ATI RN Pharmacology 2026–2027: 300 Practice
Questions with Answers & Rationales
1. A nurse is preparing to administer total parenteral nutrition (TPN) to a client. Which action is appropriate?
A. Warm the solution in a microwave before administration.
B. Remove the solution from refrigeration about 1 hr before use.
C. Add medications to the TPN bag at the bedside.
D. Hang the same bag for 48 hr.
ANSWER: B
Rationale: Allowing refrigerated TPN to reach room temperature before infusion helps reduce discomfort and supports safe
administration. TPN should be handled according to facility policy and pharmacy instructions.
2. A nurse is preparing to administer a medication. Which action best supports the right-client component of
medication administration?
A. Ask the client to state a room number.
B. Use two approved client identifiers before administration.
C. Ask a family member to identify the client.
D. Verify the client's diagnosis only.
ANSWER: B
Rationale: Two approved identifiers, such as name and date of birth, are used to verify the correct client.
3. A nurse is preparing regular insulin and NPH insulin for administration. Which action is correct when mixing
these insulins in one syringe?
A. Draw up NPH before regular insulin.
B. Draw up regular insulin before NPH insulin.
C. Shake both vials vigorously.
D. Mix the insulins and store the syringe for the next day.
ANSWER: B
Rationale: When mixing regular and NPH insulin, draw the clear regular insulin before the cloudy NPH insulin to avoid
contaminating the regular-insulin vial.
4. A client is prescribed sublingual nitroglycerin. Which medication in the client's history should the nurse
identify as a major concern?
A. Sildenafil
B. Omeprazole
C. Acetaminophen
D. Calcium carbonate
ANSWER: A
Rationale: PDE-5 inhibitors such as sildenafil can cause profound hypotension when combined with nitrates.
5. A nurse reviews prescriptions for a client receiving morphine through a patient-controlled analgesia (PCA)
pump. Which prescription should the nurse clarify?
A. A lockout interval is prescribed.
B. The client may press the button when pain occurs.
C. A family member may press the button when the client is sleeping.
D. Respiratory status is monitored regularly.
ANSWER: C
Rationale: Only the client should activate a PCA button because allowing others to do so increases the risk of opioid-induced
respiratory depression.
,6. A client weighs 132 lb. The prescription is chloramphenicol 50 mg/kg/day in 4 divided doses. The available
concentration is 100 mg/mL. How many mL should the nurse administer per dose? Round to the nearest tenth.
A. 1.5 mL
B. 3.8 mL
C. 7.5 mL
D. 15 mL
ANSWER: C
Rationale: 132 lb ÷ 2.2 = 60 kg. Daily dose = 60 × 50 = 3,000 mg. Each of 4 doses = 750 mg. At 100 mg/mL, 750 ÷ 100 = 7.5
mL.
7. A client weighs 198 lb and is prescribed filgrastim 5 mcg/kg subcutaneously daily. The available
concentration is 300 mcg/mL. How many mL should the nurse administer? Round to the nearest tenth.
A. 0.3 mL
B. 1.5 mL
C. 3.3 mL
D. 6.6 mL
ANSWER: B
Rationale: 198 lb ÷ 2.2 = 90 kg. Dose = 90 × 5 = 450 mcg. Volume = 450 ÷ 300 = 1.5 mL.
8. A nurse administers the first dose of penicillin G IM. Which finding should the nurse recognize as a possible
allergic reaction?
A. Urticaria
B. Increased appetite
C. Constipation
D. Mild thirst
ANSWER: A
Rationale: Urticaria (hives) can indicate an allergic reaction and requires prompt assessment, particularly if accompanied by
airway or cardiovascular symptoms.
9. A client taking lithium begins a strenuous exercise program. Which electrolyte imbalance places the client at
increased risk for lithium toxicity?
A. Hypermagnesemia
B. Hypercalcemia
C. Hyponatremia
D. Hyperphosphatemia
ANSWER: C
Rationale: Sodium depletion can increase renal reabsorption of lithium and raise serum lithium concentrations.
10. A nurse is teaching a client receiving IV metronidazole. Which condition is an indication for this medication?
A. Certain anaerobic bacterial infections
B. Hypokalemia
C. Migraine prevention
D. Type 1 diabetes
ANSWER: A
Rationale: Metronidazole is used for several anaerobic bacterial and protozoal infections.
11. A nurse is caring for a client taking warfarin. Which laboratory test is most important for evaluating the
therapeutic effect?
