ATI PN PHARMACOLOGY PROCTORED EXAM V4 2026/2027 - 400 VERIFIED QUESTIONS WITH
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V4 2026/2027 | 400Q Mixed A/B/C/D: A=102 B=105 C=96 D=97 | 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. [V4] Prednisone long-term side effects? - Case 1 PN Pharm 2026/2027
A. Hypoglycemia
B. Weight gain, hyperglycemia, moon face, buffalo hump, osteoporosis, infection risk
C. Weight loss
D. No effects
Answer: B
Rationale: Steroids cause Cushingoid appearance, hyperglycemia, osteoporosis. - Version 4 2026/2027
2. [V4] Albuterol side effects? - Case 2 PN Pharm 2026/2027
A. Bradycardia
B. Weight gain
C. Cough always
D. Tachycardia, tremor, nervousness - beta2 agonist
Answer: D
Rationale: Albuterol tachycardia, tremor. - Version 4 2026/2027
3. [V4] Glargine (Lantus) rule? - Case 3 PN Pharm 2026/2027
A. Do not mix, given at same time daily, no peak - basal insulin
B. Give with meals only
C. Mix with regular
D. IV push
Answer: A
Rationale: Glargine long-acting no mix, basal. - Version 4 2026/2027
4. [V4] Warfarin antidote for bleeding? - Case 4 PN Pharm 2026/2027
A. Calcium
B. Naloxone
C. Vitamin K + 4F-PCC for life-threatening
D. Protamine
Answer: C
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 4 2026/2027
5. [V4] Acetaminophen overdose antidote? - Case 5 PN Pharm 2026/2027
A. Protamine
B. Naloxone
C. N-acetylcysteine (NAC) within 8 hours
D. Vitamin K
Answer: C
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 4 2026/2027
6. [V4] Lithium therapeutic level? - Case 6 PN Pharm 2026/2027
A. 5.0
B. 0.1
C. 0.6-1.2 mEq/L, toxicity >1.5 - monitor kidney, thyroid, hydration
D. 10
Answer: C
Rationale: Lithium narrow therapeutic, monitor. - Version 4 2026/2027
7. [V4] Docusate use? - Case 7 PN Pharm 2026/2027
A. Stool softener - softens stool, needs fluids
B. Fever
C. Pain
D. Stimulant
Answer: A
Rationale: Docusate softener. - Version 4 2026/2027
8. [V4] Potassium chloride administration? - Case 8 PN Pharm 2026/2027
A. No monitor
B. Never IV push - dilute, give via pump, check kidney function, monitor EKG
C. IV push
, D. Give fast
Answer: B
Rationale: KCl never IV push, dilute. - Version 4 2026/2027
9. [V4] Haloperidol EPS treatment? - Case 9 PN Pharm 2026/2027
A. No treatment
B. Stop water
C. Benztropine/diphenhydramine for acute dystonia, monitor EPS
D. No monitor
Answer: C
Rationale: Antipsychotic EPS benztropine. - Version 4 2026/2027
10. [V4] Insulin lispro onset? - Case 10 PN Pharm 2026/2027
A. 12 hours
B. 6 hours
C. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
D. 2 hours
Answer: C
Rationale: Lispro rapid 15 min onset. - Version 4 2026/2027
11. [V4] Levodopa-carbidopa teaching? - Case 11 PN Pharm 2026/2027
A. Take with high protein
B. No teaching
C. Take low protein, avoid high protein reduces absorption, dark sweat/urine normal
D. Take with milk only
Answer: C
Rationale: Levodopa low protein diet. - Version 4 2026/2027
12. [V4] Hypoglycemia treatment conscious PN? - Case 12 PN Pharm 2026/2027
A. No treatment
B. 15g fast carb juice/glucose tabs, recheck 15 min, repeat if <70
C. Give insulin
D. Water
Answer: B
Rationale: Rule of 15 for hypo. - Version 4 2026/2027
13. [V4] Sertraline interaction? - Case 13 PN Pharm 2026/2027
A. No risk
B. Safe with MAOI
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 4 2026/2027
