ATI RN PHARMACOLOGY COMPREHENSIVE
EXAM GUIDE 2026/27 EDITION
,1. A nurse is preparing to administer vancomycin 1 g IV bolus
to a client with a methicillin-resistant Staphylococcus aureus
(MRSA) infection. During the infusion, the client develops
flushing of the face and neck, tachycardia, and hypotension.
Which of the following actions should the nurse take first?
A. Administer diphenhydramine IV
B. Stop the infusion immediately
C. Slow the infusion rate
D. Notify the provider
Correct Answer: B
Explanation: The client is experiencing Red Man Syndrome,
a reaction to rapid vancomycin infusion. The first action is
to stop the infusion immediately to prevent progression to
severe hypotension or cardiac arrest. Diphenhydramine
may be given afterward, and the infusion can be restarted
at a slower rate once symptoms resolve.
2. A client with atrial fibrillation is prescribed warfarin. The
nurse reviews the client's laboratory results and notes an
INR of 5.2. Which of the following actions should the nurse
take?
A. Administer the next dose of warfarin as scheduled
B. Hold the warfarin and notify the provider
C. Administer vitamin K orally
D. Increase the warfarin dose by 1 mg
Correct Answer: B
Explanation: An INR of 5.2 indicates a high bleeding risk
(therapeutic range is typically 2–3 for atrial fibrillation).
The nurse should hold the warfarin and notify the provider.
, Vitamin K is reserved for severe bleeding or extremely high
INR values under provider direction.
3. A nurse is administering potassium chloride 20 mEq IV to a
client with hypokalemia. Which of the following actions is
essential to prevent complications?
A. Administer the medication as an IV push
B. Dilute the medication and infuse slowly using an infusion
pump
C. Administer the medication undiluted over 10 minutes
D. Infuse the medication rapidly to achieve therapeutic levels
quickly
Correct Answer: B
Explanation: IV potassium chloride must always be diluted
and infused slowly using an infusion pump. IV push is
contraindicated due to the risk of cardiac arrest. Rapid
infusion can cause fatal hyperkalemia and arrhythmias.
4. A client with type 2 diabetes mellitus is prescribed
metformin. Which of the following assessment findings
should the nurse report to the provider as a potential adverse
effect?
A. Nausea and diarrhea
B. Muscle pain and weakness
C. Metallic taste in the mouth
D. Lactic acidosis symptoms (hyperventilation, malaise,
bradycardia)
Correct Answer: D
Explanation: Lactic acidosis is a rare but serious adverse
, effect of metformin, especially in clients with renal
impairment. Symptoms include hyperventilation, malaise,
and bradycardia. Nausea and diarrhea are common but
less serious side effects.
5. A nurse is caring for a client receiving heparin IV therapy.
The client's aPTT is 90 seconds (normal: 25–35 seconds).
Which of the following actions should the nurse take?
A. Continue the infusion as ordered
B. Increase the infusion rate by 2 units/kg/hr
C. Hold the infusion and notify the provider
D. Administer protamine sulfate immediately
Correct Answer: C
Explanation: An aPTT of 90 seconds indicates excessive
anticoagulation (therapeutic range is typically 1.5–2.5
times normal). The nurse should hold the infusion and
notify the provider. Protamine sulfate is the antidote but is
reserved for severe bleeding or extremely high aPTT under
provider orders.
6. A client with heart failure is prescribed digoxin 0.25 mg PO
daily. The nurse assesses the client's apical pulse before
administration and finds it to be 54/min. Which of the
following actions should the nurse take?
A. Administer the dose and monitor the pulse
B. Hold the dose and notify the provider
C. Administer half the dose
D. Recheck the pulse in 1 hour
Correct Answer: B
EXAM GUIDE 2026/27 EDITION
,1. A nurse is preparing to administer vancomycin 1 g IV bolus
to a client with a methicillin-resistant Staphylococcus aureus
(MRSA) infection. During the infusion, the client develops
flushing of the face and neck, tachycardia, and hypotension.
Which of the following actions should the nurse take first?
A. Administer diphenhydramine IV
B. Stop the infusion immediately
C. Slow the infusion rate
D. Notify the provider
Correct Answer: B
Explanation: The client is experiencing Red Man Syndrome,
a reaction to rapid vancomycin infusion. The first action is
to stop the infusion immediately to prevent progression to
severe hypotension or cardiac arrest. Diphenhydramine
may be given afterward, and the infusion can be restarted
at a slower rate once symptoms resolve.
2. A client with atrial fibrillation is prescribed warfarin. The
nurse reviews the client's laboratory results and notes an
INR of 5.2. Which of the following actions should the nurse
take?
A. Administer the next dose of warfarin as scheduled
B. Hold the warfarin and notify the provider
C. Administer vitamin K orally
D. Increase the warfarin dose by 1 mg
Correct Answer: B
Explanation: An INR of 5.2 indicates a high bleeding risk
(therapeutic range is typically 2–3 for atrial fibrillation).
The nurse should hold the warfarin and notify the provider.
, Vitamin K is reserved for severe bleeding or extremely high
INR values under provider direction.
3. A nurse is administering potassium chloride 20 mEq IV to a
client with hypokalemia. Which of the following actions is
essential to prevent complications?
A. Administer the medication as an IV push
B. Dilute the medication and infuse slowly using an infusion
pump
C. Administer the medication undiluted over 10 minutes
D. Infuse the medication rapidly to achieve therapeutic levels
quickly
Correct Answer: B
Explanation: IV potassium chloride must always be diluted
and infused slowly using an infusion pump. IV push is
contraindicated due to the risk of cardiac arrest. Rapid
infusion can cause fatal hyperkalemia and arrhythmias.
4. A client with type 2 diabetes mellitus is prescribed
metformin. Which of the following assessment findings
should the nurse report to the provider as a potential adverse
effect?
A. Nausea and diarrhea
B. Muscle pain and weakness
C. Metallic taste in the mouth
D. Lactic acidosis symptoms (hyperventilation, malaise,
bradycardia)
Correct Answer: D
Explanation: Lactic acidosis is a rare but serious adverse
, effect of metformin, especially in clients with renal
impairment. Symptoms include hyperventilation, malaise,
and bradycardia. Nausea and diarrhea are common but
less serious side effects.
5. A nurse is caring for a client receiving heparin IV therapy.
The client's aPTT is 90 seconds (normal: 25–35 seconds).
Which of the following actions should the nurse take?
A. Continue the infusion as ordered
B. Increase the infusion rate by 2 units/kg/hr
C. Hold the infusion and notify the provider
D. Administer protamine sulfate immediately
Correct Answer: C
Explanation: An aPTT of 90 seconds indicates excessive
anticoagulation (therapeutic range is typically 1.5–2.5
times normal). The nurse should hold the infusion and
notify the provider. Protamine sulfate is the antidote but is
reserved for severe bleeding or extremely high aPTT under
provider orders.
6. A client with heart failure is prescribed digoxin 0.25 mg PO
daily. The nurse assesses the client's apical pulse before
administration and finds it to be 54/min. Which of the
following actions should the nurse take?
A. Administer the dose and monitor the pulse
B. Hold the dose and notify the provider
C. Administer half the dose
D. Recheck the pulse in 1 hour
Correct Answer: B
