ATI RN Pharmacology Exam 2026
ATI RN Pharmacology Exam 2026 Edition
100 Advanced Questions with Answers
and Detailed Rationales
Content covered throughout the exam includes:
Cardiovascular pharmacology
Endocrine medications and insulin therapy
Antibiotics and antimicrobial agents
Anticoagulants and thrombolytics
Analgesics and opioid safety
Psychiatric medications
Respiratory medications
Neurologic medications
Electrolytes and IV therapy
Medication calculations
Prioritization and delegation
NGN-style clinical judgment, SATA, and case-based questions
ATI/NCLEX-RN–style rationales and safety-focused nursing interventions
Question 1
A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment should be performed first?
A. Blood pressure
B. Respiratory rate
C. Apical pulse for 1 minute
D. Oxygen saturation
✅ Correct Answer: C. Apical pulse for 1 minute
Rationale: Digoxin slows AV node conduction and can cause bradycardia. Hold the
medication and notify the provider if the adult apical pulse is below 60 beats/min.
, ATI RN Pharmacology Exam 2026
Question 2
A client taking lisinopril reports a persistent dry cough. What is the nurse's best
response?
A. Continue the medication because this is expected.
B. Stop the medication immediately without notifying the provider.
C. Notify the provider because this may require changing therapy.
D. Recommend an OTC cough suppressant.
✅ Correct Answer: C
Rationale: ACE inhibitors commonly cause a persistent dry cough due to bradykinin
accumulation. Many patients require an alternative such as an ARB.
Question 3
Which electrolyte imbalance places a client receiving digoxin at the highest risk for
toxicity?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
✅ Correct Answer: C
Rationale: Low potassium enhances digoxin binding to cardiac tissue, increasing the
risk of dysrhythmias and toxicity.
Question 4
A client receives furosemide. Which laboratory value requires immediate follow-up?
A. Sodium 139 mEq/L
B. Potassium 2.9 mEq/L
, ATI RN Pharmacology Exam 2026
C. Chloride 101 mEq/L
D. Magnesium 2.0 mg/dL
✅ Correct Answer: B
Rationale: Loop diuretics commonly cause potassium loss. Severe hypokalemia can
produce life-threatening dysrhythmias.
Question 5
A nurse teaches a client prescribed warfarin. Which statement indicates understanding?
A. "I'll eat large amounts of spinach every day."
B. "I'll take aspirin if I develop pain."
C. "I'll report black, tarry stools immediately."
D. "I'll double my dose if I miss one."
✅ Correct Answer: C
Rationale: Melena may indicate gastrointestinal bleeding. Clients should maintain
consistent vitamin K intake and avoid NSAIDs unless approved.
Question 6
Which medication should never be administered with grapefruit juice?
A. Amoxicillin
B. Atorvastatin
C. Acetaminophen
D. Metformin
✅ Correct Answer: B
Rationale: Grapefruit inhibits CYP3A4, increasing serum concentrations of several
statins and increasing the risk of adverse effects such as myopathy.
Question 7
, ATI RN Pharmacology Exam 2026
A nurse is administering insulin lispro. When should the medication be given?
A. At bedtime
B. 30–60 minutes before meals
C. Immediately before meals
D. Two hours after meals
✅ Correct Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of about 15 minutes and should
be given when food is available.
Question 8
Which finding indicates metformin should be withheld?
A. Blood glucose 180 mg/dL
B. Scheduled CT scan with IV contrast
C. Hemoglobin A1C 8%
D. Mild hypertension
✅ Correct Answer: B
Rationale: Metformin is temporarily withheld before and after iodinated contrast
administration because of the risk of lactic acidosis if renal function declines.
Question 9
Which medication requires regular INR monitoring?
A. Heparin
B. Warfarin
C. Enoxaparin
D. Apixaban
✅ Correct Answer: B
Rationale: Warfarin dosing is guided by the INR, typically with a therapeutic range of
2–3 for many indications.
