1
2025 ATI RN Pharmacology
Proctored Exam – 70 Actual
Medication Safety Questions with
Verified Answers | A+ Graded
Student Name: _________________________
Date: _______________
Time Limit: 90 minutes
Total Questions: 70
Question 1
A nurse is preparing to administer warfarin to a client with atrial fibrillation. Which laboratory
value should the nurse review prior to administration?
A. Platelet count
B. Hemoglobin A1c
C. International normalized ratio (INR)
D. Serum creatinine
Correct Answer: C. International normalized ratio (INR)
Rationale: Warfarin, an anticoagulant, requires monitoring of INR to assess therapeutic effect
and bleeding risk. The therapeutic INR range for atrial fibrillation is typically 2.0–3.0. Platelet
count is relevant for heparin, hemoglobin A1c for diabetes management, and serum creatinine
for renal function, but they are not directly related to warfarin.
Question 2
A nurse is teaching a client prescribed metformin for type 2 diabetes. Which statement indicates
a need for further teaching?
A. “I’ll take this medication with meals to reduce stomach upset.”
B. “I’ll monitor my blood glucose regularly.”
C. “I can stop this medication if I feel fine.”
D. “I’ll report muscle pain or weakness immediately.”
Correct Answer: C. “I can stop this medication if I feel fine.”
Rationale: Metformin, a biguanide, decreases hepatic glucose production and increases insulin
sensitivity. It must be taken consistently to manage type 2 diabetes. Stopping it without medical
, 2
advice can lead to hyperglycemia. The other statements reflect correct understanding of
administration, monitoring, and reporting adverse effects like lactic acidosis.
Question 3
A nurse is caring for a client receiving digoxin for heart failure. Which finding should the nurse
report immediately?
A. Heart rate of 62 bpm
B. Serum potassium of 3.2 mEq/L
C. Serum digoxin level of 0.8 ng/mL
D. Blood pressure of 130/80 mmHg
Correct Answer: B. Serum potassium of 3.2 mEq/L
Rationale: Digoxin, a cardiac glycoside, increases cardiac contractility but can cause toxicity,
especially with hypokalemia (normal potassium: 3.5–5.0 mEq/L). A potassium level of 3.2
mEq/L increases the risk of digoxin toxicity, manifesting as arrhythmias or visual disturbances.
The other findings are within normal ranges.
Question 4
A nurse is administering enoxaparin to a client with deep vein thrombosis. Which injection site is
most appropriate?
A. Deltoid muscle
B. Ventrogluteal muscle
C. Anterolateral abdomen
D. Upper arm subcutaneous tissue
Correct Answer: C. Anterolateral abdomen
Rationale: Enoxaparin, a low-molecular-weight heparin, is administered subcutaneously in the
anterolateral or posterolateral abdomen to ensure proper absorption and minimize tissue trauma.
Intramuscular injections (deltoid, ventrogluteal) are contraindicated due to bleeding risk, and the
upper arm is not the preferred site.
Question 5
A nurse is reviewing a client’s medication list and notes the client is taking aspirin and warfarin.
What should the nurse do?
A. Administer both medications as prescribed
B. Hold the aspirin and notify the provider
C. Increase the warfarin dose
D. Monitor for signs of hypoglycemia
Correct Answer: B. Hold the aspirin and notify the provider
, 3
Rationale: Aspirin, an antiplatelet, and warfarin, an anticoagulant, both increase bleeding risk.
Concurrent use requires careful monitoring and provider approval to avoid excessive
anticoagulation. Increasing warfarin or ignoring the combination is unsafe, and hypoglycemia is
unrelated to these drugs.
Question 6
A client receiving gentamicin for a bacterial infection develops tinnitus. What should the nurse
do first?
A. Continue the medication as prescribed
B. Administer an antihistamine
C. Notify the provider immediately
D. Encourage increased fluid intake
Correct Answer: C. Notify the provider immediately
Rationale: Gentamicin, an aminoglycoside antibiotic, can cause ototoxicity, with tinnitus as an
early sign. The nurse should notify the provider to assess for potential discontinuation or dose
adjustment. Continuing the medication risks further damage, and the other options do not address
ototoxicity.
Question 7
A nurse is preparing to administer phenobarbital to a client with a seizure disorder. How often
should the nurse expect to administer this medication?
A. Once daily
B. Twice daily
C. Three times daily
D. Four times daily
Correct Answer: A. Once daily
Rationale: Phenobarbital, a barbiturate with a long half-life (up to 4 days), maintains therapeutic
levels with once-daily dosing. This reduces the risk of toxicity and ensures seizure control. More
frequent dosing is unnecessary and increases side effect risks like sedation.
Question 8
A nurse is teaching a client prescribed spironolactone for hypertension. Which dietary instruction
should the nurse include?
