ATI CMS PHARMACOLOGY RETAKE 2023
ACTUAL EXAM
Latest Questions and Correct Answers with Rationales (A
Grade)
Question 1: A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory
value should the nurse monitor most closely?
A) Complete blood count
B) International normalized ratio (INR)
C) Liver function tests
D) Serum creatinine
Correct Answer: B) International normalized ratio (INR)
Explanation: INR is the most important laboratory value to monitor for patients taking
warfarin. It measures the blood's clotting ability and helps ensure the warfarin dose is
therapeutic while minimizing bleeding risk. The target INR for atrial fibrillation is typically
2.0-3.0.
Question 2: A client receiving morphine sulfate for post-operative pain reports nausea and
vomiting. Which medication would be most appropriate to administer?
A) Metoclopramide (Reglan)
B) Prochlorperazine (Compazine)
C) Ondansetron (Zofran)
D) All of the above are appropriate
Correct Answer: D) All of the above are appropriate
Explanation: All three medications are antiemetics that can effectively treat opioid-induced
nausea and vomiting. The choice depends on the specific clinical situation, patient factors,
and institutional protocols. Ondansetron is often preferred for its efficacy and minimal side
effects.
Question 3: A patient with heart failure is prescribed digoxin (Lanoxin). Which finding would
require immediate intervention by the nurse?
A) Heart rate of 68 beats per minute
B) Serum digoxin level of 1.2 ng/mL
C) Patient reports yellow-green halos around lights
D) Potassium level of 3.8 mEq/L
Correct Answer: C) Patient reports yellow-green halos around lights
, Explanation: Yellow-green halos are a classic sign of digoxin toxicity and require immediate
intervention. This visual disturbance indicates potentially dangerous levels of digoxin and the
prescriber should be notified immediately. The medication may need to be held or
discontinued.
Question 4: A client is prescribed metformin (Glucophage) for type 2 diabetes. Which
condition is a contraindication for metformin use?
A) Mild renal impairment
B) History of lactic acidosis
C) Age over 65
D) Concurrent use of insulin
Correct Answer: B) History of lactic acidosis
Explanation: Metformin is contraindicated in patients with a history of lactic acidosis due to
the risk of recurrence. Lactic acidosis is a rare but serious complication of metformin that
can be fatal. The medication should be discontinued immediately if this condition develops.
Question 5: A patient receiving heparin infusion develops new onset of bleeding. Which
medication should the nurse prepare to administer?
A) Vitamin K
B) Protamine sulfate
C) Fresh frozen plasma
D) Platelet transfusion
Correct Answer: B) Protamine sulfate
Explanation: Protamine sulfate is the specific antidote for heparin overdose. It works by
binding to heparin to form a stable salt complex that neutralizes heparin's anticoagulant
effect. The dose depends on the amount of heparin the patient has received in the preceding
hours.
Question 6: A client is prescribed levothyroxine (Synthroid) for hypothyroidism. When should
the nurse instruct the patient to take this medication?
A) With breakfast
B) At bedtime
C) On an empty stomach in the morning
D) With the evening meal
Correct Answer: C) On an empty stomach in the morning
Explanation: Levothyroxine should be taken on an empty stomach in the morning, 30-60
minutes before breakfast. Food, especially high-fiber foods, calcium, and iron supplements,
can interfere with levothyroxine absorption and reduce its effectiveness.
Question 7: A patient is prescribed furosemide (Lasix) for fluid overload. Which electrolyte
imbalance is most likely to occur?
ACTUAL EXAM
Latest Questions and Correct Answers with Rationales (A
Grade)
Question 1: A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory
value should the nurse monitor most closely?
A) Complete blood count
B) International normalized ratio (INR)
C) Liver function tests
D) Serum creatinine
Correct Answer: B) International normalized ratio (INR)
Explanation: INR is the most important laboratory value to monitor for patients taking
warfarin. It measures the blood's clotting ability and helps ensure the warfarin dose is
therapeutic while minimizing bleeding risk. The target INR for atrial fibrillation is typically
2.0-3.0.
Question 2: A client receiving morphine sulfate for post-operative pain reports nausea and
vomiting. Which medication would be most appropriate to administer?
A) Metoclopramide (Reglan)
B) Prochlorperazine (Compazine)
C) Ondansetron (Zofran)
D) All of the above are appropriate
Correct Answer: D) All of the above are appropriate
Explanation: All three medications are antiemetics that can effectively treat opioid-induced
nausea and vomiting. The choice depends on the specific clinical situation, patient factors,
and institutional protocols. Ondansetron is often preferred for its efficacy and minimal side
effects.
Question 3: A patient with heart failure is prescribed digoxin (Lanoxin). Which finding would
require immediate intervention by the nurse?
A) Heart rate of 68 beats per minute
B) Serum digoxin level of 1.2 ng/mL
C) Patient reports yellow-green halos around lights
D) Potassium level of 3.8 mEq/L
Correct Answer: C) Patient reports yellow-green halos around lights
, Explanation: Yellow-green halos are a classic sign of digoxin toxicity and require immediate
intervention. This visual disturbance indicates potentially dangerous levels of digoxin and the
prescriber should be notified immediately. The medication may need to be held or
discontinued.
Question 4: A client is prescribed metformin (Glucophage) for type 2 diabetes. Which
condition is a contraindication for metformin use?
A) Mild renal impairment
B) History of lactic acidosis
C) Age over 65
D) Concurrent use of insulin
Correct Answer: B) History of lactic acidosis
Explanation: Metformin is contraindicated in patients with a history of lactic acidosis due to
the risk of recurrence. Lactic acidosis is a rare but serious complication of metformin that
can be fatal. The medication should be discontinued immediately if this condition develops.
Question 5: A patient receiving heparin infusion develops new onset of bleeding. Which
medication should the nurse prepare to administer?
A) Vitamin K
B) Protamine sulfate
C) Fresh frozen plasma
D) Platelet transfusion
Correct Answer: B) Protamine sulfate
Explanation: Protamine sulfate is the specific antidote for heparin overdose. It works by
binding to heparin to form a stable salt complex that neutralizes heparin's anticoagulant
effect. The dose depends on the amount of heparin the patient has received in the preceding
hours.
Question 6: A client is prescribed levothyroxine (Synthroid) for hypothyroidism. When should
the nurse instruct the patient to take this medication?
A) With breakfast
B) At bedtime
C) On an empty stomach in the morning
D) With the evening meal
Correct Answer: C) On an empty stomach in the morning
Explanation: Levothyroxine should be taken on an empty stomach in the morning, 30-60
minutes before breakfast. Food, especially high-fiber foods, calcium, and iron supplements,
can interfere with levothyroxine absorption and reduce its effectiveness.
Question 7: A patient is prescribed furosemide (Lasix) for fluid overload. Which electrolyte
imbalance is most likely to occur?
