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VATI RN PHARMACOLOGY 2026 TEST BANK / PHARMACOLOGY
VATI RN LATEST EXAM 2024 TEST BANK QUESTIONS AND CORRECT
DETAILED ANSWERS
Question 1 — Cardiac (Digoxin)
A 72-year-old client with atrial fibrillation is prescribed digoxin. Which assessment
finding is the most important for the nurse to check before administering the dose?
A. Serum potassium level of 4.2 mEq/L
B. Blood pressure 118/70 mm Hg
C. Apical pulse rate 48 beats per minute
D. Respiratory rate 18 breaths per minute
Correct answer: C. Apical pulse rate 48 beats per minute
Rationale:
Digoxin slows AV conduction and increases vagal tone; a low heart rate (generally
<60 bpm in adults) is a key contraindication to administration because of the risk
of severe bradycardia and heart block. Checking the apical pulse for a full minute
is the most important immediate assessment. Serum potassium is also important—
hypokalemia increases digoxin toxicity risk—but a potassium of 4.2 mEq/L is
normal and not an immediate contraindication. Blood pressure 118/70 is acceptable
and doesn't override bradycardia. Respiratory rate is unrelated to digoxin safety
here. Nursing actions: hold drug if HR <60 (or institution guideline), notify
provider, monitor for signs of digoxin toxicity (nausea, visual changes,
arrhythmias), obtain ECG if indicated.
Question 2 — Cardiac (ACE inhibitor)
A patient started on lisinopril reports a new, persistent cough. The nurse should:
A. Advise the patient it’s a harmless side effect and continue the drug.
B. Recognize cough as a common ACE inhibitor adverse effect and contact the
provider for an alternative.
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C. Check the apical pulse and withhold the dose if HR <60.
D. Suggest taking an over-the-counter cough suppressant and continue lisinopril.
Correct answer: B. Recognize cough as a common ACE inhibitor adverse effect
and contact the provider for an alternative.
Rationale:
A persistent dry cough is a well-known adverse effect of ACE inhibitors (due to
increased bradykinin). It often warrants discontinuation and switching to an ARB
(e.g., losartan). It is not harmless enough to ignore; continuing without provider
input is inappropriate. Checking apical pulse is irrelevant for ACE inhibitor cough.
OTC cough suppressants may mask symptoms but won’t address the cause and
could allow continued exposure to the offending drug. Nursing action: report
symptom, anticipate medication change, monitor blood pressure and renal function
when switching.
Question 3 — Cardiac (Beta blocker)
A client with hypertension is prescribed metoprolol. Which statement by the
patient indicates correct understanding of this medication?
A. “I should stop taking it when my blood pressure feels normal.”
B. “If I have shortness of breath I should tell my provider because this drug can
affect my lungs.”
C. “I can take extra pills if my pulse drops to 50.”
D. “It’s okay to suddenly stop the drug if I feel dizzy.”
Correct answer: B. “If I have shortness of breath I should tell my provider
because this drug can affect my lungs.”
Rationale:
Beta blockers (especially nonselective ones) can exacerbate bronchospasm; even
cardioselective agents may affect respiratory status in susceptible patients—so
shortness of breath should be reported. Stopping when BP feels normal is
incorrect; antihypertensives require ongoing use. Taking extra pills for a low pulse
is dangerous. Abruptly stopping beta blockers can precipitate rebound hypertension
and angina; tapering is required. Nursing education: take as prescribed, monitor
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pulse and BP, report dizziness, dyspnea, or bradycardia, and never abruptly
discontinue.
Question 4 — Cardiac (Anticoagulant — Warfarin)
A patient on long-term warfarin therapy has an INR of 5.8 (therapeutic range for
this patient is 2–3). The nurse should:
A. Administer the scheduled dose and recheck INR in 1 week.
B. Withhold the dose and notify the provider immediately.
C. Give vitamin K orally at home and continue therapy.
D. Double the next dose to get INR into range.
Correct answer: B. Withhold the dose and notify the provider immediately.
Rationale:
INR 5.8 is significantly elevated, increasing bleeding risk; standard immediate
action is to withhold warfarin and notify provider for guidance—often vitamin K is
given depending on risk and bleeding status. Administering the dose is unsafe.
Giving vitamin K should be ordered by the provider (not automatic at-home
action). Doubling the dose would further raise INR and is dangerous. Nursing
priorities: assess for bleeding, hold warfarin, notify provider, prepare to administer
reversal agents if ordered, educate patient about bleeding precautions.
