ATI PN PHARMACOLOGY PROCTORED EXAM V6 2026/2027 - 400 VERIFIED QUESTIONS WITH
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V6 2026/2027 | 400Q Mixed A/B/C/D: A=101 B=102 C=95 D=102 | 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. [V6] NPH insulin appearance? - Case 1 PN Pharm 2026/2027
A. No appearance
B. Clear yellow
C. Cloudy - must roll not shake, 30 min to 1h onset, peak 4-12h
D. Clear
Answer: C
Rationale: NPH cloudy intermediate. - Version 6 2026/2027
2. [V6] Psyllium teaching? - Case 2 PN Pharm 2026/2027
A. At bedtime only
B. No water
C. Take dry
D. Take with full glass water, may cause bloating, fiber
Answer: D
Rationale: Psyllium needs water. - Version 6 2026/2027
3. [V6] Metronidazole teaching? - Case 3 PN Pharm 2026/2027
A. Avoid alcohol during and 48h after - disulfiram reaction nausea/vomiting
B. Drink alcohol
C. No teaching
D. Take with alcohol
Answer: A
Rationale: Flagyl no alcohol disulfiram. - Version 6 2026/2027
4. [V6] Acetaminophen overdose antidote? - Case 4 PN Pharm 2026/2027
A. Protamine
B. Vitamin K
C. N-acetylcysteine (NAC) within 8 hours
D. Naloxone
Answer: C
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 6 2026/2027
5. [V6] Lisinopril causes dry cough due to? - Case 5 PN Pharm 2026/2027
A. Na retention
B. K+ loss
C. Bradykinin accumulation in lungs - ACE inhibitor side effect
D. Histamine
Answer: C
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 6 2026/2027
6. [V6] Morphine side effects PN monitor? - Case 6 PN Pharm 2026/2027
A. Diarrhea
B. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
C. Tachycardia only
D. No effects
Answer: B
Rationale: Opioid side effects resp depression. - Version 6 2026/2027
7. [V6] Iron supplement teaching? - Case 7 PN Pharm 2026/2027
A. Take with OJ/Vit C on empty stomach, dark green stools normal, constipation
B. No teaching
C. Take with milk
D. Take with antacid
Answer: A
Rationale: Iron with Vit C, dark stools normal. - Version 6 2026/2027
8. [V6] Levothyroxine teaching? - Case 8 PN Pharm 2026/2027
A. Take with iron
B. Take with food, at night
C. Take 30-60 min before breakfast on empty stomach, same time daily
, D. Take with milk
Answer: C
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 6 2026/2027
9. [V6] Furosemide expected side effect? - Case 9 PN Pharm 2026/2027
A. Hypokalemia, hypotension, dehydration - monitor K+, I&O;, BP
B. Hyperkalemia
C. Hypernatremia
D. No side effects
Answer: A
Rationale: Loop diuretic wastes K+ - monitor hypokalemia, give K+ rich foods. - Version 6 2026/2027
10. [V6] Prednisone long-term side effects? - Case 10 PN Pharm 2026/2027
A. Hypoglycemia
B. Weight gain, hyperglycemia, moon face, buffalo hump, osteoporosis, infection risk
C. No effects
D. Weight loss
Answer: B
Rationale: Steroids cause Cushingoid appearance, hyperglycemia, osteoporosis. - Version 6 2026/2027
11. [V6] Docusate use? - Case 11 PN Pharm 2026/2027
A. Stool softener - softens stool, needs fluids
B. Stimulant
C. Pain
D. Fever
Answer: A
Rationale: Docusate softener. - Version 6 2026/2027
12. [V6] Ciprofloxacin teaching? - Case 12 PN Pharm 2026/2027
A. Avoid antacids, iron, dairy within 2h, drink fluids, avoid sun - tendon rupture risk
B. Take at bedtime only
C. Take with milk
D. No teaching
Answer: A
Rationale: Cipro avoid cations, sun, tendon risk. - Version 6 2026/2027
13. [V6] Heparin antidote? - Case 13 PN Pharm 2026/2027
A. Protamine sulfate
B. Vitamin K
C. Flumazenil
D. Naloxone
Answer: A
Rationale: Protamine binds heparin. - Version 6 2026/2027
