ATI Pharmacology Practice Assessment A 2026–
2027 Complete Study Guide with Medication
Practice Questions, Drug Review, and Rationales
Introduction
This comprehensive study guide contains 100, exam-style
questions designed to prepare nursing students for the ATI Pharmacology
Practice Assessment A for the 2026–2027 academic year. All questions are
aligned with ATI Nursing Content Mastery Series standards, current
pharmacology guidelines, and the Next Generation NCLEX (NGN) format.
ESSENTIAL PHARMACOLOGY PRINCIPLES REFERENCE
Concept Key Points
Pharmacokinetics Absorption, Distribution, Metabolism, Excretion (ADME)
Pharmacodynamics Drug-receptor interactions, therapeutic effects, adverse effects
Half-Life Time for drug concentration to decrease by 50%
Therapeutic Index Ratio of toxic dose to therapeutic dose; narrow TI = close monitoring
First-Pass Effect Drug metabolism in liver before reaching systemic circulation
Agonist Binds to receptor and produces effect
Antagonist Binds to receptor and blocks effect
,Concept Key Points
Side Effect Predictable, often mild effect at therapeutic doses
Adverse Effect Undesirable, potentially harmful effect
Toxic Effect Harmful effect from excessive dosing
Question 1
A nurse is caring for a client prescribed digoxin for heart failure. Which of the
following findings should the nurse identify as a manifestation of digoxin
toxicity?
A) Tachycardia
B) Hypertension
C) Visual disturbances (yellow-green halos)
D) Hyperkalemia
Answer: C) Visual disturbances (yellow-green halos)
Rationale: Digoxin toxicity manifests with visual disturbances, including
yellow-green halos around objects, blurred vision, and photophobia. Other
signs include bradycardia (not tachycardia, A), hypotension (not
hypertension, B), nausea, vomiting, and cardiac dysrhythmias. Hypokalemia
(not hyperkalemia, D) increases the risk of digoxin toxicity. The nurse should
monitor serum digoxin levels (therapeutic range: 0.8–2.0 ng/mL) and
potassium levels.
Question 2
A nurse is providing teaching to a client prescribed lisinopril. Which of the
following adverse effects should the nurse instruct the client to report?
,A) Dry cough
B) Swelling of the face and lips
C) Dizziness
D) Headache
Answer: B) Swelling of the face and lips
Rationale: Lisinopril is an ACE inhibitor. Angioedema (swelling of the face,
lips, tongue, and airway) is a serious adverse effect that requires immediate
medical attention. While dry cough (A) is a common side effect of ACE
inhibitors, it is not life-threatening. Dizziness (C) and headache (D) are
common side effects but do not require emergency intervention. The nurse
should instruct the client to seek emergency care if swelling occurs.
Question 3
A nurse is preparing to administer metoprolol to a client. Which of the
following assessment findings should cause the nurse to hold the medication
and notify the provider?
A) Heart rate 92/min
B) Heart rate 52/min
C) Blood pressure 142/88 mmHg
D) Respiratory rate 18/min
Answer: B) Heart rate 52/min
Rationale: Metoprolol is a beta-blocker that decreases heart rate and
myocardial contractility. A heart rate below 60/min is a contraindication for
administration and should be reported to the provider. Heart rate 92/min (A)
is within normal range. Blood pressure 142/88 mmHg (C) is elevated but not
an absolute contraindication. Respiratory rate 18/min (D) is normal. The
nurse should assess for bradycardia, hypotension, and heart block before
administering beta-blockers.
Question 4
A client prescribed warfarin has an international normalized ratio (INR) of
5.2. Which of the following actions should the nurse take?
, A) Administer vitamin K
B) Increase the warfarin dose
C) Administer protamine sulfate
D) Hold the next dose only
Answer: A) Administer vitamin K
Rationale: An INR of 5.2 is above the therapeutic range (2.0–3.0 for most
indications) and indicates an increased risk of bleeding. Vitamin K is the
antidote for warfarin and should be administered to reverse anticoagulation.
Protamine sulfate (C) is the antidote for heparin, not warfarin. Increasing the
dose (B) would worsen the elevation. Holding the next dose only (D) is
insufficient for an INR this high.
Question 5
A nurse is caring for a client prescribed amiodarone. Which of the following
adverse effects should the nurse monitor?
A) Hyperthyroidism
B) Pulmonary toxicity
C) Hypokalemia
D) Tachycardia
Answer: B) Pulmonary toxicity
Rationale: Amiodarone is a class III antiarrhythmic with a significant adverse
effect profile, including pulmonary toxicity (pulmonary fibrosis), which can be
fatal. Other adverse effects include hypothyroidism or hyperthyroidism (A),
corneal deposits, blue-gray skin discoloration, and hepatotoxicity. The nurse
should monitor for cough, dyspnea, and decreased oxygen saturation.
Hypokalemia (C) is not a primary adverse effect. Tachycardia (D) is not
expected; amiodarone is used to treat arrhythmias.
Question 6
A nurse is teaching a client about nitroglycerin transdermal patches. Which of
the following statements by the client indicates understanding?