Question 5 — Antibiotics (Aminoglycoside: Gentamicin)
Which assessment is most important to monitor in a patient taking gentamicin?
A. White blood cell count
B. Peak and trough serum drug levels and renal function
C. Fasting blood glucose
D. Liver function tests
Correct answer: B. Peak and trough serum drug levels and renal function
Rationale:
Gentamicin is nephrotoxic and ototoxic; monitoring serum drug levels (peak for
efficacy, trough for toxicity) and renal function (BUN, creatinine, urine output) is
essential to prevent toxicity. WBC relates to infection response but not direct
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gentamicin toxicity monitoring. Fasting glucose and LFTs are not primary
monitoring parameters for aminoglycosides. Nursing actions: ensure timely levels,
adjust dosing per levels and renal function, watch for hearing loss/tinnitus and
decreased urine output.
Question 6 — Antibiotics (Beta-lactam allergy)
A client with a history of anaphylaxis to penicillin needs antibiotic therapy for a
severe infection. The nurse anticipates which action?
A. Prescribe a cephalosporin because cross-reactivity is unlikely.
B. Administer vancomycin or another non–beta-lactam antibiotic.
C. Give penicillin under observation to desensitize.
D. Use amoxicillin because oral forms are less allergenic.
Correct answer: B. Administer vancomycin or another non–beta-lactam
antibiotic.
Rationale:
A history of anaphylaxis to penicillin indicates a severe allergy; cross-reactivity
with cephalosporins is possible (higher with first-generation), so safest is to choose
a non–beta-lactam such as vancomycin or another suited antibiotic based on
culture/sensitivity. Desensitization is done only in select cases under specialist
supervision and not routine. Oral versus IV formulations doesn’t make a drug less
allergenic. Nursing role: verify allergy details, flag chart, ensure alternative
antibiotic is chosen and monitor for adverse effects.
Question 7 — Antibiotics (Clindamycin & C. difficile)
Which patient education point is most important when starting clindamycin?
A. Expect mild ringing in the ears — that’s normal.
B. Immediately report watery diarrhea or abdominal cramping.
C. It can make your urine darker — this is harmless.
D. Avoid grapefruit juice while taking this medicine.
Correct answer: B. Immediately report watery diarrhea or abdominal cramping.
VATI RN PHARMACOLOGY 2026 TEST BANK / PHARMACOLOGY
VATI RN LATEST EXAM 2024 TEST BANK QUESTIONS AND CORRECT
DETAILED ANSWERS
Question 1 — Cardiac (Digoxin)
A 72-year-old client with atrial fibrillation is prescribed digoxin. Which assessment
finding is the most important for the nurse to check before administering the dose?
A. Serum potassium level of 4.2 mEq/L
B. Blood pressure 118/70 mm Hg
C. Apical pulse rate 48 beats per minute
D. Respiratory rate 18 breaths per minute
Correct answer: C. Apical pulse rate 48 beats per minute
Rationale:
Digoxin slows AV conduction and increases vagal tone; a low heart rate (generally
<60 bpm in adults) is a key contraindication to administration because of the risk
of severe bradycardia and heart block. Checking the apical pulse for a full minute
is the most important immediate assessment. Serum potassium is also important—
hypokalemia increases digoxin toxicity risk—but a potassium of 4.2 mEq/L is
normal and not an immediate contraindication. Blood pressure 118/70 is acceptable
and doesn't override bradycardia. Respiratory rate is unrelated to digoxin safety
here. Nursing actions: hold drug if HR <60 (or institution guideline), notify
provider, monitor for signs of digoxin toxicity (nausea, visual changes,
arrhythmias), obtain ECG if indicated.
Question 2 — Cardiac (ACE inhibitor)
A patient started on lisinopril reports a new, persistent cough. The nurse should:
A. Advise the patient it’s a harmless side effect and continue the drug.
B. Recognize cough as a common ACE inhibitor adverse effect and contact the
provider for an alternative.
,2 | Page
C. Check the apical pulse and withhold the dose if HR <60.
D. Suggest taking an over-the-counter cough suppressant and continue lisinopril.
Correct answer: B. Recognize cough as a common ACE inhibitor adverse effect
and contact the provider for an alternative.
Rationale:
A persistent dry cough is a well-known adverse effect of ACE inhibitors (due to
increased bradykinin). It often warrants discontinuation and switching to an ARB
(e.g., losartan). It is not harmless enough to ignore; continuing without provider
input is inappropriate. Checking apical pulse is irrelevant for ACE inhibitor cough.
