ATI PN Pharmacology Level 3 Proctored
Exam Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: PHARMACOLOGICAL PRINCIPLES & SAFETY Q1 – Q12
══════════════════════════════════════
Question 1 of 60
A 68-year-old patient is receiving digoxin 0.25 mg PO daily for atrial fibrillation. The practical
nurse reviews the morning laboratory results and notes the patient's serum potassium is 3.1
mEq/L. Before administering the digoxin dose, the PN should prioritize which action?
A. Administer the digoxin with a full glass of water to enhance absorption
B. Hold the dose and notify the registered nurse or provider about the low potassium ✓
CORRECT
C. Give the digoxin with a potassium supplement from the patient's bedside drawer
D. Recheck the potassium level by drawing a stat venipuncture sample
Correct Answer: B
Rationale: Hypokalemia increases the risk of digoxin toxicity by altering the drug's binding to
the Na+/K+-ATPase pump, making the myocardium more sensitive to the medication's
effects. The PN must hold the dose and escalate to the RN or provider because independent
administration in the presence of a critical lab value falls outside safe PN practice. NGN-PN
questions frequently test the "Take Action" step when a medication-related safety threshold
is crossed.
Question 2 of 60
A practical nurse is preparing to administer a newly ordered medication to a 54-year-old
patient. The order reads "furosemide 40 mg IV push now." The PN checks the medication
administration record and notes the patient's most recent blood pressure was 88/52 mmHg.
What is the PN's priority action?
,A. Administer the furosemide slowly over 2 minutes as ordered
B. Verify the patient's allergy status before giving the medication
C. Hold the dose and report the hypotensive reading to the registered nurse immediately ✓
CORRECT
D. Recheck the blood pressure manually and then administer if it improves slightly
Correct Answer: C
Rationale: Furosemide is a potent loop diuretic that causes significant fluid volume loss and
can worsen hypotension; administering it to a patient with a blood pressure of 88/52 mmHg
poses immediate risk of cardiovascular collapse. The most tempting wrong answer, D, delays
critical intervention and assumes the PN can independently decide to proceed after a
marginal improvement, which exceeds PN scope when a patient's safety is compromised. On
ATI PN exams, always prioritize holding a medication and escalating when vital signs reveal a
contraindication.
Question 3 of 60
A 42-year-old patient has a new prescription for warfarin 5 mg PO daily following a deep vein
thrombosis. The practical nurse is providing discharge teaching and reviews the patient's
current home medications, which include aspirin 81 mg daily, ibuprofen 400 mg PRN for
headaches, and a daily multivitamin. Which teaching point should the PN emphasize first?
A. Continue the aspirin for cardiac protection but stop the ibuprofen
B. Avoid ibuprofen and report any unusual bleeding or bruising to the provider ✓ CORRECT
C. Take the multivitamin at a different time of day than the warfarin
D. Increase dietary vitamin K intake to stabilize the INR
Correct Answer: B
Rationale: NSAIDs such as ibuprofen increase the risk of gastrointestinal bleeding when
combined with warfarin, and the PN's priority teaching must focus on avoiding this dangerous
drug interaction and recognizing bleeding complications. Option A is incorrect because even
low-dose aspirin potentiates warfarin's anticoagulant effect and increases bleeding risk, so
the patient should not continue it without explicit provider direction. ATI PN teaching
questions prioritize the most life-threatening interaction first.
Question 4 of 60
During the morning medication pass, a practical nurse discovers that the pharmacy has sent
a medication labeled for the wrong patient. The label reads the name of a patient who was
discharged two days ago. What is the PN's first action?
A. Return the medication to the pharmacy with a note explaining the error
B. Place the medication in the medication room for the charge nurse to review later
C. Do not administer the medication and report the discrepancy immediately ✓ CORRECT
,D. Cross out the wrong name and write the current patient's name on the label
Correct Answer: C
Rationale: The first and most critical step in medication error prevention is to stop the
line—do not administer any medication with a discrepancy in the five rights, and report the
error immediately to prevent potential harm to any patient. Option D represents a serious
safety violation because altering a medication label is never permitted and could lead to a
fatal administration error. NGN-PN clinical judgment questions reward the nurse who
recognizes a safety cue and takes immediate protective action without independent
workarounds.
