ATI Pharmacology Proctored Exam 2026 | Medication Safety
Practice Questions
1. A nurse is preparing to administer digoxin to a client. Which finding should cause the
nurse to withhold the medication?
A. Blood pressure 128/76 mmHg
B. Potassium level 4.2 mEq/L
C. Apical pulse 54/min
D. Respiratory rate 18/min
Answer: C. Apical pulse 54/min
Rationale: Digoxin can cause bradycardia. The nurse should withhold the medication and
notify the provider if the apical pulse is below 60/min in adults.
2. A client taking warfarin should be instructed to monitor for which adverse effect?
A. Constipation
B. Bleeding gums
C. Weight gain
D. Increased appetite
Answer: B. Bleeding gums
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Bleeding gums, bruising,
and dark stools are signs of possible toxicity.
3. Which laboratory value should the nurse monitor for a client receiving heparin therapy?
A. INR
B. Platelet count
C. Hemoglobin A1C
D. Calcium level
Answer: B. Platelet count
Rationale: Heparin can cause heparin-induced thrombocytopenia (HIT). Platelet levels must
be monitored closely.
4. A nurse is teaching a client about nitroglycerin sublingual tablets. Which statement by the
client indicates understanding?
,A. “I will store the tablets in a bathroom cabinet.”
B. “I can take up to three tablets five minutes apart.”
C. “I should swallow the tablet with water.”
D. “I should take the medication after chest pain ends.”
Answer: B. “I can take up to three tablets five minutes apart.”
Rationale: Nitroglycerin tablets are taken every 5 minutes for chest pain, up to three doses.
Emergency help should be sought if pain persists.
5. A client receiving morphine develops respiratory depression. Which medication should
the nurse prepare to administer?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Acetylcysteine
Answer: B. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression.
6. Which instruction should the nurse give a client taking tetracycline?
A. “Take the medication with milk.”
B. “Avoid sunlight exposure.”
C. “Stop the medication when symptoms improve.”
D. “Crush the medication before swallowing.”
Answer: B. “Avoid sunlight exposure.”
Rationale: Tetracycline can cause photosensitivity, increasing the risk of sunburn.
7. A nurse is administering insulin glargine. Which action is appropriate?
A. Mix with regular insulin
B. Administer intravenously
C. Give once daily at the same time
D. Shake vigorously before use
Answer: C. Give once daily at the same time
,Rationale: Insulin glargine is long-acting insulin that should not be mixed with other insulins.
8. A client taking furosemide is at risk for which electrolyte imbalance?
A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: C. Hypokalemia
Rationale: Loop diuretics like furosemide increase potassium excretion, causing
hypokalemia.
9. Which medication should the nurse question for a client with a severe penicillin allergy?
A. Azithromycin
B. Ceftriaxone
C. Acetaminophen
D. Omeprazole
Answer: B. Ceftriaxone
Rationale: Cephalosporins may cause cross-sensitivity in clients allergic to penicillin.
10. A nurse should recognize that serotonin syndrome may occur with the use of which
medications together?
A. Acetaminophen and ibuprofen
B. Sertraline and phenelzine
C. Warfarin and heparin
D. Digoxin and furosemide
Answer: B. Sertraline and phenelzine
Rationale: Combining SSRIs and MAOIs can dangerously increase serotonin levels.
11. A client taking metformin should discontinue the medication before which procedure?
A. Electrocardiogram
B. MRI with contrast dye
C. Chest X-ray
D. Ultrasound
, Answer: B. MRI with contrast dye
Rationale: Contrast dye increases the risk of lactic acidosis in clients taking metformin.
12. Which finding indicates lithium toxicity?
A. Tremors and confusion
B. Increased energy
C. Bradycardia
D. Dry cough
Answer: A. Tremors and confusion
Rationale: Early signs of lithium toxicity include tremors, confusion, vomiting, and poor
coordination.
13. A nurse is teaching a client about alendronate. Which statement indicates
understanding?
A. “I will take this medication at bedtime.”
B. “I should remain upright after taking the medication.”
C. “I can take it with orange juice.”
D. “I should chew the tablet completely.”
Answer: B. “I should remain upright after taking the medication.”
Rationale: Remaining upright for at least 30 minutes prevents esophageal irritation.
14. Which adverse effect is common with ACE inhibitors such as lisinopril?
A. Hearing loss
B. Dry cough
C. Constipation
D. Tinnitus
Answer: B. Dry cough
Rationale: ACE inhibitors commonly cause a persistent dry cough due to bradykinin
accumulation.