14. [V6] Amoxicillin allergic reaction first? - Case 14 PN Pharm 2026/2027
A. Give next dose
B. Stop drug, notify provider, assess airway - anaphylaxis risk
C. Double dose
D. Take with milk
Answer: B
Rationale: Penicillin allergy stop drug, airway assessment. - Version 6 2026/2027
15. [V6] Hypoglycemia treatment conscious PN? - Case 15 PN Pharm 2026/2027
A. Give insulin
B. 15g fast carb juice/glucose tabs, recheck 15 min, repeat if <70
C. Water
D. No treatment
Answer: B
Rationale: Rule of 15 for hypo. - Version 6 2026/2027
16. [V6] Fluoxetine (SSRI) onset? - Case 16 PN Pharm 2026/2027
A. Immediate
B. 1 hour
C. No onset
D. 2-4 weeks for full effect, watch for increased suicidal ideation early
Answer: D
Rationale: SSRI 2-4 weeks, black box suicide early. - Version 6 2026/2027
17. [V6] A client taking amlodipine reports ankle swelling. Best response? - Case 17 PN Pharm 2026/2027
, A. No action
B. Stop drug immediately
C. Take double dose
D. Ankle swelling common with amlodipine - elevate legs, notify provider if worsens, monitor BP
Answer: D
Rationale: CCB amlodipine causes peripheral edema - elevate legs, monitor. - Version 6 2026/2027
18. [V6] Sertraline interaction? - Case 18 PN Pharm 2026/2027
A. Safe with MAOI
B. Avoid MAOIs 14 days, risk serotonin syndrome with tramadol/St John's wort
C. No interactions
D. No risk
Answer: B
Rationale: SSRI + MAOI serotonin syndrome. - Version 6 2026/2027
19. [V6] Gentamicin toxicity? - Case 19 PN Pharm 2026/2027
A. No toxicity
B. Nephrotoxicity (creatinine/BUN) and ototoxicity (hearing/tinnitus)
C. Weight gain
D. Hyperkalemia only
Answer: B
Rationale: Aminoglycoside nephro/oto. - Version 6 2026/2027
20. [V6] Lithium therapeutic level? - Case 20 PN Pharm 2026/2027
A. 0.6-1.2 mEq/L, toxicity >1.5 - monitor kidney, thyroid, hydration
B. 10
C. 5.0
D. 0.1
Answer: A
Rationale: Lithium narrow therapeutic, monitor. - Version 6 2026/2027
21. [V6] Digoxin antidote? - Case 21 PN Pharm 2026/2027
A. Protamine
B. Naloxone
C. Vitamin K
D. Digoxin immune Fab (Digibind)
Answer: D
Rationale: Digibind binds digoxin in toxicity. - Version 6 2026/2027
22. [V6] Atropine use? - Case 22 PN Pharm 2026/2027
A. No use
B. Hypertension
C. Tachycardia
D. Bradycardia symptomatic, organophosphate poisoning antidote
Answer: D
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 6 2026/2027
23. [V6] Haloperidol EPS treatment? - Case 23 PN Pharm 2026/2027
A. No treatment
B. Benztropine/diphenhydramine for acute dystonia, monitor EPS
C. No monitor
D. Stop water
Answer: B
Rationale: Antipsychotic EPS benztropine. - Version 6 2026/2027
24. [V6] Ibuprofen contraindication? - Case 24 PN Pharm 2026/2027
A. Avoid in ulcer, GI bleed, kidney disease, pregnancy 3rd trimester, bleeding risk
B. No contraindication
C. No risk
D. Safe always
Answer: A
Rationale: NSAID contraindications GI bleed, renal. - Version 6 2026/2027
25. [V6] Benzodiazepine overdose antidote? - Case 25 PN Pharm 2026/2027
A. Naloxone
B. Protamine
C. Flumazenil
D. Vitamin K
, Answer: C
Rationale: Flumazenil reverses benzos, risk seizures. - Version 6 2026/2027
26. [V6] Insulin lispro onset? - Case 26 PN Pharm 2026/2027
A. 2 hours
B. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
C. 12 hours
D. 6 hours
Answer: B
Rationale: Lispro rapid 15 min onset. - Version 6 2026/2027
27. [V6] LPN cannot do IV push - Case 27 PN Pharm 2026/2027
A. Can do assessment
B. Can do IV push
C. Can do all
D. LPN cannot do IV push meds, initial assessment, teaching, unstable clients
