ATI PN PHARMACOLOGY PROCTORED EXAM V2 2026/2027 - 400 VERIFIED QUESTIONS WITH
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V2 2026/2027 | 400Q Mixed A/B/C/D: A=96 B=98 C=110 D=96 | 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. [V2] Ondansetron use? - Case 1 PN Pharm 2026/2027
A. Nausea/vomiting - monitor QT, headache, constipation
B. Diarrhea
C. Fever
D. Pain
Answer: A
Rationale: Zofran antiemetic QT risk. - Version 2 2026/2027
2. [V2] Lithium therapeutic level? - Case 2 PN Pharm 2026/2027
A. 0.6-1.2 mEq/L, toxicity >1.5 - monitor kidney, thyroid, hydration
B. 0.1
C. 5.0
D. 10
Answer: A
Rationale: Lithium narrow therapeutic, monitor. - Version 2 2026/2027
3. [V2] Lisinopril causes dry cough due to? - Case 3 PN Pharm 2026/2027
A. Na retention
B. Bradykinin accumulation in lungs - ACE inhibitor side effect
C. Histamine
D. K+ loss
Answer: B
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 2 2026/2027
4. [V2] Benzodiazepine overdose antidote? - Case 4 PN Pharm 2026/2027
A. Vitamin K
B. Naloxone
C. Protamine
D. Flumazenil
Answer: D
Rationale: Flumazenil reverses benzos, risk seizures. - Version 2 2026/2027
5. [V2] Docusate use? - Case 5 PN Pharm 2026/2027
A. Stool softener - softens stool, needs fluids
B. Stimulant
C. Fever
D. Pain
Answer: A
Rationale: Docusate softener. - Version 2 2026/2027
6. [V2] Opioid overdose antidote? - Case 6 PN Pharm 2026/2027
A. Naloxone - may need repeat due to short half-life
B. Flumazenil
C. Vitamin K
D. Protamine
Answer: A
Rationale: Naloxone opioid antagonist, monitor for re-sedation. - Version 2 2026/2027
7. [V2] Digoxin antidote? - Case 7 PN Pharm 2026/2027
A. Vitamin K
B. Protamine
C. Naloxone
D. Digoxin immune Fab (Digibind)
Answer: D
Rationale: Digibind binds digoxin in toxicity. - Version 2 2026/2027
8. [V2] Acetaminophen overdose antidote? - Case 8 PN Pharm 2026/2027
A. Naloxone
B. Vitamin K
C. Protamine
, D. N-acetylcysteine (NAC) within 8 hours
Answer: D
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 2 2026/2027
9. [V2] Albuterol side effects? - Case 9 PN Pharm 2026/2027
A. Cough always
B. Bradycardia
C. Tachycardia, tremor, nervousness - beta2 agonist
D. Weight gain
Answer: C
Rationale: Albuterol tachycardia, tremor. - Version 2 2026/2027
10. [V2] Omeprazole teaching? - Case 10 PN Pharm 2026/2027
A. No risk
B. Take 30 min before breakfast, long-term risk fractures, low Mg2+
C. Double dose
D. Take with food always
Answer: B
Rationale: PPI before breakfast. - Version 2 2026/2027
11. [V2] Carbamazepine side effect? - Case 11 PN Pharm 2026/2027
A. Weight loss only
B. No effects
C. No monitoring
D. Blood dyscrasias, check CBC, rash SJS risk, avoid grapefruit
Answer: D
Rationale: Carbamazepine CBC, rash. - Version 2 2026/2027
12. [V2] LPN cannot do IV push - Case 12 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 2 2026/2027
13. [V2] Vancomycin infusion reaction red man? - Case 13 PN Pharm 2026/2027
A. Infuse slowly over 60-90 min, antihistamine, not allergy
B. No action
C. Stop forever
D. Give fast
Answer: A
Rationale: Red man from fast infusion - slow infusion. - Version 2 2026/2027
14. [V2] Heparin antidote? - Case 14 PN Pharm 2026/2027
A. Flumazenil
B. Protamine sulfate
C. Vitamin K
