ATI RN Pharmacology Proctored Exam | Complete Questions
with Verified Correct Answers & Detailed Explanations –
2026/2027 update | Graded A+
Question 1
A nurse is preparing to administer digoxin to a client with heart failure. The
client's apical pulse is 54/min. Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Administer the medication with an antacid
D. Recheck the pulse after the medication is administered
Correct Answer: B. Hold the medication and notify the provider
Explanation:
Digoxin can decrease the heart rate. An adult apical pulse below the
prescribed parameter, commonly less than 60/min, is generally a reason to
hold digoxin and notify the provider. The nurse should also assess for
manifestations of digoxin toxicity, such as nausea, vomiting, anorexia, visual
disturbances, and dysrhythmias.
Question 2
A client taking digoxin reports seeing yellow-green halos around lights and
experiencing nausea and loss of appetite. Which action should the nurse take?
A. Administer the next dose with food
B. Hold digoxin and notify the provider
C. Encourage increased potassium restriction
D. Administer an additional dose
Correct Answer: B. Hold digoxin and notify the provider
Explanation:
Yellow-green visual disturbances, nausea, anorexia, and bradycardia are
classic manifestations of digoxin toxicity. The nurse should withhold the
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,medication and notify the provider. Serum digoxin and electrolyte levels may
be evaluated.
Question 3
A client taking furosemide reports muscle weakness and palpitations. Which
laboratory value should concern the nurse most?
A. Potassium 2.7 mEq/L
B. Sodium 139 mEq/L
C. Calcium 9.4 mg/dL
D. Magnesium 2.0 mg/dL
Correct Answer: A. Potassium 2.7 mEq/L
Explanation:
Furosemide is a loop diuretic that can cause significant potassium loss.
Severe hypokalemia can cause muscle weakness and potentially fatal cardiac
dysrhythmias. The nurse should report the finding and anticipate potassium
replacement as prescribed.
Question 4
A nurse is teaching a client who has a new prescription for spironolactone.
Which statement indicates correct understanding?
A. "I will use salt substitutes freely."
B. "I should increase my intake of potassium-rich foods."
C. "I will avoid excessive potassium intake."
D. "I should take potassium supplements every day."
Correct Answer: C. "I will avoid excessive potassium intake."
Explanation:
Spironolactone is a potassium-sparing diuretic. It can cause hyperkalemia,
particularly in clients with renal impairment. Clients should avoid
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,unnecessary potassium supplements and potassium-containing salt
substitutes unless specifically prescribed.
Question 5
A client prescribed lisinopril reports swelling of the lips and tongue. Which
action should the nurse take first?
A. Administer the next dose
B. Assess the client's airway immediately
C. Encourage oral fluids
D. Place the client in a supine position
Correct Answer: B. Assess the client's airway immediately
Explanation:
Swelling of the lips and tongue suggests angioedema, a potentially life-
threatening adverse effect of ACE inhibitors. Airway obstruction can develop
rapidly. The medication should not be administered again, and emergency
evaluation is required.
Question 6
A client taking an ACE inhibitor develops a persistent dry cough. Which
medication might the provider prescribe instead?
A. An ARB
B. A loop diuretic only
C. A calcium supplement
D. An opioid
Correct Answer: A. An ARB
Explanation:
A persistent dry cough is a common adverse effect of ACE inhibitors due
partly to increased bradykinin. An angiotensin II receptor blocker (ARB) can
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, provide similar therapeutic benefits with a lower likelihood of causing this
cough.
Question 7
A nurse is administering warfarin to a client. Which laboratory test is most
important to monitor?
A. aPTT
B. INR
C. Troponin
D. Serum amylase
Correct Answer: B. INR
Explanation:
Warfarin therapy is monitored using the INR. The therapeutic target depends
on the indication, but many clients with atrial fibrillation or venous
thromboembolism have a target range of approximately 2.0–3.0. Excessive
anticoagulation increases bleeding risk.
Question 8
A client receiving warfarin has an INR of 6.2 and reports bleeding gums.
Which action should the nurse anticipate?
