ATI RN Pharmacology 2023/2026 Proctored
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EXAM
Question 1
A nurse is administering digoxin to a client with heart failure. Which assessment finding
requires immediate intervention?
A) Heart rate of 68 bpm
B) Serum potassium level of 3.2 mEq/L
C) Blood pressure of 130/80 mmHg
D) Respiratory rate of 18 breaths/min
Answer: B) Serum potassium level of 3.2 mEq/L
Rationale: Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin toxicity
because potassium competes with digoxin for binding sites on the sodium-potassium
pump. Low potassium allows more digoxin to bind, potentiating its effects and
increasing toxicity risk. Heart rate of 68 is within acceptable range (hold if <60). The BP
and RR are normal.
Question 2
,A client taking furosemide (Lasix) reports muscle weakness and cramping. Which
laboratory value should the nurse assess first?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium excretion.
Muscle weakness and cramping are classic signs of hypokalemia. While furosemide can
affect other electrolytes, potassium is the most immediately concerning due to cardiac
implications.
Question 3
A nurse is teaching a client about a new prescription for lisinopril. Which statement by
the client indicates understanding?
A) "I should take this medication with food to prevent stomach upset."
B) "I need to avoid salt substitutes containing potassium."
C) "I can stop taking this when my blood pressure is normal."
D) "This medication will make me urinate more frequently."
Answer: B) "I need to avoid salt substitutes containing potassium."
Rationale: Lisinopril (an ACE inhibitor) can cause hyperkalemia by reducing aldosterone
production. Clients should avoid potassium supplements and salt substitutes containing
potassium. ACE inhibitors are best taken on an empty stomach. They do NOT increase
,urination (that's diuretics). Antihypertensives must be taken consistently, not stopped
when BP normalizes.
Question 4
A client receiving warfarin has an INR of 5.2. Which order should the nurse anticipate?
A) Increase the warfarin dose
B) Administer vitamin K (phytonadione)
C) Administer protamine sulfate
D) Hold the next dose and repeat INR in 24 hours
Answer: B) Administer vitamin K (phytonadione)
Rationale: Therapeutic INR for most indications is 2-3. An INR of 5.2 indicates excessive
anticoagulation and significant bleeding risk. Vitamin K is the antidote for warfarin.
Protamine sulfate is for heparin reversal. Holding one dose would be insufficient with
this high INR.
Question 5
A nurse is administering metoprolol to a client. Which assessment finding would cause
the nurse to withhold the dose?
A) Blood pressure 138/88 mmHg
B) Apical pulse 52 bpm
C) Respiratory rate 20 breaths/min
D) Temperature 37.2°C (99°F)
, Answer: B) Apical pulse 52 bpm
Rationale: Beta-blockers like metoprolol decrease heart rate. Standard practice is to
withhold if the apical pulse is <60 bpm and notify the provider. The BP is slightly
elevated but not a reason to withhold. RR and temp are normal.
Question 6
A client is prescribed simvastatin. Which instruction should the nurse include in the
teaching?
A) "Take this medication in the morning with breakfast."
B) "Avoid drinking grapefruit juice while taking this medication."
C) "You should expect muscle pain as a normal side effect."
D) "Take this medication with a full glass of milk."
Answer: B) "Avoid drinking grapefruit juice while taking this medication."
Rationale: Grapefruit juice inhibits CYP3A4 enzymes in the liver, which metabolize
simvastatin. This leads to increased drug levels and risk of adverse effects like
rhabdomyolysis. Statins are usually taken in the evening (cholesterol synthesis peaks at
night). Muscle pain is NOT normal and should be reported immediately.
Question 7
A nurse is assessing a client who recently started amiodarone. Which adverse effect
requires immediate follow-up?
Exam with NGN 70 Screenshot Questions
and Answers 100% Verified Correct Answers
Real Exam Prep Pass Fast and Score High
First Attempt
EXAM
Question 1
A nurse is administering digoxin to a client with heart failure. Which assessment finding
requires immediate intervention?
A) Heart rate of 68 bpm
B) Serum potassium level of 3.2 mEq/L
C) Blood pressure of 130/80 mmHg
D) Respiratory rate of 18 breaths/min
Answer: B) Serum potassium level of 3.2 mEq/L
Rationale: Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin toxicity
because potassium competes with digoxin for binding sites on the sodium-potassium
pump. Low potassium allows more digoxin to bind, potentiating its effects and
increasing toxicity risk. Heart rate of 68 is within acceptable range (hold if <60). The BP
and RR are normal.
Question 2
,A client taking furosemide (Lasix) reports muscle weakness and cramping. Which
laboratory value should the nurse assess first?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium excretion.
Muscle weakness and cramping are classic signs of hypokalemia. While furosemide can
affect other electrolytes, potassium is the most immediately concerning due to cardiac
implications.
Question 3
A nurse is teaching a client about a new prescription for lisinopril. Which statement by
the client indicates understanding?
A) "I should take this medication with food to prevent stomach upset."
B) "I need to avoid salt substitutes containing potassium."
C) "I can stop taking this when my blood pressure is normal."
D) "This medication will make me urinate more frequently."
Answer: B) "I need to avoid salt substitutes containing potassium."
Rationale: Lisinopril (an ACE inhibitor) can cause hyperkalemia by reducing aldosterone
production. Clients should avoid potassium supplements and salt substitutes containing
potassium. ACE inhibitors are best taken on an empty stomach. They do NOT increase
,urination (that's diuretics). Antihypertensives must be taken consistently, not stopped
when BP normalizes.
Question 4
A client receiving warfarin has an INR of 5.2. Which order should the nurse anticipate?
A) Increase the warfarin dose
B) Administer vitamin K (phytonadione)
C) Administer protamine sulfate
D) Hold the next dose and repeat INR in 24 hours
Answer: B) Administer vitamin K (phytonadione)
Rationale: Therapeutic INR for most indications is 2-3. An INR of 5.2 indicates excessive
anticoagulation and significant bleeding risk. Vitamin K is the antidote for warfarin.
Protamine sulfate is for heparin reversal. Holding one dose would be insufficient with
this high INR.
Question 5
A nurse is administering metoprolol to a client. Which assessment finding would cause
the nurse to withhold the dose?
A) Blood pressure 138/88 mmHg
B) Apical pulse 52 bpm
C) Respiratory rate 20 breaths/min
D) Temperature 37.2°C (99°F)
, Answer: B) Apical pulse 52 bpm
Rationale: Beta-blockers like metoprolol decrease heart rate. Standard practice is to
withhold if the apical pulse is <60 bpm and notify the provider. The BP is slightly
elevated but not a reason to withhold. RR and temp are normal.
Question 6
A client is prescribed simvastatin. Which instruction should the nurse include in the
teaching?
A) "Take this medication in the morning with breakfast."
B) "Avoid drinking grapefruit juice while taking this medication."
C) "You should expect muscle pain as a normal side effect."
D) "Take this medication with a full glass of milk."
Answer: B) "Avoid drinking grapefruit juice while taking this medication."
Rationale: Grapefruit juice inhibits CYP3A4 enzymes in the liver, which metabolize
simvastatin. This leads to increased drug levels and risk of adverse effects like
rhabdomyolysis. Statins are usually taken in the evening (cholesterol synthesis peaks at
night). Muscle pain is NOT normal and should be reported immediately.
Question 7
A nurse is assessing a client who recently started amiodarone. Which adverse effect
requires immediate follow-up?