D. Naloxone
Answer: B
Rationale: Protamine binds heparin. - Version 2 2026/2027
15. [V2] Levodopa-carbidopa teaching? - Case 15 PN Pharm 2026/2027
A. Take with high protein
B. No teaching
C. Take with milk only
D. Take low protein, avoid high protein reduces absorption, dark sweat/urine normal
Answer: D
Rationale: Levodopa low protein diet. - Version 2 2026/2027
16. [V2] Metformin and contrast dye - why hold? - Case 16 PN Pharm 2026/2027
A. Causes HTN
B. No reason
C. Risk lactic acidosis if contrast-induced AKI - hold 48h before/after per protocol
D. Causes hyperglycemia
Answer: C
Rationale: Hold metformin before contrast to prevent lactic acidosis with AKI. - Version 2 2026/2027
17. [V2] Levothyroxine teaching? - Case 17 PN Pharm 2026/2027
, A. Take with food, at night
B. Take 30-60 min before breakfast on empty stomach, same time daily
C. Take with iron
D. Take with milk
Answer: B
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 2 2026/2027
18. [V2] Morphine side effects PN monitor? - Case 18 PN Pharm 2026/2027
A. Diarrhea
B. No effects
C. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
D. Tachycardia only
Answer: C
Rationale: Opioid side effects resp depression. - Version 2 2026/2027
19. [V2] Epinephrine use in anaphylaxis? - Case 19 PN Pharm 2026/2027
A. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
B. No use
C. Hypotension only
D. Bradycardia only
Answer: A
Rationale: Epi first in anaphylaxis IM. - Version 2 2026/2027
20. [V2] NPH insulin appearance? - Case 20 PN Pharm 2026/2027
A. Cloudy - must roll not shake, 30 min to 1h onset, peak 4-12h
B. Clear
C. No appearance
D. Clear yellow
Answer: A
Rationale: NPH cloudy intermediate. - Version 2 2026/2027
21. [V2] Fluoxetine (SSRI) onset? - Case 21 PN Pharm 2026/2027
A. No onset
B. Immediate
C. 1 hour
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 2 2026/2027
22. [V2] Hypoglycemia treatment conscious PN? - Case 22 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 2 2026/2027
23. [V2] Gentamicin toxicity? - Case 23 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 2 2026/2027
24. [V2] Phenytoin teaching? - Case 24 PN Pharm 2026/2027
A. No hygiene
B. Skip doses
C. Double dose if missed
D. Good oral hygiene, avoid alcohol, therapeutic 10-20 mcg/mL, gum hyperplasia risk
Answer: D
Rationale: Phenytoin gum hyperplasia, hygiene. - Version 2 2026/2027
25. [V2] Warfarin antidote for bleeding? - Case 25 PN Pharm 2026/2027
A. Vitamin K + 4F-PCC for life-threatening
B. Protamine
C. Calcium
D. Naloxone
, Answer: A
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 2 2026/2027
26. [V2] Ipratropium (Atrovent) teaching? - Case 26 PN Pharm 2026/2027
A. Take with food
B. Avoid if peanut allergy - contains soy lecithin, rinse mouth
C. No rinse
D. No teaching
Answer: B
Rationale: Ipratropium caution peanut/soy allergy, rinse mouth. - Version 2 2026/2027
27. [V2] Glargine (Lantus) rule? - Case 27 PN Pharm 2026/2027
A. Mix with regular
B. IV push
C. Do not mix, given at same time daily, no peak - basal insulin
D. Give with meals only
Answer: C
Rationale: Glargine long-acting no mix, basal. - Version 2 2026/2027
28. [V2] Loperamide use? - Case 28 PN Pharm 2026/2027
A. Constipation
B. Fever
C. Pain
