Newest Digital ATI RN Pharmacology Proctored Exam
2026/2027 Level 3 with NGN Questions to Succeed in
Real RN Pharmacology Exam and Answers
1. A nurse is preparing to administer a medication. Which action is most critical to
ensure patient safety?
A. Assess the patient's pain level
B. Verify the patient's identity using two identifiers
C. Review the patient's laboratory results
D. Educate the patient about the medication
Correct Answer: B
Rationale: Verifying patient identity using two identifiers (e.g., name and date of birth)
is the most critical safety step to prevent medication errors. This is part of the "right
patient" in the seven rights of medication administration .
2. A nurse is performing the third check before administering hydromorphone.
After opening the unit-dose packet, the client refuses to take the medication.
Which action should the nurse take?
A. Return the medication to the medication cart unopened
B. Dispose of the medication with a second nurse as a witness
C. Save the medication for the client to take later
D. Document refusal and keep medication at the bedside
Correct Answer: B
Rationale: Hydromorphone is a controlled substance. If a client refuses a controlled
substance after it has been prepared, it must be wasted and witnessed by another nurse
to comply with legal regulations .
3. A nurse is reviewing a medication order: "Digoxin 0.25 mg PO daily." Which
component is missing?
A. Route
B. Dose
,C. Frequency
D. Time of administration
Correct Answer: D
Rationale: A complete medication order must include: client name, date/time, drug
name, dose, route, frequency, and signature of prescriber. This order is missing the
specific time of administration .
4. A nurse is preparing to administer an IM injection to an adult. Which needle size
is most appropriate?
A. 25 gauge, ½ inch
B. 22 gauge, 1½ inch
C. 18 gauge, 2 inch
D. 30 gauge, ⅔ inch
Correct Answer: B
Rationale: IM injections typically use a 22-25 gauge needle that is 1-1½ inches long,
depending on the patient's muscle mass and the injection site .
5. A client asks if they can crush an enteric-coated tablet. What is the nurse's best
response?
A. "Yes, crushing will make it work faster."
B. "No, crushing will destroy the protective coating and may cause stomach upset."
C. "Yes, but it will take longer to work."
D. "It depends on the medication."
Correct Answer: B
Rationale: Enteric-coated tablets should not be crushed because the coating protects
the medication from stomach acid. Crushing destroys this protective mechanism and
may lead to GI irritation or altered absorption .
6. Which statement by a client indicates understanding of sublingual medication
administration?
A. "I will swallow the tablet with a glass of water."
B. "I will place the tablet under my tongue and let it dissolve."
C. "I will chew the tablet for faster effect."
D. "I will place the tablet between my cheek and gum."
, Correct Answer: B
Rationale: Sublingual medications are placed under the tongue to dissolve and be
absorbed directly into the bloodstream, bypassing the GI tract and first-pass effect .
7. A nurse is administering a transdermal patch. Which instruction is correct?
A. "Apply the patch to the same site each time."
B. "Remove the old patch before applying a new one."
C. "Cut the patch if a smaller dose is needed."
D. "Apply the patch over a bony prominence."
Correct Answer: B
Rationale: Old patches should be removed before applying new ones to prevent
overdose. Application sites should be rotated to prevent skin irritation. Patches should
not be cut .
8. A nurse is documenting medication administration. Which entry is most
accurate?
A. "Medication given as ordered."
B. "1/25/2026 0900: Digoxin 0.25 mg PO administered. Patient tolerated well. - S. Smith,
RN"
C. "Gave digoxin."
D. "Patient received morning meds."
Correct Answer: B
Rationale: Documentation should include the date, time, medication name, dose, route,
patient response, and nurse's signature .
SECTION 2: PHARMACOLOGICAL PRINCIPLES (Questions 9-20)
9. A drug with a narrow therapeutic index requires:
A. No monitoring
B. Frequent serum level monitoring
C. Only symptom monitoring
D. Monitoring of vital signs only
2026/2027 Level 3 with NGN Questions to Succeed in
Real RN Pharmacology Exam and Answers
1. A nurse is preparing to administer a medication. Which action is most critical to
ensure patient safety?