A. INR
B. Serum amylase
C. Troponin
D. Hemoglobin A1c
ANSWER: A
Rationale: The international normalized ratio (INR) is used to monitor warfarin therapy and guide dosing.
,12. A client receiving digoxin has an apical pulse of 52/min. Which action should the nurse take?
A. Administer the medication as prescribed.
B. Hold the dose and notify the provider according to parameters.
C. Give an additional dose.
D. Administer with an antacid.
ANSWER: B
Rationale: Digoxin can slow the heart rate. A significantly low apical pulse is a reason to withhold the medication and follow
prescribed notification parameters.
13. A client taking an ACE inhibitor develops swelling of the lips and tongue. What is the priority action?
A. Give the next scheduled dose.
B. Assess the airway and obtain emergency assistance.
C. Encourage oral fluids.
D. Place the client flat and leave the room.
ANSWER: B
Rationale: Facial or tongue swelling can indicate angioedema, which can rapidly compromise the airway and requires
immediate intervention.
14. A nurse is teaching a client prescribed levothyroxine. Which instruction is appropriate?
A. Take it consistently, preferably in the morning on an empty stomach.
B. Take it only when symptoms occur.
C. Stop it when the heart rate increases slightly.
D. Take it at the same time as an iron supplement.
ANSWER: A
Rationale: Levothyroxine is generally taken consistently on an empty stomach. Iron and calcium can reduce absorption and
should be separated as directed.
15. A client receiving IV vancomycin develops flushing and itching of the face and neck during infusion. Which
action is appropriate?
A. Increase the infusion rate.
B. Stop or slow the infusion and notify the provider per protocol.
C. Give the medication as a rapid IV push.
D. Ignore the finding because it is expected.
ANSWER: B
Rationale: Rapid vancomycin infusion can cause an infusion reaction with flushing and itching. The infusion should be
managed according to protocol and the client assessed.
16. A client taking a beta blocker should be monitored most closely for which finding?
A. Bradycardia
B. Hyperthermia
C. Polyuria
D. Increased appetite
ANSWER: A
Rationale: Beta blockers can decrease heart rate and blood pressure.
17. Which instruction is appropriate for a client taking furosemide?
A. Take it late at night
B. Monitor daily weight and report rapid changes
C. Avoid all potassium-containing foods
D. Double the dose after a missed dose
ANSWER: B
Rationale: Daily weight helps evaluate fluid balance; rapid changes can indicate fluid retention or excessive loss.
18. A client taking spironolactone should avoid excessive intake of which substance?
, A. Potassium
B. Calcium
C. Vitamin C
D. Iron
ANSWER: A
Rationale: Spironolactone is potassium-sparing and can cause hyperkalemia.
19. Which adverse effect should a client taking an ACE inhibitor report immediately?
A. Mild hunger
B. Persistent dry cough only
C. Swelling of the face or tongue
D. Increased urine output
ANSWER: C
Rationale: Facial or tongue swelling may indicate angioedema and airway compromise.
20. A nurse is teaching about transdermal nitroglycerin. Which instruction is appropriate?
A. Apply continuously without a nitrate-free period
B. Follow the prescribed nitrate-free interval
C. Place the patch over broken skin
D. Cut the patch in half routinely
ANSWER: B
Rationale: A nitrate-free interval helps reduce tolerance to therapy.
21. Which finding is most concerning after administration of an antihypertensive?
A. BP 82/48 mm Hg with dizziness
B. BP 128/76 mm Hg
C. Pulse 76/min
D. Warm hands
ANSWER: A
Rationale: Severe hypotension with symptoms requires prompt assessment and intervention.
22. A client taking amiodarone should be monitored for which potentially serious adverse effect?
A. Pulmonary toxicity
B. Increased hair growth
C. Tooth discoloration
D. Hypoglycemia only
ANSWER: A
Rationale: Amiodarone can cause pulmonary, thyroid, hepatic, ocular, and cardiac toxicity.
23. Which medication is commonly used for rapid relief of an acute episode of stable angina?
A. Sublingual nitroglycerin
B. Levothyroxine
C. Warfarin
D. Metformin
ANSWER: A
Rationale: Sublingual nitroglycerin rapidly dilates coronary and systemic vessels and is used for acute angina relief.
24. A client with diabetes is shaky, sweaty, and confused. Which action is the priority if the client is conscious
and can swallow?
