ATI Pharmacology Practice Assessment B
2026–2027 Comprehensive Study Guide with
100 Practice Questions, Medication Review &
Verified Rationales
Question 1
A nurse is preparing to administer a medication to a client who has a history of
anaphylaxis to penicillin. Which of the following medications should the nurse
question?
A) Vancomycin
B) Cephalexin
C) Gentamicin
D) Metronidazole
Rationale: Clients with a history of anaphylaxis to penicillin have a cross-
sensitivity risk of approximately 10% with cephalosporins such as cephalexin. The
nurse should question this order and notify the provider. Vancomycin, gentamicin,
and metronidazole are not in the penicillin or cephalosporin classes and are safer
alternatives.
Question 2
A nurse is caring for a client who is taking warfarin. Which of the following
laboratory values indicates that the client's warfarin therapy is therapeutic?
A) INR 2.5
B) INR 1.0
C) aPTT 60 seconds
D) Platelet count 150,000/mm³
Rationale: The therapeutic INR range for warfarin therapy is typically 2.0–3.0 for
most indications (2.5–3.5 for mechanical heart valves). An INR of 2.5 indicates
,therapeutic anticoagulation. INR of 1.0 is subtherapeutic. aPTT is used to monitor
heparin therapy, not warfarin.
Question 3
A nurse is preparing to administer metoprolol to a client. Which of the following
assessment findings should the nurse report to the provider BEFORE
administration?
A) Blood pressure 142/88 mm Hg
B) Heart rate 52/min
C) Respiratory rate 18/min
D) Temperature 37.2°C (99.0°F)
Rationale: Metoprolol is a beta-blocker that decreases heart rate and blood
pressure. A heart rate of 52/min is bradycardic and should be reported before
administration. Beta-blockers can further decrease heart rate, potentially causing
symptomatic bradycardia.
Question 4
A nurse is administering digoxin to a client with heart failure. Which of the
following findings indicates digoxin toxicity?
A) Heart rate 72/min
B) Nausea, vomiting, and visual disturbances
C) Blood pressure 118/76 mm Hg
D) Urine output 60 mL/hr
Rationale: Digoxin toxicity presents with gastrointestinal symptoms (nausea,
vomiting, anorexia), visual disturbances (yellow-green halos, blurred vision), and
cardiac dysrhythmias (bradycardia, heart block). Early recognition is critical to
prevent life-threatening complications.
Question 5
,A nurse is providing teaching to a client who has a new prescription for
furosemide. Which of the following foods should the nurse recommend to prevent
potassium depletion?
A) Apples
B) Bananas
C) White bread
D) Pasta
Rationale: Furosemide is a loop diuretic that causes potassium loss. Clients should
be taught to consume potassium-rich foods such as bananas, oranges, potatoes, and
leafy green vegetables to prevent hypokalemia.
Question 6
A nurse is administering heparin subcutaneously to a client. Which of the
following actions is correct?
A) Do not aspirate before injection
B) Aspirate before injection
C) Massage the site after injection
D) Administer the injection into the deltoid muscle
Rationale: When administering subcutaneous heparin, aspiration should not be
performed to prevent hematoma formation. The site should not be massaged. The
abdomen is the preferred site for subcutaneous heparin administration.
Question 7
A nurse is caring for a client who has a prescription for lithium carbonate. Which
of the following laboratory values should the nurse monitor to assess for lithium
toxicity?
A) Serum sodium
B) Serum lithium level
C) Serum potassium
D) Serum glucose
, Rationale: Lithium has a narrow therapeutic index. Serum lithium levels must be
monitored regularly to prevent toxicity. Therapeutic range is 0.6–1.2 mEq/L.
Levels above 1.5 mEq/L indicate toxicity.
Question 8
A nurse is providing teaching to a client who has a new prescription for an MAO
inhibitor. Which of the following foods should the nurse instruct the client to
AVOID?
A) Aged cheese
B) Apples
C) Rice
D) Chicken
Rationale: MAO inhibitors interact with tyramine-rich foods, which can cause a
hypertensive crisis. Foods to avoid include aged cheese, cured meats, fermented
foods, red wine, and fava beans.
Question 9
A nurse is assessing a client who is receiving morphine via IV. Which of the
following findings indicates an adverse effect of the medication?
A) Respiratory rate 8/min
B) Blood pressure 128/78 mm Hg
C) Heart rate 88/min
D) Pupils equal and reactive
Rationale: Morphine, an opioid analgesic, can cause respiratory depression. A
respiratory rate of 8/min is below the normal range (12–20/min) and indicates an
adverse effect requiring immediate intervention, such as administering naloxone.
Question 10
A nurse is preparing to administer a medication that is a liquid suspension. Which
of the following actions should the nurse take?