14. [V4] Levothyroxine teaching? - Case 14 PN Pharm 2026/2027
A. Take with milk
B. Take with food, at night
C. Take 30-60 min before breakfast on empty stomach, same time daily
D. Take with iron
Answer: C
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 4 2026/2027
15. [V4] LPN cannot do IV push - Case 15 PN Pharm 2026/2027
A. Can do assessment
B. LPN cannot do IV push meds, initial assessment, teaching, unstable clients
C. Can do all
D. Can do IV push
Answer: B
Rationale: LPN scope no IV push, no initial assessment. - Version 4 2026/2027
16. [V4] Psyllium teaching? - Case 16 PN Pharm 2026/2027
A. No water
B. Take with full glass water, may cause bloating, fiber
C. At bedtime only
D. Take dry
Answer: B
Rationale: Psyllium needs water. - Version 4 2026/2027
17. [V4] Fluoxetine (SSRI) onset? - Case 17 PN Pharm 2026/2027
, A. 1 hour
B. Immediate
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 4 2026/2027
18. [V4] Bisacodyl use? - Case 18 PN Pharm 2026/2027
A. Constipation - stimulant laxative
B. Fever
C. Diarrhea
D. Pain
Answer: A
Rationale: Stimulant laxative. - Version 4 2026/2027
19. [V4] Ibuprofen contraindication? - Case 19 PN Pharm 2026/2027
A. No risk
B. Safe always
C. Avoid in ulcer, GI bleed, kidney disease, pregnancy 3rd trimester, bleeding risk
D. No contraindication
Answer: C
Rationale: NSAID contraindications GI bleed, renal. - Version 4 2026/2027
20. [V4] Furosemide expected side effect? - Case 20 PN Pharm 2026/2027
A. Hyperkalemia
B. No side effects
C. Hypernatremia
D. Hypokalemia, hypotension, dehydration - monitor K+, I&O;, BP
Answer: D
Rationale: Loop diuretic wastes K+ - monitor hypokalemia, give K+ rich foods. - Version 4 2026/2027
21. [V4] Atropine use? - Case 21 PN Pharm 2026/2027
A. Bradycardia symptomatic, organophosphate poisoning antidote
B. Tachycardia
C. No use
D. Hypertension
Answer: A
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 4 2026/2027
22. [V4] Ciprofloxacin teaching? - Case 22 PN Pharm 2026/2027
A. Take with milk
B. No teaching
C. Take at bedtime only
D. Avoid antacids, iron, dairy within 2h, drink fluids, avoid sun - tendon rupture risk
Answer: D
Rationale: Cipro avoid cations, sun, tendon risk. - Version 4 2026/2027
23. [V4] Morphine side effects PN monitor? - Case 23 PN Pharm 2026/2027
A. Diarrhea
B. Tachycardia only
C. No effects
D. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
Answer: D
Rationale: Opioid side effects resp depression. - Version 4 2026/2027
24. [V4] Iron supplement teaching? - Case 24 PN Pharm 2026/2027
A. Take with OJ/Vit C on empty stomach, dark green stools normal, constipation
B. Take with antacid
C. No teaching
D. Take with milk
Answer: A
Rationale: Iron with Vit C, dark stools normal. - Version 4 2026/2027
25. [V4] Epinephrine use in anaphylaxis? - Case 25 PN Pharm 2026/2027
A. Bradycardia only
B. Hypotension only
C. No use
D. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
, Answer: D
Rationale: Epi first in anaphylaxis IM. - Version 4 2026/2027
26. [V4] Gentamicin toxicity? - Case 26 PN Pharm 2026/2027
A. No toxicity
B. Hyperkalemia only
C. Weight gain
D. Nephrotoxicity (creatinine/BUN) and ototoxicity (hearing/tinnitus)
Answer: D
Rationale: Aminoglycoside nephro/oto. - Version 4 2026/2027
27. [V4] Omeprazole teaching? - Case 27 PN Pharm 2026/2027
