ATI RN Pharmacology Edition 10 - Complete Test Bank (2026 Updated) 240 Questions
ATI RN Pharmacology — Edition 10 Complete Test Bank
2026 Updated · 240 Multiple-Choice Questions · 11 Sections · Aligned to the ATI RN Pharmacology
Proctored Blueprint
Instructions for the candidate: Select the ONE best answer for each question. Rationales follow each question and include
pharmacological reasoning, monitoring parameters, and ATI test-taking strategy notes. Cognitive level distribution: 30% recall /
50% application / 20% analysis. High-alert medications (anticoagulants, insulin, digoxin, opioids, chemotherapy) are
emphasized throughout.
SECTION 1 — Pharmacological Principles and Pharmacokinetics
(Absorption, Distribution, Metabolism, Excretion, Half-Life, & Drug
Interactions) — Q1–Q24
Q1: A 72-year-old client is receiving multiple oral medications. The nurse understands that age-related
changes in the GI tract most directly affect which phase of pharmacokinetics?
A. Metabolism via hepatic CYP3A4 induction
B. Absorption due to decreased gastric acidity and slower gastric emptying [CORRECT]
C. Distribution related to increased total body water
D. Excretion from increased glomerular filtration rate
Correct Answer: B
Rationale: Aging reduces gastric acid secretion, slows gastric emptying, and decreases intestinal blood flow, all of which alter
the rate and extent of absorption. Metabolism (option A) is primarily hepatic and affected by CYP activity changes; distribution
(option C) is altered by increased fat and decreased total body water; excretion (option D) declines with reduced GFR.
Absorption is the phase most directly linked to GI changes described.
Q2: A client is started on a medication with a half-life of 12 hours. Assuming no loading dose and linear
pharmacokinetics, approximately how long will it take to reach steady state?
A. 12 hours
B. 24 hours
C. 48 hours
D. 60 hours (about 5 half-lives) [CORRECT]
Correct Answer: D
Rationale: Steady state is reached in approximately 4–5 half-lives of a drug. With a half-life of 12 hours, 5 × 12 = 60 hours.
Administering a loading dose achieves therapeutic levels sooner but does not change the time to true steady state. Options A–C
each underestimate the principle of repeated dosing accumulation.
Q3: A client taking warfarin is newly prescribed amiodarone. The nurse anticipates which pharmacokinetic
interaction, and what monitoring is required?
A. Amiodarone induces CYP2C9, lowering warfarin effect; INR will decrease
B. Amiodarone inhibits CYP2C9 and 3A4, increasing warfarin effect; INR will rise and bleeding risk
increases [CORRECT]
C. Amiodarone increases warfarin renal clearance, requiring dose escalation
D. No interaction exists; routine INR monitoring is sufficient
Correct Answer: B
Rationale: Amiodarone is a potent CYP2C9 and CYP3A4 inhibitor. Because warfarin's S-enantiomer is metabolized by
CYP2C9, inhibition sharply raises INR and bleeding risk. The nurse should expect more frequent INR checks and a warfarin dose
Page 1
,ATI RN Pharmacology Edition 10 - Complete Test Bank (2026 Updated) 240 Questions
reduction (often 25–50%). Induction (option A) is incorrect; warfarin metabolism is hepatic, not renal (option C); option D
ignores a major drug–drug interaction.
Q4: Which statement by the nurse best explains the first-pass effect to a nursing student?
A. Drugs absorbed in the mouth bypass the liver and have higher bioavailability
B. Orally administered drugs are partially metabolized in the liver before reaching systemic circulation
[CORRECT]
C. First-pass refers to renal tubular reabsorption of active drug
D. First-pass occurs only with transdermal medications
Correct Answer: B
Rationale: The first-pass (presystemic) effect describes hepatic metabolism of a portion of an orally administered drug before it
reaches systemic circulation, reducing bioavailability. Sublingual (option A) and IV routes bypass the portal circulation. Renal
reabsorption (option C) and transdermal (option D) are unrelated to first-pass metabolism.
Q5: A client weighing 80 kg receives an IV bolus of a drug with a volume of distribution (Vd) of 0.5 L/kg.
What is the approximate initial plasma concentration if the dose is 400 mg? (Assume instantaneous
distribution.)
