ATI PN PHARMACOLOGY PROCTORED PRACTICE
EXAMINATION 2026–2027 — NGN | STUDY GUIDE |
LATEST UPDATE 2026/2027 | PRACTICE QUESTIONS
AND ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS | ALREADY
GRADED A+
This original practice examination is designed for practical/vocational
nursing students preparing for the ATI PN Pharmacology proctored
assessment and the NCLEX-PN®. The 100-question test evaluates
mastery of medication safety, drug classifications, therapeutic uses,
adverse effects, drug interactions, dosage calculations, and nursing
responsibilities within the LPN/LVN scope. Questions are written at the
application and analysis level to mirror the cognitive complexity of
proctored pharmacology examinations, including Next Generation
NCLEX clinical judgment scenarios. The 2026–2027 edition incorporates
current evidence-based pharmacology, FDA safety alerts, and national
patient safety standards. Use this comprehensive review to assess
readiness, identify knowledge gaps, and strengthen your understanding
of safe medication administration. This is an independent educational
resource, not affiliated with or endorsed by ATI.
Table of Contents
I. Pharmacokinetics, Drug Interactions, and Medication Safety
II. Autonomic Nervous System and Cardiovascular Medications
III. Anticoagulants, Antiplatelets, and Thrombolytics
IV. Respiratory, Endocrine, and Gastrointestinal Medications
V. Anti-Infectives and Immunologic Agents
VI. Central Nervous System and Psychotropic Medications
,VII. Pain Management and Anesthetic Agents
VIII. Dosage Calculations and Intravenous Therapy
1. A practical nurse is preparing to administer digoxin to a client with
heart failure. The client's serum digoxin level is 2.4 ng/mL
(therapeutic range 0.5–2.0 ng/mL). Which assessment finding is
most consistent with digoxin toxicity?
A) Hypertension and tachycardia
B) Visual disturbances such as yellow halos and anorexia
C) Hyperactive bowel sounds and diarrhea with hyperkalemia
D) Flushing and throbbing headache
Correct Answer: B
Digoxin toxicity commonly presents with gastrointestinal symptoms
(anorexia, nausea), visual changes (yellow or green halos, blurred
vision), and cardiac dysrhythmias. Hypokalemia, not hyperkalemia,
potentiates digoxin toxicity. Hypertension and tachycardia are not
typical. Flushing and headache suggest nitroglycerin or calcium channel
blocker effects.
2. A client is prescribed warfarin for atrial fibrillation. The nurse
should instruct the client to avoid which over-the-counter
medication due to increased bleeding risk?
A) Acetaminophen
B) Ibuprofen
C) Calcium carbonate
D) Diphenhydramine
Correct Answer: B
Ibuprofen is an NSAID that inhibits platelet aggregation and increases
,the risk of bleeding when taken with warfarin. Acetaminophen is safer in
moderation but may affect INR at high doses. Calcium carbonate and
diphenhydramine do not significantly increase bleeding risk.
3. A client is receiving a continuous infusion of unfractionated
heparin. The aPTT is 90 seconds (control 30 seconds). The client
has no signs of bleeding. Which action should the nurse take?
A) Stop the infusion and administer protamine sulfate
B) Continue the infusion at the current rate
C) Reduce the infusion rate according to the titration nomogram
and recheck aPTT in 6 hours
D) Administer vitamin K orally
Correct Answer: C
The aPTT is supratherapeutic (3 times control). Without bleeding, the
appropriate action is to reduce the rate per protocol and recheck.
Protamine is for severe bleeding or overdose. Vitamin K reverses
warfarin, not heparin. Continuing the rate increases bleeding risk.
4. A nurse is teaching a client with type 2 diabetes who is prescribed
metformin. Which statement by the client indicates a need for
further teaching?
A) "I will take the medication with meals to reduce stomach
upset."
B) "I will stop the medication before any procedure that uses
contrast dye."
C) "I will have my kidney function checked regularly."
D) "I can drink alcohol in moderation while taking this
medication."
, Correct Answer: D
Alcohol can increase the risk of lactic acidosis with metformin and
should be limited or avoided. The other statements are correct:
metformin should be held before contrast procedures and renal function
monitored.
5. A client with a history of asthma is prescribed propranolol for
migraine prophylaxis. What is the nurse's priority action?
A) Administer the medication as prescribed
B) Hold the medication and notify the provider due to the risk of
bronchospasm
C) Give the medication with a bronchodilator
D) Reduce the dose by half and administer
Correct Answer: B
Propranolol is a nonselective beta-blocker that can cause bronchospasm
in clients with asthma and is contraindicated. The nurse should hold the
medication and notify the provider. Administering risks respiratory
distress. The nurse cannot alter the dose or give with a bronchodilator
without an order.
6. A nurse is preparing to administer levothyroxine to a client with
hypothyroidism. Which client statement indicates the client
understands how to take the medication?
A) "I will take it with a glass of milk at bedtime."
B) "I will take it on an empty stomach in the morning."
C) "I will take it with an antacid to prevent upset stomach."
D) "I will take it with food to improve absorption."