A. No risk
B. Double dose
C. Take with food always
D. Take 30 min before breakfast, long-term risk fractures, low Mg2+
Answer: D
Rationale: PPI before breakfast. - Version 4 2026/2027
28. [V4] A client taking amlodipine reports ankle swelling. Best response? - Case 28 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 4 2026/2027
29. [V4] Ipratropium (Atrovent) teaching? - Case 29 PN Pharm 2026/2027
A. Avoid if peanut allergy - contains soy lecithin, rinse mouth
B. No rinse
C. No teaching
D. Take with food
Answer: A
Rationale: Ipratropium caution peanut/soy allergy, rinse mouth. - Version 4 2026/2027
30. [V4] Ondansetron use? - Case 30 PN Pharm 2026/2027
A. Pain
B. Diarrhea
C. Fever
D. Nausea/vomiting - monitor QT, headache, constipation
Answer: D
Rationale: Zofran antiemetic QT risk. - Version 4 2026/2027
31. [V4] Montelukast when to take? - Case 31 PN Pharm 2026/2027
A. No timing
B. Morning only
C. Evening - asthma prophylaxis, not rescue
D. During attack only
Answer: C
Rationale: Montelukast evening daily, not rescue. - Version 4 2026/2027
32. [V4] Amoxicillin allergic reaction first? - Case 32 PN Pharm 2026/2027
A. Double dose
B. Stop drug, notify provider, assess airway - anaphylaxis risk
C. Take with milk
D. Give next dose
Answer: B
Rationale: Penicillin allergy stop drug, airway assessment. - Version 4 2026/2027
33. [V4] Opioid overdose antidote? - Case 33 PN Pharm 2026/2027
A. Flumazenil
B. Naloxone - may need repeat due to short half-life
C. Vitamin K
D. Protamine
Answer: B
Rationale: Naloxone opioid antagonist, monitor for re-sedation. - Version 4 2026/2027
34. [V4] Loperamide use? - Case 34 PN Pharm 2026/2027
A. Pain
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V4 2026/2027 | 400Q Mixed A/B/C/D: A=102 B=105 C=96 D=97 | 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. [V4] Prednisone long-term side effects? - Case 1 PN Pharm 2026/2027
A. Hypoglycemia
B. Weight gain, hyperglycemia, moon face, buffalo hump, osteoporosis, infection risk
C. Weight loss
D. No effects
Answer: B
Rationale: Steroids cause Cushingoid appearance, hyperglycemia, osteoporosis. - Version 4 2026/2027
2. [V4] Albuterol side effects? - Case 2 PN Pharm 2026/2027
A. Bradycardia
B. Weight gain
C. Cough always
D. Tachycardia, tremor, nervousness - beta2 agonist
Answer: D
Rationale: Albuterol tachycardia, tremor. - Version 4 2026/2027
3. [V4] Glargine (Lantus) rule? - Case 3 PN Pharm 2026/2027
A. Do not mix, given at same time daily, no peak - basal insulin
B. Give with meals only
C. Mix with regular
D. IV push
Answer: A
Rationale: Glargine long-acting no mix, basal. - Version 4 2026/2027
4. [V4] Warfarin antidote for bleeding? - Case 4 PN Pharm 2026/2027
A. Calcium
B. Naloxone
C. Vitamin K + 4F-PCC for life-threatening
D. Protamine
Answer: C
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 4 2026/2027
5. [V4] Acetaminophen overdose antidote? - Case 5 PN Pharm 2026/2027
A. Protamine
B. Naloxone
C. N-acetylcysteine (NAC) within 8 hours
D. Vitamin K
Answer: C
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 4 2026/2027
6. [V4] Lithium therapeutic level? - Case 6 PN Pharm 2026/2027
A. 5.0
B. 0.1
C. 0.6-1.2 mEq/L, toxicity >1.5 - monitor kidney, thyroid, hydration
D. 10
Answer: C
