RN ATI Pharmacology Latest Exam Review (70+ Questions Extracted from 2023/25 ATI RN Exam with Verified Answers)

RN ATI Pharmacology Latest Exam Review (70+ Questions Extracted from 2023/25 ATI RN Exam with Verified Answers) Question 1 of 70 A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first? ◯ Obtain the client's blood pressure. ◯ Contact the client's provider. ◯ Inform the charge nurse. ◯ Complete an incident report. Correct Answer: ◯ Obtain the client's blood pressure. Explanation: The nurse should first assess the client's blood pressure because atenolol is a beta-blocker that can lower blood pressure. Assessing the client’s status will help determine the immediate effects of the medication error. Question 2 of 70 A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? ◯ "I will have increased saliva production." ◯ "I will continue taking the medication until the rash disappears." ◯ "I will taper off the medication before discontinuing it."◯ "I will report any urinary incontinence." Correct Answer: ◯ "I will taper off the medication before discontinuing it." Explanation: Cyclobenzaprine, a muscle relaxant, should be tapered off gradually to avoid withdrawal symptoms. Sudden discontinuation can cause adverse effects such as rebound muscle spasms. (Copy/Paste Link on your Browser to Download) Question 3 of 70A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first? ◯ Diphenhydramine ◯ Albuterol inhaler ◯ Epinephrine ◯ Prednisone Correct Answer: ◯ Epinephrine Explanation: The client is likely experiencing an anaphylactic reaction, which is a life-threatening emergency. Epinephrine should be administered first to reverse symptoms of anaphylaxis, including hypotension and respiratory distress. Question 4 of 70 The nurse is ready to begin the blood transfusion. For each potential nursing action, click to specify if the action is indicated or not indicated for the client. Not Nursing Action Indicated Indicated Document the blood product transfusion in the client’s medical record. ◯ ◯ Stay with the client for the first 15 min of the transfusion. ◯ ◯ Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg. ◯ ◯ Obtain the first unit of packed RBCs from the blood bank. ◯ ◯ Start an IV bolus of lactated Ringer's solution. ◯ ◯ Correct Answers:• Document the blood product transfusion in the client’s medical record: Indicated • Stay with the client for the first 15 min of the transfusion: Indicated • Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg: Not Indicated • Obtain the first unit of packed RBCs from the blood bank: Indicated • Start an IV bolus of lactated Ringer's solution: Not Indicated Explanation: The nurse should always document the transfusion in the medical record and remain with the client for the first 15 minutes to monitor for adverse reactions. Blood pressure should be monitored but not maintained by titrating the infusion rate. Starting an IV bolus of lactated Ringer's solution is not indicated during blood transfusion unless there is a specific order or issue like volume depletion. Question 5 of 70 A nurse is preparing to administer medication to a client who is 2 days postoperative following a hip arthroplasty. The nurse notes that the client is receiving enoxaparin subcutaneously. The nurse should explain that the purpose of enoxaparin is to do which of the following? ◯ Reduce the risk of deep-vein thrombosis. ◯ Prevent hypertensive crisis. ◯ Treat postoperative pain. ◯ Minimize the risk of a paralytic ileus. Correct Answer: ◯ Reduce the risk of deep-vein thrombosis. Explanation: Enoxaparin is a low-molecular-weight heparin used to prevent deep vein thrombosis (DVT) and pulmonary embolism, which are common complications following surgeries like hip arthroplasty.Question 6 of 70 A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? ◯ Stop the medication if you experience weight gain. ◯ Take the medication on an empty stomach. ◯ Decrease your intake of foods high in potassium. ◯ Do not discontinue the medication abruptly. Correct Answer: ◯ Do not discontinue the medication abruptly. Explanation: Prednisone, a corticosteroid, should not be discontinued abruptly to avoid adrenal insufficiency. The dosage should be gradually tapered under the guidance of a healthcare provider. Question 7 of 70 A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply.) Dry mouth Tinnitus Blurred vision Bradycardia Dry eyes Correct Answers: Dry mouth☐ Blurred vision Dry eyes Explanation: Oxybutynin is an anticholinergic medication used to treat overactive bladder. Common