ATI RN Pharmacology Proctored Exam Retake 2023/2026 with NGN: 200
Practice Questions with Answers and Rationales
SECTION 1: CARDIOVASCULAR MEDICATIONS
Question 1
A nurse is preparing to administer a scheduled dose of warfarin to a client. Which of the following laboratory tests should the nurse
review prior to administration?
A. PT/INR
B. Total iron-binding capacity
C. WBC count
D. PTT
Correct Answer: A. PT/INR
Rationale: Warfarin is an anticoagulant that inhibits vitamin K-dependent clotting factors. The therapeutic effect is monitored using
the International Normalized Ratio (INR) and Prothrombin Time (PT). The target INR for most indications is 2.0-3.0. PTT is used to
monitor heparin therapy.
Question 2
A client is prescribed digoxin and furosemide. Which finding requires immediate intervention?
A. Urinary output of 200 mL in 2 hours
B. Serum potassium 3.2 mEq/L
C. Blood pressure 135/85 mm Hg
D. Bilateral +1 pedal edema
Correct Answer: B. Serum potassium 3.2 mEq/L
,Rationale: A serum potassium of 3.2 mEq/L indicates hypokalemia, which increases the risk of digoxin toxicity and cardiac
arrhythmias. Furosemide is a loop diuretic that causes potassium loss. The nurse should notify the provider immediately.
Question 3
A client is prescribed digoxin. Which finding suggests digoxin toxicity?
A. Bradycardia and nausea
B. Hypertension and polyuria
C. Hyperkalemia and muscle cramps
D. Tachycardia and dry mouth
Correct Answer: A. Bradycardia and nausea
Rationale: Digoxin toxicity presents with bradycardia, nausea, vomiting, visual disturbances (yellow-green halos), and cardiac
arrhythmias. Early signs include gastrointestinal symptoms and visual changes.
Question 4
A nurse is teaching a client about warfarin. Which statement indicates understanding?
A. "I will eat more green leafy vegetables."
B. "I will take ibuprofen for headaches."
C. "I will use an electric razor for shaving."
D. "I will check my blood glucose daily."
Correct Answer: C. "I will use an electric razor for shaving."
Rationale: Warfarin increases bleeding risk. An electric razor prevents cuts from shaving. Green leafy vegetables contain vitamin K,
which reduces warfarin efficacy. Ibuprofen increases GI bleeding risk.
Question 5
A client receives enoxaparin subcutaneously. Which action is correct?
A. Expel air bubble before injection
B. Massage site after injection
C. Inject into abdominal tissue with needle at 90-degree angle
D. Aspirate before injecting
,Correct Answer: C. Inject into abdominal tissue with needle at 90-degree angle
Rationale: Enoxaparin is given deep subcutaneously in the abdomen at a 90-degree angle. The air bubble should be left in the
syringe to prevent medication loss. Do not massage or aspirate.
Question 6
A client is prescribed lisinopril. Which statement indicates understanding?
A. "I will change positions slowly to prevent dizziness."
B. "I will take potassium supplements to prevent muscle cramps."
C. "I will report a dry cough to my provider."
D. "I will avoid salt substitutes."
Correct Answer: A. "I will change positions slowly to prevent dizziness."
Rationale: Lisinopril is an ACE inhibitor that can cause orthostatic hypotension. Clients should change positions slowly. ACE inhibitors
can cause hyperkalemia, so potassium supplements and salt substitutes should be avoided. A dry cough is a common side effect that
should be reported.
Question 7
A nurse is caring for a client who has a new prescription for clopidogrel. The nurse should monitor the client for which adverse
effect?
A. Insomnia
B. Tachycardia
C. Bleeding
D. Constipation
Correct Answer: C. Bleeding
Rationale: Clopidogrel is an antiplatelet medication that inhibits platelet aggregation, increasing the risk of bleeding. The nurse
should monitor for signs of bleeding such as bruising, petechiae, and gastrointestinal bleeding.
Question 8
A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which finding should the nurse identify as an
adverse effect?
, A. Bradycardia
B. Red man syndrome
C. Hypoglycemia
D. Hypotension
Correct Answer: D. Hypotension
Rationale: Rapid IV administration of phenytoin can cause hypotension and cardiac dysrhythmias. The medication should be
administered no faster than 50 mg/min. Red man syndrome is associated with vancomycin.
Question 9
A client is prescribed metoprolol for hypertension. The nurse should assess which of the following before administering the
medication?
A. Blood pressure and apical pulse
B. Respiratory rate
C. Blood glucose
D. Temperature
Correct Answer: A. Blood pressure and apical pulse
Rationale: Metoprolol is a beta-blocker that reduces heart rate and blood pressure. The nurse should assess both before
administration. If the apical pulse is below 60 bpm, the medication should be held and the provider notified.
Question 10
A client is prescribed amiodarone. Which adverse effect should the nurse monitor for?
A. Pulmonary toxicity
B. Hepatotoxicity
C. Nephrotoxicity
D. Cardiotoxicity
Correct Answer: A. Pulmonary toxicity
Rationale: Amiodarone can cause pulmonary toxicity, including pulmonary fibrosis. Clients should be monitored for dyspnea, cough,
and chest pain. Baseline and periodic pulmonary function tests may be ordered.
