1
ATI RN Pharmacology Level 3 Proctored Exam 2023
with NGN All 70 Questions With Answers
pg. 1
,2
pg. 2
,3
ATI RN Pharmacology Level 3 Proctored Exam with NGN – 70 Practice Questions
1. A client with heart failure is prescribed digoxin. Prior to administration, the
nurse should:
A. Assess the client's blood pressure.
B. Assess the apical pulse for one full minute.
C. Assess the client's oxygen saturation.
D. Assess the client's pain level.
Answer: B. Assess the apical pulse for one full minute.
Rationale: Digoxin can cause bradycardia. The apical pulse must be counted for a
full minute. Hold the medication and notify the provider if the heart rate is <60
bpm in adults.
2. A client taking warfarin has an INR of 5.2. The nurse should anticipate
administering which medication?
A. Protamine sulfate
B. Vitamin K (phytonadione)
C. Aminocaproic acid
D. Fresh frozen plasma
Answer: B. Vitamin K (phytonadione).
Rationale: Vitamin K is the antidote for warfarin overdose. Protamine sulfate
reverses heparin. Fresh frozen plasma may be used for rapid reversal with active
bleeding, but vitamin K is the first-line agent for elevated INR without bleeding.
3. A client is receiving vancomycin IV. Which adverse effect should the nurse
monitor for?
A. Ototoxicity
B. Hepatotoxicity
C. Hypokalemia
D. Seizures
pg. 3
, 4
Answer: A. Ototoxicity.
Rationale: Vancomycin can cause ototoxicity (hearing loss, tinnitus) and
nephrotoxicity. Serum trough levels and renal function should be monitored.
4. A client with type 1 diabetes reports feeling shaky, diaphoretic, and has a
blood glucose of 62 mg/dL. The client is alert and able to swallow. What is the
priority nursing action?
A. Administer glucagon IM.
B. Administer 50% dextrose IV push.
C. Give the client 15 grams of a fast-acting carbohydrate.
D. Give a snack with protein and complex carbohydrates.
Answer: C. Give the client 15 grams of a fast-acting carbohydrate.
Rationale: The "Rule of 15" is standard for conscious hypoglycemia: 15 grams of
fast-acting carbs (4 oz juice, 3-4 glucose tablets), recheck blood glucose in 15
minutes. IV dextrose or glucagon are reserved for unconscious or uncooperative
clients.
5. A client is prescribed furosemide. Which food should the nurse encourage the
client to increase?
A. Bananas
B. White bread
C. Cheddar cheese
D. Canned soup
Answer: A. Bananas.
Rationale: Furosemide is a potassium-wasting diuretic. The client should increase
dietary potassium (bananas, oranges, potatoes) to prevent hypokalemia. Canned
soup and cheese are high in sodium, which should be restricted.
6. A client is receiving morphine via PCA pump and is difficult to arouse with a
respiratory rate of 6/min. Which medication should the nurse anticipate
administering?
pg. 4
ATI RN Pharmacology Level 3 Proctored Exam 2023
with NGN All 70 Questions With Answers
pg. 1
,2
pg. 2
,3
ATI RN Pharmacology Level 3 Proctored Exam with NGN – 70 Practice Questions
1. A client with heart failure is prescribed digoxin. Prior to administration, the
nurse should:
A. Assess the client's blood pressure.
B. Assess the apical pulse for one full minute.
C. Assess the client's oxygen saturation.
D. Assess the client's pain level.
Answer: B. Assess the apical pulse for one full minute.
Rationale: Digoxin can cause bradycardia. The apical pulse must be counted for a
full minute. Hold the medication and notify the provider if the heart rate is <60
bpm in adults.
2. A client taking warfarin has an INR of 5.2. The nurse should anticipate
administering which medication?
A. Protamine sulfate
B. Vitamin K (phytonadione)
C. Aminocaproic acid
D. Fresh frozen plasma
Answer: B. Vitamin K (phytonadione).
Rationale: Vitamin K is the antidote for warfarin overdose. Protamine sulfate
reverses heparin. Fresh frozen plasma may be used for rapid reversal with active
bleeding, but vitamin K is the first-line agent for elevated INR without bleeding.
3. A client is receiving vancomycin IV. Which adverse effect should the nurse
monitor for?
A. Ototoxicity
B. Hepatotoxicity
C. Hypokalemia
D. Seizures
pg. 3
, 4
Answer: A. Ototoxicity.
Rationale: Vancomycin can cause ototoxicity (hearing loss, tinnitus) and
nephrotoxicity. Serum trough levels and renal function should be monitored.
4. A client with type 1 diabetes reports feeling shaky, diaphoretic, and has a
blood glucose of 62 mg/dL. The client is alert and able to swallow. What is the
priority nursing action?
A. Administer glucagon IM.
B. Administer 50% dextrose IV push.
C. Give the client 15 grams of a fast-acting carbohydrate.
D. Give a snack with protein and complex carbohydrates.
Answer: C. Give the client 15 grams of a fast-acting carbohydrate.
Rationale: The "Rule of 15" is standard for conscious hypoglycemia: 15 grams of
fast-acting carbs (4 oz juice, 3-4 glucose tablets), recheck blood glucose in 15
minutes. IV dextrose or glucagon are reserved for unconscious or uncooperative
clients.
5. A client is prescribed furosemide. Which food should the nurse encourage the
client to increase?
A. Bananas
B. White bread
C. Cheddar cheese
D. Canned soup
Answer: A. Bananas.
Rationale: Furosemide is a potassium-wasting diuretic. The client should increase
dietary potassium (bananas, oranges, potatoes) to prevent hypokalemia. Canned
soup and cheese are high in sodium, which should be restricted.
6. A client is receiving morphine via PCA pump and is difficult to arouse with a
respiratory rate of 6/min. Which medication should the nurse anticipate
administering?
pg. 4
