ATI COMPREHENSIVE PN PHARMACOLOGY
EXAM 2025/2026 – 140 QUESTIONS WITH
NGN & SOLUTIONS (GRADED A+)
EXAM
1. A nurse is preparing to administer a subcutaneous injection of heparin. Which
needle length is most appropriate?
A. 1 inch
B. 5/8 inch
C. 1.5 inches
D. 2 inches
Correct answer: B – ✓✓ *5/8 inch.*
Rationale: *Subcutaneous injections require a short needle (usually 5/8 inch or
less) to deposit medication into subcutaneous tissue. Longer needles may reach
muscle, causing pain and bleeding.*
2. A client is prescribed propranolol. Which finding would indicate a therapeutic
effect?
A. Heart rate 110 bpm
B. Blood pressure 150/90 mmHg
C. Heart rate 68 bpm and blood pressure 120/80 mmHg
D. Wheezing
Correct answer: C – ✓✓ *Heart rate 68 bpm and blood pressure 120/80 mmHg.*
Rationale: Propranolol is a beta-blocker used for hypertension, tachycardia, and
migraine prevention. Therapeutic effect includes reduced heart rate and blood
pressure. Wheezing is an adverse effect.
3. NGN – A client with diabetes is found to have a blood glucose of 45 mg/dL and
is conscious. Which three actions should the nurse take? (Select all that apply)
A. Give 15 g of fast-acting carbohydrate (e.g., 4 oz juice)
B. Administer glucagon subcutaneously
,C. Recheck blood glucose in 15 minutes
D. Give insulin lispro 5 units
E. Repeat treatment if glucose remains <70 mg/dL
Correct answers: A, C, E – ✓✓ *Give 15 g fast-acting carbohydrate, recheck in 15
minutes, and repeat treatment if glucose remains <70 mg/dL.*
Rationale: For conscious hypoglycemia, the rule of 15 applies: give 15 g carb,
recheck in 15 minutes, repeat if needed. Glucagon is for unconscious patients;
insulin would worsen hypoglycemia.
4. A client is prescribed lisinopril. Which finding requires immediate
discontinuation of the medication?
A. Dry cough
B. Serum potassium 4.8 mEq/L
C. Angioedema (swelling of tongue and lips)
D. Headache
Correct answer: C – ✓✓ Angioedema (swelling of tongue and lips).
Rationale: *Angioedema is a life-threatening allergic reaction to ACE inhibitors.
Dry cough is common but not emergent; potassium 4.8 is normal; headache is not
serious.*
5. A nurse is teaching a client about warfarin. Which statement indicates a need
for further teaching?
A. “I will have my INR checked regularly.”
B. “I can take ibuprofen for my headaches.”
C. “I will watch for bleeding gums.”
D. “I will tell my dentist I take warfarin.”
Correct answer: B – ✓✓ “I can take ibuprofen for my headaches.”
Rationale: Ibuprofen (NSAID) increases bleeding risk when combined with
warfarin. Acetaminophen is safer. The other statements are correct.
6. A client is prescribed metformin. The nurse should instruct the client to
temporarily stop the medication before which diagnostic test?
A. Chest X-ray
B. MRI without contrast
C. IV contrast for a CT scan
D. Electrocardiogram
,Correct answer: C – ✓✓ IV contrast for a CT scan.
Rationale: *IV contrast can cause acute kidney injury, which increases the risk of
metformin-associated lactic acidosis. Metformin should be held 48 hours before
and after contrast, depending on renal function.*
7. A client with asthma is prescribed salmeterol. Which instruction is most
important?
A. “Use this inhaler for sudden shortness of breath.”
B. “This medication works immediately to open airways.”
C. “You should also use a rescue inhaler for acute symptoms.”
D. “Rinse your mouth after each use.”
Correct answer: C – ✓✓ “You should also use a rescue inhaler for acute
symptoms.”
Rationale: Salmeterol is a long-acting beta agonist (LABA) used for maintenance,
not rescue. Clients must have a short-acting beta agonist (e.g., albuterol) for acute
symptoms. Rinsing mouth is for corticosteroids, not salmeterol.
8. A client is prescribed furosemide. Which finding indicates the medication is
effective?
A. Decreased peripheral edema
B. Increased blood pressure
C. Weight gain of 2 kg
D. Serum potassium 3.2 mEq/L
Correct answer: A – ✓✓ Decreased peripheral edema.
