ATI PN PHARMACOLOGY PROCTORED EXAM V9 2026/2027 - 400 VERIFIED QUESTIONS WITH
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V9 2026/2027 | 400Q Mixed A/B/C/D: A=109 B=93 C=93 D=105 | 2026/2027 - No
Repeat Edition
9 new versions - 100% unique questions - no repeat from previous PN Pharm file. Original 2026/2027 content, mixed keys.
1. [V9] Docusate use? - Case 1 PN Pharm 2026/2027
A. Pain
B. Stool softener - softens stool, needs fluids
C. Stimulant
D. Fever
Answer: B
Rationale: Docusate softener. - Version 9 2026/2027
2. [V9] Levothyroxine teaching? - Case 2 PN Pharm 2026/2027
A. Take with iron
B. Take 30-60 min before breakfast on empty stomach, same time daily
C. Take with food, at night
D. Take with milk
Answer: B
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 9 2026/2027
3. [V9] LPN cannot do IV push - Case 3 PN Pharm 2026/2027
A. LPN cannot do IV push meds, initial assessment, teaching, unstable clients
B. Can do IV push
C. Can do assessment
D. Can do all
Answer: A
Rationale: LPN scope no IV push, no initial assessment. - Version 9 2026/2027
4. [V9] Lisinopril causes dry cough due to? - Case 4 PN Pharm 2026/2027
A. K+ loss
B. Na retention
C. Bradykinin accumulation in lungs - ACE inhibitor side effect
D. Histamine
Answer: C
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 9 2026/2027
5. [V9] Epinephrine use in anaphylaxis? - Case 5 PN Pharm 2026/2027
A. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
B. Hypotension only
C. Bradycardia only
D. No use
Answer: A
Rationale: Epi first in anaphylaxis IM. - Version 9 2026/2027
6. [V9] Morphine side effects PN monitor? - Case 6 PN Pharm 2026/2027
A. No effects
B. Diarrhea
C. Tachycardia only
D. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
Answer: D
Rationale: Opioid side effects resp depression. - Version 9 2026/2027
7. [V9] Ondansetron use? - Case 7 PN Pharm 2026/2027
A. Pain
B. Fever
C. Nausea/vomiting - monitor QT, headache, constipation
D. Diarrhea
Answer: C
Rationale: Zofran antiemetic QT risk. - Version 9 2026/2027
8. [V9] Ibuprofen contraindication? - Case 8 PN Pharm 2026/2027
A. Safe always
B. No risk
C. No contraindication
, D. Avoid in ulcer, GI bleed, kidney disease, pregnancy 3rd trimester, bleeding risk
Answer: D
Rationale: NSAID contraindications GI bleed, renal. - Version 9 2026/2027
9. [V9] Glargine (Lantus) rule? - Case 9 PN Pharm 2026/2027
A. Do not mix, given at same time daily, no peak - basal insulin
B. Mix with regular
C. IV push
D. Give with meals only
Answer: A
Rationale: Glargine long-acting no mix, basal. - Version 9 2026/2027
10. [V9] Atropine use? - Case 10 PN Pharm 2026/2027
A. Tachycardia
B. No use
C. Bradycardia symptomatic, organophosphate poisoning antidote
D. Hypertension
Answer: C
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 9 2026/2027
11. [V9] Psyllium teaching? - Case 11 PN Pharm 2026/2027
A. Take dry
B. No water
C. At bedtime only
D. Take with full glass water, may cause bloating, fiber
Answer: D
Rationale: Psyllium needs water. - Version 9 2026/2027
12. [V9] Ciprofloxacin teaching? - Case 12 PN Pharm 2026/2027
A. Take with milk
B. Take at bedtime only
C. No teaching
D. Avoid antacids, iron, dairy within 2h, drink fluids, avoid sun - tendon rupture risk
Answer: D
Rationale: Cipro avoid cations, sun, tendon risk. - Version 9 2026/2027
13. [V9] Gentamicin toxicity? - Case 13 PN Pharm 2026/2027
A. Weight gain
B. Hyperkalemia only
C. Nephrotoxicity (creatinine/BUN) and ototoxicity (hearing/tinnitus)
