**The Pharmacology Frontier: ATI RN Advanced
Pharmacology Proctored Exam 2025 (NGN) – Clinical
Mastery Edition**
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**Question 1**
A nurse is administering IV push furosemide (Lasix) to a client with acute pulmonary edema. Which
adverse effect requires immediate action?
A. Tinnitus
B. Dry mouth
C. Headache
D. Constipation
💫RATIONALE✔️✔️: Tinnitus indicates ototoxicity (dose-related, especially rapid IV push). Dry mouth and
headache are common but not emergent.
💫ANSWER✔️✔️: A. Tinnitus
---
**Question 2**
A client with heart failure is prescribed digoxin 0.125 mg daily and furosemide 40 mg daily. Which
finding indicates digoxin toxicity?
A. Heart rate 58 bpm
B. Visual halos (yellow-green)
C. Weight gain of 2 lb in 3 days
D. Blood pressure 130/80 mm Hg
,💫RATIONALE✔️✔️: Visual disturbances (yellow-green halos, blurred vision) are classic digoxin toxicity. HR
58 may be digoxin effect but not specific. Weight gain indicates fluid retention.
💫ANSWER✔️✔️: B. Visual halos (yellow-green)
---
**Question 3**
A nurse is teaching a client about warfarin (Coumadin). Which statement indicates understanding?
A. "I will take ibuprofen for headaches."
B. "I will increase dark green leafy vegetables."
C. "I will report any bruising or bleeding."
D. "I will stop warfarin if I feel better."
💫RATIONALE✔️✔️: Bleeding (hematuria, black stools, bruising) must be reported. Ibuprofen increases
bleeding. Vitamin K (greens) antagonizes warfarin.
💫ANSWER✔️✔️: C. "I will report any bruising or bleeding."
---
**Question 4**
A client is prescribed metformin (Glucophage) for type 2 diabetes. Which finding requires immediate
provider notification?
A. Nausea and diarrhea
B. Weight loss of 2 lb
C. Muscle pain and malaise
D. Metallic taste
💫RATIONALE✔️✔️: Muscle pain, malaise, hyperventilation suggest lactic acidosis (rare but fatal). Nausea
and metallic taste are common.
,💫ANSWER✔️✔️: C. Muscle pain and malaise
---
**Question 5**
A nurse is administering enoxaparin (Lovenox) subcutaneously. Which technique is correct?
A. Aspirate before injection.
B. Massage site after injection.
C. Administer into abdomen 2 inches from umbilicus.
D. Expel air bubble from prefilled syringe.
💫RATIONALE✔️✔️: Abdomen is preferred site, away from umbilicus. Do not aspirate or massage
(bruising). Do not expel air bubble (clears needle).
💫ANSWER✔️✔️: C. Administer into abdomen 2 inches from umbilicus.
---
**Question 6**
A client takes lithium (Lithobid) for bipolar disorder. Which dietary instruction is most important?
A. "Increase your salt intake."
B. "Maintain consistent sodium and fluid intake."
C. "Avoid all dairy products."
D. "Drink at least 1 liter of water daily."
💫RATIONALE✔️✔️: Consistent sodium and fluid (2-3 L/day) prevent lithium toxicity. Dehydration or low
sodium increases lithium levels.
💫ANSWER✔️✔️: B. "Maintain consistent sodium and fluid intake."
---
, **Question 7**
A nurse is administering albuterol nebulizer to a client with asthma. Which finding indicates medication
effectiveness?
A. Heart rate 120 bpm
B. Respiratory rate 28/min
C. Peak expiratory flow increased from 200 to 350 L/min
D. Client reports headache
💫RATIONALE✔️✔️: Increased peak flow indicates bronchodilation. Tachycardia and headache are side
effects, not efficacy.
💫ANSWER✔️✔️: C. Peak expiratory flow increased from 200 to 350 L/min
---
**Question 8**
A client is prescribed amlodipine (Norvasc) for hypertension. Which side effect should the nurse
monitor?
A. Dry cough
B. Peripheral edema
C. Hyperkalemia
D. Bradycardia
💫RATIONALE✔️✔️: Amlodipine (CCB) causes peripheral edema (ankle swelling). Dry cough is ACE
inhibitor. Hyperkalemia is ACE/ARB. Bradycardia is beta-blocker.