OTC cough suppressants may mask symptoms but won’t address the cause and
could allow continued exposure to the offending drug. Nursing action: report
symptom, anticipate medication change, monitor blood pressure and renal function
when switching.
Question 3 — Cardiac (Beta blocker)
A client with hypertension is prescribed metoprolol. Which statement by the
patient indicates correct understanding of this medication?
A. “I should stop taking it when my blood pressure feels normal.”
B. “If I have shortness of breath I should tell my provider because this drug can
affect my lungs.”
C. “I can take extra pills if my pulse drops to 50.”
D. “It’s okay to suddenly stop the drug if I feel dizzy.”
Correct answer: B. “If I have shortness of breath I should tell my provider
because this drug can affect my lungs.”
Rationale:
Beta blockers (especially nonselective ones) can exacerbate bronchospasm; even
cardioselective agents may affect respiratory status in susceptible patients—so
shortness of breath should be reported. Stopping when BP feels normal is
incorrect; antihypertensives require ongoing use. Taking extra pills for a low pulse
is dangerous. Abruptly stopping beta blockers can precipitate rebound hypertension
and angina; tapering is required. Nursing education: take as prescribed, monitor
,3 | Page
pulse and BP, report dizziness, dyspnea, or bradycardia, and never abruptly
discontinue.
Question 4 — Cardiac (Anticoagulant — Warfarin)
A patient on long-term warfarin therapy has an INR of 5.8 (therapeutic range for
this patient is 2–3). The nurse should:
A. Administer the scheduled dose and recheck INR in 1 week.
B. Withhold the dose and notify the provider immediately.
C. Give vitamin K orally at home and continue therapy.
D. Double the next dose to get INR into range.
Correct answer: B. Withhold the dose and notify the provider immediately.
Rationale:
INR 5.8 is significantly elevated, increasing bleeding risk; standard immediate
action is to withhold warfarin and notify provider for guidance—often vitamin K is
given depending on risk and bleeding status. Administering the dose is unsafe.
Giving vitamin K should be ordered by the provider (not automatic at-home
action). Doubling the dose would further raise INR and is dangerous. Nursing
priorities: assess for bleeding, hold warfarin, notify provider, prepare to administer
reversal agents if ordered, educate patient about bleeding precautions.
Question 5 — Antibiotics (Aminoglycoside: Gentamicin)
Which assessment is most important to monitor in a patient taking gentamicin?
A. White blood cell count
B. Peak and trough serum drug levels and renal function
C. Fasting blood glucose
D. Liver function tests
Correct answer: B. Peak and trough serum drug levels and renal function
Rationale:
Gentamicin is nephrotoxic and ototoxic; monitoring serum drug levels (peak for
efficacy, trough for toxicity) and renal function (BUN, creatinine, urine output) is
essential to prevent toxicity. WBC relates to infection response but not direct
, 4 | Page
gentamicin toxicity monitoring. Fasting glucose and LFTs are not primary
monitoring parameters for aminoglycosides. Nursing actions: ensure timely levels,
adjust dosing per levels and renal function, watch for hearing loss/tinnitus and
decreased urine output.
Question 6 — Antibiotics (Beta-lactam allergy)
A client with a history of anaphylaxis to penicillin needs antibiotic therapy for a
severe infection. The nurse anticipates which action?
A. Prescribe a cephalosporin because cross-reactivity is unlikely.
B. Administer vancomycin or another non–beta-lactam antibiotic.
C. Give penicillin under observation to desensitize.
D. Use amoxicillin because oral forms are less allergenic.
Correct answer: B. Administer vancomycin or another non–beta-lactam
antibiotic.
Rationale:
A history of anaphylaxis to penicillin indicates a severe allergy; cross-reactivity
with cephalosporins is possible (higher with first-generation), so safest is to choose
a non–beta-lactam such as vancomycin or another suited antibiotic based on
culture/sensitivity. Desensitization is done only in select cases under specialist
supervision and not routine. Oral versus IV formulations doesn’t make a drug less
allergenic. Nursing role: verify allergy details, flag chart, ensure alternative
antibiotic is chosen and monitor for adverse effects.
Question 7 — Antibiotics (Clindamycin & C. difficile)
Which patient education point is most important when starting clindamycin?
A. Expect mild ringing in the ears — that’s normal.
B. Immediately report watery diarrhea or abdominal cramping.
C. It can make your urine darker — this is harmless.
D. Avoid grapefruit juice while taking this medicine.
Correct answer: B. Immediately report watery diarrhea or abdominal cramping.