adverse effects of anticholinergic medications include dry mouth, blurred vision, and dry eyes due to the inhibition of secretions and effects on smooth muscle. Question 8 of 70 A nurse is preparing to administer dextrose 5% in water (D5W) 400 mL IV to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) gtt/min Correct Answer: 100 gtt/min Explanation: To calculate the drip rate, use the formula: Flow rate=(Volume to be infused×Drop factorTime in minutes)text{Flow rate} = left( frac{text{Volume to be infused} times text{Drop factor}}{text{Time in minutes}} right)Flow rate=(Time in minutesVolume to be infused×Drop factor) Flow rate=(400 mL×15 gtt/mL60 min)=100 gtt/mintext{Flow rate} = left( frac{400 , text{mL} times 15 , text{gtt/mL}}{60 , text{min}} right) = 100 , text{gtt/min}Flow rate=(60min400mL×15gtt/mL)=100gtt/min Question 9 of 70A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take? ◯ Administer the medication outside the 5-cm (2-in) radius of the umbilicus. ◯ Aspirate for blood return before injecting. ◯ Rub vigorously after the injection to promote absorption. ◯ Place a pressure dressing on the injection site to prevent bleeding. Correct Answer: ◯ Administer the medication outside the 5-cm (2-in) radius of the umbilicus. Explanation: Heparin is administered subcutaneously in the abdomen, and it is important to avoid injecting within 5 cm (2 in) of the umbilicus to minimize the risk of complications. Aspirating, rubbing, or applying a pressure dressing are not appropriate actions for subcutaneous heparin injections. Question 10 of 70 A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching? ◯ Hot flashes ◯ Urinary retention ◯ Constipation ◯ Bradycardia Correct Answer: ◯ Hot flashes Explanation: Tamoxifen is a selective estrogen receptor modulator (SERM) used to treat breast cancer. It commonly causes adverse effects similar to menopause, including hot flashes, as it blocks estrogen in breast tissue.Question 11 of 70 A nurse is reviewing the laboratory results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to the provider? ◯ Calcium level 9.2 mg/dL ◯ Magnesium level 1.6 mEq/L ◯ Digoxin level 1.1 ng/mL ◯ Potassium level 2.8 mEq/L Correct Answer: ◯ Potassium level 2.8 mEq/L Explanation: Hypokalemia (potassium level less than 3.5 mEq/L) increases the risk of digoxin toxicity. The nurse should report the low potassium level to the provider, as it can lead to serious cardiac arrhythmias in clients taking digoxin. Question 12 of 70 A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching? ◯ Decreases stomach acid secretion ◯ Neutralizes acids in the stomach ◯ Forms a protective barrier over ulcers ◯ Treats ulcers by eradicating H. pylori Correct Answer: ◯ Forms a protective barrier over ulcersExplanation: Sucralfate is a mucosal protectant that forms a gel-like barrier over the ulcer site to protect it from further damage by stomach acid, allowing the ulcer to heal. It does not affect acid secretion or eradicate H. pylori. Question 13 of 70 A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect? ◯ Tachycardia ◯ Oliguria ◯ Xerostomia ◯ Miosis Correct Answer: ◯ Miosis Explanation: Neostigmine, a cholinesterase inhibitor, can cause parasympathetic effects such as miosis (pupil constriction). Other adverse effects can include bradycardia, increased salivation, and increased urinary output. Question 14 of 70 A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) mg Correct Answer:300 mg Explanation: Convert the child’s weight from pounds to kilograms (44 lb ÷ 2.2 = 20 kg). Then multiply the weight by the dosage (15 mg/kg × 20 kg = 300 mg). The nurse should administer 300 mg per dose. Question 15 of 70 A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication? ◯ Constipation ◯ Tinnitus ◯ Hypoglycemia ◯ Joint pain Correct Answer: ◯ Tinnitus Explanation: Gentamicin, an aminoglycoside antibiotic, is ototoxic and can cause hearing loss, tinnitus, and vertigo. The nurse should report any signs of ototoxicity to the provider immediately to prevent permanent hearing damage. Question 16 of 70 A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching?