1
ATI PN Pharmacology Exam with NGN 2026
Complete Practice Q&A Bank with Verified Answers & Detailed
Rationales
Updated for 2025/2026 | Next Generation NCLEX Style
Question 1:
A nurse is performing the third check before administering hydromorphone to a client.
After opening the unit-dose packet, the client states they do not want to take the
medication now. Which action should the nurse take?
A) Return the medication to the automated dispensing cabinet for later use
B) Dispose of the medication with a second nurse as a witness
C) Document the refusal and store the opened medication at the nurse's station
D) Encourage the client to take the medication and reassess in 30 minutes
Correct Answer: B) Dispose of the medication with a second nurse as a witness
Rationale: Hydromorphone is a Schedule II controlled substance. Once a controlled
substance is opened or prepared, it cannot be returned to stock if the client refuses it. The
nurse is legally required to have a second nurse witness the disposal of the medication and
document the waste according to facility and federal regulations .
Question 2:
A nurse is reviewing the medication administration record of a client who has an NG
tube. Which medication should the nurse plan to administer through the NG tube?
A) Lovastatin
B) Warfarin
C) Metoprolol
D) Furosemide
Correct Answer: C) Metoprolol
Rationale: Metoprolol tartrate (immediate-release) tablets can be crushed and safely given
via NG tube. Lovastatin is an extended-release formulation that should not be crushed as
Sure pass
,2
it alters absorption. Warfarin and furosemide can be crushed if prescribed, but the nurse
must always verify compatibility with the specific tube type .
Question 3:
A nurse is preparing to administer a medication that has a delayed-release capsule
formulation. The client cannot swallow capsules. Which action should the nurse take?
A) Crush the capsule and mix with applesauce
B) Open the capsule and sprinkle the contents on applesauce
C) Chew the capsule thoroughly before swallowing
D) Dissolve the capsule in a glass of water and drink immediately
Correct Answer: B) Open the capsule and sprinkle the contents on applesauce
Rationale: Delayed-release capsules contain enteric-coated granules that protect the drug
from stomach acid. The granules must not be crushed or chewed. However, the capsule
can be opened, and the granules can be sprinkled onto a small amount of soft food
(applesauce) and swallowed immediately without chewing .
Question 4:
A nurse is assessing a client who is receiving intravenous therapy. The nurse should
identify which of the following findings as a manifestation of fluid volume excess?
A) Bilateral muscle weakness
B) Decreased bowel sounds
C) Thread pulse
D) Distended neck veins
Correct Answer: D) Distended neck veins
Rationale: Fluid volume excess (hypervolemia) causes venous congestion, leading to
distended neck veins, peripheral edema, and hypertension. Other signs include dyspnea,
crackles in the lungs, and weight gain. Distended neck veins are a key clinical finding .
Sure pass
,3
Question 5:
What are specific considerations for adult clients, clients who are taking anticoagulants,
and clients who have fragile veins when starting an IV?
A) Avoiding tourniquets, using a BP cuff to visualize veins
B) No slapping to dilate veins
C) Hold hand below the heart
D) Avoid using the back of the hand
E) Avoid rigorous friction while cleaning the site
F) All of the above
Correct Answer: F) All of the above
Rationale: When starting IVs in clients taking anticoagulants, those with fragile veins, and
adult clients, special considerations include avoiding tourniquets (use a BP cuff instead),
avoiding slapping to dilate veins, holding the hand below the heart, avoiding the back of
the hand (more fragile), and avoiding rigorous friction while cleaning the site to prevent
skin damage .
Question 6:
An IV that is pale, has local swelling, decreased skin temperature around the site, damp
dressing, and slowed infusion is what complication?
A) Infiltration
B) Phlebitis
C) Extravasation
D) Infection
Correct Answer: A) Infiltration
Rationale: Infiltration is characterized by pale skin, local swelling, decreased skin
temperature around the IV site, a damp dressing, and slowed infusion. This indicates that
IV fluid has leaked into the surrounding tissue. The IV should be discontinued and a new
site established .
Question 7:
A nurse is reinforcing teaching with a client who has a new prescription for propranolol.
Sure pass
, 4
Which of the following information should the nurse include in the teaching?
A) The medication can be stopped abruptly if side effects occur
B) Monitor for signs of bradycardia and report if heart rate drops below 60 bpm
C) This medication is safe to take with over-the-counter cold medications
D) It will increase exercise tolerance immediately
Correct Answer: B) Monitor for signs of bradycardia and report if heart rate drops
below 60 bpm
Rationale: Propranolol is a nonselective beta-blocker that can cause bradycardia. Clients
should monitor their heart rate and report if it drops below 60 bpm. Abrupt
discontinuation can cause rebound tachycardia and hypertension. It should not be taken
with cold medications containing decongestants .
Question 8:
A nurse is caring for a client who has a prescription for tizanidine (Zanaflex) for relief of
muscle spasm following a back injury. Which of the following lab values should the
nurse expect to monitor while the client is taking this medication?
A) Serum creatinine
B) Liver enzymes
C) WBC count
D) RBC count
Correct Answer: B) Liver enzymes
Rationale: Tizanidine can cause hepatotoxicity and liver enzyme elevation. Liver function
tests should be monitored at baseline and periodically during therapy. The client should be
instructed to report signs of liver dysfunction such as jaundice, dark urine, or fatigue .
Question 9:
A nurse is reinforcing teaching to a client with asthma about how to use cromolyn
(Intal). Which of the following should the nurse include in the teaching? (Select all that
apply)
A) Take the medication 15 minutes before exercising
B) Follow a fixed-dosage schedule for long-term control of asthma
Sure pass
ATI PN Pharmacology Exam with NGN 2026
Complete Practice Q&A Bank with Verified Answers & Detailed
Rationales
Updated for 2025/2026 | Next Generation NCLEX Style
Question 1:
A nurse is performing the third check before administering hydromorphone to a client.
