ATI Pharmacology Proctored Assessment Q&A with
Verified Correct Solutions, Detailed Rationales, and
NCLEX RN Clinical Preparation Guide for Nursing
Students (2026 Edition)
Section 1: Medication Administration & Safety
Question 1
A nurse is preparing to administer a scheduled dose of warfarin to a client. Which
laboratory test should the nurse review prior to administration?
A) Total iron-binding capacity
B) WBC count
C) PTT
D) PT/INR
Correct Answer: D
Rationale: Prothrombin time (PT) and International Normalized Ratio (INR) are
used to monitor warfarin therapy. Warfarin prolongs PT by inhibiting vitamin K-
dependent clotting factors. PTT is used to monitor heparin therapy, not warfarin .
Question 2
A nurse is preparing to administer digoxin to a client with heart failure. Which
finding requires the nurse to withhold the medication and notify the provider?
A) Potassium level of 4.2 mEq/L
B) Apical pulse of 54/min
C) Blood pressure of 138/84 mm Hg
D) Respiratory rate of 18/min
Correct Answer: B
,Rationale: Digoxin should be withheld if the apical pulse is below 60/min in adults
(or 70/min in children) due to the risk of bradycardia and digoxin toxicity. The
nurse should notify the provider for further instructions .
Question 3
A nurse is preparing to administer eye drops to a client. Which of the following
actions should the nurse take? (Select all that apply.)
A) Have the client lie on her side
B) Ask the client to look up at the ceiling
C) Tell the client to blink when the drops enter her eye
D) Drop the medication into the center of the client's conjunctival sac
E) Instruct the client to close her eye gently after instillation
Correct Answers: B, D, E
Rationale: The client should look upward to prevent drops from falling onto the
cornea. The nurse should drop medication into the center of the conjunctival sac to
promote distribution. The client should close the eye gently to promote distribution
of the medication .
Question 4
A nurse is completing discharge teaching for a client who has a new prescription
for transdermal patches. Which statement indicates that the client understands
the instructions?
A) "I will clean the site with an alcohol swab before I apply the patch."
B) "I will rotate the application sites weekly."
C) "I will apply the patch to an area of skin with no hair."
D) "I will place the new patch on the site of the old patch."
Correct Answer: C
, Rationale: The client should apply the patch to a hairless area of skin to promote
absorption of the medication. Hair can prevent proper adhesion and absorption of
transdermal medications .
Question 5
A nurse is caring for a group of clients. Which situation requires completion of an
incident report?
A) A client vomits after receiving an oral medication
B) A client experiences a seizure
C) A client receives their insulin 1 hour before the scheduled time
D) A client receives their meal tray 20 minutes late
Correct Answer: C
Rationale: Administering insulin either too early or too late can place the client at
risk for hypoglycemia or hyperglycemia. This is a medication administration error
and requires an incident report .
Question 6
A nurse is preparing to administer methotrexate in oral tablet form to a client.
Which action should the nurse take?
A) Don a protective gown
B) Handle the medication in a controlled ventilation area
C) Wear an N95 mask
D) Apply gloves
Correct Answer: D
Rationale: When handling oral chemotherapeutic or antineoplastic agents like
methotrexate, gloves are required to reduce exposure. This is a standard safety
precaution for handling hazardous drugs .
Verified Correct Solutions, Detailed Rationales, and
NCLEX RN Clinical Preparation Guide for Nursing
Students (2026 Edition)
Section 1: Medication Administration & Safety
Question 1
A nurse is preparing to administer a scheduled dose of warfarin to a client. Which
laboratory test should the nurse review prior to administration?
A) Total iron-binding capacity
B) WBC count
C) PTT
D) PT/INR
Correct Answer: D
Rationale: Prothrombin time (PT) and International Normalized Ratio (INR) are
used to monitor warfarin therapy. Warfarin prolongs PT by inhibiting vitamin K-
dependent clotting factors. PTT is used to monitor heparin therapy, not warfarin .
Question 2
A nurse is preparing to administer digoxin to a client with heart failure. Which
finding requires the nurse to withhold the medication and notify the provider?
A) Potassium level of 4.2 mEq/L
B) Apical pulse of 54/min
C) Blood pressure of 138/84 mm Hg
D) Respiratory rate of 18/min
Correct Answer: B
,Rationale: Digoxin should be withheld if the apical pulse is below 60/min in adults
(or 70/min in children) due to the risk of bradycardia and digoxin toxicity. The
nurse should notify the provider for further instructions .
Question 3
A nurse is preparing to administer eye drops to a client. Which of the following
actions should the nurse take? (Select all that apply.)
A) Have the client lie on her side
B) Ask the client to look up at the ceiling
C) Tell the client to blink when the drops enter her eye
D) Drop the medication into the center of the client's conjunctival sac
E) Instruct the client to close her eye gently after instillation
Correct Answers: B, D, E
Rationale: The client should look upward to prevent drops from falling onto the
cornea. The nurse should drop medication into the center of the conjunctival sac to
promote distribution. The client should close the eye gently to promote distribution
of the medication .
Question 4
A nurse is completing discharge teaching for a client who has a new prescription
for transdermal patches. Which statement indicates that the client understands
the instructions?
A) "I will clean the site with an alcohol swab before I apply the patch."
B) "I will rotate the application sites weekly."
C) "I will apply the patch to an area of skin with no hair."
D) "I will place the new patch on the site of the old patch."
Correct Answer: C
, Rationale: The client should apply the patch to a hairless area of skin to promote
absorption of the medication. Hair can prevent proper adhesion and absorption of
transdermal medications .
Question 5
A nurse is caring for a group of clients. Which situation requires completion of an
incident report?
A) A client vomits after receiving an oral medication
B) A client experiences a seizure
C) A client receives their insulin 1 hour before the scheduled time
D) A client receives their meal tray 20 minutes late
Correct Answer: C
Rationale: Administering insulin either too early or too late can place the client at
risk for hypoglycemia or hyperglycemia. This is a medication administration error
and requires an incident report .
Question 6
A nurse is preparing to administer methotrexate in oral tablet form to a client.
Which action should the nurse take?
A) Don a protective gown
B) Handle the medication in a controlled ventilation area
C) Wear an N95 mask
D) Apply gloves
Correct Answer: D
Rationale: When handling oral chemotherapeutic or antineoplastic agents like
methotrexate, gloves are required to reduce exposure. This is a standard safety
precaution for handling hazardous drugs .