A. 2.5 mg/L
B. 5 mg/L
C. 10 mg/L [CORRECT]
D. 20 mg/L
Correct Answer: C
Rationale: Vd = 0.5 L/kg × 80 kg = 40 L. Concentration = Dose / Vd = 400 mg / 40 L = 10 mg/L (10 mcg/mL). Options A, B,
and D represent miscalculations of Vd or dose conversion. The nurse uses this principle to anticipate peak levels and toxicity
thresholds.
Q6: A client with severe hepatic cirrhosis is prescribed a benzodiazepine for alcohol withdrawal. Which
pharmacokinetic change most increases the risk of accumulation and prolonged sedation?
A. Increased CYP3A4 metabolism shortens half-life
B. Decreased protein synthesis increases free drug fraction; impaired metabolism prolongs half-life
[CORRECT]
C. Enhanced biliary excretion compensates for impaired metabolism
D. Increased glomerular filtration accelerates elimination
Correct Answer: B
Rationale: In cirrhosis, hypoalbuminemia increases the free (active) fraction of highly protein-bound drugs like diazepam, and
decreased CYP activity prolongs half-life. The combined effect raises accumulation and oversedation risk. Options A, C, and D
each describe opposite physiological changes. Long-acting benzodiazepines are typically avoided; lorazepam or oxazepam (less
hepatic metabolism) are preferred.
Q7: Grapefruit juice consumed with oral felodipine produces clinically significant hypotension. The
pharmacokinetic mechanism is best described as:
A. Induction of CYP3A4 in the intestinal wall
B. Mechanism-based inhibition of intestinal CYP3A4, increasing bioavailability [CORRECT]
C. Increased gastric acidity that enhances absorption
D. Competition for renal tubular secretion
Correct Answer: B
Rationale: Grapefruit juice irreversibly inhibits intestinal CYP3A4, increasing systemic bioavailability of CYP3A4 substrates
such as felodipine, statins (simvastatin, atorvastatin), and cyclosporine. The effect is not hepatic CYP induction (option A), not
Page 2
,ATI RN Pharmacology Edition 10 - Complete Test Bank (2026 Updated) 240 Questions
gastric (option C), and not renal (option D). Patients should be educated to avoid grapefruit juice with these medications.
Q8: A drug with a narrow therapeutic index requires plasma drug level monitoring. Which laboratory value
reflects the lowest steady-state concentration and is used to adjust dosing?
A. Peak level drawn 30 minutes after IV bolus
B. Trough level drawn just before the next scheduled dose [CORRECT]
C. Loading level drawn 5 minutes after first dose
D. Random non-steady-state level
Correct Answer: B
Rationale: Trough levels are drawn immediately before the next dose at steady state (5 half-lives) and reflect the minimum
concentration preventing therapeutic failure. Peak levels (option A) reflect maximum effect/toxicity. Loading or random levels
(options C, D) are not used for routine dose adjustment of narrow-index drugs such as vancomycin, aminoglycosides, digoxin,
and phenytoin.
Q9: A client on phenytoin therapy develops nystagmus, ataxia, and confusion. The nurse recognizes these as
signs of toxicity that correlate most directly with which pharmacokinetic property?
A. Nonlinear (zero-order) metabolism producing disproportionate increases in level with dose escalation
[CORRECT]
B. Linear first-order kinetics producing predictable dose-proportional levels
C. Renal elimination that increases with elevated plasma levels
D. High-volume distribution that lowers plasma concentration
Correct Answer: A
Rationale: Phenytoin undergoes saturable (Michaelis–Menten) metabolism; small dose increases near saturation can
dramatically raise plasma concentration, causing toxicity (nystagmus, ataxia, confusion). Linear kinetics (option B) would
produce predictable changes. Phenytoin is primarily hepatically metabolized (option C), and Vd is ~0.6–0.8 L/kg (option D).
Therapeutic range is 10–20 mcg/mL.
Q10: A pregnant client at 28 weeks asks the nurse about placental drug transfer. The nurse correctly explains
that drugs most likely to cross the placenta have which properties?
