ATI PN PHARMACOLOGY PROCTORED EXAM V3 2026/2027 - 400 VERIFIED QUESTIONS WITH
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V3 2026/2027 | 400Q Mixed A/B/C/D: A=97 B=111 C=94 D=98 | 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. [V3] Amoxicillin allergic reaction first? - Case 1 PN Pharm 2026/2027
A. Stop drug, notify provider, assess airway - anaphylaxis risk
B. Double dose
C. Give next dose
D. Take with milk
Answer: A
Rationale: Penicillin allergy stop drug, airway assessment. - Version 3 2026/2027
2. [V3] Heparin antidote? - Case 2 PN Pharm 2026/2027
A. Protamine sulfate
B. Flumazenil
C. Naloxone
D. Vitamin K
Answer: A
Rationale: Protamine binds heparin. - Version 3 2026/2027
3. [V3] Montelukast when to take? - Case 3 PN Pharm 2026/2027
A. No timing
B. Evening - asthma prophylaxis, not rescue
C. During attack only
D. Morning only
Answer: B
Rationale: Montelukast evening daily, not rescue. - Version 3 2026/2027
4. [V3] Warfarin antidote for bleeding? - Case 4 PN Pharm 2026/2027
A. Naloxone
B. Protamine
C. Vitamin K + 4F-PCC for life-threatening
D. Calcium
Answer: C
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 3 2026/2027
5. [V3] Levodopa-carbidopa teaching? - Case 5 PN Pharm 2026/2027
A. No teaching
B. Take with milk only
C. Take with high protein
D. Take low protein, avoid high protein reduces absorption, dark sweat/urine normal
Answer: D
Rationale: Levodopa low protein diet. - Version 3 2026/2027
6. [V3] NPH insulin appearance? - Case 6 PN Pharm 2026/2027
A. Clear yellow
B. No appearance
C. Cloudy - must roll not shake, 30 min to 1h onset, peak 4-12h
D. Clear
Answer: C
Rationale: NPH cloudy intermediate. - Version 3 2026/2027
7. [V3] Levothyroxine teaching? - Case 7 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 3 2026/2027
8. [V3] Atropine use? - Case 8 PN Pharm 2026/2027
A. Bradycardia symptomatic, organophosphate poisoning antidote
B. Hypertension
C. Tachycardia
, D. No use
Answer: A
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 3 2026/2027
9. [V3] Lisinopril causes dry cough due to? - Case 9 PN Pharm 2026/2027
A. Na retention
B. Histamine
C. K+ loss
D. Bradykinin accumulation in lungs - ACE inhibitor side effect
Answer: D
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 3 2026/2027
10. [V3] Fluoxetine (SSRI) onset? - Case 10 PN Pharm 2026/2027
A. Immediate
B. 2-4 weeks for full effect, watch for increased suicidal ideation early
C. 1 hour
D. No onset
Answer: B
Rationale: SSRI 2-4 weeks, black box suicide early. - Version 3 2026/2027
11. [V3] Sertraline interaction? - Case 11 PN Pharm 2026/2027
A. Avoid MAOIs 14 days, risk serotonin syndrome with tramadol/St John's wort
B. No risk
C. Safe with MAOI
D. No interactions
Answer: A
Rationale: SSRI + MAOI serotonin syndrome. - Version 3 2026/2027
12. [V3] Benzodiazepine overdose antidote? - Case 12 PN Pharm 2026/2027
A. Flumazenil
B. Vitamin K
C. Protamine
D. Naloxone
Answer: A
Rationale: Flumazenil reverses benzos, risk seizures. - Version 3 2026/2027
13. [V3] Opioid overdose antidote? - Case 13 PN Pharm 2026/2027
A. Vitamin K
B. Protamine
C. Flumazenil
D. Naloxone - may need repeat due to short half-life
Answer: D