A. Increase potassium-rich foods
B. Restrict potassium-rich foods
C. Avoid high-fiber foods
D. Limit fluid intake
2025 ATI RN Pharmacology
Proctored Exam – 70 Actual
Medication Safety Questions with
Verified Answers | A+ Graded
Student Name: _________________________
Date: _______________
Time Limit: 90 minutes
Total Questions: 70
Question 1
A nurse is preparing to administer warfarin to a client with atrial fibrillation. Which laboratory
value should the nurse review prior to administration?
A. Platelet count
B. Hemoglobin A1c
C. International normalized ratio (INR)
D. Serum creatinine
Correct Answer: C. International normalized ratio (INR)
Rationale: Warfarin, an anticoagulant, requires monitoring of INR to assess therapeutic effect
and bleeding risk. The therapeutic INR range for atrial fibrillation is typically 2.0–3.0. Platelet
count is relevant for heparin, hemoglobin A1c for diabetes management, and serum creatinine
for renal function, but they are not directly related to warfarin.
Question 2
A nurse is teaching a client prescribed metformin for type 2 diabetes. Which statement indicates
a need for further teaching?
A. “I’ll take this medication with meals to reduce stomach upset.”
B. “I’ll monitor my blood glucose regularly.”
C. “I can stop this medication if I feel fine.”
D. “I’ll report muscle pain or weakness immediately.”
Correct Answer: C. “I can stop this medication if I feel fine.”
Rationale: Metformin, a biguanide, decreases hepatic glucose production and increases insulin
sensitivity. It must be taken consistently to manage type 2 diabetes. Stopping it without medical
, 2
advice can lead to hyperglycemia. The other statements reflect correct understanding of
administration, monitoring, and reporting adverse effects like lactic acidosis.
Question 3
A nurse is caring for a client receiving digoxin for heart failure. Which finding should the nurse
report immediately?
A. Heart rate of 62 bpm
B. Serum potassium of 3.2 mEq/L
C. Serum digoxin level of 0.8 ng/mL
D. Blood pressure of 130/80 mmHg
Correct Answer: B. Serum potassium of 3.2 mEq/L
Rationale: Digoxin, a cardiac glycoside, increases cardiac contractility but can cause toxicity,
especially with hypokalemia (normal potassium: 3.5–5.0 mEq/L). A potassium level of 3.2
mEq/L increases the risk of digoxin toxicity, manifesting as arrhythmias or visual disturbances.
The other findings are within normal ranges.
Question 4
A nurse is administering enoxaparin to a client with deep vein thrombosis. Which injection site is
most appropriate?
A. Deltoid muscle
B. Ventrogluteal muscle
C. Anterolateral abdomen
D. Upper arm subcutaneous tissue
Correct Answer: C. Anterolateral abdomen
Rationale: Enoxaparin, a low-molecular-weight heparin, is administered subcutaneously in the
anterolateral or posterolateral abdomen to ensure proper absorption and minimize tissue trauma.
Intramuscular injections (deltoid, ventrogluteal) are contraindicated due to bleeding risk, and the
upper arm is not the preferred site.
Question 5
A nurse is reviewing a client’s medication list and notes the client is taking aspirin and warfarin.
What should the nurse do?
A. Administer both medications as prescribed
B. Hold the aspirin and notify the provider
C. Increase the warfarin dose
D. Monitor for signs of hypoglycemia
Correct Answer: B. Hold the aspirin and notify the provider
, 3
Rationale: Aspirin, an antiplatelet, and warfarin, an anticoagulant, both increase bleeding risk.
Concurrent use requires careful monitoring and provider approval to avoid excessive
anticoagulation. Increasing warfarin or ignoring the combination is unsafe, and hypoglycemia is
unrelated to these drugs.
Question 6
A client receiving gentamicin for a bacterial infection develops tinnitus. What should the nurse
do first?
A. Continue the medication as prescribed
B. Administer an antihistamine
C. Notify the provider immediately
D. Encourage increased fluid intake
Correct Answer: C. Notify the provider immediately
Rationale: Gentamicin, an aminoglycoside antibiotic, can cause ototoxicity, with tinnitus as an
early sign. The nurse should notify the provider to assess for potential discontinuation or dose
adjustment. Continuing the medication risks further damage, and the other options do not address
ototoxicity.
Question 7
A nurse is preparing to administer phenobarbital to a client with a seizure disorder. How often
should the nurse expect to administer this medication?
A. Once daily
B. Twice daily
C. Three times daily
D. Four times daily
Correct Answer: A. Once daily
Rationale: Phenobarbital, a barbiturate with a long half-life (up to 4 days), maintains therapeutic
levels with once-daily dosing. This reduces the risk of toxicity and ensures seizure control. More
frequent dosing is unnecessary and increases side effect risks like sedation.
Question 8
A nurse is teaching a client prescribed spironolactone for hypertension. Which dietary instruction
should the nurse include?
A. Increase potassium-rich foods
B. Restrict potassium-rich foods
C. Avoid high-fiber foods
D. Limit fluid intake