A. Highly ionized, highly protein-bound, large molecular weight
B. Lipid-soluble, non-ionized, low protein-binding, low molecular weight [CORRECT]
C. Polar, water-soluble, and active transport-dependent only
D. Bound to alpha-1-acid glycoprotein and > 500 Da
Correct Answer: B
Rationale: Placental transfer mirrors passive diffusion across membranes: lipid-soluble, non-ionized, weakly bound,
low-molecular-weight drugs cross most readily. Highly ionized/protein-bound (option A) and polar (option C) drugs cross
poorly. Most drugs < 500 Da cross the placenta; the nurse must consider teratogenic risk (FDA pregnancy categories are now
replaced by the Pregnancy and Lactation Labeling Rule [PLLR]).
Q11: A client receiving IV gentamicin has a peak of 9 mcg/mL (therapeutic 5–10) and a trough of 4 mcg/mL
(therapeutic < 2). The nurse's best interpretation is:
A. Both peak and trough are within range; continue current dosing
B. Trough is elevated, suggesting accumulation and risk of nephrotoxicity/ototoxicity; extend dosing interval
[CORRECT]
C. Peak is too low; increase the dose
D. Levels are unrelated to toxicity; no action needed
Correct Answer: B
Page 3
, ATI RN Pharmacology Edition 10 - Complete Test Bank (2026 Updated) 240 Questions
Rationale: Aminoglycoside troughs > 2 mcg/mL indicate accumulation and rising risk of nephrotoxicity and ototoxicity. The
standard response is to lengthen the dosing interval (e.g., q8h → q12h or q24h) or reduce the dose, and recheck levels. The peak
is therapeutic, so increasing the dose (option C) would raise the trough further. Option D is unsafe.
Q12: Which laboratory test is the most reliable indicator of renal drug excretion capacity and is used to adjust
renally cleared medications such as vancomycin and metformin?
A. Serum creatinine alone
B. Blood urea nitrogen (BUN)
C. Estimated creatinine clearance (CrCl) or eGFR [CORRECT]
D. Urine specific gravity
Correct Answer: C
Rationale: Creatinine clearance (Cockcroft–Gault) or eGFR provides a functional estimate of GFR and is the standard for renal
dosing. Serum creatinine (option A) alone is influenced by muscle mass; BUN (option B) is affected by hydration and protein
intake; urine specific gravity (option D) reflects hydration, not clearance. Many formularies require CrCl before dosing renally
cleared drugs.
Q13: A client asks why the nurse administers oral tetracycline with water but instructs avoidance of dairy
products, antacids, and iron supplements within 2 hours. The pharmacokinetic mechanism is:
A. Increased first-pass metabolism by calcium
B. Chelation in the GI tract reducing absorption and bioavailability [CORRECT]
C. Enhanced gastric emptying by calcium
D. Induction of CYP3A4 by polyvalent cations
Correct Answer: B
Rationale: Polyvalent cations (Ca2+, Mg2+, Al3+, Fe2+, Zn2+) chelate tetracycline and fluoroquinolones in the GI lumen,
forming insoluble complexes that prevent absorption. Separation by at least 2 hours maintains bioavailability. Options A, C, and
D do not describe the chelation interaction. Dairy, antacids, iron, and zinc supplements are the most common sources.
Q14: A client who is a CYP2D6 poor metabolizer is prescribed codeine for postoperative pain. The nurse
anticipates which clinical outcome?
A. Increased conversion to morphine causing respiratory depression
B. Reduced conversion to morphine and inadequate analgesia [CORRECT]
C. No change in therapeutic effect because codeine is itself the active agent
D. Immediate anaphylaxis due to histamine release
Correct Answer: B
Rationale: Codeine is a prodrug requiring O-demethylation by CYP2D6 to morphine for analgesic effect. Poor metabolizers
produce little morphine and experience inadequate pain relief. Ultrarapid metabolizers (option A) face morphine toxicity risk,
including respiratory depression. Codeine itself has low affinity for μ-opioid receptors (option C). Anaphylaxis (option D) is rare
and unrelated to CYP2D6 status.