Rationale: Naloxone opioid antagonist, monitor for re-sedation. - Version 3 2026/2027
14. [V3] Omeprazole teaching? - Case 14 PN Pharm 2026/2027
A. Double dose
B. Take 30 min before breakfast, long-term risk fractures, low Mg2+
C. No risk
D. Take with food always
Answer: B
Rationale: PPI before breakfast. - Version 3 2026/2027
15. [V3] Iron supplement teaching? - Case 15 PN Pharm 2026/2027
A. Take with OJ/Vit C on empty stomach, dark green stools normal, constipation
B. Take with milk
C. No teaching
D. Take with antacid
Answer: A
Rationale: Iron with Vit C, dark stools normal. - Version 3 2026/2027
16. [V3] Phenytoin teaching? - Case 16 PN Pharm 2026/2027
A. Good oral hygiene, avoid alcohol, therapeutic 10-20 mcg/mL, gum hyperplasia risk
B. Skip doses
C. Double dose if missed
D. No hygiene
Answer: A
Rationale: Phenytoin gum hyperplasia, hygiene. - Version 3 2026/2027
17. [V3] Psyllium teaching? - Case 17 PN Pharm 2026/2027
, A. At bedtime only
B. Take with full glass water, may cause bloating, fiber
C. Take dry
D. No water
Answer: B
Rationale: Psyllium needs water. - Version 3 2026/2027
18. [V3] Insulin lispro onset? - Case 18 PN Pharm 2026/2027
A. 12 hours
B. 6 hours
C. 2 hours
D. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
Answer: D
Rationale: Lispro rapid 15 min onset. - Version 3 2026/2027
19. [V3] Gentamicin toxicity? - Case 19 PN Pharm 2026/2027
A. No toxicity
B. Nephrotoxicity (creatinine/BUN) and ototoxicity (hearing/tinnitus)
C. Hyperkalemia only
D. Weight gain
Answer: B
Rationale: Aminoglycoside nephro/oto. - Version 3 2026/2027
20. [V3] Albuterol side effects? - Case 20 PN Pharm 2026/2027
A. Weight gain
B. Cough always
C. Tachycardia, tremor, nervousness - beta2 agonist
D. Bradycardia
Answer: C
Rationale: Albuterol tachycardia, tremor. - Version 3 2026/2027
21. [V3] Ipratropium (Atrovent) teaching? - Case 21 PN Pharm 2026/2027
A. Take with food
B. Avoid if peanut allergy - contains soy lecithin, rinse mouth
C. No teaching
D. No rinse
Answer: B
Rationale: Ipratropium caution peanut/soy allergy, rinse mouth. - Version 3 2026/2027
22. [V3] Glargine (Lantus) rule? - Case 22 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 3 2026/2027
23. [V3] Epinephrine use in anaphylaxis? - Case 23 PN Pharm 2026/2027
A. Bradycardia only
B. No use
C. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
D. Hypotension only
Answer: C
Rationale: Epi first in anaphylaxis IM. - Version 3 2026/2027
24. [V3] Carbamazepine side effect? - Case 24 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 3 2026/2027
25. [V3] Lithium therapeutic level? - Case 25 PN Pharm 2026/2027
A. 0.1
B. 10
C. 0.6-1.2 mEq/L, toxicity >1.5 - monitor kidney, thyroid, hydration
D. 5.0
, Answer: C
Rationale: Lithium narrow therapeutic, monitor. - Version 3 2026/2027
26. [V3] Metformin and contrast dye - why hold? - Case 26 PN Pharm 2026/2027
A. Causes hyperglycemia
B. Causes HTN
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 3 2026/2027
27. [V3] Digoxin antidote? - Case 27 PN Pharm 2026/2027
A. Digoxin immune Fab (Digibind)
B. Protamine
C. Vitamin K
D. Naloxone
Answer: A
Rationale: Digibind binds digoxin in toxicity. - Version 3 2026/2027
28. [V3] Potassium chloride administration? - Case 28 PN Pharm 2026/2027