D. Diarrhea - anti-diarrheal, monitor fluid/electrolytes
Answer: D
Rationale: Loperamide anti-diarrheal. - Version 2 2026/2027
29. [V2] Prednisone long-term side effects? - Case 29 PN Pharm 2026/2027
A. No effects
B. Weight gain, hyperglycemia, moon face, buffalo hump, osteoporosis, infection risk
C. Hypoglycemia
D. Weight loss
Answer: B
Rationale: Steroids cause Cushingoid appearance, hyperglycemia, osteoporosis. - Version 2 2026/2027
30. [V2] Psyllium teaching? - Case 30 PN Pharm 2026/2027
A. Take dry
B. Take with full glass water, may cause bloating, fiber
C. At bedtime only
D. No water
Answer: B
Rationale: Psyllium needs water. - Version 2 2026/2027
31. [V2] PN role in blood transfusion? - Case 31 PN Pharm 2026/2027
A. Start transfusion
B. Monitor transfusion, vitals q15min, stop if reaction, notify RN/provider
C. Crossmatch
D. Order blood
Answer: B
Rationale: PN monitors transfusion, stops if reaction. - Version 2 2026/2027
32. [V2] Sertraline interaction? - Case 32 PN Pharm 2026/2027
A. No interactions
B. Safe with MAOI
C. No risk
D. Avoid MAOIs 14 days, risk serotonin syndrome with tramadol/St John's wort
Answer: D
Rationale: SSRI + MAOI serotonin syndrome. - Version 2 2026/2027
33. [V2] Amoxicillin allergic reaction first? - Case 33 PN Pharm 2026/2027
A. Take with milk
B. Stop drug, notify provider, assess airway - anaphylaxis risk
C. Give next dose
D. Double dose
Answer: B
Rationale: Penicillin allergy stop drug, airway assessment. - Version 2 2026/2027
34. [V2] Acetaminophen max dose PN? - Case 34 PN Pharm 2026/2027
A. No max
MIXED ANSWERS A,B,C,D & RATIONALES | A+ GRADED - NO REPEAT
Course: ATI PN Pharmacology Proctored V2 2026/2027 | 400Q Mixed A/B/C/D: A=96 B=98 C=110 D=96 | 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. [V2] Ondansetron use? - Case 1 PN Pharm 2026/2027
A. Nausea/vomiting - monitor QT, headache, constipation
B. Diarrhea
C. Fever
D. Pain
Answer: A
Rationale: Zofran antiemetic QT risk. - Version 2 2026/2027
2. [V2] Lithium therapeutic level? - Case 2 PN Pharm 2026/2027
A. 0.6-1.2 mEq/L, toxicity >1.5 - monitor kidney, thyroid, hydration
B. 0.1
C. 5.0
D. 10
Answer: A
Rationale: Lithium narrow therapeutic, monitor. - Version 2 2026/2027
3. [V2] Lisinopril causes dry cough due to? - Case 3 PN Pharm 2026/2027
A. Na retention
B. Bradykinin accumulation in lungs - ACE inhibitor side effect
C. Histamine
D. K+ loss
Answer: B
Rationale: ACE cough from bradykinin. Switch to ARB if intolerable. - Version 2 2026/2027
4. [V2] Benzodiazepine overdose antidote? - Case 4 PN Pharm 2026/2027
A. Vitamin K
B. Naloxone
C. Protamine
D. Flumazenil
Answer: D
Rationale: Flumazenil reverses benzos, risk seizures. - Version 2 2026/2027
5. [V2] Docusate use? - Case 5 PN Pharm 2026/2027
A. Stool softener - softens stool, needs fluids
B. Stimulant
C. Fever
D. Pain
Answer: A
Rationale: Docusate softener. - Version 2 2026/2027
6. [V2] Opioid overdose antidote? - Case 6 PN Pharm 2026/2027
A. Naloxone - may need repeat due to short half-life
B. Flumazenil
C. Vitamin K
D. Protamine
Answer: A
Rationale: Naloxone opioid antagonist, monitor for re-sedation. - Version 2 2026/2027
7. [V2] Digoxin antidote? - Case 7 PN Pharm 2026/2027
A. Vitamin K
B. Protamine
C. Naloxone