Practice Questions with Answers and Rationales
SECTION 1: CARDIOVASCULAR MEDICATIONS
Question 1
A nurse is preparing to administer a scheduled dose of warfarin to a client. Which of the following laboratory tests should the nurse
review prior to administration?
A. PT/INR
B. Total iron-binding capacity
C. WBC count
D. PTT
Correct Answer: A. PT/INR
Rationale: Warfarin is an anticoagulant that inhibits vitamin K-dependent clotting factors. The therapeutic effect is monitored using
the International Normalized Ratio (INR) and Prothrombin Time (PT). The target INR for most indications is 2.0-3.0. PTT is used to
monitor heparin therapy.
Question 2
A client is prescribed digoxin and furosemide. Which finding requires immediate intervention?
A. Urinary output of 200 mL in 2 hours
B. Serum potassium 3.2 mEq/L
C. Blood pressure 135/85 mm Hg
D. Bilateral +1 pedal edema
Correct Answer: B. Serum potassium 3.2 mEq/L
,Rationale: A serum potassium of 3.2 mEq/L indicates hypokalemia, which increases the risk of digoxin toxicity and cardiac
arrhythmias. Furosemide is a loop diuretic that causes potassium loss. The nurse should notify the provider immediately.
Question 3
A client is prescribed digoxin. Which finding suggests digoxin toxicity?
A. Bradycardia and nausea
B. Hypertension and polyuria
C. Hyperkalemia and muscle cramps
D. Tachycardia and dry mouth
Correct Answer: A. Bradycardia and nausea
Rationale: Digoxin toxicity presents with bradycardia, nausea, vomiting, visual disturbances (yellow-green halos), and cardiac
arrhythmias. Early signs include gastrointestinal symptoms and visual changes.
Question 4
A nurse is teaching a client about warfarin. Which statement indicates understanding?
A. "I will eat more green leafy vegetables."
B. "I will take ibuprofen for headaches."
C. "I will use an electric razor for shaving."
D. "I will check my blood glucose daily."
Correct Answer: C. "I will use an electric razor for shaving."
Rationale: Warfarin increases bleeding risk. An electric razor prevents cuts from shaving. Green leafy vegetables contain vitamin K,
which reduces warfarin efficacy. Ibuprofen increases GI bleeding risk.
Question 5
A client receives enoxaparin subcutaneously. Which action is correct?
A. Expel air bubble before injection
B. Massage site after injection
C. Inject into abdominal tissue with needle at 90-degree angle
D. Aspirate before injecting
,Correct Answer: C. Inject into abdominal tissue with needle at 90-degree angle
Rationale: Enoxaparin is given deep subcutaneously in the abdomen at a 90-degree angle. The air bubble should be left in the
syringe to prevent medication loss. Do not massage or aspirate.
Question 6
A client is prescribed lisinopril. Which statement indicates understanding?
A. "I will change positions slowly to prevent dizziness."
B. "I will take potassium supplements to prevent muscle cramps."
C. "I will report a dry cough to my provider."
D. "I will avoid salt substitutes."
Correct Answer: A. "I will change positions slowly to prevent dizziness."
Rationale: Lisinopril is an ACE inhibitor that can cause orthostatic hypotension. Clients should change positions slowly. ACE inhibitors
can cause hyperkalemia, so potassium supplements and salt substitutes should be avoided. A dry cough is a common side effect that
should be reported.
Question 7
A nurse is caring for a client who has a new prescription for clopidogrel. The nurse should monitor the client for which adverse
effect?
A. Insomnia
B. Tachycardia
C. Bleeding
D. Constipation
Correct Answer: C. Bleeding
Rationale: Clopidogrel is an antiplatelet medication that inhibits platelet aggregation, increasing the risk of bleeding. The nurse
should monitor for signs of bleeding such as bruising, petechiae, and gastrointestinal bleeding.
Question 8
A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which finding should the nurse identify as an
adverse effect?
, A. Bradycardia
B. Red man syndrome
C. Hypoglycemia
D. Hypotension
Correct Answer: D. Hypotension
Rationale: Rapid IV administration of phenytoin can cause hypotension and cardiac dysrhythmias. The medication should be
administered no faster than 50 mg/min. Red man syndrome is associated with vancomycin.
Question 9
A client is prescribed metoprolol for hypertension. The nurse should assess which of the following before administering the
medication?
A. Blood pressure and apical pulse
B. Respiratory rate
C. Blood glucose
D. Temperature
Correct Answer: A. Blood pressure and apical pulse
Rationale: Metoprolol is a beta-blocker that reduces heart rate and blood pressure. The nurse should assess both before
administration. If the apical pulse is below 60 bpm, the medication should be held and the provider notified.
Question 10
A client is prescribed amiodarone. Which adverse effect should the nurse monitor for?
A. Pulmonary toxicity
B. Hepatotoxicity
C. Nephrotoxicity
D. Cardiotoxicity
Correct Answer: A. Pulmonary toxicity
Rationale: Amiodarone can cause pulmonary toxicity, including pulmonary fibrosis. Clients should be monitored for dyspnea, cough,
and chest pain. Baseline and periodic pulmonary function tests may be ordered.
