ATI PN PHARMACOLOGY PROCTORED
EXAM REVIEW 2026 COMPREHENSIVE
PRACTICE QUESTIONS WITH CORRECT
ANSWERS AND DETAILED RATIONALES
PRACTICAL NURSING PHARMACOLOGY
STUDY GUIDE NCLEX-PN PREPARATION
127.) The nurse provides medication instructions to an older hypertensive
client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The
nurse evaluates the need for further teaching when the client states which
of the following?
1. "I can skip a dose once a week."
2. "I need to change my position slowly."
3. "I take the pill after breakfast each day."
4. "If I get a bad headache, I should call my doctor immediately." -
CORRECT ANSWER -1. "I can skip a dose once a week."
Rationale:
Lisinopril is an antihypertensive angiotensin-converting enzyme (ACE)
inhibitor. The usual dosage range is 20 to 40 mg per day. Adverse effects
include headache, dizziness, fatigue, orthostatic hypotension, tachycardia,
and angioedema. Specific client teaching points include taking one pill a
day, not stopping the medication without consulting the health care
provider (HCP), and monitoring for side effects and adverse reactions. The
client should notify the HCP if side effects occur.
,128.) A nurse is providing instructions to an adolescent who has a history of
seizures and is taking an anticonvulsant medication. Which of the following
statements indicates that the client understands the instructions?
1. "I will never be able to drive a car."
2. "My anticonvulsant medication will clear up my skin."
3. "I can't drink alcohol while I am taking my medication."
4. "If I forget my morning medication, I can take two pills at bedtime." -
CORRECT ANSWER -3. "I can't drink alcohol while I am taking my
medication."
Rationale:
Alcohol will lower the seizure threshold and should be avoided. Adolescents
can obtain a driver's license in most states when they have been seizure free
for 1 year. Anticonvulsants cause acne and oily skin; therefore a
dermatologist may need to be consulted. If an anticonvulsant medication is
missed, the health care provider should be notified.
129.) Megestrol acetate (Megace), an antineoplastic medication, is
prescribed for the client with metastatic endometrial carcinoma. The nurse
reviews the client's history and contacts the registered nurse if which
diagnosis is documented in the client's history?
1. Gout
2. Asthma
3. Thrombophlebitis
4. Myocardial infarction - CORRECT ANSWER -3. Thrombophlebitis
Rationale:
Megestrol acetate (Megace) suppresses the release of luteinizing hormone
from the anterior pituitary by inhibiting pituitary function and regressing
,tumor size. Megestrol is used with caution if the client has a history of
thrombophlebitis.
**megestrol acetate is a hormonal antagonist enzyme and that a side effect
is thrombotic disorders**
130.) The nurse is analyzing the laboratory results of a client with leukemia
who has received a regimen of chemotherapy. Which laboratory value
would the nurse specifically note as a result of the massive cell destruction
that occurred from the chemotherapy?
1. Anemia
2. Decreased platelets
3. Increased uric acid level
4. Decreased leukocyte count - CORRECT ANSWER -3. Increased uric acid
level
Rationale:
Hyperuricemia is especially common following treatment for leukemias and
lymphomas because chemotherapy results in a massive cell kill. Although
options 1, 2, and 4 also may be noted, an increased uric acid level is related
specifically to cell destruction.
131.) The nurse is reinforcing medication instructions to a client with breast
cancer who is receiving cyclophosphamide (Neosar). The nurse tells the
client to:
1. Take the medication with food.
2. Increase fluid intake to 2000 to 3000 mL daily.
3. Decrease sodium intake while taking the medication.
4. Increase potassium intake while taking the medication. - CORRECT
ANSWER -2. Increase fluid intake to 2000 to 3000 mL daily.
, Rationale:
Hemorrhagic cystitis is a toxic effect that can occur with the use of
cyclophosphamide. The client needs to be instructed to drink copious
amounts of fluid during the administration of this medication. Clients also
should monitor urine output for hematuria. The medication should be
taken on an empty stomach, unless gastrointestinal (GI) upset occurs.
Hyperkalemia can result from the use of the medication; therefore the
client would not be told to increase potassium intake. The client would not
be instructed to alter sodium intake.
132.) The client with non-Hodgkin's lymphoma is receiving daunorubicin
(DaunoXome). Which of the following would indicate to the nurse that the
client is experiencing a toxic effect related to the medication?
1. Fever
2. Diarrhea Patient identifiers - CORRECT ANSWER --Medical record
number
-home telephone number
What lab values should a nurse monitor for a patient with chronic renal
failure? - CORRECT ANSWER -■ Urinalysis
☐ Hematuria, proteinuria, and alterations in specific gravity
☐ Serum creatinine
- Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal
failure (ARF)
- Gradual increase over months to years for chronic renal failure (CRF)
exceeding 4 mg/dL
■ Blood urea nitrogen (BUN)
EXAM REVIEW 2026 COMPREHENSIVE
PRACTICE QUESTIONS WITH CORRECT
ANSWERS AND DETAILED RATIONALES
PRACTICAL NURSING PHARMACOLOGY
STUDY GUIDE NCLEX-PN PREPARATION
127.) The nurse provides medication instructions to an older hypertensive
client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The
nurse evaluates the need for further teaching when the client states which
of the following?