D. Digoxin immune Fab (Digibind)
Answer: D
Rationale: Digibind binds digoxin in toxicity. - Version 2 2026/2027
8. [V2] Acetaminophen overdose antidote? - Case 8 PN Pharm 2026/2027
A. Naloxone
B. Vitamin K
C. Protamine
, D. N-acetylcysteine (NAC) within 8 hours
Answer: D
Rationale: NAC replenishes glutathione in acetaminophen toxicity. - Version 2 2026/2027
9. [V2] Albuterol side effects? - Case 9 PN Pharm 2026/2027
A. Cough always
B. Bradycardia
C. Tachycardia, tremor, nervousness - beta2 agonist
D. Weight gain
Answer: C
Rationale: Albuterol tachycardia, tremor. - Version 2 2026/2027
10. [V2] Omeprazole teaching? - Case 10 PN Pharm 2026/2027
A. No risk
B. Take 30 min before breakfast, long-term risk fractures, low Mg2+
C. Double dose
D. Take with food always
Answer: B
Rationale: PPI before breakfast. - Version 2 2026/2027
11. [V2] Carbamazepine side effect? - Case 11 PN Pharm 2026/2027
A. Weight loss only
B. No effects
C. No monitoring
D. Blood dyscrasias, check CBC, rash SJS risk, avoid grapefruit
Answer: D
Rationale: Carbamazepine CBC, rash. - Version 2 2026/2027
12. [V2] LPN cannot do IV push - Case 12 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 2 2026/2027
13. [V2] Vancomycin infusion reaction red man? - Case 13 PN Pharm 2026/2027
A. Infuse slowly over 60-90 min, antihistamine, not allergy
B. No action
C. Stop forever
D. Give fast
Answer: A
Rationale: Red man from fast infusion - slow infusion. - Version 2 2026/2027
14. [V2] Heparin antidote? - Case 14 PN Pharm 2026/2027
A. Flumazenil
B. Protamine sulfate
C. Vitamin K
D. Naloxone
Answer: B
Rationale: Protamine binds heparin. - Version 2 2026/2027
15. [V2] Levodopa-carbidopa teaching? - Case 15 PN Pharm 2026/2027
A. Take with high protein
B. No teaching
C. Take with milk only
D. Take low protein, avoid high protein reduces absorption, dark sweat/urine normal
Answer: D
Rationale: Levodopa low protein diet. - Version 2 2026/2027
16. [V2] Metformin and contrast dye - why hold? - Case 16 PN Pharm 2026/2027
A. Causes HTN
B. No reason
C. Risk lactic acidosis if contrast-induced AKI - hold 48h before/after per protocol
D. Causes hyperglycemia
Answer: C
Rationale: Hold metformin before contrast to prevent lactic acidosis with AKI. - Version 2 2026/2027
17. [V2] Levothyroxine teaching? - Case 17 PN Pharm 2026/2027
, A. Take with food, at night
B. Take 30-60 min before breakfast on empty stomach, same time daily
C. Take with iron
D. Take with milk
Answer: B
Rationale: Levo empty stomach, no soy, iron, calcium within 4h. - Version 2 2026/2027
18. [V2] Morphine side effects PN monitor? - Case 18 PN Pharm 2026/2027
A. Diarrhea
B. No effects
C. Respiratory depression, sedation, constipation, hypotension, pinpoint pupils
D. Tachycardia only
Answer: C
Rationale: Opioid side effects resp depression. - Version 2 2026/2027
19. [V2] Epinephrine use in anaphylaxis? - Case 19 PN Pharm 2026/2027
A. Anaphylaxis first-line - IM in mid-thigh, bronchodilation, vasoconstriction
B. No use
C. Hypotension only
D. Bradycardia only
Answer: A
Rationale: Epi first in anaphylaxis IM. - Version 2 2026/2027
20. [V2] NPH insulin appearance? - Case 20 PN Pharm 2026/2027
A. Cloudy - must roll not shake, 30 min to 1h onset, peak 4-12h