◯ The client’s provider is required to complete medication reconciliation. ◯ Medication reconciliation at discharge is limited to the medication ordered at the time of discharge. ◯ A transition in care requires the nurse to conduct medication reconciliation. ◯ Medical reconciliation is limited to the name of the medications that the client is currently taking. Correct Answer: ◯ A transition in care requires the nurse to conduct medication reconciliation. Explanation: Medication reconciliation is a safety process in which the nurse reviews and documents all of a client’s medications when there is a transition in care, such as upon admission, transfer, or discharge. This helps prevent medication errors by ensuring the correct medications are continued or adjusted as needed. Question: 17 of 70 A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first? Report the incident to the charge nurse. Notify the provider. Check the client’s blood glucose. Fill out an incident report. Correct Answer: Check the client’s blood glucose.Explanation: When a medication error occurs, the priority is to assess the client for any adverse effects or harm caused by the error. Since metformin is used to lower blood glucose levels, the nurse should first check the client’s blood glucose to ensure they are not at risk of hypoglycemia. Other actions, such as notifying the provider and reporting the incident, should follow after assessing the client’s condition. Question: 18 of 70 A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? ☐ Potassium iodide Glucagon Atropine Protamine Correct Answer: Atropine Explanation: A cholinergic crisis is caused by excessive acetylcholine due to overmedication with cholinesterase inhibitors. Atropine, an anticholinergic drug, is used to reverse the muscarinic effects of cholinergic crisis, such as bradycardia and excessive salivation. Question: 19 of 70 A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? Increased neutrophil count☐ Increased RBC count Decreased prothrombin time Decreased triglycerides Correct Answer: Increased neutrophil count Explanation: Filgrastim is used to stimulate the production of neutrophils in clients with neutropenia, especially those receiving chemotherapy. An increase in neutrophil count indicates the effectiveness of the therapy. Question: 20 of 70 A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer? Methadone Naloxone Diazepam Bupropion Correct Answer: Naloxone Explanation: Naloxone is an opioid antagonist used to reverse opioid toxicity, including respiratory depression caused by heroin overdose. It works by competitively binding to opioid receptors.Question: 21 of 70 A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions? "Take one tablet three times a day before meals." "Take one tablet at onset of migraine." "Take up to eight tablets as needed within a 24-hour period." "Take one tablet every 15 minutes until migraine subsides." Correct Answer: "Take one tablet at onset of migraine." Explanation: Ergotamine is used to abort migraine attacks and should be taken at the first sign of a migraine to be most effective. It is not meant for routine daily use but rather for acute migraine relief. Question: 2 of 70 A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? "I will drink a glass of milk when I take the risedronate." "I will take the risedronate 15 minutes after my evening meal." "I should take an antacid with the risedronate to avoid nausea." "I should sit up for 30 minutes after taking the risedronate." Correct Answer: "I should sit up for 30 minutes after taking the risedronate."Explanation: Risedronate can cause esophageal irritation. To prevent this, clients should take the medication with a full glass of water and remain upright for at least 30 minutes after taking the medication. Question: 23 of 70 A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following overthecounter medications? Aspirin Ibuprofen Famotidine Bisacodyl Correct Answer: Ibuprofen Explanation: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can increase lithium levels, leading to toxicity. Aspirin is an alternative as it does not have the same effect. Question: 24 of 70 A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? Muscle weakness Sedation☐ Tinnitus Peripheral edema Correct Answer: Sedation Explanation: Metoclopramide can cause central nervous system (CNS) effects such as drowsiness and sedation. Monitoring for sedation is crucial to prevent complications. Question: 25 of 70 A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide? Minimize diaphoresis Maintain abstinence Lessen craving Prevent delirium tremens Correct Answer: Prevent delirium tremens Explanation: Chlordiazepoxide is a benzodiazepine used to prevent the severe withdrawal symptoms of alcohol, including delirium tremens (DTs), a potentially life-threatening condition. Question: 26 of 70 A nurse is reviewing the laboratory results for a client who is receiving heparin via continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings?