# VATI PHARMACOLOGY PROCTORED
EXAM 2025
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**1.** A nurse is caring for a client receiving a continuous IV heparin infusion. Which laboratory value
should the nurse monitor to determine therapeutic effectiveness?
A) INR
B) aPTT
C) Platelet count
D) Fibrinogen level
💡 RATIONALE -- Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
The therapeutic goal is 1.5 to 2.5 times the normal control value.
✔️ ANSWER -- B) aPTT
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**2.** A client with heart failure is prescribed digoxin. Which finding should the nurse identify as an
early sign of digoxin toxicity?
A) Tachycardia
B) Anorexia and nausea
C) Hypertension
D) Polyuria
💡 RATIONALE -- Early signs of digoxin toxicity include gastrointestinal symptoms such as anorexia,
nausea, vomiting, and abdominal pain. Bradycardia and visual changes occur later.
,✔️ ANSWER -- B) Anorexia and nausea
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**3.** A nurse is providing teaching to a client who has a new prescription for metformin. Which
statement by the client indicates understanding?
A) "I will take this medication with meals to prevent stomach upset."
B) "I can expect to lose weight because this medication suppresses my appetite."
C) "I will check my blood glucose before each meal."
D) "This medication may cause my urine to turn orange."
💡 RATIONALE -- Metformin commonly causes gastrointestinal side effects such as nausea and diarrhea.
Taking it with meals reduces these symptoms. It does not typically cause hypoglycemia alone.
✔️ ANSWER -- A) "I will take this medication with meals to prevent stomach upset."
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**4.** A client is prescribed warfarin for atrial fibrillation. Which dietary instruction should the nurse
include?
A) "Increase your intake of green leafy vegetables."
B) "Maintain a consistent intake of vitamin K‑rich foods."
C) "Avoid all foods containing vitamin K."
D) "Take vitamin K supplements daily."
💡 RATIONALE -- Consistency in vitamin K intake is key for stable INR. Clients should not drastically
increase or decrease foods high in vitamin K (e.g., spinach, kale) without consulting the provider.
✔️ ANSWER -- B) "Maintain a consistent intake of vitamin K‑rich foods."
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**5.** A client is receiving IV furosemide. Which finding indicates the medication is having a therapeutic
effect?
A) Decreased blood pressure
B) Increased urinary output
C) Decreased heart rate
D) Increased crackles on auscultation
💡 RATIONALE -- Furosemide is a loop diuretic that promotes excretion of water and sodium. Increased
urine output and resolution of pulmonary congestion indicate effectiveness.
✔️ ANSWER -- B) Increased urinary output
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**6.** A nurse is administering IV vancomycin. Which adverse effect is associated with rapid infusion of
this medication?
A) Red man syndrome
B) Stevens‑Johnson syndrome
C) Ototoxicity
D) Nephrotoxicity
💡 RATIONALE -- Red man syndrome (flushing, rash, hypotension) occurs with rapid IV vancomycin
infusion. Infusing over at least 60 minutes prevents this reaction.
✔️ ANSWER -- A) Red man syndrome
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, **7.** A client is prescribed lisinopril. Which finding should the nurse report to the provider
immediately?
A) Dry, nonproductive cough
B) Angioedema of the lips and tongue
C) Dizziness when standing
D) Headache
💡 RATIONALE -- Angioedema (swelling of the lips, tongue, face, or airway) is a life‑threatening adverse
effect of ACE inhibitors and requires immediate medical attention.
✔️ ANSWER -- B) Angioedema of the lips and tongue
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**8.** A client with type 2 diabetes is prescribed glipizide. Which manifestation should the nurse
instruct the client to report as a sign of hypoglycemia?
A) Polyuria and polydipsia
B) Sweating, tremors, and confusion
C) Fruity breath odor
D) Weight gain
💡 RATIONALE -- Glipizide (sulfonylurea) can cause hypoglycemia. Signs include sweating, tremors,
hunger, confusion, and palpitations.
✔️ ANSWER -- B) Sweating, tremors, and confusion
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**9.** A client is prescribed enoxaparin subcutaneously. Which technique is correct for administration?