Answer: D
Rationale: LPN scope no IV push, no initial assessment. - Version 6 2026/2027
28. [V6] Metformin and contrast dye - why hold? - Case 28 PN Pharm 2026/2027
A. Causes HTN
B. Causes hyperglycemia
C. Risk lactic acidosis if contrast-induced AKI - hold 48h before/after per protocol
D. No reason
Answer: C
Rationale: Hold metformin before contrast to prevent lactic acidosis with AKI. - Version 6 2026/2027
29. [V6] Epinephrine use in anaphylaxis? - Case 29 PN Pharm 2026/2027
A. No use
B. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
C. Hypotension only
D. Bradycardia only
Answer: B
Rationale: Epi first in anaphylaxis IM. - Version 6 2026/2027
30. [V6] Ondansetron use? - Case 30 PN Pharm 2026/2027
A. Diarrhea
B. Pain
C. Fever
D. Nausea/vomiting - monitor QT, headache, constipation
Answer: D
Rationale: Zofran antiemetic QT risk. - Version 6 2026/2027
31. [V6] Carbamazepine side effect? - Case 31 PN Pharm 2026/2027
A. No effects
B. Blood dyscrasias, check CBC, rash SJS risk, avoid grapefruit
C. No monitoring
D. Weight loss only
Answer: B
Rationale: Carbamazepine CBC, rash. - Version 6 2026/2027
32. [V6] Ipratropium (Atrovent) teaching? - Case 32 PN Pharm 2026/2027
A. Take with food
B. No teaching
C. No rinse
D. Avoid if peanut allergy - contains soy lecithin, rinse mouth
Answer: D
Rationale: Ipratropium caution peanut/soy allergy, rinse mouth. - Version 6 2026/2027
33. [V6] PN role in blood transfusion? - Case 33 PN Pharm 2026/2027
A. Crossmatch
B. Order blood
C. Monitor transfusion, vitals q15min, stop if reaction, notify RN/provider
D. Start transfusion
Answer: C
Rationale: PN monitors transfusion, stops if reaction. - Version 6 2026/2027
34. [V6] Warfarin antidote for bleeding? - Case 34 PN Pharm 2026/2027
A. Protamine
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V6 2026/2027 | 400Q Mixed A/B/C/D: A=101 B=102 C=95 D=102 | 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. [V6] NPH insulin appearance? - Case 1 PN Pharm 2026/2027
A. No appearance
B. Clear yellow
C. Cloudy - must roll not shake, 30 min to 1h onset, peak 4-12h
D. Clear
Answer: C
Rationale: NPH cloudy intermediate. - Version 6 2026/2027
2. [V6] Psyllium teaching? - Case 2 PN Pharm 2026/2027
A. At bedtime only
B. No water
C. Take dry
D. Take with full glass water, may cause bloating, fiber
Answer: D
Rationale: Psyllium needs water. - Version 6 2026/2027
3. [V6] Metronidazole teaching? - Case 3 PN Pharm 2026/2027
A. Avoid alcohol during and 48h after - disulfiram reaction nausea/vomiting
B. Drink alcohol
C. No teaching
D. Take with alcohol
Answer: A
Rationale: Flagyl no alcohol disulfiram. - Version 6 2026/2027
4. [V6] Acetaminophen overdose antidote? - Case 4 PN Pharm 2026/2027
A. Protamine
B. Vitamin K
C. N-acetylcysteine (NAC) within 8 hours
D. Naloxone
Answer: C
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 6 2026/2027
5. [V6] Lisinopril causes dry cough due to? - Case 5 PN Pharm 2026/2027
A. Na retention
B. K+ loss
C. Bradykinin accumulation in lungs - ACE inhibitor side effect
D. Histamine
Answer: C
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 6 2026/2027
6. [V6] Morphine side effects PN monitor? - Case 6 PN Pharm 2026/2027
A. Diarrhea
B. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
C. Tachycardia only
D. No effects
Answer: B
Rationale: Opioid side effects resp depression. - Version 6 2026/2027
7. [V6] Iron supplement teaching? - Case 7 PN Pharm 2026/2027