1. "I can skip a dose once a week."
2. "I need to change my position slowly."
3. "I take the pill after breakfast each day."
4. "If I get a bad headache, I should call my doctor immediately." -
CORRECT ANSWER -1. "I can skip a dose once a week."
Rationale:
Lisinopril is an antihypertensive angiotensin-converting enzyme (ACE)
inhibitor. The usual dosage range is 20 to 40 mg per day. Adverse effects
include headache, dizziness, fatigue, orthostatic hypotension, tachycardia,
and angioedema. Specific client teaching points include taking one pill a
day, not stopping the medication without consulting the health care
provider (HCP), and monitoring for side effects and adverse reactions. The
client should notify the HCP if side effects occur.
,128.) A nurse is providing instructions to an adolescent who has a history of
seizures and is taking an anticonvulsant medication. Which of the following
statements indicates that the client understands the instructions?
1. "I will never be able to drive a car."
2. "My anticonvulsant medication will clear up my skin."
3. "I can't drink alcohol while I am taking my medication."
4. "If I forget my morning medication, I can take two pills at bedtime." -
CORRECT ANSWER -3. "I can't drink alcohol while I am taking my
medication."
Rationale:
Alcohol will lower the seizure threshold and should be avoided. Adolescents
can obtain a driver's license in most states when they have been seizure free
for 1 year. Anticonvulsants cause acne and oily skin; therefore a
dermatologist may need to be consulted. If an anticonvulsant medication is
missed, the health care provider should be notified.
129.) Megestrol acetate (Megace), an antineoplastic medication, is
prescribed for the client with metastatic endometrial carcinoma. The nurse
reviews the client's history and contacts the registered nurse if which
diagnosis is documented in the client's history?
1. Gout
2. Asthma
3. Thrombophlebitis
4. Myocardial infarction - CORRECT ANSWER -3. Thrombophlebitis
Rationale:
Megestrol acetate (Megace) suppresses the release of luteinizing hormone
from the anterior pituitary by inhibiting pituitary function and regressing
,tumor size. Megestrol is used with caution if the client has a history of
thrombophlebitis.
**megestrol acetate is a hormonal antagonist enzyme and that a side effect
is thrombotic disorders**
130.) The nurse is analyzing the laboratory results of a client with leukemia
who has received a regimen of chemotherapy. Which laboratory value
would the nurse specifically note as a result of the massive cell destruction
that occurred from the chemotherapy?
1. Anemia
2. Decreased platelets
3. Increased uric acid level
4. Decreased leukocyte count - CORRECT ANSWER -3. Increased uric acid
level
Rationale:
Hyperuricemia is especially common following treatment for leukemias and
lymphomas because chemotherapy results in a massive cell kill. Although
options 1, 2, and 4 also may be noted, an increased uric acid level is related
specifically to cell destruction.
131.) The nurse is reinforcing medication instructions to a client with breast
cancer who is receiving cyclophosphamide (Neosar). The nurse tells the
client to:
1. Take the medication with food.
2. Increase fluid intake to 2000 to 3000 mL daily.
3. Decrease sodium intake while taking the medication.
4. Increase potassium intake while taking the medication. - CORRECT
ANSWER -2. Increase fluid intake to 2000 to 3000 mL daily.
, Rationale:
Hemorrhagic cystitis is a toxic effect that can occur with the use of
cyclophosphamide. The client needs to be instructed to drink copious
amounts of fluid during the administration of this medication. Clients also
should monitor urine output for hematuria. The medication should be
taken on an empty stomach, unless gastrointestinal (GI) upset occurs.
Hyperkalemia can result from the use of the medication; therefore the
client would not be told to increase potassium intake. The client would not
be instructed to alter sodium intake.
132.) The client with non-Hodgkin's lymphoma is receiving daunorubicin
(DaunoXome). Which of the following would indicate to the nurse that the
client is experiencing a toxic effect related to the medication?
1. Fever
2. Diarrhea Patient identifiers - CORRECT ANSWER --Medical record
number
-home telephone number
What lab values should a nurse monitor for a patient with chronic renal
failure? - CORRECT ANSWER -■ Urinalysis
☐ Hematuria, proteinuria, and alterations in specific gravity
☐ Serum creatinine
- Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal
failure (ARF)
- Gradual increase over months to years for chronic renal failure (CRF)
exceeding 4 mg/dL
■ Blood urea nitrogen (BUN)