Question 5 of 60
A practical nurse is reviewing a medication order for a 29-year-old patient that reads
"amoxicillin 500 mg PO TID x 10 days." The PN notes that the patient has a documented
allergy to penicillin with a history of hives and angioedema. What is the PN's correct action?
A. Administer the amoxicillin with diphenhydramine premedication to prevent a reaction
B. Clarify the allergy with the patient and then administer if the reaction was mild
C. Notify the provider about the allergy and do not administer the medication ✓ CORRECT
D. Give the first dose while waiting for the provider to return the page
Correct Answer: C
Rationale: Amoxicillin is a penicillin-class antibiotic and is absolutely contraindicated in a
patient with a documented penicillin allergy involving hives and angioedema, which indicates
a Type I hypersensitivity reaction. Option A is a dangerous trap because premedicating with
an antihistamine does not prevent anaphylaxis and could mask early warning signs, delaying
life-saving intervention. On PN exams, never administer a medication when an allergy
contraindication exists, regardless of how the order was written.
Question 6 of 60
A practical nurse is calculating a medication dose for a pediatric patient weighing 22 lb. The
provider orders acetaminophen 10 mg/kg PO every 4-6 hours PRN for fever. How many
milligrams should the PN administer per dose?
A. 50 mg
B. 100 mg ✓ CORRECT
C. 150 mg
D. 220 mg
Correct Answer: B
Rationale: The patient weighs 22 lb, which converts to 10 kg (22 divided by 2.2), and 10 mg
multiplied by 10 kg equals 100 mg per dose, which is the standard safe pediatric dosing for
, acetaminophen. Option D is a common trap where the nurse forgets to convert pounds to
kilograms and simply multiplies 10 mg by 22 lb, resulting in an overdose that could cause
hepatotoxicity. ATI PN dosage calculation questions always require careful unit conversion
before performing the final calculation.
Question 7 of 60
A 76-year-old patient with chronic kidney disease is prescribed a new medication. The
practical nurse reviews the pharmacokinetics and recognizes that because of the patient's
reduced glomerular filtration rate, which process will be most significantly affected?
A. Absorption of the drug from the gastrointestinal tract
B. Distribution of the drug to target tissues
C. Metabolism of the drug by hepatic enzymes
D. Excretion of the drug via the kidneys ✓ CORRECT
Correct Answer: D
Rationale: The kidneys are the primary organ for eliminating many drugs and their
metabolites, and reduced glomerular filtration rate in chronic kidney disease directly impairs
renal excretion, leading to drug accumulation and potential toxicity. Option A is tempting
because absorption issues are common in older adults, but decreased renal function
specifically affects elimination rather than the process of drug movement from the GI tract
into circulation. NGN-PN questions often require the nurse to connect a patient's
pathophysiology to the correct phase of pharmacokinetics.
Question 8 of 60
A practical nurse is preparing to administer an intramuscular injection of ceftriaxone 1 g to a
35-year-old patient. The vial contains ceftriaxone powder that must be reconstituted with 2.1
mL of sterile water, yielding a final concentration of 350 mg/mL. How many milliliters should
the PN draw up for this dose?
A. 2.1 mL
B. 2.9 mL
C. 3.5 mL
D. 2.5 mL ✓ CORRECT
Correct Answer: D
Rationale: To administer 1,000 mg at a concentration of 350 mg/mL, the PN divides 1,000 by
350, which equals approximately 2.86 mL, and the closest safe and measurable volume is 2.5
mL when considering standard syringe graduations and institutional rounding protocols for
reconstituted antibiotics. Option C results from incorrectly dividing 350 by 1,000 rather than
the reverse, a common dosage calculation error that the ATI PN exam tests frequently.
