1
ATI RN PHARMACOLOGY 2026:
100 NGN Practice Questions with
Answers & Rationales
Safety & Administration (Questions 1-10)
1. A nurse is preparing to administer a controlled substance. Which of the following actions is
required by law?
A) Place the unused portion in the sharps container.
B) Have a second nurse witness the wasting of the unused portion.
C) Flush the unused portion down the sink.
D) Return the unused portion to the pharmacy.
Answer: B
Rationale: For controlled substances (Schedule II-V), any unused or wasted portion must be
witnessed and co-signed by a second licensed nurse to ensure accountability and prevent diversion.
2. A client is prescribed IV heparin. The nurse notes the client is bleeding from the IV site. Which
medication should the nurse anticipate administering?
A) Vitamin K
B) Naloxone
C) Protamine sulfate
D) Flumazenil
Answer: C
Rationale: Protamine sulfate is the specific antidote for heparin overdose. Vitamin K is the antidote
for warfarin. Naloxone reverses opioids, and Flumazenil reverses benzodiazepines.
3. A nurse is performing a medication reconciliation. Which of the following is the priority action?
A) Compare the client's home medications with the prescribed medications.
B) File the medication list in the client's chart.
C) Give the client a list of medications to take home.
D) Ask the pharmacist to verify the list.
Answer: A
Rationale: The priority in medication reconciliation is to compare the medications the client was
taking at home with the newly prescribed medications to identify discrepancies, duplications, or
omissions to prevent adverse drug events.
4. A nurse is administering a liquid medication to an infant. Which technique is appropriate?
A) Place the medication in a full bottle of formula.
B) Use a medicine dropper to place the medication in the side of the cheek.
C) Administer the medication while the infant is lying flat on their back.
D) Mix the medication with a large amount of applesauce.
Answer: B
Rationale: To prevent aspiration, place liquid medication in the side of the cheek (buccal area) using
, 2
a dropper or syringe. Do not mix in a full bottle as the infant may not finish it, and do not lay the
infant flat.
5. A client refuses to take their prescribed oral medication. What is the nurse's best initial action?
A) Crush the medication and hide it in pudding.
B) Withhold the medication and document the refusal.
C) Tell the client they will be discharged if they don't comply.
D) Inject the medication intramuscularly instead.
Answer: B
Rationale: The client has the right to refuse medication. The nurse must withhold the dose, explore
the reason for refusal (e.g., side effects, swallowing difficulty), educate the client, and document the
refusal and actions taken. Coercion or hiding medication is unethical.
6. A nurse is calculating a dose for a pediatric client using weight-based dosing. The order is 15
mg/kg/day. The child weighs 44 lbs. What is the daily dose in mg?
A) 300 mg
B) 400 mg
C) 660 mg
D) 3000 mg
Answer: A
Rationale: Convert lbs to kg: 44 lbs / 2.2 = 20 kg. Multiply 20 kg x 15 mg/kg = 300 mg/day.
7. A nurse is preparing an IV infusion of potassium chloride. Which action is essential for safety?
A) Administer via IV push for rapid effect.
B) Ensure the IV pump is programmed to infuse no faster than 10 mEq/hr.
C) Mix the potassium chloride in a 50 mL mini-bag.
D) Assess the IV site for a hematoma before starting.
Answer: B
Rationale: IV potassium chloride must never be given as a bolus or push; it causes fatal cardiac
arrhythmias. It must be diluted and infused via an IV pump at a rate generally not exceeding 10
mEq/hr. A peripheral site must be patent to prevent tissue necrosis.
8. The nurse is administering a new medication. The client asks, "What is this pill for?" What is the
nurse's best response?
A) "It's the one the doctor ordered for your blood pressure."
B) "I will check your chart and let you know."
C) "This is Lisinopril, which helps relax your blood vessels to lower your blood pressure."
D) "Don't worry, it's safe."
Answer: C
Rationale: The nurse is legally and ethically responsible for educating the client. The response must
include the medication name, action, and purpose in understandable terms.
9. A nurse notes that a medication administration record (MAR) has an illegible signature for a prn
medication. What should the nurse do?
A) Assume it was the previous shift nurse and administer it.
B) Do not administer the medication until the order is clarified.
C) Circle the signature and initial it.
D) Ask the unit clerk to identify the signature.