A. Assess the patient's pain level
B. Verify the patient's identity using two identifiers
C. Review the patient's laboratory results
D. Educate the patient about the medication
Correct Answer: B
Rationale: Verifying patient identity using two identifiers (e.g., name and date of birth)
is the most critical safety step to prevent medication errors. This is part of the "right
patient" in the seven rights of medication administration .
2. A nurse is performing the third check before administering hydromorphone.
After opening the unit-dose packet, the client refuses to take the medication.
Which action should the nurse take?
A. Return the medication to the medication cart unopened
B. Dispose of the medication with a second nurse as a witness
C. Save the medication for the client to take later
D. Document refusal and keep medication at the bedside
Correct Answer: B
Rationale: Hydromorphone is a controlled substance. If a client refuses a controlled
substance after it has been prepared, it must be wasted and witnessed by another nurse
to comply with legal regulations .
3. A nurse is reviewing a medication order: "Digoxin 0.25 mg PO daily." Which
component is missing?
A. Route
B. Dose
,C. Frequency
D. Time of administration
Correct Answer: D
Rationale: A complete medication order must include: client name, date/time, drug
name, dose, route, frequency, and signature of prescriber. This order is missing the
specific time of administration .
4. A nurse is preparing to administer an IM injection to an adult. Which needle size
is most appropriate?
A. 25 gauge, ½ inch
B. 22 gauge, 1½ inch
C. 18 gauge, 2 inch
D. 30 gauge, ⅔ inch
Correct Answer: B
Rationale: IM injections typically use a 22-25 gauge needle that is 1-1½ inches long,
depending on the patient's muscle mass and the injection site .
5. A client asks if they can crush an enteric-coated tablet. What is the nurse's best
response?
A. "Yes, crushing will make it work faster."
B. "No, crushing will destroy the protective coating and may cause stomach upset."
C. "Yes, but it will take longer to work."
D. "It depends on the medication."
Correct Answer: B
Rationale: Enteric-coated tablets should not be crushed because the coating protects
the medication from stomach acid. Crushing destroys this protective mechanism and
may lead to GI irritation or altered absorption .
6. Which statement by a client indicates understanding of sublingual medication
administration?
A. "I will swallow the tablet with a glass of water."
B. "I will place the tablet under my tongue and let it dissolve."
C. "I will chew the tablet for faster effect."
D. "I will place the tablet between my cheek and gum."
, Correct Answer: B
Rationale: Sublingual medications are placed under the tongue to dissolve and be
absorbed directly into the bloodstream, bypassing the GI tract and first-pass effect .
7. A nurse is administering a transdermal patch. Which instruction is correct?
A. "Apply the patch to the same site each time."
B. "Remove the old patch before applying a new one."
C. "Cut the patch if a smaller dose is needed."
D. "Apply the patch over a bony prominence."
Correct Answer: B
Rationale: Old patches should be removed before applying new ones to prevent
overdose. Application sites should be rotated to prevent skin irritation. Patches should
not be cut .
8. A nurse is documenting medication administration. Which entry is most
accurate?
A. "Medication given as ordered."
B. "1/25/2026 0900: Digoxin 0.25 mg PO administered. Patient tolerated well. - S. Smith,
RN"
C. "Gave digoxin."
D. "Patient received morning meds."
Correct Answer: B
Rationale: Documentation should include the date, time, medication name, dose, route,
patient response, and nurse's signature .
SECTION 2: PHARMACOLOGICAL PRINCIPLES (Questions 9-20)
9. A drug with a narrow therapeutic index requires:
A. No monitoring
B. Frequent serum level monitoring
C. Only symptom monitoring
D. Monitoring of vital signs only