B. Clear
C. No appearance
D. Clear yellow
Answer: A
Rationale: NPH cloudy intermediate. - Version 2 2026/2027
21. [V2] Fluoxetine (SSRI) onset? - Case 21 PN Pharm 2026/2027
A. No onset
B. Immediate
C. 1 hour
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 2 2026/2027
22. [V2] Hypoglycemia treatment conscious PN? - Case 22 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 2 2026/2027
23. [V2] Gentamicin toxicity? - Case 23 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 2 2026/2027
24. [V2] Phenytoin teaching? - Case 24 PN Pharm 2026/2027
A. No hygiene
B. Skip doses
C. Double dose if missed
D. Good oral hygiene, avoid alcohol, therapeutic 10-20 mcg/mL, gum hyperplasia risk
Answer: D
Rationale: Phenytoin gum hyperplasia, hygiene. - Version 2 2026/2027
25. [V2] Warfarin antidote for bleeding? - Case 25 PN Pharm 2026/2027
A. Vitamin K + 4F-PCC for life-threatening
B. Protamine
C. Calcium
D. Naloxone
, Answer: A
Rationale: Vitamin K for warfarin reversal, PCC for severe bleed. - Version 2 2026/2027
26. [V2] Ipratropium (Atrovent) teaching? - Case 26 PN Pharm 2026/2027
A. Take with food
B. Avoid if peanut allergy - contains soy lecithin, rinse mouth
C. No rinse
D. No teaching
Answer: B
Rationale: Ipratropium caution peanut/soy allergy, rinse mouth. - Version 2 2026/2027
27. [V2] Glargine (Lantus) rule? - Case 27 PN Pharm 2026/2027
A. Mix with regular
B. IV push
C. Do not mix, given at same time daily, no peak - basal insulin
D. Give with meals only
Answer: C
Rationale: Glargine long-acting no mix, basal. - Version 2 2026/2027
28. [V2] Loperamide use? - Case 28 PN Pharm 2026/2027
A. Constipation
B. Fever
C. Pain
D. Diarrhea - anti-diarrheal, monitor fluid/electrolytes
Answer: D
Rationale: Loperamide anti-diarrheal. - Version 2 2026/2027
29. [V2] Prednisone long-term side effects? - Case 29 PN Pharm 2026/2027
A. No effects
B. Weight gain, hyperglycemia, moon face, buffalo hump, osteoporosis, infection risk
C. Hypoglycemia
D. Weight loss
Answer: B
Rationale: Steroids cause Cushingoid appearance, hyperglycemia, osteoporosis. - Version 2 2026/2027
30. [V2] Psyllium teaching? - Case 30 PN Pharm 2026/2027
A. Take dry
B. Take with full glass water, may cause bloating, fiber
C. At bedtime only
D. No water
Answer: B
Rationale: Psyllium needs water. - Version 2 2026/2027
31. [V2] PN role in blood transfusion? - Case 31 PN Pharm 2026/2027
A. Start transfusion
B. Monitor transfusion, vitals q15min, stop if reaction, notify RN/provider
C. Crossmatch
D. Order blood
Answer: B
Rationale: PN monitors transfusion, stops if reaction. - Version 2 2026/2027
32. [V2] Sertraline interaction? - Case 32 PN Pharm 2026/2027
A. No interactions
B. Safe with MAOI
C. No risk
D. Avoid MAOIs 14 days, risk serotonin syndrome with tramadol/St John's wort
Answer: D
Rationale: SSRI + MAOI serotonin syndrome. - Version 2 2026/2027
33. [V2] Amoxicillin allergic reaction first? - Case 33 PN Pharm 2026/2027
A. Take with milk
B. Stop drug, notify provider, assess airway - anaphylaxis risk
C. Give next dose
D. Double dose
Answer: B
Rationale: Penicillin allergy stop drug, airway assessment. - Version 2 2026/2027
34. [V2] Acetaminophen max dose PN? - Case 34 PN Pharm 2026/2027
A. No max