2026–2027 Comprehensive Study Guide with
100 Practice Questions, Medication Review &
Verified Rationales
Question 1
A nurse is preparing to administer a medication to a client who has a history of
anaphylaxis to penicillin. Which of the following medications should the nurse
question?
A) Vancomycin
B) Cephalexin
C) Gentamicin
D) Metronidazole
Rationale: Clients with a history of anaphylaxis to penicillin have a cross-
sensitivity risk of approximately 10% with cephalosporins such as cephalexin. The
nurse should question this order and notify the provider. Vancomycin, gentamicin,
and metronidazole are not in the penicillin or cephalosporin classes and are safer
alternatives.
Question 2
A nurse is caring for a client who is taking warfarin. Which of the following
laboratory values indicates that the client's warfarin therapy is therapeutic?
A) INR 2.5
B) INR 1.0
C) aPTT 60 seconds
D) Platelet count 150,000/mm³
Rationale: The therapeutic INR range for warfarin therapy is typically 2.0–3.0 for
most indications (2.5–3.5 for mechanical heart valves). An INR of 2.5 indicates
,therapeutic anticoagulation. INR of 1.0 is subtherapeutic. aPTT is used to monitor
heparin therapy, not warfarin.
Question 3
A nurse is preparing to administer metoprolol to a client. Which of the following
assessment findings should the nurse report to the provider BEFORE
administration?
A) Blood pressure 142/88 mm Hg
B) Heart rate 52/min
C) Respiratory rate 18/min
D) Temperature 37.2°C (99.0°F)
Rationale: Metoprolol is a beta-blocker that decreases heart rate and blood
pressure. A heart rate of 52/min is bradycardic and should be reported before
administration. Beta-blockers can further decrease heart rate, potentially causing
symptomatic bradycardia.
Question 4
A nurse is administering digoxin to a client with heart failure. Which of the
following findings indicates digoxin toxicity?
A) Heart rate 72/min
B) Nausea, vomiting, and visual disturbances
C) Blood pressure 118/76 mm Hg
D) Urine output 60 mL/hr
Rationale: Digoxin toxicity presents with gastrointestinal symptoms (nausea,
vomiting, anorexia), visual disturbances (yellow-green halos, blurred vision), and
cardiac dysrhythmias (bradycardia, heart block). Early recognition is critical to
prevent life-threatening complications.
Question 5
,A nurse is providing teaching to a client who has a new prescription for
furosemide. Which of the following foods should the nurse recommend to prevent
potassium depletion?
A) Apples
B) Bananas
C) White bread
D) Pasta
Rationale: Furosemide is a loop diuretic that causes potassium loss. Clients should
be taught to consume potassium-rich foods such as bananas, oranges, potatoes, and
leafy green vegetables to prevent hypokalemia.
Question 6
A nurse is administering heparin subcutaneously to a client. Which of the
following actions is correct?
A) Do not aspirate before injection
B) Aspirate before injection
C) Massage the site after injection
D) Administer the injection into the deltoid muscle
Rationale: When administering subcutaneous heparin, aspiration should not be
performed to prevent hematoma formation. The site should not be massaged. The
abdomen is the preferred site for subcutaneous heparin administration.
Question 7
A nurse is caring for a client who has a prescription for lithium carbonate. Which
of the following laboratory values should the nurse monitor to assess for lithium
toxicity?
A) Serum sodium
B) Serum lithium level
C) Serum potassium
D) Serum glucose
, Rationale: Lithium has a narrow therapeutic index. Serum lithium levels must be
monitored regularly to prevent toxicity. Therapeutic range is 0.6–1.2 mEq/L.
Levels above 1.5 mEq/L indicate toxicity.
Question 8
A nurse is providing teaching to a client who has a new prescription for an MAO
inhibitor. Which of the following foods should the nurse instruct the client to
AVOID?
A) Aged cheese
B) Apples
C) Rice
D) Chicken
Rationale: MAO inhibitors interact with tyramine-rich foods, which can cause a
hypertensive crisis. Foods to avoid include aged cheese, cured meats, fermented
foods, red wine, and fava beans.
Question 9
A nurse is assessing a client who is receiving morphine via IV. Which of the
following findings indicates an adverse effect of the medication?
A) Respiratory rate 8/min
B) Blood pressure 128/78 mm Hg
C) Heart rate 88/min
D) Pupils equal and reactive
Rationale: Morphine, an opioid analgesic, can cause respiratory depression. A
respiratory rate of 8/min is below the normal range (12–20/min) and indicates an
adverse effect requiring immediate intervention, such as administering naloxone.
Question 10
A nurse is preparing to administer a medication that is a liquid suspension. Which
of the following actions should the nurse take?