D. No toxicity
Answer: C
Rationale: Aminoglycoside nephro/oto. - Version 9 2026/2027
14. [V9] Benzodiazepine overdose antidote? - Case 14 PN Pharm 2026/2027
A. Protamine
B. Flumazenil
C. Vitamin K
D. Naloxone
Answer: B
Rationale: Flumazenil reverses benzos, risk seizures. - Version 9 2026/2027
15. [V9] Heparin antidote? - Case 15 PN Pharm 2026/2027
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: C
Rationale: Protamine binds heparin. - Version 9 2026/2027
16. [V9] Insulin lispro onset? - Case 16 PN Pharm 2026/2027
A. 2 hours
B. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
C. 6 hours
D. 12 hours
Answer: B
Rationale: Lispro rapid 15 min onset. - Version 9 2026/2027
17. [V9] Levodopa-carbidopa teaching? - Case 17 PN Pharm 2026/2027
, A. Take low protein, avoid high protein reduces absorption, dark sweat/urine normal
B. No teaching
C. Take with milk only
D. Take with high protein
Answer: A
Rationale: Levodopa low protein diet. - Version 9 2026/2027
18. [V9] Fluoxetine (SSRI) onset? - Case 18 PN Pharm 2026/2027
A. Immediate
B. 2-4 weeks for full effect, watch for increased suicidal ideation early
C. No onset
D. 1 hour
Answer: B
Rationale: SSRI 2-4 weeks, black box suicide early. - Version 9 2026/2027
19. [V9] Digoxin antidote? - Case 19 PN Pharm 2026/2027
A. Vitamin K
B. Protamine
C. Digoxin immune Fab (Digibind)
D. Naloxone
Answer: C
Rationale: Digibind binds digoxin in toxicity. - Version 9 2026/2027
20. [V9] Phenytoin teaching? - Case 20 PN Pharm 2026/2027
A. Good oral hygiene, avoid alcohol, therapeutic 10-20 mcg/mL, gum hyperplasia risk
B. Double dose if missed
C. No hygiene
D. Skip doses
Answer: A
Rationale: Phenytoin gum hyperplasia, hygiene. - Version 9 2026/2027
21. [V9] Omeprazole teaching? - Case 21 PN Pharm 2026/2027
A. Take with food always
B. Double dose
C. Take 30 min before breakfast, long-term risk fractures, low Mg2+
D. No risk
Answer: C
Rationale: PPI before breakfast. - Version 9 2026/2027
22. [V9] PN role in blood transfusion? - Case 22 PN Pharm 2026/2027
A. Crossmatch
B. Order blood
C. Start transfusion
D. Monitor transfusion, vitals q15min, stop if reaction, notify RN/provider
Answer: D
Rationale: PN monitors transfusion, stops if reaction. - Version 9 2026/2027
23. [V9] Vancomycin infusion reaction red man? - Case 23 PN Pharm 2026/2027
A. No action
B. Give fast
C. Stop forever
D. Infuse slowly over 60-90 min, antihistamine, not allergy
Answer: D
Rationale: Red man from fast infusion - slow infusion. - Version 9 2026/2027
24. [V9] Sertraline interaction? - Case 24 PN Pharm 2026/2027
A. Safe with MAOI
B. No risk
C. Avoid MAOIs 14 days, risk serotonin syndrome with tramadol/St John's wort
D. No interactions
Answer: C
Rationale: SSRI + MAOI serotonin syndrome. - Version 9 2026/2027
25. [V9] Carbamazepine side effect? - Case 25 PN Pharm 2026/2027
A. No effects
B. No monitoring
C. Blood dyscrasias, check CBC, rash SJS risk, avoid grapefruit
D. Weight loss only
, Answer: C
Rationale: Carbamazepine CBC, rash. - Version 9 2026/2027
26. [V9] Loperamide use? - Case 26 PN Pharm 2026/2027
A. Pain
B. Fever
C. Constipation
D. Diarrhea - anti-diarrheal, monitor fluid/electrolytes
Answer: D
Rationale: Loperamide anti-diarrheal. - Version 9 2026/2027
27. [V9] NPH insulin appearance? - Case 27 PN Pharm 2026/2027
A. Cloudy - must roll not shake, 30 min to 1h onset, peak 4-12h
B. Clear yellow
C. No appearance
D. Clear
Answer: A
Rationale: NPH cloudy intermediate. - Version 9 2026/2027
