ATI Capstone Pharmacology 1 & 2 EXAM LATEST VERSION
2026-2027 EXAM WITH ACTUAL 110+ QUESTION AND
CORRECT DETAILED ANSWERS WITH RATIONALES.
A nurse is providing discharge teaching to a client who has a new
prescription for oxybutynin. Which of the following statements by the client
indicates a correct understanding of the medication's potential adverse
effects and necessary precautions?
A) "I should increase my intake of fluids to prevent dehydration."
B) "I need to avoid jogging on warm days."
C) "I can take this medication with my morning coffee."
D) "I should expect to have increased sweating while on this medication."
Correct Answer: B) "I need to avoid jogging on warm days."
Rationale
Oxybutynin is an anticholinergic medication used to treat overactive bladder
by relaxing the detrusor muscle. A significant adverse effect of
anticholinergic agents is the suppression of sweating, which impairs the
body's ability to dissipate heat through evaporation. This places the client at
increased risk for hyperthermia, particularly during physical exertion in warm
environments. Therefore, advising the client to avoid activities such as
jogging on warm days is a critical safety precaution. The other options are
incorrect: increasing fluids does not mitigate the risk of heat-related illness
from suppressed sweating; caffeine can exacerbate anticholinergic effects
such as dry mouth and tachycardia; and increased sweating is not an
expected effect of this medication.
DIF: Cognitive Level: Apply (Application)
TOP: Pharmacology
MSC: NCLEX: Physiological Integrity
,A nurse is reviewing laboratory findings for a client who is taking zidovudine
as part of a treatment regimen for HIV. Which of the following laboratory
values should the nurse identify as a priority to report to the provider?
A) Hemoglobin 12.5 g/dL
B) Platelet count 180,000/mm³
C) Neutrophil count 650/mm³
D) Serum creatinine 0.9 mg/dL
Correct Answer: C) Neutrophil count 650/mm³
Rationale
Zidovudine is a nucleoside reverse transcriptase inhibitor (NRTI) used in the
management of HIV infection. A significant and potentially life-threatening
adverse effect of zidovudine therapy is bone marrow suppression, which can
manifest as neutropenia, anemia, or thrombocytopenia. The normal
reference range for neutrophils is 1,500 to 8,000/mm³. A neutrophil count of
650/mm³ represents severe neutropenia and places the client at a
substantially increased risk for opportunistic infections, necessitating
immediate reporting to the provider. The hemoglobin level of 12.5 g/dL is
within normal limits for an adult female, the platelet count of 180,000/mm³
is within the normal range (150,000-400,000), and the serum creatinine of
0.9 mg/dL is also within normal limits (0.6-1.2 mg/dL). These values do not
represent the same level of clinical urgency.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Pharmacology
MSC: NCLEX: Physiological Integrity
A nurse is assessing a client who is receiving gemfibrozil therapy for the
management of hyperlipidemia. Which of the following findings should the
nurse identify as a potential adverse effect of this medication that warrants
further evaluation?
,A) Constipation
B) Muscle tenderness
C) Increased appetite
D) Headache
Correct Answer: B) Muscle tenderness
Rationale
Gemfibrozil is a fibric acid derivative (fibrate) used to lower triglyceride
levels and increase high-density lipoprotein (HDL) cholesterol. A significant
and potentially serious adverse effect associated with fibrate therapy is
myopathy, which can manifest as muscle tenderness, weakness, or pain. This
myopathy can progress to rhabdomyolysis, a life-threatening condition
characterized by muscle breakdown and acute kidney injury. The risk of
myopathy is increased when gemfibrozil is used concomitantly with statins.
The nurse should assess the client for muscle-related symptoms and report
them promptly. Constipation, increased appetite, and headache are not the
most significant or characteristic adverse effects associated with gemfibrozil.
DIF: Cognitive Level: Apply (Application)
TOP: Pharmacology
MSC: NCLEX: Physiological Integrity
A nurse is caring for a client with type 2 diabetes mellitus who began therapy
with metformin two days ago. The client reports experiencing nausea and
diarrhea. Which of the following responses by the nurse is most
appropriate?
A) "You should stop taking the medication and notify your provider
immediately."
B) "Your symptoms are common adverse effects of metformin and should
decrease with time."
C) "This indicates that you may be developing lactic acidosis, and you need
to go to the emergency room."
, D) "You should take this medication with a high-fat meal to reduce these
symptoms."
Correct Answer: B) "Your symptoms are common adverse effects of
metformin and should decrease with time."
Rationale
Metformin is a biguanide oral antidiabetic agent that works primarily by
decreasing hepatic glucose production and improving insulin sensitivity.
Gastrointestinal (GI) manifestations, including nausea, diarrhea, abdominal
cramping, and a metallic taste, are common and expected adverse effects
that occur in up to 30% of clients at the initiation of therapy. These
symptoms are typically self-limiting and often subside within a few days to
weeks as the body adjusts to the medication. The client should be reassured
and encouraged to continue the medication. It is not necessary to
discontinue the medication for these mild symptoms. Lactic acidosis is a rare
but serious adverse effect of metformin, characterized by symptoms such as
profound weakness, myalgia, and hyperventilation, and it is not typically
associated with the initial GI complaints. Taking metformin with meals,
rather than a high-fat meal, can help minimize GI distress.
DIF: Cognitive Level: Apply (Application)
TOP: Pharmacology
MSC: NCLEX: Physiological Integrity
A nurse is caring for four clients who have peptic ulcer disease. The nurse
should recognize that misoprostol is contraindicated for which of the
following clients?