Q15: A client is ordered a 250 mcg dose of oral digoxin. The available tablets are 0.125 mg. How many tablets
should the nurse administer?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets [CORRECT]
D. 4 tablets
Correct Answer: C
Rationale: Convert: 0.125 mg = 125 mcg. 250 mcg ÷ 125 mcg/tablet = 2 tablets. The nurse should verify the dose against
therapeutic range (0.5–2 ng/mL) and check apical pulse for 1 minute before administration; hold if HR < 60 bpm. Options A, B,
Page 4
ATI RN Pharmacology — Edition 10 Complete Test Bank
2026 Updated · 240 Multiple-Choice Questions · 11 Sections · Aligned to the ATI RN Pharmacology
Proctored Blueprint
Instructions for the candidate: Select the ONE best answer for each question. Rationales follow each question and include
pharmacological reasoning, monitoring parameters, and ATI test-taking strategy notes. Cognitive level distribution: 30% recall /
50% application / 20% analysis. High-alert medications (anticoagulants, insulin, digoxin, opioids, chemotherapy) are
emphasized throughout.
SECTION 1 — Pharmacological Principles and Pharmacokinetics
(Absorption, Distribution, Metabolism, Excretion, Half-Life, & Drug
Interactions) — Q1–Q24
Q1: A 72-year-old client is receiving multiple oral medications. The nurse understands that age-related
changes in the GI tract most directly affect which phase of pharmacokinetics?
A. Metabolism via hepatic CYP3A4 induction
B. Absorption due to decreased gastric acidity and slower gastric emptying [CORRECT]
C. Distribution related to increased total body water
D. Excretion from increased glomerular filtration rate
Correct Answer: B
Rationale: Aging reduces gastric acid secretion, slows gastric emptying, and decreases intestinal blood flow, all of which alter
the rate and extent of absorption. Metabolism (option A) is primarily hepatic and affected by CYP activity changes; distribution
(option C) is altered by increased fat and decreased total body water; excretion (option D) declines with reduced GFR.
Absorption is the phase most directly linked to GI changes described.
Q2: A client is started on a medication with a half-life of 12 hours. Assuming no loading dose and linear
pharmacokinetics, approximately how long will it take to reach steady state?
A. 12 hours
B. 24 hours
C. 48 hours
D. 60 hours (about 5 half-lives) [CORRECT]
Correct Answer: D
Rationale: Steady state is reached in approximately 4–5 half-lives of a drug. With a half-life of 12 hours, 5 × 12 = 60 hours.
Administering a loading dose achieves therapeutic levels sooner but does not change the time to true steady state. Options A–C
each underestimate the principle of repeated dosing accumulation.
Q3: A client taking warfarin is newly prescribed amiodarone. The nurse anticipates which pharmacokinetic
interaction, and what monitoring is required?
A. Amiodarone induces CYP2C9, lowering warfarin effect; INR will decrease
B. Amiodarone inhibits CYP2C9 and 3A4, increasing warfarin effect; INR will rise and bleeding risk
increases [CORRECT]
C. Amiodarone increases warfarin renal clearance, requiring dose escalation
D. No interaction exists; routine INR monitoring is sufficient
Correct Answer: B
Rationale: Amiodarone is a potent CYP2C9 and CYP3A4 inhibitor. Because warfarin's S-enantiomer is metabolized by
CYP2C9, inhibition sharply raises INR and bleeding risk. The nurse should expect more frequent INR checks and a warfarin dose
Page 1
,ATI RN Pharmacology Edition 10 - Complete Test Bank (2026 Updated) 240 Questions
reduction (often 25–50%). Induction (option A) is incorrect; warfarin metabolism is hepatic, not renal (option C); option D
ignores a major drug–drug interaction.
Q4: Which statement by the nurse best explains the first-pass effect to a nursing student?
A. Drugs absorbed in the mouth bypass the liver and have higher bioavailability
B. Orally administered drugs are partially metabolized in the liver before reaching systemic circulation
[CORRECT]
C. First-pass refers to renal tubular reabsorption of active drug
D. First-pass occurs only with transdermal medications
Correct Answer: B
Rationale: The first-pass (presystemic) effect describes hepatic metabolism of a portion of an orally administered drug before it
reaches systemic circulation, reducing bioavailability. Sublingual (option A) and IV routes bypass the portal circulation. Renal
reabsorption (option C) and transdermal (option D) are unrelated to first-pass metabolism.
Q5: A client weighing 80 kg receives an IV bolus of a drug with a volume of distribution (Vd) of 0.5 L/kg.
What is the approximate initial plasma concentration if the dose is 400 mg? (Assume instantaneous
distribution.)