A. Give fast
B. IV push
C. Never IV push - dilute, give via pump, check kidney function, monitor EKG
D. No monitor
Answer: C
Rationale: KCl never IV push, dilute. - Version 3 2026/2027
29. [V3] Metronidazole teaching? - Case 29 PN Pharm 2026/2027
A. No teaching
B. Take with alcohol
C. Drink alcohol
D. Avoid alcohol during and 48h after - disulfiram reaction nausea/vomiting
Answer: D
Rationale: Flagyl no alcohol disulfiram. - Version 3 2026/2027
30. [V3] Ciprofloxacin teaching? - Case 30 PN Pharm 2026/2027
A. Avoid antacids, iron, dairy within 2h, drink fluids, avoid sun - tendon rupture risk
B. No teaching
C. Take with milk
D. Take at bedtime only
Answer: A
Rationale: Cipro avoid cations, sun, tendon risk. - Version 3 2026/2027
31. [V3] Ondansetron use? - Case 31 PN Pharm 2026/2027
A. Diarrhea
B. Nausea/vomiting - monitor QT, headache, constipation
C. Fever
D. Pain
Answer: B
Rationale: Zofran antiemetic QT risk. - Version 3 2026/2027
32. [V3] A client taking amlodipine reports ankle swelling. Best response? - Case 32 PN Pharm 2026/2027
A. No action
B. Stop drug immediately
C. Ankle swelling common with amlodipine - elevate legs, notify provider if worsens, monitor BP
D. Take double dose
Answer: C
Rationale: CCB amlodipine causes peripheral edema - elevate legs, monitor. - Version 3 2026/2027
33. [V3] Acetaminophen overdose antidote? - Case 33 PN Pharm 2026/2027
A. Naloxone
B. N-acetylcysteine (NAC) within 8 hours
C. Vitamin K
D. Protamine
Answer: B
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 3 2026/2027
34. [V3] Docusate use? - Case 34 PN Pharm 2026/2027
A. Fever
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V3 2026/2027 | 400Q Mixed A/B/C/D: A=97 B=111 C=94 D=98 | 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. [V3] Amoxicillin allergic reaction first? - Case 1 PN Pharm 2026/2027
A. Stop drug, notify provider, assess airway - anaphylaxis risk
B. Double dose
C. Give next dose
D. Take with milk
Answer: A
Rationale: Penicillin allergy stop drug, airway assessment. - Version 3 2026/2027
2. [V3] Heparin antidote? - Case 2 PN Pharm 2026/2027
A. Protamine sulfate
B. Flumazenil
C. Naloxone
D. Vitamin K
Answer: A
Rationale: Protamine binds heparin. - Version 3 2026/2027
3. [V3] Montelukast when to take? - Case 3 PN Pharm 2026/2027
A. No timing
B. Evening - asthma prophylaxis, not rescue
C. During attack only
D. Morning only
Answer: B
Rationale: Montelukast evening daily, not rescue. - Version 3 2026/2027
4. [V3] Warfarin antidote for bleeding? - Case 4 PN Pharm 2026/2027
A. Naloxone
B. Protamine
C. Vitamin K + 4F-PCC for life-threatening
D. Calcium
Answer: C
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 3 2026/2027
5. [V3] Levodopa-carbidopa teaching? - Case 5 PN Pharm 2026/2027
A. No teaching
B. Take with milk only
C. Take with high protein
D. Take low protein, avoid high protein reduces absorption, dark sweat/urine normal
Answer: D
Rationale: Levodopa low protein diet. - Version 3 2026/2027
6. [V3] NPH insulin appearance? - Case 6 PN Pharm 2026/2027
A. Clear yellow
B. No appearance
C. Cloudy - must roll not shake, 30 min to 1h onset, peak 4-12h
D. Clear
Answer: C