Rationale: Lithium narrow therapeutic, monitor. - Version 4 2026/2027
7. [V4] Docusate use? - Case 7 PN Pharm 2026/2027
A. Stool softener - softens stool, needs fluids
B. Fever
C. Pain
D. Stimulant
Answer: A
Rationale: Docusate softener. - Version 4 2026/2027
8. [V4] Potassium chloride administration? - Case 8 PN Pharm 2026/2027
A. No monitor
B. Never IV push - dilute, give via pump, check kidney function, monitor EKG
C. IV push
, D. Give fast
Answer: B
Rationale: KCl never IV push, dilute. - Version 4 2026/2027
9. [V4] Haloperidol EPS treatment? - Case 9 PN Pharm 2026/2027
A. No treatment
B. Stop water
C. Benztropine/diphenhydramine for acute dystonia, monitor EPS
D. No monitor
Answer: C
Rationale: Antipsychotic EPS benztropine. - Version 4 2026/2027
10. [V4] Insulin lispro onset? - Case 10 PN Pharm 2026/2027
A. 12 hours
B. 6 hours
C. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
D. 2 hours
Answer: C
Rationale: Lispro rapid 15 min onset. - Version 4 2026/2027
11. [V4] Levodopa-carbidopa teaching? - Case 11 PN Pharm 2026/2027
A. Take with high protein
B. No teaching
C. Take low protein, avoid high protein reduces absorption, dark sweat/urine normal
D. Take with milk only
Answer: C
Rationale: Levodopa low protein diet. - Version 4 2026/2027
12. [V4] Hypoglycemia treatment conscious PN? - Case 12 PN Pharm 2026/2027
A. No treatment
B. 15g fast carb juice/glucose tabs, recheck 15 min, repeat if <70
C. Give insulin
D. Water
Answer: B
Rationale: Rule of 15 for hypo. - Version 4 2026/2027
13. [V4] Sertraline interaction? - Case 13 PN Pharm 2026/2027
A. No risk
B. Safe with MAOI
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 4 2026/2027
14. [V4] Levothyroxine teaching? - Case 14 PN Pharm 2026/2027
A. Take with milk
B. Take with food, at night
C. Take 30-60 min before breakfast on empty stomach, same time daily
D. Take with iron
Answer: C
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 4 2026/2027
15. [V4] LPN cannot do IV push - Case 15 PN Pharm 2026/2027
A. Can do assessment
B. LPN cannot do IV push meds, initial assessment, teaching, unstable clients
C. Can do all
D. Can do IV push
Answer: B
Rationale: LPN scope no IV push, no initial assessment. - Version 4 2026/2027
16. [V4] Psyllium teaching? - Case 16 PN Pharm 2026/2027
A. No water
B. Take with full glass water, may cause bloating, fiber
C. At bedtime only
D. Take dry
Answer: B
Rationale: Psyllium needs water. - Version 4 2026/2027
17. [V4] Fluoxetine (SSRI) onset? - Case 17 PN Pharm 2026/2027
, A. 1 hour
B. Immediate
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 4 2026/2027
18. [V4] Bisacodyl use? - Case 18 PN Pharm 2026/2027
A. Constipation - stimulant laxative
B. Fever
C. Diarrhea
D. Pain
Answer: A
Rationale: Stimulant laxative. - Version 4 2026/2027
19. [V4] Ibuprofen contraindication? - Case 19 PN Pharm 2026/2027
A. No risk
B. Safe always
C. Avoid in ulcer, GI bleed, kidney disease, pregnancy 3rd trimester, bleeding risk
D. No contraindication
Answer: C
Rationale: NSAID contraindications GI bleed, renal. - Version 4 2026/2027
20. [V4] Furosemide expected side effect? - Case 20 PN Pharm 2026/2027
A. Hyperkalemia
B. No side effects
C. Hypernatremia
D. Hypokalemia, hypotension, dehydration - monitor K+, I&O;, BP
Answer: D
Rationale: Loop diuretic wastes K+ - monitor hypokalemia, give K+ rich foods. - Version 4 2026/2027