Rationale: Furosemide reduces fluid overload, so decreased edema indicates
therapeutic effect. Blood pressure should decrease; weight should decrease;
hypokalemia is an adverse effect.
9. A nurse is administering IV vancomycin. Which finding indicates red man
syndrome?
A. Flushing and rash on the face, neck, and upper torso
B. Fever and chills
C. Tinnitus and hearing loss
D. Hypotension without rash
Correct answer: A – ✓✓ Flushing and rash on the face, neck, and upper torso.
Rationale: Red man syndrome is caused by rapid vancomycin infusion, presenting
, with erythema, flushing, and pruritus on the upper body. Slowing the infusion
resolves it.
10. A client is prescribed phenytoin. Which finding indicates a therapeutic serum
level?
A. 8 mcg/mL
B. 15 mcg/mL
C. 25 mcg/mL
D. 35 mcg/mL
Correct answer: B – ✓✓ *15 mcg/mL.*
Rationale: *Therapeutic phenytoin level is 10–20 mcg/mL. 8 mcg/mL is
subtherapeutic; 25 and 35 mcg/mL are toxic.*
11. A client with heart failure is prescribed digoxin. The nurse should hold the
dose if which finding is present?
A. Heart rate 62 bpm
B. Serum potassium 4.1 mEq/L
C. Apical pulse 52 bpm
D. Blood pressure 130/80 mmHg
Correct answer: C – ✓✓ Apical pulse 52 bpm.
Rationale: *Digoxin is held if the apical pulse is below 60 bpm (or as specified by
provider). Bradycardia may indicate digoxin toxicity. HR 62 is acceptable; K+ 4.1 is
normal; BP is normal.*
12. NGN – A client is receiving a heparin infusion. The nurse notes aPTT of 120
seconds (normal 30). Which two actions should the nurse take? (Select all that
apply)
A. Stop the heparin infusion
B. Continue the heparin at the same rate
C. Notify the provider
D. Administer protamine sulfate without an order
E. Decrease the infusion rate
Correct answers: A, C – ✓✓ Stop the heparin infusion and notify the provider.
Rationale: aPTT >100 seconds is supratherapeutic and increases bleeding risk.
Stop the infusion and notify the provider. Protamine requires an order; decreasing
rate may be ordered but stopping first is priority.
EXAM 2025/2026 – 140 QUESTIONS WITH
NGN & SOLUTIONS (GRADED A+)
EXAM
1. A nurse is preparing to administer a subcutaneous injection of heparin. Which
needle length is most appropriate?
A. 1 inch
B. 5/8 inch
C. 1.5 inches
D. 2 inches
Correct answer: B – ✓✓ *5/8 inch.*
Rationale: *Subcutaneous injections require a short needle (usually 5/8 inch or
less) to deposit medication into subcutaneous tissue. Longer needles may reach
muscle, causing pain and bleeding.*
2. A client is prescribed propranolol. Which finding would indicate a therapeutic
effect?
A. Heart rate 110 bpm
B. Blood pressure 150/90 mmHg
C. Heart rate 68 bpm and blood pressure 120/80 mmHg
D. Wheezing
Correct answer: C – ✓✓ *Heart rate 68 bpm and blood pressure 120/80 mmHg.*
Rationale: Propranolol is a beta-blocker used for hypertension, tachycardia, and
migraine prevention. Therapeutic effect includes reduced heart rate and blood
pressure. Wheezing is an adverse effect.
3. NGN – A client with diabetes is found to have a blood glucose of 45 mg/dL and
is conscious. Which three actions should the nurse take? (Select all that apply)
A. Give 15 g of fast-acting carbohydrate (e.g., 4 oz juice)
B. Administer glucagon subcutaneously
,C. Recheck blood glucose in 15 minutes
D. Give insulin lispro 5 units
E. Repeat treatment if glucose remains <70 mg/dL
Correct answers: A, C, E – ✓✓ *Give 15 g fast-acting carbohydrate, recheck in 15
minutes, and repeat treatment if glucose remains <70 mg/dL.*
Rationale: For conscious hypoglycemia, the rule of 15 applies: give 15 g carb,
recheck in 15 minutes, repeat if needed. Glucagon is for unconscious patients;
insulin would worsen hypoglycemia.
4. A client is prescribed lisinopril. Which finding requires immediate
discontinuation of the medication?
A. Dry cough
B. Serum potassium 4.8 mEq/L
C. Angioedema (swelling of tongue and lips)
D. Headache
Correct answer: C – ✓✓ Angioedema (swelling of tongue and lips).