Rationale: NPH cloudy intermediate. - Version 3 2026/2027
7. [V3] Levothyroxine teaching? - Case 7 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 3 2026/2027
8. [V3] Atropine use? - Case 8 PN Pharm 2026/2027
A. Bradycardia symptomatic, organophosphate poisoning antidote
B. Hypertension
C. Tachycardia
, D. No use
Answer: A
Rationale: Atropine increases HR in symptomatic bradycardia. - Version 3 2026/2027
9. [V3] Lisinopril causes dry cough due to? - Case 9 PN Pharm 2026/2027
A. Na retention
B. Histamine
C. K+ loss
D. Bradykinin accumulation in lungs - ACE inhibitor side effect
Answer: D
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 3 2026/2027
10. [V3] Fluoxetine (SSRI) onset? - Case 10 PN Pharm 2026/2027
A. Immediate
B. 2-4 weeks for full effect, watch for increased suicidal ideation early
C. 1 hour
D. No onset
Answer: B
Rationale: SSRI 2-4 weeks, black box suicide early. - Version 3 2026/2027
11. [V3] Sertraline interaction? - Case 11 PN Pharm 2026/2027
A. Avoid MAOIs 14 days, risk serotonin syndrome with tramadol/St John's wort
B. No risk
C. Safe with MAOI
D. No interactions
Answer: A
Rationale: SSRI + MAOI serotonin syndrome. - Version 3 2026/2027
12. [V3] Benzodiazepine overdose antidote? - Case 12 PN Pharm 2026/2027
A. Flumazenil
B. Vitamin K
C. Protamine
D. Naloxone
Answer: A
Rationale: Flumazenil reverses benzos, risk seizures. - Version 3 2026/2027
13. [V3] Opioid overdose antidote? - Case 13 PN Pharm 2026/2027
A. Vitamin K
B. Protamine
C. Flumazenil
D. Naloxone - may need repeat due to short half-life
Answer: D
Rationale: Naloxone opioid antagonist, monitor for re-sedation. - Version 3 2026/2027
14. [V3] Omeprazole teaching? - Case 14 PN Pharm 2026/2027
A. Double dose
B. Take 30 min before breakfast, long-term risk fractures, low Mg2+
C. No risk
D. Take with food always
Answer: B
Rationale: PPI before breakfast. - Version 3 2026/2027
15. [V3] Iron supplement teaching? - Case 15 PN Pharm 2026/2027
A. Take with OJ/Vit C on empty stomach, dark green stools normal, constipation
B. Take with milk
C. No teaching
D. Take with antacid
Answer: A
Rationale: Iron with Vit C, dark stools normal. - Version 3 2026/2027
16. [V3] Phenytoin teaching? - Case 16 PN Pharm 2026/2027
A. Good oral hygiene, avoid alcohol, therapeutic 10-20 mcg/mL, gum hyperplasia risk
B. Skip doses
C. Double dose if missed
D. No hygiene
Answer: A
Rationale: Phenytoin gum hyperplasia, hygiene. - Version 3 2026/2027
17. [V3] Psyllium teaching? - Case 17 PN Pharm 2026/2027
, A. At bedtime only
B. Take with full glass water, may cause bloating, fiber
C. Take dry
D. No water
Answer: B
Rationale: Psyllium needs water. - Version 3 2026/2027
18. [V3] Insulin lispro onset? - Case 18 PN Pharm 2026/2027
A. 12 hours
B. 6 hours
C. 2 hours
D. 15 minutes rapid-acting, peak 1-2h, duration 3-4h
Answer: D
Rationale: Lispro rapid 15 min onset. - Version 3 2026/2027
19. [V3] Gentamicin toxicity? - Case 19 PN Pharm 2026/2027
A. No toxicity
B. Nephrotoxicity (creatinine/BUN) and ototoxicity (hearing/tinnitus)
C. Hyperkalemia only
D. Weight gain
Answer: B
Rationale: Aminoglycoside nephro/oto. - Version 3 2026/2027
20. [V3] Albuterol side effects? - Case 20 PN Pharm 2026/2027
A. Weight gain