A. Take with OJ/Vit C on empty stomach, dark green stools normal, constipation
B. No teaching
C. Take with milk
D. Take with antacid
Answer: A
Rationale: Iron with Vit C, dark stools normal. - Version 6 2026/2027
8. [V6] Levothyroxine teaching? - Case 8 PN Pharm 2026/2027
A. Take with iron
B. Take with food, at night
C. Take 30-60 min before breakfast on empty stomach, same time daily
, D. Take with milk
Answer: C
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 6 2026/2027
9. [V6] Furosemide expected side effect? - Case 9 PN Pharm 2026/2027
A. Hypokalemia, hypotension, dehydration - monitor K+, I&O;, BP
B. Hyperkalemia
C. Hypernatremia
D. No side effects
Answer: A
Rationale: Loop diuretic wastes K+ - monitor hypokalemia, give K+ rich foods. - Version 6 2026/2027
10. [V6] Prednisone long-term side effects? - Case 10 PN Pharm 2026/2027
A. Hypoglycemia
B. Weight gain, hyperglycemia, moon face, buffalo hump, osteoporosis, infection risk
C. No effects
D. Weight loss
Answer: B
Rationale: Steroids cause Cushingoid appearance, hyperglycemia, osteoporosis. - Version 6 2026/2027
11. [V6] Docusate use? - Case 11 PN Pharm 2026/2027
A. Stool softener - softens stool, needs fluids
B. Stimulant
C. Pain
D. Fever
Answer: A
Rationale: Docusate softener. - Version 6 2026/2027
12. [V6] Ciprofloxacin teaching? - Case 12 PN Pharm 2026/2027
A. Avoid antacids, iron, dairy within 2h, drink fluids, avoid sun - tendon rupture risk
B. Take at bedtime only
C. Take with milk
D. No teaching
Answer: A
Rationale: Cipro avoid cations, sun, tendon risk. - Version 6 2026/2027
13. [V6] Heparin antidote? - Case 13 PN Pharm 2026/2027
A. Protamine sulfate
B. Vitamin K
C. Flumazenil
D. Naloxone
Answer: A
Rationale: Protamine binds heparin. - Version 6 2026/2027
14. [V6] Amoxicillin allergic reaction first? - Case 14 PN Pharm 2026/2027
A. Give next dose
B. Stop drug, notify provider, assess airway - anaphylaxis risk
C. Double dose
D. Take with milk
Answer: B
Rationale: Penicillin allergy stop drug, airway assessment. - Version 6 2026/2027
15. [V6] Hypoglycemia treatment conscious PN? - Case 15 PN Pharm 2026/2027
A. Give insulin
B. 15g fast carb juice/glucose tabs, recheck 15 min, repeat if <70
C. Water
D. No treatment
Answer: B
Rationale: Rule of 15 for hypo. - Version 6 2026/2027
16. [V6] Fluoxetine (SSRI) onset? - Case 16 PN Pharm 2026/2027
A. Immediate
B. 1 hour
C. No onset
D. 2-4 weeks for full effect, watch for increased suicidal ideation early
Answer: D
Rationale: SSRI 2-4 weeks, black box suicide early. - Version 6 2026/2027
17. [V6] A client taking amlodipine reports ankle swelling. Best response? - Case 17 PN Pharm 2026/2027
, A. No action
B. Stop drug immediately
C. Take double dose
D. Ankle swelling common with amlodipine - elevate legs, notify provider if worsens, monitor BP
Answer: D
Rationale: CCB amlodipine causes peripheral edema - elevate legs, monitor. - Version 6 2026/2027
18. [V6] Sertraline interaction? - Case 18 PN Pharm 2026/2027
A. Safe with MAOI
B. Avoid MAOIs 14 days, risk serotonin syndrome with tramadol/St John's wort
C. No interactions
D. No risk
Answer: B
Rationale: SSRI + MAOI serotonin syndrome. - Version 6 2026/2027
19. [V6] Gentamicin toxicity? - Case 19 PN Pharm 2026/2027
A. No toxicity
B. Nephrotoxicity (creatinine/BUN) and ototoxicity (hearing/tinnitus)
C. Weight gain
D. Hyperkalemia only
Answer: B
Rationale: Aminoglycoside nephro/oto. - Version 6 2026/2027
20. [V6] Lithium therapeutic level? - Case 20 PN Pharm 2026/2027