15. A nurse should monitor for which adverse effect in a client taking aminoglycosides?
A. Ototoxicity
B. Hypertension
Practice Questions
1. A nurse is preparing to administer digoxin to a client. Which finding should cause the
nurse to withhold the medication?
A. Blood pressure 128/76 mmHg
B. Potassium level 4.2 mEq/L
C. Apical pulse 54/min
D. Respiratory rate 18/min
Answer: C. Apical pulse 54/min
Rationale: Digoxin can cause bradycardia. The nurse should withhold the medication and
notify the provider if the apical pulse is below 60/min in adults.
2. A client taking warfarin should be instructed to monitor for which adverse effect?
A. Constipation
B. Bleeding gums
C. Weight gain
D. Increased appetite
Answer: B. Bleeding gums
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Bleeding gums, bruising,
and dark stools are signs of possible toxicity.
3. Which laboratory value should the nurse monitor for a client receiving heparin therapy?
A. INR
B. Platelet count
C. Hemoglobin A1C
D. Calcium level
Answer: B. Platelet count
Rationale: Heparin can cause heparin-induced thrombocytopenia (HIT). Platelet levels must
be monitored closely.
4. A nurse is teaching a client about nitroglycerin sublingual tablets. Which statement by the
client indicates understanding?
,A. “I will store the tablets in a bathroom cabinet.”
B. “I can take up to three tablets five minutes apart.”
C. “I should swallow the tablet with water.”
D. “I should take the medication after chest pain ends.”
Answer: B. “I can take up to three tablets five minutes apart.”
Rationale: Nitroglycerin tablets are taken every 5 minutes for chest pain, up to three doses.
Emergency help should be sought if pain persists.
5. A client receiving morphine develops respiratory depression. Which medication should
the nurse prepare to administer?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Acetylcysteine
Answer: B. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression.
6. Which instruction should the nurse give a client taking tetracycline?
A. “Take the medication with milk.”
B. “Avoid sunlight exposure.”
C. “Stop the medication when symptoms improve.”
D. “Crush the medication before swallowing.”
Answer: B. “Avoid sunlight exposure.”
Rationale: Tetracycline can cause photosensitivity, increasing the risk of sunburn.
7. A nurse is administering insulin glargine. Which action is appropriate?
A. Mix with regular insulin
B. Administer intravenously
C. Give once daily at the same time
D. Shake vigorously before use
Answer: C. Give once daily at the same time
,Rationale: Insulin glargine is long-acting insulin that should not be mixed with other insulins.
8. A client taking furosemide is at risk for which electrolyte imbalance?
A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: C. Hypokalemia
Rationale: Loop diuretics like furosemide increase potassium excretion, causing
hypokalemia.
9. Which medication should the nurse question for a client with a severe penicillin allergy?
A. Azithromycin
B. Ceftriaxone
C. Acetaminophen
D. Omeprazole
Answer: B. Ceftriaxone
Rationale: Cephalosporins may cause cross-sensitivity in clients allergic to penicillin.
10. A nurse should recognize that serotonin syndrome may occur with the use of which
medications together?
A. Acetaminophen and ibuprofen
B. Sertraline and phenelzine
C. Warfarin and heparin
D. Digoxin and furosemide
Answer: B. Sertraline and phenelzine
Rationale: Combining SSRIs and MAOIs can dangerously increase serotonin levels.
11. A client taking metformin should discontinue the medication before which procedure?
A. Electrocardiogram
B. MRI with contrast dye
C. Chest X-ray
D. Ultrasound
, Answer: B. MRI with contrast dye
Rationale: Contrast dye increases the risk of lactic acidosis in clients taking metformin.
12. Which finding indicates lithium toxicity?
A. Tremors and confusion
B. Increased energy
C. Bradycardia
D. Dry cough
Answer: A. Tremors and confusion
Rationale: Early signs of lithium toxicity include tremors, confusion, vomiting, and poor
coordination.
13. A nurse is teaching a client about alendronate. Which statement indicates
understanding?
A. “I will take this medication at bedtime.”
B. “I should remain upright after taking the medication.”
C. “I can take it with orange juice.”
D. “I should chew the tablet completely.”
Answer: B. “I should remain upright after taking the medication.”
Rationale: Remaining upright for at least 30 minutes prevents esophageal irritation.
14. Which adverse effect is common with ACE inhibitors such as lisinopril?
A. Hearing loss
B. Dry cough
C. Constipation
D. Tinnitus
Answer: B. Dry cough
Rationale: ACE inhibitors commonly cause a persistent dry cough due to bradykinin
accumulation.
15. A nurse should monitor for which adverse effect in a client taking aminoglycosides?
A. Ototoxicity
B. Hypertension