A. Give a rapid-acting carbohydrate
B. Give long-acting insulin
C. Restrict fluids
D. Encourage exercise
Questions with Answers & Rationales
1. A nurse is preparing to administer total parenteral nutrition (TPN) to a client. Which action is appropriate?
A. Warm the solution in a microwave before administration.
B. Remove the solution from refrigeration about 1 hr before use.
C. Add medications to the TPN bag at the bedside.
D. Hang the same bag for 48 hr.
ANSWER: B
Rationale: Allowing refrigerated TPN to reach room temperature before infusion helps reduce discomfort and supports safe
administration. TPN should be handled according to facility policy and pharmacy instructions.
2. A nurse is preparing to administer a medication. Which action best supports the right-client component of
medication administration?
A. Ask the client to state a room number.
B. Use two approved client identifiers before administration.
C. Ask a family member to identify the client.
D. Verify the client's diagnosis only.
ANSWER: B
Rationale: Two approved identifiers, such as name and date of birth, are used to verify the correct client.
3. A nurse is preparing regular insulin and NPH insulin for administration. Which action is correct when mixing
these insulins in one syringe?
A. Draw up NPH before regular insulin.
B. Draw up regular insulin before NPH insulin.
C. Shake both vials vigorously.
D. Mix the insulins and store the syringe for the next day.
ANSWER: B
Rationale: When mixing regular and NPH insulin, draw the clear regular insulin before the cloudy NPH insulin to avoid
contaminating the regular-insulin vial.
4. A client is prescribed sublingual nitroglycerin. Which medication in the client's history should the nurse
identify as a major concern?
A. Sildenafil
B. Omeprazole
C. Acetaminophen
D. Calcium carbonate
ANSWER: A
Rationale: PDE-5 inhibitors such as sildenafil can cause profound hypotension when combined with nitrates.
5. A nurse reviews prescriptions for a client receiving morphine through a patient-controlled analgesia (PCA)
pump. Which prescription should the nurse clarify?
A. A lockout interval is prescribed.
B. The client may press the button when pain occurs.
C. A family member may press the button when the client is sleeping.
D. Respiratory status is monitored regularly.
ANSWER: C
Rationale: Only the client should activate a PCA button because allowing others to do so increases the risk of opioid-induced
respiratory depression.
,6. A client weighs 132 lb. The prescription is chloramphenicol 50 mg/kg/day in 4 divided doses. The available
concentration is 100 mg/mL. How many mL should the nurse administer per dose? Round to the nearest tenth.
A. 1.5 mL
B. 3.8 mL
C. 7.5 mL
D. 15 mL
ANSWER: C
Rationale: 132 lb ÷ 2.2 = 60 kg. Daily dose = 60 × 50 = 3,000 mg. Each of 4 doses = 750 mg. At 100 mg/mL, 750 ÷ 100 = 7.5
mL.
7. A client weighs 198 lb and is prescribed filgrastim 5 mcg/kg subcutaneously daily. The available
concentration is 300 mcg/mL. How many mL should the nurse administer? Round to the nearest tenth.
A. 0.3 mL
B. 1.5 mL
C. 3.3 mL
D. 6.6 mL
ANSWER: B
Rationale: 198 lb ÷ 2.2 = 90 kg. Dose = 90 × 5 = 450 mcg. Volume = 450 ÷ 300 = 1.5 mL.
8. A nurse administers the first dose of penicillin G IM. Which finding should the nurse recognize as a possible
allergic reaction?
A. Urticaria
B. Increased appetite
C. Constipation
D. Mild thirst
ANSWER: A
Rationale: Urticaria (hives) can indicate an allergic reaction and requires prompt assessment, particularly if accompanied by
airway or cardiovascular symptoms.
9. A client taking lithium begins a strenuous exercise program. Which electrolyte imbalance places the client at
increased risk for lithium toxicity?
A. Hypermagnesemia
B. Hypercalcemia
C. Hyponatremia
D. Hyperphosphatemia
ANSWER: C
Rationale: Sodium depletion can increase renal reabsorption of lithium and raise serum lithium concentrations.
10. A nurse is teaching a client receiving IV metronidazole. Which condition is an indication for this medication?
A. Certain anaerobic bacterial infections
B. Hypokalemia
C. Migraine prevention
D. Type 1 diabetes
ANSWER: A
Rationale: Metronidazole is used for several anaerobic bacterial and protozoal infections.
11. A nurse is caring for a client taking warfarin. Which laboratory test is most important for evaluating the
therapeutic effect?
