, F 126 D 162 B
19 B 55 B, C, D, F 91 D 127 A 163 B
20 A 56 B 92 D 128 B, C, D, F 164 D
21 A, C, E, F 57 A 93 A 129 B, C, D, E, F 165 D
22 B 58 B 94 A, B, C, E 130 A 166 B
23 C 59 A 95 B 131 A 167 B
24 C 60 A, B, C, F 96 C 132 C 168 C
25 B 61 A 97 A 133 A 169 A, B, D
26 A, B, C, D 62 D 98 D 134 C 170 D
27 D 63 D 99 A, B, D, E 135 D 171 D
28 A 64 A, B, E, F 100 A 136 D 172 B
29 B 65 C 101 A 137 C, E, F 173 C
30 D 66 D 102 B 138 C 174 C
31 C 67 C 103 A 139 C 175 D
32 B, C, D, E 68 A 104 C 140 D 176 C
,33 B 69 D 105 B, C, E, F 141 A, D, E, F 177 D
34 C 70 B 106 A, C, D, F 142 A 178 A, B, D, E
35 B 71 A 107 A 143 C 179 A
36 B 72 B, C, D, F 108 B 144 A 180 C, D, E, F
, ATI PN Pharmacology 2026 — Answer Key & Rationales
Question 1 Multiple Choice | Pharmacological Principles & Safe Medication Administration
A practical nurse (PN) is preparing to administer digoxin 0.125 mg PO to an adult client with chronic heart
failure. The nurse counts an apical pulse of 54/min for one full minute. The client denies dizziness and the
blood pressure is 118/72 mm Hg. Which action should the nurse take?
A. Administer half of the prescribed dose and document the finding.
B. Administer the medication with a potassium supplement to prevent toxicity.
C. Withhold the medication, document the apical rate, and notify the provider.
D. Administer the medication and recheck the apical pulse in 1 hour.
CORRECT ANSWER: C
Rationale
Digoxin increases myocardial contractility (positive inotrope) while slowing the heart rate (negative
chronotrope) and AV conduction (negative dromotrope). Because of its narrow therapeutic index (0.5–2.0
ng/mL; many references target 0.5–1.0 ng/mL in heart failure), the nurse always takes a full-minute apical
pulse before administration. Hold parameters: adults < 60/min, children < 70/min, infants < 90–110/min. A
rate of 54/min means the drug must be withheld, the finding documented, and the provider notified. Absence
of symptoms does not change the action—the parameter, not the symptom, drives the decision.
Option-by-option analysis
✘ A. Administer half of the prescribed dose and document the finding. — Incorrect. Altering a dose is a
prescriptive decision outside the PN scope. A partial dose is still a medication error and still slows the
heart.
✘ B. Administer the medication with a potassium supplement to prevent toxicity. — Incorrect. Potassium is
only given when prescribed and when the level is known to be low. It does not make digoxin safe to
give when the heart rate is already below the hold parameter.
✔ C. Withhold the medication, document the apical rate, and notify the provider. — Correct. Digoxin slows
conduction through the AV node (negative chronotrope). The standard hold parameter for adults is an
apical pulse below 60/min. The nurse withholds, documents the reason, and reports so the provider
can check a digoxin level, potassium, and decide on further dosing.
✘ D. Administer the medication and recheck the apical pulse in 1 hour. — Incorrect. Giving digoxin to an
adult with an apical rate below 60/min can deepen bradycardia and precipitate heart block. Rechecking
after the dose does not undo the risk that already occurred.
High-yield tip: Digoxin = always count an APICAL pulse for a FULL minute. Below 60 (adult) → hold, document,
report.
Answer Key • Page 4