A. 2.5 mg/L
B. 5 mg/L
C. 10 mg/L [CORRECT]
D. 20 mg/L
Correct Answer: C
Rationale: Vd = 0.5 L/kg × 80 kg = 40 L. Concentration = Dose / Vd = 400 mg / 40 L = 10 mg/L (10 mcg/mL). Options A, B,
and D represent miscalculations of Vd or dose conversion. The nurse uses this principle to anticipate peak levels and toxicity
thresholds.
Q6: A client with severe hepatic cirrhosis is prescribed a benzodiazepine for alcohol withdrawal. Which
pharmacokinetic change most increases the risk of accumulation and prolonged sedation?
A. Increased CYP3A4 metabolism shortens half-life
B. Decreased protein synthesis increases free drug fraction; impaired metabolism prolongs half-life
[CORRECT]
C. Enhanced biliary excretion compensates for impaired metabolism
D. Increased glomerular filtration accelerates elimination
Correct Answer: B
Rationale: In cirrhosis, hypoalbuminemia increases the free (active) fraction of highly protein-bound drugs like diazepam, and
decreased CYP activity prolongs half-life. The combined effect raises accumulation and oversedation risk. Options A, C, and D
each describe opposite physiological changes. Long-acting benzodiazepines are typically avoided; lorazepam or oxazepam (less
hepatic metabolism) are preferred.
Q7: Grapefruit juice consumed with oral felodipine produces clinically significant hypotension. The
pharmacokinetic mechanism is best described as:
A. Induction of CYP3A4 in the intestinal wall
B. Mechanism-based inhibition of intestinal CYP3A4, increasing bioavailability [CORRECT]
C. Increased gastric acidity that enhances absorption
D. Competition for renal tubular secretion
Correct Answer: B
Rationale: Grapefruit juice irreversibly inhibits intestinal CYP3A4, increasing systemic bioavailability of CYP3A4 substrates
such as felodipine, statins (simvastatin, atorvastatin), and cyclosporine. The effect is not hepatic CYP induction (option A), not
Page 2
,ATI RN Pharmacology Edition 10 - Complete Test Bank (2026 Updated) 240 Questions
gastric (option C), and not renal (option D). Patients should be educated to avoid grapefruit juice with these medications.
Q8: A drug with a narrow therapeutic index requires plasma drug level monitoring. Which laboratory value
reflects the lowest steady-state concentration and is used to adjust dosing?
A. Peak level drawn 30 minutes after IV bolus
B. Trough level drawn just before the next scheduled dose [CORRECT]
C. Loading level drawn 5 minutes after first dose
D. Random non-steady-state level
Correct Answer: B
Rationale: Trough levels are drawn immediately before the next dose at steady state (5 half-lives) and reflect the minimum
concentration preventing therapeutic failure. Peak levels (option A) reflect maximum effect/toxicity. Loading or random levels
(options C, D) are not used for routine dose adjustment of narrow-index drugs such as vancomycin, aminoglycosides, digoxin,
and phenytoin.
Q9: A client on phenytoin therapy develops nystagmus, ataxia, and confusion. The nurse recognizes these as
signs of toxicity that correlate most directly with which pharmacokinetic property?
A. Nonlinear (zero-order) metabolism producing disproportionate increases in level with dose escalation
[CORRECT]
B. Linear first-order kinetics producing predictable dose-proportional levels
C. Renal elimination that increases with elevated plasma levels
D. High-volume distribution that lowers plasma concentration
Correct Answer: A
Rationale: Phenytoin undergoes saturable (Michaelis–Menten) metabolism; small dose increases near saturation can
dramatically raise plasma concentration, causing toxicity (nystagmus, ataxia, confusion). Linear kinetics (option B) would
produce predictable changes. Phenytoin is primarily hepatically metabolized (option C), and Vd is ~0.6–0.8 L/kg (option D).
Therapeutic range is 10–20 mcg/mL.
Q10: A pregnant client at 28 weeks asks the nurse about placental drug transfer. The nurse correctly explains
that drugs most likely to cross the placenta have which properties?
A. Highly ionized, highly protein-bound, large molecular weight
B. Lipid-soluble, non-ionized, low protein-binding, low molecular weight [CORRECT]
C. Polar, water-soluble, and active transport-dependent only
D. Bound to alpha-1-acid glycoprotein and > 500 Da
Correct Answer: B
Rationale: Placental transfer mirrors passive diffusion across membranes: lipid-soluble, non-ionized, weakly bound,
low-molecular-weight drugs cross most readily. Highly ionized/protein-bound (option A) and polar (option C) drugs cross
poorly. Most drugs < 500 Da cross the placenta; the nurse must consider teratogenic risk (FDA pregnancy categories are now
replaced by the Pregnancy and Lactation Labeling Rule [PLLR]).