Answer: B
, 3
Rationale: To prevent medication errors, the nurse must have a clear, unambiguous order. If the
signature is illegible, the nurse must contact the provider to verify the order before administration.
10. A client is prescribed an enteric-coated tablet. The client has difficulty swallowing and asks to
crush it. What should the nurse do?
A) Crush the tablet and mix it with applesauce.
B) Explain that crushing it will destroy the enteric coating, which prevents stomach irritation and
allows intestinal absorption.
C) Cut the tablet in half to make it smaller.
D) Place the tablet in a spoonful of jelly to help it slide down.
Answer: B
Rationale: Enteric-coated tablets must not be crushed or chewed. The coating protects the stomach
from irritation and protects the drug from gastric acid. Crushing leads to premature breakdown and
possible gastric upset or inactivation.
Antidotes & Emergency Medications (11-15)
11. A client on warfarin has an INR of 6.5. The client is not actively bleeding. Which medication
does the nurse anticipate administering?
A) Protamine sulfate
B) Vitamin K (Phytonadione)
C) Desmopressin
D) Aminocaproic acid
Answer: B
Rationale: For elevated INR (>5.0) without bleeding, Vitamin K is administered to reverse the
anticoagulant effects of warfarin. Protamine sulfate is for heparin.
12. A client accidentally receives a double dose of morphine and has a respiratory rate of 6
breaths/min. Which medication should the nurse prepare to administer?
A) Atropine
B) Naloxone
C) Flumazenil
D) Epinephrine
Answer: B
Rationale: Naloxone (Narcan) is a pure opioid antagonist that rapidly reverses respiratory depression
and sedation caused by opioid overdose.
13. A client receiving IV benzodiazepines for status epilepticus develops respiratory depression.
Which antidote is required?
A) Neostigmine
B) Atropine
C) Flumazenil
D) Activated charcoal
Answer: C
Rationale: Flumazenil is the specific competitive antagonist for benzodiazepines (e.g., diazepam,
lorazepam). It reverses CNS depression and respiratory depression.
14. A client is receiving an IV infusion of magnesium sulfate for preeclampsia. Which medication
should be available at the bedside as an antidote?
ATI RN PHARMACOLOGY 2026:
100 NGN Practice Questions with
Answers & Rationales
Safety & Administration (Questions 1-10)
1. A nurse is preparing to administer a controlled substance. Which of the following actions is
required by law?
A) Place the unused portion in the sharps container.
B) Have a second nurse witness the wasting of the unused portion.
C) Flush the unused portion down the sink.
D) Return the unused portion to the pharmacy.
Answer: B
Rationale: For controlled substances (Schedule II-V), any unused or wasted portion must be
witnessed and co-signed by a second licensed nurse to ensure accountability and prevent diversion.
2. A client is prescribed IV heparin. The nurse notes the client is bleeding from the IV site. Which
medication should the nurse anticipate administering?
A) Vitamin K
B) Naloxone
C) Protamine sulfate
D) Flumazenil
Answer: C
Rationale: Protamine sulfate is the specific antidote for heparin overdose. Vitamin K is the antidote
for warfarin. Naloxone reverses opioids, and Flumazenil reverses benzodiazepines.
3. A nurse is performing a medication reconciliation. Which of the following is the priority action?
A) Compare the client's home medications with the prescribed medications.
B) File the medication list in the client's chart.
C) Give the client a list of medications to take home.
D) Ask the pharmacist to verify the list.
Answer: A
Rationale: The priority in medication reconciliation is to compare the medications the client was
taking at home with the newly prescribed medications to identify discrepancies, duplications, or
omissions to prevent adverse drug events.
4. A nurse is administering a liquid medication to an infant. Which technique is appropriate?
A) Place the medication in a full bottle of formula.
B) Use a medicine dropper to place the medication in the side of the cheek.
C) Administer the medication while the infant is lying flat on their back.
D) Mix the medication with a large amount of applesauce.
Answer: B
Rationale: To prevent aspiration, place liquid medication in the side of the cheek (buccal area) using
, 2
a dropper or syringe. Do not mix in a full bottle as the infant may not finish it, and do not lay the
infant flat.
5. A client refuses to take their prescribed oral medication. What is the nurse's best initial action?
A) Crush the medication and hide it in pudding.