28. [V9] Warfarin antidote for bleeding? - Case 28 PN Pharm 2026/2027
A. Naloxone
B. Vitamin K + 4F-PCC for life-threatening
C. Protamine
D. Calcium
Answer: B
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 9 2026/2027
29. [V9] Potassium chloride administration? - Case 29 PN Pharm 2026/2027
A. IV push
B. No monitor
C. Never IV push - dilute, give via pump, check kidney function, monitor EKG
D. Give fast
Answer: C
Rationale: KCl never IV push, dilute. - Version 9 2026/2027
30. [V9] Montelukast when to take? - Case 30 PN Pharm 2026/2027
A. Evening - asthma prophylaxis, not rescue
B. No timing
C. Morning only
D. During attack only
Answer: A
Rationale: Montelukast evening daily, not rescue. - Version 9 2026/2027
31. [V9] Hypoglycemia treatment conscious PN? - Case 31 PN Pharm 2026/2027
A. No treatment
B. Water
C. Give insulin
D. 15g fast carb juice/glucose tabs, recheck 15 min, repeat if <70
Answer: D
Rationale: Rule of 15 for hypo. - Version 9 2026/2027
32. [V9] A client taking amlodipine reports ankle swelling. Best response? - Case 32 PN Pharm 2026/2027
A. Stop drug immediately
B. Take double dose
C. Ankle swelling common with amlodipine - elevate legs, notify provider if worsens, monitor BP
D. No action
Answer: C
Rationale: CCB amlodipine causes peripheral edema - elevate legs, monitor. - Version 9 2026/2027
33. [V9] Metformin and contrast dye - why hold? - Case 33 PN Pharm 2026/2027
A. No reason
B. Causes hyperglycemia
C. Risk lactic acidosis if contrast-induced AKI - hold 48h before/after per protocol
D. Causes HTN
Answer: C
Rationale: Hold metformin before contrast to prevent lactic acidosis with AKI. - Version 9 2026/2027
34. [V9] Ipratropium (Atrovent) teaching? - Case 34 PN Pharm 2026/2027
A. Take with food
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V9 2026/2027 | 400Q Mixed A/B/C/D: A=109 B=93 C=93 D=105 | 2026/2027 - No
Repeat Edition
9 new versions - 100% unique questions - no repeat from previous PN Pharm file. Original 2026/2027 content, mixed keys.
1. [V9] Docusate use? - Case 1 PN Pharm 2026/2027
A. Pain
B. Stool softener - softens stool, needs fluids
C. Stimulant
D. Fever
Answer: B
Rationale: Docusate softener. - Version 9 2026/2027
2. [V9] Levothyroxine teaching? - Case 2 PN Pharm 2026/2027
A. Take with iron
B. Take 30-60 min before breakfast on empty stomach, same time daily
C. Take with food, at night
D. Take with milk
Answer: B
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 9 2026/2027
3. [V9] LPN cannot do IV push - Case 3 PN Pharm 2026/2027
A. LPN cannot do IV push meds, initial assessment, teaching, unstable clients
B. Can do IV push
C. Can do assessment
D. Can do all
Answer: A
Rationale: LPN scope no IV push, no initial assessment. - Version 9 2026/2027
4. [V9] Lisinopril causes dry cough due to? - Case 4 PN Pharm 2026/2027
A. K+ loss
B. Na retention
C. Bradykinin accumulation in lungs - ACE inhibitor side effect
D. Histamine
Answer: C
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 9 2026/2027
5. [V9] Epinephrine use in anaphylaxis? - Case 5 PN Pharm 2026/2027
A. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
B. Hypotension only
C. Bradycardia only
D. No use
Answer: A
Rationale: Epi first in anaphylaxis IM. - Version 9 2026/2027
6. [V9] Morphine side effects PN monitor? - Case 6 PN Pharm 2026/2027
A. No effects
B. Diarrhea
C. Tachycardia only
D. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
Answer: D