A. 0.6-1.2 mEq/L, toxicity >1.5 - monitor kidney, thyroid, hydration
B. 10
C. 5.0
D. 0.1
Answer: A
Rationale: Lithium narrow therapeutic, monitor. - Version 6 2026/2027
21. [V6] Digoxin antidote? - Case 21 PN Pharm 2026/2027
A. Protamine
B. Naloxone
C. Vitamin K
D. Digoxin immune Fab (Digibind)
Answer: D
Rationale: Digibind binds digoxin in toxicity. - Version 6 2026/2027
22. [V6] Atropine use? - Case 22 PN Pharm 2026/2027
A. No use
B. Hypertension
C. Tachycardia
D. Bradycardia symptomatic, organophosphate poisoning antidote
Answer: D
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 6 2026/2027
23. [V6] Haloperidol EPS treatment? - Case 23 PN Pharm 2026/2027
A. No treatment
B. Benztropine/diphenhydramine for acute dystonia, monitor EPS
C. No monitor
D. Stop water
Answer: B
Rationale: Antipsychotic EPS benztropine. - Version 6 2026/2027
24. [V6] Ibuprofen contraindication? - Case 24 PN Pharm 2026/2027
A. Avoid in ulcer, GI bleed, kidney disease, pregnancy 3rd trimester, bleeding risk
B. No contraindication
C. No risk
D. Safe always
Answer: A
Rationale: NSAID contraindications GI bleed, renal. - Version 6 2026/2027
25. [V6] Benzodiazepine overdose antidote? - Case 25 PN Pharm 2026/2027
A. Naloxone
B. Protamine
C. Flumazenil
D. Vitamin K
, Answer: C
Rationale: Flumazenil reverses benzos, risk seizures. - Version 6 2026/2027
26. [V6] Insulin lispro onset? - Case 26 PN Pharm 2026/2027
A. 2 hours
B. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
C. 12 hours
D. 6 hours
Answer: B
Rationale: Lispro rapid 15 min onset. - Version 6 2026/2027
27. [V6] LPN cannot do IV push - Case 27 PN Pharm 2026/2027
A. Can do assessment
B. Can do IV push
C. Can do all
D. LPN cannot do IV push meds, initial assessment, teaching, unstable clients
Answer: D
Rationale: LPN scope no IV push, no initial assessment. - Version 6 2026/2027
28. [V6] Metformin and contrast dye - why hold? - Case 28 PN Pharm 2026/2027
A. Causes HTN
B. Causes hyperglycemia
C. Risk lactic acidosis if contrast-induced AKI - hold 48h before/after per protocol
D. No reason
Answer: C
Rationale: Hold metformin before contrast to prevent lactic acidosis with AKI. - Version 6 2026/2027
29. [V6] Epinephrine use in anaphylaxis? - Case 29 PN Pharm 2026/2027
A. No use
B. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
C. Hypotension only
D. Bradycardia only
Answer: B
Rationale: Epi first in anaphylaxis IM. - Version 6 2026/2027
30. [V6] Ondansetron use? - Case 30 PN Pharm 2026/2027
A. Diarrhea
B. Pain
C. Fever
D. Nausea/vomiting - monitor QT, headache, constipation
Answer: D
Rationale: Zofran antiemetic QT risk. - Version 6 2026/2027
31. [V6] Carbamazepine side effect? - Case 31 PN Pharm 2026/2027
A. No effects
B. Blood dyscrasias, check CBC, rash SJS risk, avoid grapefruit
C. No monitoring
D. Weight loss only
Answer: B
Rationale: Carbamazepine CBC, rash. - Version 6 2026/2027
32. [V6] Ipratropium (Atrovent) teaching? - Case 32 PN Pharm 2026/2027
A. Take with food
B. No teaching
C. No rinse
D. Avoid if peanut allergy - contains soy lecithin, rinse mouth
Answer: D
Rationale: Ipratropium caution peanut/soy allergy, rinse mouth. - Version 6 2026/2027
33. [V6] PN role in blood transfusion? - Case 33 PN Pharm 2026/2027
A. Crossmatch
B. Order blood
C. Monitor transfusion, vitals q15min, stop if reaction, notify RN/provider
D. Start transfusion
Answer: C
Rationale: PN monitors transfusion, stops if reaction. - Version 6 2026/2027
34. [V6] Warfarin antidote for bleeding? - Case 34 PN Pharm 2026/2027
A. Protamine