A. INR
B. Serum amylase
C. Troponin
D. Hemoglobin A1c
ANSWER: A
Rationale: The international normalized ratio (INR) is used to monitor warfarin therapy and guide dosing.
,12. A client receiving digoxin has an apical pulse of 52/min. Which action should the nurse take?
A. Administer the medication as prescribed.
B. Hold the dose and notify the provider according to parameters.
C. Give an additional dose.
D. Administer with an antacid.
ANSWER: B
Rationale: Digoxin can slow the heart rate. A significantly low apical pulse is a reason to withhold the medication and follow
prescribed notification parameters.
13. A client taking an ACE inhibitor develops swelling of the lips and tongue. What is the priority action?
A. Give the next scheduled dose.
B. Assess the airway and obtain emergency assistance.
C. Encourage oral fluids.
D. Place the client flat and leave the room.
ANSWER: B
Rationale: Facial or tongue swelling can indicate angioedema, which can rapidly compromise the airway and requires
immediate intervention.
14. A nurse is teaching a client prescribed levothyroxine. Which instruction is appropriate?
A. Take it consistently, preferably in the morning on an empty stomach.
B. Take it only when symptoms occur.
C. Stop it when the heart rate increases slightly.
D. Take it at the same time as an iron supplement.
ANSWER: A
Rationale: Levothyroxine is generally taken consistently on an empty stomach. Iron and calcium can reduce absorption and
should be separated as directed.
15. A client receiving IV vancomycin develops flushing and itching of the face and neck during infusion. Which
action is appropriate?
A. Increase the infusion rate.
B. Stop or slow the infusion and notify the provider per protocol.
C. Give the medication as a rapid IV push.
D. Ignore the finding because it is expected.
ANSWER: B
Rationale: Rapid vancomycin infusion can cause an infusion reaction with flushing and itching. The infusion should be
managed according to protocol and the client assessed.
16. A client taking a beta blocker should be monitored most closely for which finding?
A. Bradycardia
B. Hyperthermia
C. Polyuria
D. Increased appetite
ANSWER: A
Rationale: Beta blockers can decrease heart rate and blood pressure.
17. Which instruction is appropriate for a client taking furosemide?
A. Take it late at night
B. Monitor daily weight and report rapid changes
C. Avoid all potassium-containing foods
D. Double the dose after a missed dose
ANSWER: B
Rationale: Daily weight helps evaluate fluid balance; rapid changes can indicate fluid retention or excessive loss.
18. A client taking spironolactone should avoid excessive intake of which substance?
, A. Potassium
B. Calcium
C. Vitamin C
D. Iron
ANSWER: A
Rationale: Spironolactone is potassium-sparing and can cause hyperkalemia.
19. Which adverse effect should a client taking an ACE inhibitor report immediately?
A. Mild hunger
B. Persistent dry cough only
C. Swelling of the face or tongue
D. Increased urine output
ANSWER: C
Rationale: Facial or tongue swelling may indicate angioedema and airway compromise.
20. A nurse is teaching about transdermal nitroglycerin. Which instruction is appropriate?
A. Apply continuously without a nitrate-free period
B. Follow the prescribed nitrate-free interval
C. Place the patch over broken skin
D. Cut the patch in half routinely
ANSWER: B
Rationale: A nitrate-free interval helps reduce tolerance to therapy.
21. Which finding is most concerning after administration of an antihypertensive?
A. BP 82/48 mm Hg with dizziness
B. BP 128/76 mm Hg
C. Pulse 76/min
D. Warm hands
ANSWER: A
Rationale: Severe hypotension with symptoms requires prompt assessment and intervention.
22. A client taking amiodarone should be monitored for which potentially serious adverse effect?
A. Pulmonary toxicity
B. Increased hair growth
C. Tooth discoloration
D. Hypoglycemia only
ANSWER: A
Rationale: Amiodarone can cause pulmonary, thyroid, hepatic, ocular, and cardiac toxicity.
23. Which medication is commonly used for rapid relief of an acute episode of stable angina?
A. Sublingual nitroglycerin
B. Levothyroxine
C. Warfarin
D. Metformin
ANSWER: A
Rationale: Sublingual nitroglycerin rapidly dilates coronary and systemic vessels and is used for acute angina relief.
24. A client with diabetes is shaky, sweaty, and confused. Which action is the priority if the client is conscious
and can swallow?
A. Give a rapid-acting carbohydrate
B. Give long-acting insulin
C. Restrict fluids
D. Encourage exercise