Q11: A client receiving IV gentamicin has a peak of 9 mcg/mL (therapeutic 5–10) and a trough of 4 mcg/mL
(therapeutic < 2). The nurse's best interpretation is:
A. Both peak and trough are within range; continue current dosing
B. Trough is elevated, suggesting accumulation and risk of nephrotoxicity/ototoxicity; extend dosing interval
[CORRECT]
C. Peak is too low; increase the dose
D. Levels are unrelated to toxicity; no action needed
Correct Answer: B
Page 3
, ATI RN Pharmacology Edition 10 - Complete Test Bank (2026 Updated) 240 Questions
Rationale: Aminoglycoside troughs > 2 mcg/mL indicate accumulation and rising risk of nephrotoxicity and ototoxicity. The
standard response is to lengthen the dosing interval (e.g., q8h → q12h or q24h) or reduce the dose, and recheck levels. The peak
is therapeutic, so increasing the dose (option C) would raise the trough further. Option D is unsafe.
Q12: Which laboratory test is the most reliable indicator of renal drug excretion capacity and is used to adjust
renally cleared medications such as vancomycin and metformin?
A. Serum creatinine alone
B. Blood urea nitrogen (BUN)
C. Estimated creatinine clearance (CrCl) or eGFR [CORRECT]
D. Urine specific gravity
Correct Answer: C
Rationale: Creatinine clearance (Cockcroft–Gault) or eGFR provides a functional estimate of GFR and is the standard for renal
dosing. Serum creatinine (option A) alone is influenced by muscle mass; BUN (option B) is affected by hydration and protein
intake; urine specific gravity (option D) reflects hydration, not clearance. Many formularies require CrCl before dosing renally
cleared drugs.
Q13: A client asks why the nurse administers oral tetracycline with water but instructs avoidance of dairy
products, antacids, and iron supplements within 2 hours. The pharmacokinetic mechanism is:
A. Increased first-pass metabolism by calcium
B. Chelation in the GI tract reducing absorption and bioavailability [CORRECT]
C. Enhanced gastric emptying by calcium
D. Induction of CYP3A4 by polyvalent cations
Correct Answer: B
Rationale: Polyvalent cations (Ca2+, Mg2+, Al3+, Fe2+, Zn2+) chelate tetracycline and fluoroquinolones in the GI lumen,
forming insoluble complexes that prevent absorption. Separation by at least 2 hours maintains bioavailability. Options A, C, and
D do not describe the chelation interaction. Dairy, antacids, iron, and zinc supplements are the most common sources.
Q14: A client who is a CYP2D6 poor metabolizer is prescribed codeine for postoperative pain. The nurse
anticipates which clinical outcome?
A. Increased conversion to morphine causing respiratory depression
B. Reduced conversion to morphine and inadequate analgesia [CORRECT]
C. No change in therapeutic effect because codeine is itself the active agent
D. Immediate anaphylaxis due to histamine release
Correct Answer: B
Rationale: Codeine is a prodrug requiring O-demethylation by CYP2D6 to morphine for analgesic effect. Poor metabolizers
produce little morphine and experience inadequate pain relief. Ultrarapid metabolizers (option A) face morphine toxicity risk,
including respiratory depression. Codeine itself has low affinity for μ-opioid receptors (option C). Anaphylaxis (option D) is rare
and unrelated to CYP2D6 status.
Q15: A client is ordered a 250 mcg dose of oral digoxin. The available tablets are 0.125 mg. How many tablets
should the nurse administer?
A. 0.5 tablet
B. 1 tablet
C. 2 tablets [CORRECT]
D. 4 tablets
Correct Answer: C
Rationale: Convert: 0.125 mg = 125 mcg. 250 mcg ÷ 125 mcg/tablet = 2 tablets. The nurse should verify the dose against
therapeutic range (0.5–2 ng/mL) and check apical pulse for 1 minute before administration; hold if HR < 60 bpm. Options A, B,
Page 4