B. Cough always
C. Tachycardia, tremor, nervousness - beta2 agonist
D. Bradycardia
Answer: C
Rationale: Albuterol tachycardia, tremor. - Version 3 2026/2027
21. [V3] Ipratropium (Atrovent) teaching? - Case 21 PN Pharm 2026/2027
A. Take with food
B. Avoid if peanut allergy - contains soy lecithin, rinse mouth
C. No teaching
D. No rinse
Answer: B
Rationale: Ipratropium caution peanut/soy allergy, rinse mouth. - Version 3 2026/2027
22. [V3] Glargine (Lantus) rule? - Case 22 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 3 2026/2027
23. [V3] Epinephrine use in anaphylaxis? - Case 23 PN Pharm 2026/2027
A. Bradycardia only
B. No use
C. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
D. Hypotension only
Answer: C
Rationale: Epi first in anaphylaxis IM. - Version 3 2026/2027
24. [V3] Carbamazepine side effect? - Case 24 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 3 2026/2027
25. [V3] Lithium therapeutic level? - Case 25 PN Pharm 2026/2027
A. 0.1
B. 10
C. 0.6-1.2 mEq/L, toxicity >1.5 - monitor kidney, thyroid, hydration
D. 5.0
, Answer: C
Rationale: Lithium narrow therapeutic, monitor. - Version 3 2026/2027
26. [V3] Metformin and contrast dye - why hold? - Case 26 PN Pharm 2026/2027
A. Causes hyperglycemia
B. Causes HTN
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 3 2026/2027
27. [V3] Digoxin antidote? - Case 27 PN Pharm 2026/2027
A. Digoxin immune Fab (Digibind)
B. Protamine
C. Vitamin K
D. Naloxone
Answer: A
Rationale: Digibind binds digoxin in toxicity. - Version 3 2026/2027
28. [V3] Potassium chloride administration? - Case 28 PN Pharm 2026/2027
A. Give fast
B. IV push
C. Never IV push - dilute, give via pump, check kidney function, monitor EKG
D. No monitor
Answer: C
Rationale: KCl never IV push, dilute. - Version 3 2026/2027
29. [V3] Metronidazole teaching? - Case 29 PN Pharm 2026/2027
A. No teaching
B. Take with alcohol
C. Drink alcohol
D. Avoid alcohol during and 48h after - disulfiram reaction nausea/vomiting
Answer: D
Rationale: Flagyl no alcohol disulfiram. - Version 3 2026/2027
30. [V3] Ciprofloxacin teaching? - Case 30 PN Pharm 2026/2027
A. Avoid antacids, iron, dairy within 2h, drink fluids, avoid sun - tendon rupture risk
B. No teaching
C. Take with milk
D. Take at bedtime only
Answer: A
Rationale: Cipro avoid cations, sun, tendon risk. - Version 3 2026/2027
31. [V3] Ondansetron use? - Case 31 PN Pharm 2026/2027
A. Diarrhea
B. Nausea/vomiting - monitor QT, headache, constipation
C. Fever
D. Pain
Answer: B
Rationale: Zofran antiemetic QT risk. - Version 3 2026/2027
32. [V3] A client taking amlodipine reports ankle swelling. Best response? - Case 32 PN Pharm 2026/2027
A. No action
B. Stop drug immediately
C. Ankle swelling common with amlodipine - elevate legs, notify provider if worsens, monitor BP
D. Take double dose
Answer: C
Rationale: CCB amlodipine causes peripheral edema - elevate legs, monitor. - Version 3 2026/2027
33. [V3] Acetaminophen overdose antidote? - Case 33 PN Pharm 2026/2027
A. Naloxone
B. N-acetylcysteine (NAC) within 8 hours
C. Vitamin K
D. Protamine
Answer: B
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 3 2026/2027
34. [V3] Docusate use? - Case 34 PN Pharm 2026/2027
A. Fever