Rationale: *Angioedema is a life-threatening allergic reaction to ACE inhibitors.
Dry cough is common but not emergent; potassium 4.8 is normal; headache is not
serious.*
5. A nurse is teaching a client about warfarin. Which statement indicates a need
for further teaching?
A. “I will have my INR checked regularly.”
B. “I can take ibuprofen for my headaches.”
C. “I will watch for bleeding gums.”
D. “I will tell my dentist I take warfarin.”
Correct answer: B – ✓✓ “I can take ibuprofen for my headaches.”
Rationale: Ibuprofen (NSAID) increases bleeding risk when combined with
warfarin. Acetaminophen is safer. The other statements are correct.
6. A client is prescribed metformin. The nurse should instruct the client to
temporarily stop the medication before which diagnostic test?
A. Chest X-ray
B. MRI without contrast
C. IV contrast for a CT scan
D. Electrocardiogram
,Correct answer: C – ✓✓ IV contrast for a CT scan.
Rationale: *IV contrast can cause acute kidney injury, which increases the risk of
metformin-associated lactic acidosis. Metformin should be held 48 hours before
and after contrast, depending on renal function.*
7. A client with asthma is prescribed salmeterol. Which instruction is most
important?
A. “Use this inhaler for sudden shortness of breath.”
B. “This medication works immediately to open airways.”
C. “You should also use a rescue inhaler for acute symptoms.”
D. “Rinse your mouth after each use.”
Correct answer: C – ✓✓ “You should also use a rescue inhaler for acute
symptoms.”
Rationale: Salmeterol is a long-acting beta agonist (LABA) used for maintenance,
not rescue. Clients must have a short-acting beta agonist (e.g., albuterol) for acute
symptoms. Rinsing mouth is for corticosteroids, not salmeterol.
8. A client is prescribed furosemide. Which finding indicates the medication is
effective?
A. Decreased peripheral edema
B. Increased blood pressure
C. Weight gain of 2 kg
D. Serum potassium 3.2 mEq/L
Correct answer: A – ✓✓ Decreased peripheral edema.
Rationale: Furosemide reduces fluid overload, so decreased edema indicates
therapeutic effect. Blood pressure should decrease; weight should decrease;
hypokalemia is an adverse effect.
9. A nurse is administering IV vancomycin. Which finding indicates red man
syndrome?
A. Flushing and rash on the face, neck, and upper torso
B. Fever and chills
C. Tinnitus and hearing loss
D. Hypotension without rash
Correct answer: A – ✓✓ Flushing and rash on the face, neck, and upper torso.
Rationale: Red man syndrome is caused by rapid vancomycin infusion, presenting
, with erythema, flushing, and pruritus on the upper body. Slowing the infusion
resolves it.
10. A client is prescribed phenytoin. Which finding indicates a therapeutic serum
level?
A. 8 mcg/mL
B. 15 mcg/mL
C. 25 mcg/mL
D. 35 mcg/mL
Correct answer: B – ✓✓ *15 mcg/mL.*
Rationale: *Therapeutic phenytoin level is 10–20 mcg/mL. 8 mcg/mL is
subtherapeutic; 25 and 35 mcg/mL are toxic.*
11. A client with heart failure is prescribed digoxin. The nurse should hold the
dose if which finding is present?
A. Heart rate 62 bpm
B. Serum potassium 4.1 mEq/L
C. Apical pulse 52 bpm
D. Blood pressure 130/80 mmHg
Correct answer: C – ✓✓ Apical pulse 52 bpm.
Rationale: *Digoxin is held if the apical pulse is below 60 bpm (or as specified by
provider). Bradycardia may indicate digoxin toxicity. HR 62 is acceptable; K+ 4.1 is
normal; BP is normal.*
12. NGN – A client is receiving a heparin infusion. The nurse notes aPTT of 120
seconds (normal 30). Which two actions should the nurse take? (Select all that
apply)
A. Stop the heparin infusion
B. Continue the heparin at the same rate
C. Notify the provider
D. Administer protamine sulfate without an order
E. Decrease the infusion rate
Correct answers: A, C – ✓✓ Stop the heparin infusion and notify the provider.
Rationale: aPTT >100 seconds is supratherapeutic and increases bleeding risk.
Stop the infusion and notify the provider. Protamine requires an order; decreasing
rate may be ordered but stopping first is priority.