A) A client who has a history of hypertension
B) A client who has a history of asthma
C) A client who might be pregnant
D) A client who has a history of diabetes mellitus
2026-2027 EXAM WITH ACTUAL 110+ QUESTION AND
CORRECT DETAILED ANSWERS WITH RATIONALES.
A nurse is providing discharge teaching to a client who has a new
prescription for oxybutynin. Which of the following statements by the client
indicates a correct understanding of the medication's potential adverse
effects and necessary precautions?
A) "I should increase my intake of fluids to prevent dehydration."
B) "I need to avoid jogging on warm days."
C) "I can take this medication with my morning coffee."
D) "I should expect to have increased sweating while on this medication."
Correct Answer: B) "I need to avoid jogging on warm days."
Rationale
Oxybutynin is an anticholinergic medication used to treat overactive bladder
by relaxing the detrusor muscle. A significant adverse effect of
anticholinergic agents is the suppression of sweating, which impairs the
body's ability to dissipate heat through evaporation. This places the client at
increased risk for hyperthermia, particularly during physical exertion in warm
environments. Therefore, advising the client to avoid activities such as
jogging on warm days is a critical safety precaution. The other options are
incorrect: increasing fluids does not mitigate the risk of heat-related illness
from suppressed sweating; caffeine can exacerbate anticholinergic effects
such as dry mouth and tachycardia; and increased sweating is not an
expected effect of this medication.
DIF: Cognitive Level: Apply (Application)
TOP: Pharmacology
MSC: NCLEX: Physiological Integrity
,A nurse is reviewing laboratory findings for a client who is taking zidovudine
as part of a treatment regimen for HIV. Which of the following laboratory
values should the nurse identify as a priority to report to the provider?
A) Hemoglobin 12.5 g/dL
B) Platelet count 180,000/mm³
C) Neutrophil count 650/mm³
D) Serum creatinine 0.9 mg/dL
Correct Answer: C) Neutrophil count 650/mm³
Rationale
Zidovudine is a nucleoside reverse transcriptase inhibitor (NRTI) used in the
management of HIV infection. A significant and potentially life-threatening
adverse effect of zidovudine therapy is bone marrow suppression, which can
manifest as neutropenia, anemia, or thrombocytopenia. The normal
reference range for neutrophils is 1,500 to 8,000/mm³. A neutrophil count of
650/mm³ represents severe neutropenia and places the client at a
substantially increased risk for opportunistic infections, necessitating
immediate reporting to the provider. The hemoglobin level of 12.5 g/dL is
within normal limits for an adult female, the platelet count of 180,000/mm³
is within the normal range (150,000-400,000), and the serum creatinine of
0.9 mg/dL is also within normal limits (0.6-1.2 mg/dL). These values do not
represent the same level of clinical urgency.
DIF: Cognitive Level: Analyze (Analysis)
TOP: Pharmacology
MSC: NCLEX: Physiological Integrity
A nurse is assessing a client who is receiving gemfibrozil therapy for the
management of hyperlipidemia. Which of the following findings should the
nurse identify as a potential adverse effect of this medication that warrants
further evaluation?
,A) Constipation
B) Muscle tenderness
C) Increased appetite
D) Headache
Correct Answer: B) Muscle tenderness
Rationale
Gemfibrozil is a fibric acid derivative (fibrate) used to lower triglyceride
levels and increase high-density lipoprotein (HDL) cholesterol. A significant
and potentially serious adverse effect associated with fibrate therapy is
myopathy, which can manifest as muscle tenderness, weakness, or pain. This
myopathy can progress to rhabdomyolysis, a life-threatening condition
characterized by muscle breakdown and acute kidney injury. The risk of
myopathy is increased when gemfibrozil is used concomitantly with statins.
The nurse should assess the client for muscle-related symptoms and report
them promptly. Constipation, increased appetite, and headache are not the
most significant or characteristic adverse effects associated with gemfibrozil.
DIF: Cognitive Level: Apply (Application)
TOP: Pharmacology
MSC: NCLEX: Physiological Integrity
A nurse is caring for a client with type 2 diabetes mellitus who began therapy
with metformin two days ago. The client reports experiencing nausea and
diarrhea. Which of the following responses by the nurse is most
appropriate?
A) "You should stop taking the medication and notify your provider
immediately."
B) "Your symptoms are common adverse effects of metformin and should
decrease with time."
C) "This indicates that you may be developing lactic acidosis, and you need
to go to the emergency room."
, D) "You should take this medication with a high-fat meal to reduce these
symptoms."
Correct Answer: B) "Your symptoms are common adverse effects of
metformin and should decrease with time."
Rationale
Metformin is a biguanide oral antidiabetic agent that works primarily by
decreasing hepatic glucose production and improving insulin sensitivity.
Gastrointestinal (GI) manifestations, including nausea, diarrhea, abdominal
cramping, and a metallic taste, are common and expected adverse effects
that occur in up to 30% of clients at the initiation of therapy. These
symptoms are typically self-limiting and often subside within a few days to
weeks as the body adjusts to the medication. The client should be reassured
and encouraged to continue the medication. It is not necessary to
discontinue the medication for these mild symptoms. Lactic acidosis is a rare
but serious adverse effect of metformin, characterized by symptoms such as
profound weakness, myalgia, and hyperventilation, and it is not typically
associated with the initial GI complaints. Taking metformin with meals,
rather than a high-fat meal, can help minimize GI distress.
DIF: Cognitive Level: Apply (Application)
TOP: Pharmacology
MSC: NCLEX: Physiological Integrity
A nurse is caring for four clients who have peptic ulcer disease. The nurse
should recognize that misoprostol is contraindicated for which of the
following clients?
A) A client who has a history of hypertension
B) A client who has a history of asthma
C) A client who might be pregnant
D) A client who has a history of diabetes mellitus