21. [V4] Atropine use? - Case 21 PN Pharm 2026/2027
A. Bradycardia symptomatic, organophosphate poisoning antidote
B. Tachycardia
C. No use
D. Hypertension
Answer: A
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 4 2026/2027
22. [V4] Ciprofloxacin teaching? - Case 22 PN Pharm 2026/2027
A. Take with milk
B. No teaching
C. Take at bedtime only
D. Avoid antacids, iron, dairy within 2h, drink fluids, avoid sun - tendon rupture risk
Answer: D
Rationale: Cipro avoid cations, sun, tendon risk. - Version 4 2026/2027
23. [V4] Morphine side effects PN monitor? - Case 23 PN Pharm 2026/2027
A. Diarrhea
B. Tachycardia only
C. No effects
D. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
Answer: D
Rationale: Opioid side effects resp depression. - Version 4 2026/2027
24. [V4] Iron supplement teaching? - Case 24 PN Pharm 2026/2027
A. Take with OJ/Vit C on empty stomach, dark green stools normal, constipation
B. Take with antacid
C. No teaching
D. Take with milk
Answer: A
Rationale: Iron with Vit C, dark stools normal. - Version 4 2026/2027
25. [V4] Epinephrine use in anaphylaxis? - Case 25 PN Pharm 2026/2027
A. Bradycardia only
B. Hypotension only
C. No use
D. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
, Answer: D
Rationale: Epi first in anaphylaxis IM. - Version 4 2026/2027
26. [V4] Gentamicin toxicity? - Case 26 PN Pharm 2026/2027
A. No toxicity
B. Hyperkalemia only
C. Weight gain
D. Nephrotoxicity (creatinine/BUN) and ototoxicity (hearing/tinnitus)
Answer: D
Rationale: Aminoglycoside nephro/oto. - Version 4 2026/2027
27. [V4] Omeprazole teaching? - Case 27 PN Pharm 2026/2027
A. No risk
B. Double dose
C. Take with food always
D. Take 30 min before breakfast, long-term risk fractures, low Mg2+
Answer: D
Rationale: PPI before breakfast. - Version 4 2026/2027
28. [V4] A client taking amlodipine reports ankle swelling. Best response? - Case 28 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 4 2026/2027
29. [V4] Ipratropium (Atrovent) teaching? - Case 29 PN Pharm 2026/2027
A. Avoid if peanut allergy - contains soy lecithin, rinse mouth
B. No rinse
C. No teaching
D. Take with food
Answer: A
Rationale: Ipratropium caution peanut/soy allergy, rinse mouth. - Version 4 2026/2027
30. [V4] Ondansetron use? - Case 30 PN Pharm 2026/2027
A. Pain
B. Diarrhea
C. Fever
D. Nausea/vomiting - monitor QT, headache, constipation
Answer: D
Rationale: Zofran antiemetic QT risk. - Version 4 2026/2027
31. [V4] Montelukast when to take? - Case 31 PN Pharm 2026/2027
A. No timing
B. Morning only
C. Evening - asthma prophylaxis, not rescue
D. During attack only
Answer: C
Rationale: Montelukast evening daily, not rescue. - Version 4 2026/2027
32. [V4] Amoxicillin allergic reaction first? - Case 32 PN Pharm 2026/2027
A. Double dose
B. Stop drug, notify provider, assess airway - anaphylaxis risk
C. Take with milk
D. Give next dose
Answer: B
Rationale: Penicillin allergy stop drug, airway assessment. - Version 4 2026/2027
33. [V4] Opioid overdose antidote? - Case 33 PN Pharm 2026/2027
A. Flumazenil
B. Naloxone - may need repeat due to short half-life
C. Vitamin K
D. Protamine
Answer: B
Rationale: Naloxone opioid antagonist, monitor for re-sedation. - Version 4 2026/2027
34. [V4] Loperamide use? - Case 34 PN Pharm 2026/2027
A. Pain