Rationale: Opioid side effects resp depression. - Version 9 2026/2027
7. [V9] Ondansetron use? - Case 7 PN Pharm 2026/2027
A. Pain
B. Fever
C. Nausea/vomiting - monitor QT, headache, constipation
D. Diarrhea
Answer: C
Rationale: Zofran antiemetic QT risk. - Version 9 2026/2027
8. [V9] Ibuprofen contraindication? - Case 8 PN Pharm 2026/2027
A. Safe always
B. No risk
C. No contraindication
, D. Avoid in ulcer, GI bleed, kidney disease, pregnancy 3rd trimester, bleeding risk
Answer: D
Rationale: NSAID contraindications GI bleed, renal. - Version 9 2026/2027
9. [V9] Glargine (Lantus) rule? - Case 9 PN Pharm 2026/2027
A. Do not mix, given at same time daily, no peak - basal insulin
B. Mix with regular
C. IV push
D. Give with meals only
Answer: A
Rationale: Glargine long-acting no mix, basal. - Version 9 2026/2027
10. [V9] Atropine use? - Case 10 PN Pharm 2026/2027
A. Tachycardia
B. No use
C. Bradycardia symptomatic, organophosphate poisoning antidote
D. Hypertension
Answer: C
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 9 2026/2027
11. [V9] Psyllium teaching? - Case 11 PN Pharm 2026/2027
A. Take dry
B. No water
C. At bedtime only
D. Take with full glass water, may cause bloating, fiber
Answer: D
Rationale: Psyllium needs water. - Version 9 2026/2027
12. [V9] Ciprofloxacin teaching? - Case 12 PN Pharm 2026/2027
A. Take with milk
B. Take at bedtime only
C. No teaching
D. Avoid antacids, iron, dairy within 2h, drink fluids, avoid sun - tendon rupture risk
Answer: D
Rationale: Cipro avoid cations, sun, tendon risk. - Version 9 2026/2027
13. [V9] Gentamicin toxicity? - Case 13 PN Pharm 2026/2027
A. Weight gain
B. Hyperkalemia only
C. Nephrotoxicity (creatinine/BUN) and ototoxicity (hearing/tinnitus)
D. No toxicity
Answer: C
Rationale: Aminoglycoside nephro/oto. - Version 9 2026/2027
14. [V9] Benzodiazepine overdose antidote? - Case 14 PN Pharm 2026/2027
A. Protamine
B. Flumazenil
C. Vitamin K
D. Naloxone
Answer: B
Rationale: Flumazenil reverses benzos, risk seizures. - Version 9 2026/2027
15. [V9] Heparin antidote? - Case 15 PN Pharm 2026/2027
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: C
Rationale: Protamine binds heparin. - Version 9 2026/2027
16. [V9] Insulin lispro onset? - Case 16 PN Pharm 2026/2027
A. 2 hours
B. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
C. 6 hours
D. 12 hours
Answer: B
Rationale: Lispro rapid 15 min onset. - Version 9 2026/2027
17. [V9] Levodopa-carbidopa teaching? - Case 17 PN Pharm 2026/2027
, A. Take low protein, avoid high protein reduces absorption, dark sweat/urine normal
B. No teaching
C. Take with milk only
D. Take with high protein
Answer: A
Rationale: Levodopa low protein diet. - Version 9 2026/2027
18. [V9] Fluoxetine (SSRI) onset? - Case 18 PN Pharm 2026/2027
A. Immediate
B. 2-4 weeks for full effect, watch for increased suicidal ideation early
C. No onset
D. 1 hour
Answer: B
Rationale: SSRI 2-4 weeks, black box suicide early. - Version 9 2026/2027
19. [V9] Digoxin antidote? - Case 19 PN Pharm 2026/2027
A. Vitamin K
B. Protamine
C. Digoxin immune Fab (Digibind)
D. Naloxone
Answer: C
Rationale: Digibind binds digoxin in toxicity. - Version 9 2026/2027
20. [V9] Phenytoin teaching? - Case 20 PN Pharm 2026/2027
A. Good oral hygiene, avoid alcohol, therapeutic 10-20 mcg/mL, gum hyperplasia risk
B. Double dose if missed
C. No hygiene
D. Skip doses
Answer: A
Rationale: Phenytoin gum hyperplasia, hygiene. - Version 9 2026/2027
21. [V9] Omeprazole teaching? - Case 21 PN Pharm 2026/2027
