ATI PN Pharmacology 2026
Proctored Exam Level 3: 200
Practice Questions & NGN
Rationales Guaranteed Pass
(GRADED A+)
Question 1
A practical nurse (PN) is preparing to administer digoxin 0.25 mg
PO to a client with heart failure. Prior to administration, the nurse
obtains an apical pulse of 54/min. Which of the following actions
should the nurse take?
A. Administer the medication as prescribed.
B. Recheck the pulse in 30 minutes and give if above 50/min.
C. Hold the medication and notify the charge nurse/provider.
D. Administer the medication with a glass of orange juice.
Rationale: Digoxin slows the heart rate and is typically withheld
when the apical pulse is below 60/min in adults due to the risk of
worsening bradycardia and potential heart block. The nurse should
hold the dose and notify the provider for further orders.
,Administering the medication at this rate places the client at risk for
symptomatic bradycardia and digoxin toxicity.
Question 2
A PN is monitoring a client receiving continuous intravenous
heparin for deep vein thrombosis (DVT). Which of the following
laboratory values indicates a therapeutic response to heparin
therapy?
A. Prothrombin time (PT) of 12 seconds
B. Activated partial thromboplastin time (aPTT) of 65 seconds
C. International normalized ratio (INR) of 3.2
D. Platelet count of 95,000/mm³
Rationale: The therapeutic range for aPTT during heparin therapy is
typically 1.5 to 2.5 times the control value, generally around 60 to
80 seconds. A PT of 12 seconds and INR of 3.2 are more relevant to
warfarin monitoring. A platelet count of 95,000/mm³ may indicate
heparin-induced thrombocytopenia (HIT), an adverse effect, not a
therapeutic response.
Question 3
A nurse is reinforcing teaching with a client who has a new
prescription for furosemide 40 mg PO daily. Which of the
,following instructions should the nurse include? (Select All That
Apply)
A. Eat foods high in potassium, such as bananas and oranges.
B. Take the medication at bedtime to maximize efficacy.
C. Change positions slowly when standing up from a sitting
position.
D. Limit fluid intake to less than 1 Liter per day.
E. Report muscle weakness, cramps, or cardiac palpitations
immediately.
Rationale: Furosemide is a loop diuretic that causes potassium loss,
so clients should increase dietary potassium intake and report signs
of hypokalemia (muscle weakness, cramps, palpitations). Taking the
medication at bedtime would cause nocturia and disrupt sleep, so it
should be taken in the morning. Orthostatic hypotension is a
common effect, so position changes should be slow. Fluid restriction
is not a standard instruction for all clients on furosemide.
Question 4
A PN is preparing to administer sublingual nitroglycerin to a client
experiencing acute angina. Which of the following statements by
the client demonstrates a correct understanding of
administration?
A. “I will swallow the tablet whole with a full glass of water.”
, B. “I can take up to 3 tablets 5 minutes apart, and call 911 if
pain persists after the first dose.”
C. “I should crush the pill and mix it with applesauce if my mouth
is dry.”
D. “I will store my tablets in a clear plastic container on my sunny
windowsill.”
Rationale: Sublingual nitroglycerin should be taken as 1 tablet
every 5 minutes for up to 3 doses. If chest pain persists after the first
dose, the client should call 911 per current guidelines. The tablet
must be placed under the tongue and allowed to dissolve—not
swallowed, crushed, or taken with water. Nitroglycerin is light-
sensitive and must be stored in its original dark glass container, not
exposed to sunlight.
Question 5
A nurse is reviewing lab results for a client taking lisinopril for
hypertension. Which lab value represents an adverse effect that
requires immediate provider notification?
A. Serum sodium 138 mEq/L
B. Serum potassium 5.8 mEq/L
C. Fasting blood glucose 110 mg/dL
D. Total cholesterol 190 mg/dL
Proctored Exam Level 3: 200
Practice Questions & NGN
Rationales Guaranteed Pass
(GRADED A+)
Question 1
A practical nurse (PN) is preparing to administer digoxin 0.25 mg
PO to a client with heart failure. Prior to administration, the nurse
obtains an apical pulse of 54/min. Which of the following actions
should the nurse take?
A. Administer the medication as prescribed.
B. Recheck the pulse in 30 minutes and give if above 50/min.
C. Hold the medication and notify the charge nurse/provider.
D. Administer the medication with a glass of orange juice.
Rationale: Digoxin slows the heart rate and is typically withheld
when the apical pulse is below 60/min in adults due to the risk of
worsening bradycardia and potential heart block. The nurse should
hold the dose and notify the provider for further orders.
,Administering the medication at this rate places the client at risk for
symptomatic bradycardia and digoxin toxicity.
Question 2
A PN is monitoring a client receiving continuous intravenous
heparin for deep vein thrombosis (DVT). Which of the following
laboratory values indicates a therapeutic response to heparin
therapy?
A. Prothrombin time (PT) of 12 seconds
B. Activated partial thromboplastin time (aPTT) of 65 seconds
C. International normalized ratio (INR) of 3.2
D. Platelet count of 95,000/mm³
Rationale: The therapeutic range for aPTT during heparin therapy is
typically 1.5 to 2.5 times the control value, generally around 60 to
80 seconds. A PT of 12 seconds and INR of 3.2 are more relevant to
warfarin monitoring. A platelet count of 95,000/mm³ may indicate
heparin-induced thrombocytopenia (HIT), an adverse effect, not a
therapeutic response.
Question 3
A nurse is reinforcing teaching with a client who has a new
prescription for furosemide 40 mg PO daily. Which of the
,following instructions should the nurse include? (Select All That
Apply)
A. Eat foods high in potassium, such as bananas and oranges.
B. Take the medication at bedtime to maximize efficacy.
C. Change positions slowly when standing up from a sitting
position.
D. Limit fluid intake to less than 1 Liter per day.
E. Report muscle weakness, cramps, or cardiac palpitations
immediately.
Rationale: Furosemide is a loop diuretic that causes potassium loss,
so clients should increase dietary potassium intake and report signs
of hypokalemia (muscle weakness, cramps, palpitations). Taking the
medication at bedtime would cause nocturia and disrupt sleep, so it
should be taken in the morning. Orthostatic hypotension is a
common effect, so position changes should be slow. Fluid restriction
is not a standard instruction for all clients on furosemide.
Question 4
A PN is preparing to administer sublingual nitroglycerin to a client
experiencing acute angina. Which of the following statements by
the client demonstrates a correct understanding of
administration?
A. “I will swallow the tablet whole with a full glass of water.”
, B. “I can take up to 3 tablets 5 minutes apart, and call 911 if
pain persists after the first dose.”
C. “I should crush the pill and mix it with applesauce if my mouth
is dry.”
D. “I will store my tablets in a clear plastic container on my sunny
windowsill.”
Rationale: Sublingual nitroglycerin should be taken as 1 tablet
every 5 minutes for up to 3 doses. If chest pain persists after the first
dose, the client should call 911 per current guidelines. The tablet
must be placed under the tongue and allowed to dissolve—not
swallowed, crushed, or taken with water. Nitroglycerin is light-
sensitive and must be stored in its original dark glass container, not
exposed to sunlight.
Question 5
A nurse is reviewing lab results for a client taking lisinopril for
hypertension. Which lab value represents an adverse effect that
requires immediate provider notification?
A. Serum sodium 138 mEq/L
B. Serum potassium 5.8 mEq/L
C. Fasting blood glucose 110 mg/dL
D. Total cholesterol 190 mg/dL