B) Withhold the medication and document the refusal.
C) Tell the client they will be discharged if they don't comply.
D) Inject the medication intramuscularly instead.
Answer: B
Rationale: The client has the right to refuse medication. The nurse must withhold the dose, explore
the reason for refusal (e.g., side effects, swallowing difficulty), educate the client, and document the
refusal and actions taken. Coercion or hiding medication is unethical.
6. A nurse is calculating a dose for a pediatric client using weight-based dosing. The order is 15
mg/kg/day. The child weighs 44 lbs. What is the daily dose in mg?
A) 300 mg
B) 400 mg
C) 660 mg
D) 3000 mg
Answer: A
Rationale: Convert lbs to kg: 44 lbs / 2.2 = 20 kg. Multiply 20 kg x 15 mg/kg = 300 mg/day.
7. A nurse is preparing an IV infusion of potassium chloride. Which action is essential for safety?
A) Administer via IV push for rapid effect.
B) Ensure the IV pump is programmed to infuse no faster than 10 mEq/hr.
C) Mix the potassium chloride in a 50 mL mini-bag.
D) Assess the IV site for a hematoma before starting.
Answer: B
Rationale: IV potassium chloride must never be given as a bolus or push; it causes fatal cardiac
arrhythmias. It must be diluted and infused via an IV pump at a rate generally not exceeding 10
mEq/hr. A peripheral site must be patent to prevent tissue necrosis.
8. The nurse is administering a new medication. The client asks, "What is this pill for?" What is the
nurse's best response?
A) "It's the one the doctor ordered for your blood pressure."
B) "I will check your chart and let you know."
C) "This is Lisinopril, which helps relax your blood vessels to lower your blood pressure."
D) "Don't worry, it's safe."
Answer: C
Rationale: The nurse is legally and ethically responsible for educating the client. The response must
include the medication name, action, and purpose in understandable terms.
9. A nurse notes that a medication administration record (MAR) has an illegible signature for a prn
medication. What should the nurse do?
A) Assume it was the previous shift nurse and administer it.
B) Do not administer the medication until the order is clarified.
C) Circle the signature and initial it.
D) Ask the unit clerk to identify the signature.
Answer: B
, 3
Rationale: To prevent medication errors, the nurse must have a clear, unambiguous order. If the
signature is illegible, the nurse must contact the provider to verify the order before administration.
10. A client is prescribed an enteric-coated tablet. The client has difficulty swallowing and asks to
crush it. What should the nurse do?
A) Crush the tablet and mix it with applesauce.
B) Explain that crushing it will destroy the enteric coating, which prevents stomach irritation and
allows intestinal absorption.
C) Cut the tablet in half to make it smaller.
D) Place the tablet in a spoonful of jelly to help it slide down.
Answer: B
Rationale: Enteric-coated tablets must not be crushed or chewed. The coating protects the stomach
from irritation and protects the drug from gastric acid. Crushing leads to premature breakdown and
possible gastric upset or inactivation.
Antidotes & Emergency Medications (11-15)
11. A client on warfarin has an INR of 6.5. The client is not actively bleeding. Which medication
does the nurse anticipate administering?
A) Protamine sulfate
B) Vitamin K (Phytonadione)
C) Desmopressin
D) Aminocaproic acid
Answer: B
Rationale: For elevated INR (>5.0) without bleeding, Vitamin K is administered to reverse the
anticoagulant effects of warfarin. Protamine sulfate is for heparin.
12. A client accidentally receives a double dose of morphine and has a respiratory rate of 6
breaths/min. Which medication should the nurse prepare to administer?
A) Atropine
B) Naloxone
C) Flumazenil
D) Epinephrine
Answer: B
Rationale: Naloxone (Narcan) is a pure opioid antagonist that rapidly reverses respiratory depression
and sedation caused by opioid overdose.
13. A client receiving IV benzodiazepines for status epilepticus develops respiratory depression.
Which antidote is required?
A) Neostigmine
B) Atropine
C) Flumazenil
D) Activated charcoal
Answer: C
Rationale: Flumazenil is the specific competitive antagonist for benzodiazepines (e.g., diazepam,
lorazepam). It reverses CNS depression and respiratory depression.
14. A client is receiving an IV infusion of magnesium sulfate for preeclampsia. Which medication
should be available at the bedside as an antidote?