☐ Potassium 5.0 mEq/L aPTT 2 times the control Hemoglobin 15 g/dL Platelets 96,000/mm³ Correct Answer: Platelets 96,000/mm³ Explanation: A significant drop in platelet count can indicate heparin-induced thrombocytopenia (HIT), a potentially serious complication of heparin therapy. The nurse should discontinue the heparin infusion and notify the provider. Question: 31 of 70 A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider? Vomiting Blood in the urine Positive Chvostek's sign Ringing in the ears Correct Answer: Blood in the urine Explanation: Blood in the urine (hematuria) is a sign of bleeding, which is a potential adverse effect of heparin therapy. Heparin increases the risk of bleeding, so this finding should be reported to the provider immediately.Question: 32 of 70 A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? Decrease in WBC count Decrease in amount of time sleeping Increase in appetite Increase in ability to focus Correct Answer: Increase in ability to focus Explanation: Graves' disease is a hyperthyroid condition that causes symptoms such as restlessness, increased metabolic rate, and difficulty concentrating. An improvement in the client's ability to focus indicates that the medication is effective in controlling hyperthyroid symptoms. Question: 33 of 70 A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge? The client's capnography has returned to baseline. The client can respond to their name when called. The client is passing flatus.☐ The client is requesting oral intake. Correct Answer: The client can respond to their name when called. Explanation: Midazolam is a sedative that causes short-term sedation. The nurse should ensure that the client is awake, alert, and able to respond to verbal stimuli before discharge. This ensures that the effects of the sedative have sufficiently worn off. Question: 34 of 70 A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching? Chew on the medication stick to release the medication. Leave the medication stick in one location of the mouth until melted. Allow the medication 1 hr for analgesia effects to begin. Store unused medication sticks in a storage container. Correct Answer: Leave the medication stick in one location of the mouth until melted. Explanation: Oral transmucosal fentanyl lozenges are designed to be absorbed through the oral mucosa. The client should leave the lozenge in one location in the mouth to allow the medication to dissolve slowly and be absorbed effectively. Question: 35 of 70A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? Tingling of fingers Constipation Weight gain Oliguria Correct Answer: Tingling of fingers Explanation: Acetazolamide, a carbonic anhydrase inhibitor, can cause paresthesia (tingling sensation), especially in the fingers and toes. The client should be instructed to report this side effect if it occurs. Question: 36 of 70 A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? Weigh the client weekly. Determine apical pulse prior to administering. Administer the medication 30 min prior to breakfast. Monitor the client for jaundice. Correct Answer: Determine apical pulse prior to administering.Explanation: Metoprolol is a beta-blocker that can decrease heart rate. The nurse should assess the apical pulse prior to administration and hold the medication if the pulse is below 60 beats per minute. Question: 37 of 70 A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? ☐ Ondansetron Magnesium sulfate Flumazenil Protamine sulfate Correct Answer: Flumazenil Explanation: Flumazenil is the antidote for benzodiazepine overdose, such as diazepam. It reverses the sedative effects of benzodiazepines by competitively inhibiting their action at the GABA receptor. Question: 38 of 70 A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately? Dyspepsia Diarrhea☐ Dizziness Dyspnea Correct Answer: Dyspnea Explanation: Dyspnea (difficulty breathing) is a serious adverse effect that may indicate that the client is experiencing bronchoconstriction, a potential side effect of donepezil. This should be reported to the provider immediately. Question: 39 of 70 A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? Turn the client to a side-lying position. Disconnect the client’s oxytocin from the maintenance IV. Apply oxygen to the client by face mask. Increase the client’s maintenance IV infusion rate. Correct Answer: Turn the client to a side-lying position. Explanation: Late decelerations are a sign of uteroplacental