A. Take with food always
B. Double dose
C. Take 30 min before breakfast, long-term risk fractures, low Mg2+
D. No risk
Answer: C
Rationale: PPI before breakfast. - Version 9 2026/2027
22. [V9] PN role in blood transfusion? - Case 22 PN Pharm 2026/2027
A. Crossmatch
B. Order blood
C. Start transfusion
D. Monitor transfusion, vitals q15min, stop if reaction, notify RN/provider
Answer: D
Rationale: PN monitors transfusion, stops if reaction. - Version 9 2026/2027
23. [V9] Vancomycin infusion reaction red man? - Case 23 PN Pharm 2026/2027
A. No action
B. Give fast
C. Stop forever
D. Infuse slowly over 60-90 min, antihistamine, not allergy
Answer: D
Rationale: Red man from fast infusion - slow infusion. - Version 9 2026/2027
24. [V9] Sertraline interaction? - Case 24 PN Pharm 2026/2027
A. Safe with MAOI
B. No risk
C. Avoid MAOIs 14 days, risk serotonin syndrome with tramadol/St John's wort
D. No interactions
Answer: C
Rationale: SSRI + MAOI serotonin syndrome. - Version 9 2026/2027
25. [V9] Carbamazepine side effect? - Case 25 PN Pharm 2026/2027
A. No effects
B. No monitoring
C. Blood dyscrasias, check CBC, rash SJS risk, avoid grapefruit
D. Weight loss only
, Answer: C
Rationale: Carbamazepine CBC, rash. - Version 9 2026/2027
26. [V9] Loperamide use? - Case 26 PN Pharm 2026/2027
A. Pain
B. Fever
C. Constipation
D. Diarrhea - anti-diarrheal, monitor fluid/electrolytes
Answer: D
Rationale: Loperamide anti-diarrheal. - Version 9 2026/2027
27. [V9] NPH insulin appearance? - Case 27 PN Pharm 2026/2027
A. Cloudy - must roll not shake, 30 min to 1h onset, peak 4-12h
B. Clear yellow
C. No appearance
D. Clear
Answer: A
Rationale: NPH cloudy intermediate. - Version 9 2026/2027
28. [V9] Warfarin antidote for bleeding? - Case 28 PN Pharm 2026/2027
A. Naloxone
B. Vitamin K + 4F-PCC for life-threatening
C. Protamine
D. Calcium
Answer: B
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 9 2026/2027
29. [V9] Potassium chloride administration? - Case 29 PN Pharm 2026/2027
A. IV push
B. No monitor
C. Never IV push - dilute, give via pump, check kidney function, monitor EKG
D. Give fast
Answer: C
Rationale: KCl never IV push, dilute. - Version 9 2026/2027
30. [V9] Montelukast when to take? - Case 30 PN Pharm 2026/2027
A. Evening - asthma prophylaxis, not rescue
B. No timing
C. Morning only
D. During attack only
Answer: A
Rationale: Montelukast evening daily, not rescue. - Version 9 2026/2027
31. [V9] Hypoglycemia treatment conscious PN? - Case 31 PN Pharm 2026/2027
A. No treatment
B. Water
C. Give insulin
D. 15g fast carb juice/glucose tabs, recheck 15 min, repeat if <70
Answer: D
Rationale: Rule of 15 for hypo. - Version 9 2026/2027
32. [V9] A client taking amlodipine reports ankle swelling. Best response? - Case 32 PN Pharm 2026/2027
A. Stop drug immediately
B. Take double dose
C. Ankle swelling common with amlodipine - elevate legs, notify provider if worsens, monitor BP
D. No action
Answer: C
Rationale: CCB amlodipine causes peripheral edema - elevate legs, monitor. - Version 9 2026/2027
33. [V9] Metformin and contrast dye - why hold? - Case 33 PN Pharm 2026/2027
A. No reason
B. Causes hyperglycemia
C. Risk lactic acidosis if contrast-induced AKI - hold 48h before/after per protocol
D. Causes HTN
Answer: C
Rationale: Hold metformin before contrast to prevent lactic acidosis with AKI. - Version 9 2026/2027
34. [V9] Ipratropium (Atrovent) teaching? - Case 34 PN Pharm 2026/2027
A. Take with food