A) Inject into the deltoid muscle
EXAM 2025
---
**1.** A nurse is caring for a client receiving a continuous IV heparin infusion. Which laboratory value
should the nurse monitor to determine therapeutic effectiveness?
A) INR
B) aPTT
C) Platelet count
D) Fibrinogen level
💡 RATIONALE -- Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
The therapeutic goal is 1.5 to 2.5 times the normal control value.
✔️ ANSWER -- B) aPTT
---
**2.** A client with heart failure is prescribed digoxin. Which finding should the nurse identify as an
early sign of digoxin toxicity?
A) Tachycardia
B) Anorexia and nausea
C) Hypertension
D) Polyuria
💡 RATIONALE -- Early signs of digoxin toxicity include gastrointestinal symptoms such as anorexia,
nausea, vomiting, and abdominal pain. Bradycardia and visual changes occur later.
,✔️ ANSWER -- B) Anorexia and nausea
---
**3.** A nurse is providing teaching to a client who has a new prescription for metformin. Which
statement by the client indicates understanding?
A) "I will take this medication with meals to prevent stomach upset."
B) "I can expect to lose weight because this medication suppresses my appetite."
C) "I will check my blood glucose before each meal."
D) "This medication may cause my urine to turn orange."
💡 RATIONALE -- Metformin commonly causes gastrointestinal side effects such as nausea and diarrhea.
Taking it with meals reduces these symptoms. It does not typically cause hypoglycemia alone.
✔️ ANSWER -- A) "I will take this medication with meals to prevent stomach upset."
---
**4.** A client is prescribed warfarin for atrial fibrillation. Which dietary instruction should the nurse
include?
A) "Increase your intake of green leafy vegetables."
B) "Maintain a consistent intake of vitamin K‑rich foods."
C) "Avoid all foods containing vitamin K."
D) "Take vitamin K supplements daily."
💡 RATIONALE -- Consistency in vitamin K intake is key for stable INR. Clients should not drastically
increase or decrease foods high in vitamin K (e.g., spinach, kale) without consulting the provider.
✔️ ANSWER -- B) "Maintain a consistent intake of vitamin K‑rich foods."
,---
**5.** A client is receiving IV furosemide. Which finding indicates the medication is having a therapeutic
effect?
A) Decreased blood pressure
B) Increased urinary output
C) Decreased heart rate
D) Increased crackles on auscultation
💡 RATIONALE -- Furosemide is a loop diuretic that promotes excretion of water and sodium. Increased
urine output and resolution of pulmonary congestion indicate effectiveness.
✔️ ANSWER -- B) Increased urinary output
---
**6.** A nurse is administering IV vancomycin. Which adverse effect is associated with rapid infusion of
this medication?
A) Red man syndrome
B) Stevens‑Johnson syndrome
C) Ototoxicity
D) Nephrotoxicity
💡 RATIONALE -- Red man syndrome (flushing, rash, hypotension) occurs with rapid IV vancomycin
infusion. Infusing over at least 60 minutes prevents this reaction.
✔️ ANSWER -- A) Red man syndrome
---
, **7.** A client is prescribed lisinopril. Which finding should the nurse report to the provider
immediately?
A) Dry, nonproductive cough
B) Angioedema of the lips and tongue
C) Dizziness when standing
D) Headache
💡 RATIONALE -- Angioedema (swelling of the lips, tongue, face, or airway) is a life‑threatening adverse
effect of ACE inhibitors and requires immediate medical attention.
✔️ ANSWER -- B) Angioedema of the lips and tongue
---
**8.** A client with type 2 diabetes is prescribed glipizide. Which manifestation should the nurse
instruct the client to report as a sign of hypoglycemia?
A) Polyuria and polydipsia
B) Sweating, tremors, and confusion
C) Fruity breath odor
D) Weight gain
💡 RATIONALE -- Glipizide (sulfonylurea) can cause hypoglycemia. Signs include sweating, tremors,
hunger, confusion, and palpitations.
✔️ ANSWER -- B) Sweating, tremors, and confusion
---
**9.** A client is prescribed enoxaparin subcutaneously. Which technique is correct for administration?
A) Inject into the deltoid muscle