ATI RN Pharmacology Exam 2026 Edition
100 Advanced Questions with Answers
and Detailed Rationales
Content covered throughout the exam includes:
Cardiovascular pharmacology
Endocrine medications and insulin therapy
Antibiotics and antimicrobial agents
Anticoagulants and thrombolytics
Analgesics and opioid safety
Psychiatric medications
Respiratory medications
Neurologic medications
Electrolytes and IV therapy
Medication calculations
Prioritization and delegation
NGN-style clinical judgment, SATA, and case-based questions
ATI/NCLEX-RN–style rationales and safety-focused nursing interventions
Question 1
A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment should be performed first?
A. Blood pressure
B. Respiratory rate
C. Apical pulse for 1 minute
D. Oxygen saturation
✅ Correct Answer: C. Apical pulse for 1 minute
Rationale: Digoxin slows AV node conduction and can cause bradycardia. Hold the
medication and notify the provider if the adult apical pulse is below 60 beats/min.
, ATI RN Pharmacology Exam 2026
Question 2
A client taking lisinopril reports a persistent dry cough. What is the nurse's best
response?
A. Continue the medication because this is expected.
B. Stop the medication immediately without notifying the provider.
C. Notify the provider because this may require changing therapy.
D. Recommend an OTC cough suppressant.
✅ Correct Answer: C
Rationale: ACE inhibitors commonly cause a persistent dry cough due to bradykinin
accumulation. Many patients require an alternative such as an ARB.
Question 3
Which electrolyte imbalance places a client receiving digoxin at the highest risk for
toxicity?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
✅ Correct Answer: C
Rationale: Low potassium enhances digoxin binding to cardiac tissue, increasing the
risk of dysrhythmias and toxicity.
Question 4
A client receives furosemide. Which laboratory value requires immediate follow-up?
A. Sodium 139 mEq/L
B. Potassium 2.9 mEq/L
, ATI RN Pharmacology Exam 2026
C. Chloride 101 mEq/L
D. Magnesium 2.0 mg/dL
✅ Correct Answer: B
Rationale: Loop diuretics commonly cause potassium loss. Severe hypokalemia can
produce life-threatening dysrhythmias.
Question 5
A nurse teaches a client prescribed warfarin. Which statement indicates understanding?
A. "I'll eat large amounts of spinach every day."
B. "I'll take aspirin if I develop pain."
C. "I'll report black, tarry stools immediately."
D. "I'll double my dose if I miss one."
✅ Correct Answer: C
Rationale: Melena may indicate gastrointestinal bleeding. Clients should maintain
consistent vitamin K intake and avoid NSAIDs unless approved.
Question 6
Which medication should never be administered with grapefruit juice?
A. Amoxicillin
B. Atorvastatin
C. Acetaminophen
D. Metformin
✅ Correct Answer: B
Rationale: Grapefruit inhibits CYP3A4, increasing serum concentrations of several
statins and increasing the risk of adverse effects such as myopathy.
Question 7
, ATI RN Pharmacology Exam 2026
A nurse is administering insulin lispro. When should the medication be given?
A. At bedtime
B. 30–60 minutes before meals
C. Immediately before meals
D. Two hours after meals
✅ Correct Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of about 15 minutes and should
be given when food is available.
Question 8
Which finding indicates metformin should be withheld?
A. Blood glucose 180 mg/dL
B. Scheduled CT scan with IV contrast
C. Hemoglobin A1C 8%
D. Mild hypertension
✅ Correct Answer: B
Rationale: Metformin is temporarily withheld before and after iodinated contrast
administration because of the risk of lactic acidosis if renal function declines.
Question 9
Which medication requires regular INR monitoring?
A. Heparin
B. Warfarin
C. Enoxaparin
D. Apixaban
✅ Correct Answer: B
Rationale: Warfarin dosing is guided by the INR, typically with a therapeutic range of
2–3 for many indications.