Correct Answer: B
Levothyroxine is best absorbed on an empty stomach, preferably in the
EXAMINATION 2026–2027 — NGN | STUDY GUIDE |
LATEST UPDATE 2026/2027 | PRACTICE QUESTIONS
AND ANSWERS | EXAM REVIEW | 100% CORRECT
ANSWERS | VERIFIED SOLUTIONS | ALREADY
GRADED A+
This original practice examination is designed for practical/vocational
nursing students preparing for the ATI PN Pharmacology proctored
assessment and the NCLEX-PN®. The 100-question test evaluates
mastery of medication safety, drug classifications, therapeutic uses,
adverse effects, drug interactions, dosage calculations, and nursing
responsibilities within the LPN/LVN scope. Questions are written at the
application and analysis level to mirror the cognitive complexity of
proctored pharmacology examinations, including Next Generation
NCLEX clinical judgment scenarios. The 2026–2027 edition incorporates
current evidence-based pharmacology, FDA safety alerts, and national
patient safety standards. Use this comprehensive review to assess
readiness, identify knowledge gaps, and strengthen your understanding
of safe medication administration. This is an independent educational
resource, not affiliated with or endorsed by ATI.
Table of Contents
I. Pharmacokinetics, Drug Interactions, and Medication Safety
II. Autonomic Nervous System and Cardiovascular Medications
III. Anticoagulants, Antiplatelets, and Thrombolytics
IV. Respiratory, Endocrine, and Gastrointestinal Medications
V. Anti-Infectives and Immunologic Agents
VI. Central Nervous System and Psychotropic Medications
,VII. Pain Management and Anesthetic Agents
VIII. Dosage Calculations and Intravenous Therapy
1. A practical nurse is preparing to administer digoxin to a client with
heart failure. The client's serum digoxin level is 2.4 ng/mL
(therapeutic range 0.5–2.0 ng/mL). Which assessment finding is
most consistent with digoxin toxicity?
A) Hypertension and tachycardia
B) Visual disturbances such as yellow halos and anorexia
C) Hyperactive bowel sounds and diarrhea with hyperkalemia
D) Flushing and throbbing headache
Correct Answer: B
Digoxin toxicity commonly presents with gastrointestinal symptoms
(anorexia, nausea), visual changes (yellow or green halos, blurred
vision), and cardiac dysrhythmias. Hypokalemia, not hyperkalemia,
potentiates digoxin toxicity. Hypertension and tachycardia are not
typical. Flushing and headache suggest nitroglycerin or calcium channel
blocker effects.
2. A client is prescribed warfarin for atrial fibrillation. The nurse
should instruct the client to avoid which over-the-counter
medication due to increased bleeding risk?
A) Acetaminophen
B) Ibuprofen
C) Calcium carbonate
D) Diphenhydramine
Correct Answer: B
Ibuprofen is an NSAID that inhibits platelet aggregation and increases
,the risk of bleeding when taken with warfarin. Acetaminophen is safer in
moderation but may affect INR at high doses. Calcium carbonate and
diphenhydramine do not significantly increase bleeding risk.
3. A client is receiving a continuous infusion of unfractionated
heparin. The aPTT is 90 seconds (control 30 seconds). The client
has no signs of bleeding. Which action should the nurse take?
A) Stop the infusion and administer protamine sulfate
B) Continue the infusion at the current rate
C) Reduce the infusion rate according to the titration nomogram
and recheck aPTT in 6 hours
D) Administer vitamin K orally
Correct Answer: C
The aPTT is supratherapeutic (3 times control). Without bleeding, the
appropriate action is to reduce the rate per protocol and recheck.
Protamine is for severe bleeding or overdose. Vitamin K reverses
warfarin, not heparin. Continuing the rate increases bleeding risk.
4. A nurse is teaching a client with type 2 diabetes who is prescribed
metformin. Which statement by the client indicates a need for
further teaching?
A) "I will take the medication with meals to reduce stomach
upset."
B) "I will stop the medication before any procedure that uses
contrast dye."
C) "I will have my kidney function checked regularly."
D) "I can drink alcohol in moderation while taking this
medication."
, Correct Answer: D
Alcohol can increase the risk of lactic acidosis with metformin and
should be limited or avoided. The other statements are correct:
metformin should be held before contrast procedures and renal function
monitored.
5. A client with a history of asthma is prescribed propranolol for
migraine prophylaxis. What is the nurse's priority action?
A) Administer the medication as prescribed
B) Hold the medication and notify the provider due to the risk of
bronchospasm
C) Give the medication with a bronchodilator
D) Reduce the dose by half and administer
Correct Answer: B
Propranolol is a nonselective beta-blocker that can cause bronchospasm
in clients with asthma and is contraindicated. The nurse should hold the
medication and notify the provider. Administering risks respiratory
distress. The nurse cannot alter the dose or give with a bronchodilator
without an order.
6. A nurse is preparing to administer levothyroxine to a client with
hypothyroidism. Which client statement indicates the client
understands how to take the medication?
A) "I will take it with a glass of milk at bedtime."
B) "I will take it on an empty stomach in the morning."
C) "I will take it with an antacid to prevent upset stomach."
D) "I will take it with food to improve absorption."
Correct Answer: B
Levothyroxine is best absorbed on an empty stomach, preferably in the