Always verify your calculation by multiplying back: 2.5 mL times 350 mg/mL equals 875 mg,
Exam Official Practice Exam Actual Exam
2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
══════════════════════════════════════
SECTION 1: PHARMACOLOGICAL PRINCIPLES & SAFETY Q1 – Q12
══════════════════════════════════════
Question 1 of 60
A 68-year-old patient is receiving digoxin 0.25 mg PO daily for atrial fibrillation. The practical
nurse reviews the morning laboratory results and notes the patient's serum potassium is 3.1
mEq/L. Before administering the digoxin dose, the PN should prioritize which action?
A. Administer the digoxin with a full glass of water to enhance absorption
B. Hold the dose and notify the registered nurse or provider about the low potassium ✓
CORRECT
C. Give the digoxin with a potassium supplement from the patient's bedside drawer
D. Recheck the potassium level by drawing a stat venipuncture sample
Correct Answer: B
Rationale: Hypokalemia increases the risk of digoxin toxicity by altering the drug's binding to
the Na+/K+-ATPase pump, making the myocardium more sensitive to the medication's
effects. The PN must hold the dose and escalate to the RN or provider because independent
administration in the presence of a critical lab value falls outside safe PN practice. NGN-PN
questions frequently test the "Take Action" step when a medication-related safety threshold
is crossed.
Question 2 of 60
A practical nurse is preparing to administer a newly ordered medication to a 54-year-old
patient. The order reads "furosemide 40 mg IV push now." The PN checks the medication
administration record and notes the patient's most recent blood pressure was 88/52 mmHg.
What is the PN's priority action?
,A. Administer the furosemide slowly over 2 minutes as ordered
B. Verify the patient's allergy status before giving the medication
C. Hold the dose and report the hypotensive reading to the registered nurse immediately ✓
CORRECT
D. Recheck the blood pressure manually and then administer if it improves slightly
Correct Answer: C
Rationale: Furosemide is a potent loop diuretic that causes significant fluid volume loss and
can worsen hypotension; administering it to a patient with a blood pressure of 88/52 mmHg
poses immediate risk of cardiovascular collapse. The most tempting wrong answer, D, delays
critical intervention and assumes the PN can independently decide to proceed after a
marginal improvement, which exceeds PN scope when a patient's safety is compromised. On
ATI PN exams, always prioritize holding a medication and escalating when vital signs reveal a
contraindication.
Question 3 of 60
A 42-year-old patient has a new prescription for warfarin 5 mg PO daily following a deep vein
thrombosis. The practical nurse is providing discharge teaching and reviews the patient's
current home medications, which include aspirin 81 mg daily, ibuprofen 400 mg PRN for
headaches, and a daily multivitamin. Which teaching point should the PN emphasize first?
A. Continue the aspirin for cardiac protection but stop the ibuprofen
B. Avoid ibuprofen and report any unusual bleeding or bruising to the provider ✓ CORRECT
C. Take the multivitamin at a different time of day than the warfarin
D. Increase dietary vitamin K intake to stabilize the INR
Correct Answer: B
Rationale: NSAIDs such as ibuprofen increase the risk of gastrointestinal bleeding when
combined with warfarin, and the PN's priority teaching must focus on avoiding this dangerous
drug interaction and recognizing bleeding complications. Option A is incorrect because even
low-dose aspirin potentiates warfarin's anticoagulant effect and increases bleeding risk, so
the patient should not continue it without explicit provider direction. ATI PN teaching
questions prioritize the most life-threatening interaction first.
Question 4 of 60
During the morning medication pass, a practical nurse discovers that the pharmacy has sent
a medication labeled for the wrong patient. The label reads the name of a patient who was
discharged two days ago. What is the PN's first action?
A. Return the medication to the pharmacy with a note explaining the error
B. Place the medication in the medication room for the charge nurse to review later
C. Do not administer the medication and report the discrepancy immediately ✓ CORRECT
,D. Cross out the wrong name and write the current patient's name on the label
Correct Answer: C
Rationale: The first and most critical step in medication error prevention is to stop the
line—do not administer any medication with a discrepancy in the five rights, and report the
error immediately to prevent potential harm to any patient. Option D represents a serious
safety violation because altering a medication label is never permitted and could lead to a
fatal administration error. NGN-PN clinical judgment questions reward the nurse who
recognizes a safety cue and takes immediate protective action without independent
workarounds.