A. Administer the next warfarin dose
B. Hold warfarin and notify the provider
C. Encourage increased vitamin E intake
D. Administer heparin
Correct Answer: B. Hold warfarin and notify the provider
Explanation:
An INR of 6.2 represents excessive anticoagulation, particularly concerning
when active bleeding is present. Warfarin should be held and the provider
4|Page
with Verified Correct Answers & Detailed Explanations –
2026/2027 update | Graded A+
Question 1
A nurse is preparing to administer digoxin to a client with heart failure. The
client's apical pulse is 54/min. Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Administer the medication with an antacid
D. Recheck the pulse after the medication is administered
Correct Answer: B. Hold the medication and notify the provider
Explanation:
Digoxin can decrease the heart rate. An adult apical pulse below the
prescribed parameter, commonly less than 60/min, is generally a reason to
hold digoxin and notify the provider. The nurse should also assess for
manifestations of digoxin toxicity, such as nausea, vomiting, anorexia, visual
disturbances, and dysrhythmias.
Question 2
A client taking digoxin reports seeing yellow-green halos around lights and
experiencing nausea and loss of appetite. Which action should the nurse take?
A. Administer the next dose with food
B. Hold digoxin and notify the provider
C. Encourage increased potassium restriction
D. Administer an additional dose
Correct Answer: B. Hold digoxin and notify the provider
Explanation:
Yellow-green visual disturbances, nausea, anorexia, and bradycardia are
classic manifestations of digoxin toxicity. The nurse should withhold the
1|Page
,medication and notify the provider. Serum digoxin and electrolyte levels may
be evaluated.
Question 3
A client taking furosemide reports muscle weakness and palpitations. Which
laboratory value should concern the nurse most?
A. Potassium 2.7 mEq/L
B. Sodium 139 mEq/L
C. Calcium 9.4 mg/dL
D. Magnesium 2.0 mg/dL
Correct Answer: A. Potassium 2.7 mEq/L
Explanation:
Furosemide is a loop diuretic that can cause significant potassium loss.
Severe hypokalemia can cause muscle weakness and potentially fatal cardiac
dysrhythmias. The nurse should report the finding and anticipate potassium
replacement as prescribed.
Question 4
A nurse is teaching a client who has a new prescription for spironolactone.
Which statement indicates correct understanding?
A. "I will use salt substitutes freely."
B. "I should increase my intake of potassium-rich foods."
C. "I will avoid excessive potassium intake."
D. "I should take potassium supplements every day."
Correct Answer: C. "I will avoid excessive potassium intake."
Explanation:
Spironolactone is a potassium-sparing diuretic. It can cause hyperkalemia,
particularly in clients with renal impairment. Clients should avoid
2|Page
,unnecessary potassium supplements and potassium-containing salt
substitutes unless specifically prescribed.
Question 5
A client prescribed lisinopril reports swelling of the lips and tongue. Which
action should the nurse take first?
A. Administer the next dose
B. Assess the client's airway immediately
C. Encourage oral fluids
D. Place the client in a supine position
Correct Answer: B. Assess the client's airway immediately
Explanation:
Swelling of the lips and tongue suggests angioedema, a potentially life-
threatening adverse effect of ACE inhibitors. Airway obstruction can develop
rapidly. The medication should not be administered again, and emergency
evaluation is required.
Question 6
A client taking an ACE inhibitor develops a persistent dry cough. Which
medication might the provider prescribe instead?
A. An ARB
B. A loop diuretic only
C. A calcium supplement
D. An opioid
Correct Answer: A. An ARB
Explanation:
A persistent dry cough is a common adverse effect of ACE inhibitors due
partly to increased bradykinin. An angiotensin II receptor blocker (ARB) can
3|Page
, provide similar therapeutic benefits with a lower likelihood of causing this
cough.
Question 7
A nurse is administering warfarin to a client. Which laboratory test is most
important to monitor?
A. aPTT
B. INR
C. Troponin
D. Serum amylase
Correct Answer: B. INR
Explanation:
Warfarin therapy is monitored using the INR. The therapeutic target depends
on the indication, but many clients with atrial fibrillation or venous
thromboembolism have a target range of approximately 2.0–3.0. Excessive
anticoagulation increases bleeding risk.
Question 8
A client receiving warfarin has an INR of 6.2 and reports bleeding gums.
Which action should the nurse anticipate?
A. Administer the next warfarin dose
B. Hold warfarin and notify the provider
C. Encourage increased vitamin E intake
D. Administer heparin
Correct Answer: B. Hold warfarin and notify the provider
Explanation:
An INR of 6.2 represents excessive anticoagulation, particularly concerning
when active bleeding is present. Warfarin should be held and the provider
4|Page