💫ANSWER✔️✔️: B. Peripheral edema
---
**Question 9**
Pharmacology Proctored Exam 2025 (NGN) – Clinical
Mastery Edition**
---
**Question 1**
A nurse is administering IV push furosemide (Lasix) to a client with acute pulmonary edema. Which
adverse effect requires immediate action?
A. Tinnitus
B. Dry mouth
C. Headache
D. Constipation
💫RATIONALE✔️✔️: Tinnitus indicates ototoxicity (dose-related, especially rapid IV push). Dry mouth and
headache are common but not emergent.
💫ANSWER✔️✔️: A. Tinnitus
---
**Question 2**
A client with heart failure is prescribed digoxin 0.125 mg daily and furosemide 40 mg daily. Which
finding indicates digoxin toxicity?
A. Heart rate 58 bpm
B. Visual halos (yellow-green)
C. Weight gain of 2 lb in 3 days
D. Blood pressure 130/80 mm Hg
,💫RATIONALE✔️✔️: Visual disturbances (yellow-green halos, blurred vision) are classic digoxin toxicity. HR
58 may be digoxin effect but not specific. Weight gain indicates fluid retention.
💫ANSWER✔️✔️: B. Visual halos (yellow-green)
---
**Question 3**
A nurse is teaching a client about warfarin (Coumadin). Which statement indicates understanding?
A. "I will take ibuprofen for headaches."
B. "I will increase dark green leafy vegetables."
C. "I will report any bruising or bleeding."
D. "I will stop warfarin if I feel better."
💫RATIONALE✔️✔️: Bleeding (hematuria, black stools, bruising) must be reported. Ibuprofen increases
bleeding. Vitamin K (greens) antagonizes warfarin.
💫ANSWER✔️✔️: C. "I will report any bruising or bleeding."
---
**Question 4**
A client is prescribed metformin (Glucophage) for type 2 diabetes. Which finding requires immediate
provider notification?
A. Nausea and diarrhea
B. Weight loss of 2 lb
C. Muscle pain and malaise
D. Metallic taste
💫RATIONALE✔️✔️: Muscle pain, malaise, hyperventilation suggest lactic acidosis (rare but fatal). Nausea
and metallic taste are common.
,💫ANSWER✔️✔️: C. Muscle pain and malaise
---
**Question 5**
A nurse is administering enoxaparin (Lovenox) subcutaneously. Which technique is correct?
A. Aspirate before injection.
B. Massage site after injection.
C. Administer into abdomen 2 inches from umbilicus.
D. Expel air bubble from prefilled syringe.
💫RATIONALE✔️✔️: Abdomen is preferred site, away from umbilicus. Do not aspirate or massage
(bruising). Do not expel air bubble (clears needle).
💫ANSWER✔️✔️: C. Administer into abdomen 2 inches from umbilicus.
---
**Question 6**
A client takes lithium (Lithobid) for bipolar disorder. Which dietary instruction is most important?
A. "Increase your salt intake."
B. "Maintain consistent sodium and fluid intake."
C. "Avoid all dairy products."
D. "Drink at least 1 liter of water daily."
💫RATIONALE✔️✔️: Consistent sodium and fluid (2-3 L/day) prevent lithium toxicity. Dehydration or low
sodium increases lithium levels.
💫ANSWER✔️✔️: B. "Maintain consistent sodium and fluid intake."
---
, **Question 7**
A nurse is administering albuterol nebulizer to a client with asthma. Which finding indicates medication
effectiveness?
A. Heart rate 120 bpm
B. Respiratory rate 28/min
C. Peak expiratory flow increased from 200 to 350 L/min
D. Client reports headache
💫RATIONALE✔️✔️: Increased peak flow indicates bronchodilation. Tachycardia and headache are side
effects, not efficacy.
💫ANSWER✔️✔️: C. Peak expiratory flow increased from 200 to 350 L/min
---
**Question 8**
A client is prescribed amlodipine (Norvasc) for hypertension. Which side effect should the nurse
monitor?
A. Dry cough
B. Peripheral edema
C. Hyperkalemia
D. Bradycardia
💫RATIONALE✔️✔️: Amlodipine (CCB) causes peripheral edema (ankle swelling). Dry cough is ACE
inhibitor. Hyperkalemia is ACE/ARB. Bradycardia is beta-blocker.
💫ANSWER✔️✔️: B. Peripheral edema
---
**Question 9**