After opening the unit-dose packet, the client states they do not want to take the
medication now. Which action should the nurse take?
A) Return the medication to the automated dispensing cabinet for later use
B) Dispose of the medication with a second nurse as a witness
C) Document the refusal and store the opened medication at the nurse's station
D) Encourage the client to take the medication and reassess in 30 minutes
Correct Answer: B) Dispose of the medication with a second nurse as a witness
Rationale: Hydromorphone is a Schedule II controlled substance. Once a controlled
substance is opened or prepared, it cannot be returned to stock if the client refuses it. The
nurse is legally required to have a second nurse witness the disposal of the medication and
document the waste according to facility and federal regulations .
Question 2:
A nurse is reviewing the medication administration record of a client who has an NG
tube. Which medication should the nurse plan to administer through the NG tube?
A) Lovastatin
B) Warfarin
C) Metoprolol
D) Furosemide
Correct Answer: C) Metoprolol
Rationale: Metoprolol tartrate (immediate-release) tablets can be crushed and safely given
via NG tube. Lovastatin is an extended-release formulation that should not be crushed as
Sure pass
,2
it alters absorption. Warfarin and furosemide can be crushed if prescribed, but the nurse
must always verify compatibility with the specific tube type .
Question 3:
A nurse is preparing to administer a medication that has a delayed-release capsule
formulation. The client cannot swallow capsules. Which action should the nurse take?
A) Crush the capsule and mix with applesauce
B) Open the capsule and sprinkle the contents on applesauce
C) Chew the capsule thoroughly before swallowing
D) Dissolve the capsule in a glass of water and drink immediately
Correct Answer: B) Open the capsule and sprinkle the contents on applesauce
Rationale: Delayed-release capsules contain enteric-coated granules that protect the drug
from stomach acid. The granules must not be crushed or chewed. However, the capsule
can be opened, and the granules can be sprinkled onto a small amount of soft food
(applesauce) and swallowed immediately without chewing .
Question 4:
A nurse is assessing a client who is receiving intravenous therapy. The nurse should
identify which of the following findings as a manifestation of fluid volume excess?
A) Bilateral muscle weakness
B) Decreased bowel sounds
C) Thread pulse
D) Distended neck veins
Correct Answer: D) Distended neck veins
Rationale: Fluid volume excess (hypervolemia) causes venous congestion, leading to
distended neck veins, peripheral edema, and hypertension. Other signs include dyspnea,
crackles in the lungs, and weight gain. Distended neck veins are a key clinical finding .
Sure pass
,3
Question 5:
What are specific considerations for adult clients, clients who are taking anticoagulants,
and clients who have fragile veins when starting an IV?
A) Avoiding tourniquets, using a BP cuff to visualize veins
B) No slapping to dilate veins
C) Hold hand below the heart
D) Avoid using the back of the hand
E) Avoid rigorous friction while cleaning the site
F) All of the above
Correct Answer: F) All of the above
Rationale: When starting IVs in clients taking anticoagulants, those with fragile veins, and
adult clients, special considerations include avoiding tourniquets (use a BP cuff instead),
avoiding slapping to dilate veins, holding the hand below the heart, avoiding the back of
the hand (more fragile), and avoiding rigorous friction while cleaning the site to prevent
skin damage .
Question 6:
An IV that is pale, has local swelling, decreased skin temperature around the site, damp
dressing, and slowed infusion is what complication?
A) Infiltration
B) Phlebitis
C) Extravasation
D) Infection
Correct Answer: A) Infiltration
Rationale: Infiltration is characterized by pale skin, local swelling, decreased skin
temperature around the IV site, a damp dressing, and slowed infusion. This indicates that
IV fluid has leaked into the surrounding tissue. The IV should be discontinued and a new
site established .
Question 7:
A nurse is reinforcing teaching with a client who has a new prescription for propranolol.
Sure pass
, 4
Which of the following information should the nurse include in the teaching?
A) The medication can be stopped abruptly if side effects occur
B) Monitor for signs of bradycardia and report if heart rate drops below 60 bpm
C) This medication is safe to take with over-the-counter cold medications
D) It will increase exercise tolerance immediately
Correct Answer: B) Monitor for signs of bradycardia and report if heart rate drops
below 60 bpm
Rationale: Propranolol is a nonselective beta-blocker that can cause bradycardia. Clients
should monitor their heart rate and report if it drops below 60 bpm. Abrupt
discontinuation can cause rebound tachycardia and hypertension. It should not be taken
with cold medications containing decongestants .
Question 8:
A nurse is caring for a client who has a prescription for tizanidine (Zanaflex) for relief of
muscle spasm following a back injury. Which of the following lab values should the
nurse expect to monitor while the client is taking this medication?
A) Serum creatinine
B) Liver enzymes
C) WBC count
D) RBC count
Correct Answer: B) Liver enzymes
Rationale: Tizanidine can cause hepatotoxicity and liver enzyme elevation. Liver function
tests should be monitored at baseline and periodically during therapy. The client should be
instructed to report signs of liver dysfunction such as jaundice, dark urine, or fatigue .
Question 9:
A nurse is reinforcing teaching to a client with asthma about how to use cromolyn
(Intal). Which of the following should the nurse include in the teaching? (Select all that
apply)
A) Take the medication 15 minutes before exercising
B) Follow a fixed-dosage schedule for long-term control of asthma
Sure pass