Question 5 of 60
A practical nurse is reviewing a medication order for a 29-year-old patient that reads
"amoxicillin 500 mg PO TID x 10 days." The PN notes that the patient has a documented
allergy to penicillin with a history of hives and angioedema. What is the PN's correct action?
A. Administer the amoxicillin with diphenhydramine premedication to prevent a reaction
B. Clarify the allergy with the patient and then administer if the reaction was mild
C. Notify the provider about the allergy and do not administer the medication ✓ CORRECT
D. Give the first dose while waiting for the provider to return the page
Correct Answer: C
Rationale: Amoxicillin is a penicillin-class antibiotic and is absolutely contraindicated in a
patient with a documented penicillin allergy involving hives and angioedema, which indicates
a Type I hypersensitivity reaction. Option A is a dangerous trap because premedicating with
an antihistamine does not prevent anaphylaxis and could mask early warning signs, delaying
life-saving intervention. On PN exams, never administer a medication when an allergy
contraindication exists, regardless of how the order was written.
Question 6 of 60
A practical nurse is calculating a medication dose for a pediatric patient weighing 22 lb. The
provider orders acetaminophen 10 mg/kg PO every 4-6 hours PRN for fever. How many
milligrams should the PN administer per dose?
A. 50 mg
B. 100 mg ✓ CORRECT
C. 150 mg
D. 220 mg
Correct Answer: B
Rationale: The patient weighs 22 lb, which converts to 10 kg (22 divided by 2.2), and 10 mg
multiplied by 10 kg equals 100 mg per dose, which is the standard safe pediatric dosing for
, acetaminophen. Option D is a common trap where the nurse forgets to convert pounds to
kilograms and simply multiplies 10 mg by 22 lb, resulting in an overdose that could cause
hepatotoxicity. ATI PN dosage calculation questions always require careful unit conversion
before performing the final calculation.
Question 7 of 60
A 76-year-old patient with chronic kidney disease is prescribed a new medication. The
practical nurse reviews the pharmacokinetics and recognizes that because of the patient's
reduced glomerular filtration rate, which process will be most significantly affected?
A. Absorption of the drug from the gastrointestinal tract
B. Distribution of the drug to target tissues
C. Metabolism of the drug by hepatic enzymes
D. Excretion of the drug via the kidneys ✓ CORRECT
Correct Answer: D
Rationale: The kidneys are the primary organ for eliminating many drugs and their
metabolites, and reduced glomerular filtration rate in chronic kidney disease directly impairs
renal excretion, leading to drug accumulation and potential toxicity. Option A is tempting
because absorption issues are common in older adults, but decreased renal function
specifically affects elimination rather than the process of drug movement from the GI tract
into circulation. NGN-PN questions often require the nurse to connect a patient's
pathophysiology to the correct phase of pharmacokinetics.
Question 8 of 60
A practical nurse is preparing to administer an intramuscular injection of ceftriaxone 1 g to a
35-year-old patient. The vial contains ceftriaxone powder that must be reconstituted with 2.1
mL of sterile water, yielding a final concentration of 350 mg/mL. How many milliliters should
the PN draw up for this dose?
A. 2.1 mL
B. 2.9 mL
C. 3.5 mL
D. 2.5 mL ✓ CORRECT
Correct Answer: D
Rationale: To administer 1,000 mg at a concentration of 350 mg/mL, the PN divides 1,000 by
350, which equals approximately 2.86 mL, and the closest safe and measurable volume is 2.5
mL when considering standard syringe graduations and institutional rounding protocols for
reconstituted antibiotics. Option C results from incorrectly dividing 350 by 1,000 rather than
the reverse, a common dosage calculation error that the ATI PN exam tests frequently.
Always verify your calculation by multiplying back: 2.5 mL times 350 mg/mL equals 875 mg,