insufficiency. The first action the nurse should take is to turn the client to a side-lying position to improve blood flow to the placenta. Other interventions such as applying oxygen and discontinuing oxytocin may follow if the condition does not improve.Question: 40 of 70 A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.) Report muscle pain to the provider. Avoid taking the medication with grapefruit juice. Take the medication in the early morning. Expect a flushing of the skin as a reaction to the medication. Expect therapy with this medication to be lifelong. Correct Answers: • Report muscle pain to the provider. • Avoid taking the medication with grapefruit juice. • Expect therapy with this medication to be lifelong. Explanation: Muscle pain can indicate myopathy, a serious side effect of simvastatin. Grapefruit juice can increase the levels of statins in the blood, leading to toxicity. Statins are often prescribed for lifelong use to manage cholesterol levels. The medication is typically taken in the evening, not in the early morning, and skin flushing is not a common side effect. Question: 42 of 70 A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? "I should take the medication with food."☐ "I should take naproxen if I develop joint pain." "I should tell my provider if I develop a sore throat." "I should expect the medication to cause my urine to look orange." Correct Answer: I should tell my provider if I develop a sore throat. Explanation: Captopril, an ACE inhibitor, can cause neutropenia, which may result in an increased risk of infection. A sore throat could be a sign of infection, and the client should notify their provider. Question: 43 of 70 A nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill until I get home today." Which of the following actions should the nurse take? Document the refusal and inform the client's provider. File an incident report with the risk manager. Contact the pharmacist to pick up the medication. Give the client the medication to take at home and document that it was administered. Correct Answer: Document the refusal and inform the client's provider. Explanation: The nurse should document the client's refusal and inform the provider to address the situation and potentially adjust the care plan. Question: 44 of 70A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate? Felodipine Guaifenesin Digoxin Regular insulin Correct Answer: Digoxin Explanation: Calcium gluconate can increase the risk of digoxin toxicity. The nurse should monitor the client closely for signs of digoxin toxicity when these medications are administered together. Question: 45 of 70 A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply.) Blood glucose levels will be monitored during therapy. Avoid contact with people who have known infections. Take the medication 1 hr before breakfast. Decrease dietary intake of foods containing potassium. Grapefruit juice can increase the effects of the medication.Correct Answers: • Blood glucose levels will be monitored during therapy. • Avoid contact with people who have known infections. • Grapefruit juice can increase the effects of the medication. Explanation: Methylprednisolone, a corticosteroid, can increase blood glucose levels and suppress the immune system, so clients should avoid exposure to infections. Grapefruit juice can increase corticosteroid levels in the bloodstream, leading to an increased risk of side effects. Question: 46 of 70 A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication? Oral candidiasis Headache Joint pain Adrenal suppression Correct Answer: Oral candidiasis Explanation: Fluticasone is a corticosteroid inhaler that can cause oral candidiasis (thrush) if not properly rinsed after use. Using a spacer can reduce the amount of medication that remains in the mouth and throat, decreasing the risk of developing thrush.Question: 47 of 70 A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects of morphine? Constipation Drowsiness Facial flushing Itching Correct Answer: Constipation Explanation: Morphine can cause constipation as a common side effect. Docusate sodium is a stool softener that helps prevent or relieve constipation associated with opioid use. Question: 48 of 70 A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication? Cough Joint pain Alopecia InsomniaCorrect Answer: Insomnia Explanation: Bupropion is a stimulant-like antidepressant that can cause insomnia as a side effect. Clients should be advised to take the medication early in the day to minimize sleep disturbances.