2027 Complete Study Guide with Medication
Practice Questions, Drug Review, and Rationales
Introduction
This comprehensive study guide contains 100, exam-style
questions designed to prepare nursing students for the ATI Pharmacology
Practice Assessment A for the 2026–2027 academic year. All questions are
aligned with ATI Nursing Content Mastery Series standards, current
pharmacology guidelines, and the Next Generation NCLEX (NGN) format.
ESSENTIAL PHARMACOLOGY PRINCIPLES REFERENCE
Concept Key Points
Pharmacokinetics Absorption, Distribution, Metabolism, Excretion (ADME)
Pharmacodynamics Drug-receptor interactions, therapeutic effects, adverse effects
Half-Life Time for drug concentration to decrease by 50%
Therapeutic Index Ratio of toxic dose to therapeutic dose; narrow TI = close monitoring
First-Pass Effect Drug metabolism in liver before reaching systemic circulation
Agonist Binds to receptor and produces effect
Antagonist Binds to receptor and blocks effect
,Concept Key Points
Side Effect Predictable, often mild effect at therapeutic doses
Adverse Effect Undesirable, potentially harmful effect
Toxic Effect Harmful effect from excessive dosing
Question 1
A nurse is caring for a client prescribed digoxin for heart failure. Which of the
following findings should the nurse identify as a manifestation of digoxin
toxicity?
A) Tachycardia
B) Hypertension
C) Visual disturbances (yellow-green halos)
D) Hyperkalemia
Answer: C) Visual disturbances (yellow-green halos)
Rationale: Digoxin toxicity manifests with visual disturbances, including
yellow-green halos around objects, blurred vision, and photophobia. Other
signs include bradycardia (not tachycardia, A), hypotension (not
hypertension, B), nausea, vomiting, and cardiac dysrhythmias. Hypokalemia
(not hyperkalemia, D) increases the risk of digoxin toxicity. The nurse should
monitor serum digoxin levels (therapeutic range: 0.8–2.0 ng/mL) and
potassium levels.
Question 2
A nurse is providing teaching to a client prescribed lisinopril. Which of the
following adverse effects should the nurse instruct the client to report?
,A) Dry cough
B) Swelling of the face and lips
C) Dizziness
D) Headache
Answer: B) Swelling of the face and lips
Rationale: Lisinopril is an ACE inhibitor. Angioedema (swelling of the face,
lips, tongue, and airway) is a serious adverse effect that requires immediate
medical attention. While dry cough (A) is a common side effect of ACE
inhibitors, it is not life-threatening. Dizziness (C) and headache (D) are
common side effects but do not require emergency intervention. The nurse
should instruct the client to seek emergency care if swelling occurs.
Question 3
A nurse is preparing to administer metoprolol to a client. Which of the
following assessment findings should cause the nurse to hold the medication
and notify the provider?
A) Heart rate 92/min
B) Heart rate 52/min
C) Blood pressure 142/88 mmHg
D) Respiratory rate 18/min
Answer: B) Heart rate 52/min
Rationale: Metoprolol is a beta-blocker that decreases heart rate and
myocardial contractility. A heart rate below 60/min is a contraindication for
administration and should be reported to the provider. Heart rate 92/min (A)
is within normal range. Blood pressure 142/88 mmHg (C) is elevated but not
an absolute contraindication. Respiratory rate 18/min (D) is normal. The
nurse should assess for bradycardia, hypotension, and heart block before
administering beta-blockers.
Question 4
A client prescribed warfarin has an international normalized ratio (INR) of
5.2. Which of the following actions should the nurse take?
, A) Administer vitamin K
B) Increase the warfarin dose
C) Administer protamine sulfate
D) Hold the next dose only
Answer: A) Administer vitamin K
Rationale: An INR of 5.2 is above the therapeutic range (2.0–3.0 for most
indications) and indicates an increased risk of bleeding. Vitamin K is the
antidote for warfarin and should be administered to reverse anticoagulation.
Protamine sulfate (C) is the antidote for heparin, not warfarin. Increasing the
dose (B) would worsen the elevation. Holding the next dose only (D) is
insufficient for an INR this high.
Question 5
A nurse is caring for a client prescribed amiodarone. Which of the following
adverse effects should the nurse monitor?
A) Hyperthyroidism
B) Pulmonary toxicity
C) Hypokalemia
D) Tachycardia
Answer: B) Pulmonary toxicity
Rationale: Amiodarone is a class III antiarrhythmic with a significant adverse
effect profile, including pulmonary toxicity (pulmonary fibrosis), which can be
fatal. Other adverse effects include hypothyroidism or hyperthyroidism (A),
corneal deposits, blue-gray skin discoloration, and hepatotoxicity. The nurse
should monitor for cough, dyspnea, and decreased oxygen saturation.
Hypokalemia (C) is not a primary adverse effect. Tachycardia (D) is not
expected; amiodarone is used to treat arrhythmias.
Question 6
A nurse is teaching a client about nitroglycerin transdermal patches. Which of
the following statements by the client indicates understanding?
