ATI PN PHARMACOLOGY 2025-2026 PROCTORED
EXAM WITH NGN | 200 Practice Questions with
Verified Answers and Rationales Complete Study Pack
SECTION 1: CARDIOVASCULAR & ANTICOAGULANT
MEDICATIONS (Questions 1–35)
Question 1
Which of the following findings indicates a client may be at increased risk for digoxin
toxicity? (Select all that apply)
A) Serum potassium 3.1 mEq/L
B) Serum creatinine 1.9 mg/dL
C) Serum digoxin level 1.8 ng/mL
D) Client reports nausea and yellow-green halos around lights
E) Heart rate 62/min
Correct Answers: A, B, D
Rationale: A) Hypokalemia (K+ < 3.5 mEq/L) increases the risk of digoxin
toxicity by enhancing the drug's effect on cardiac muscle. B) Elevated serum
creatinine indicates renal impairment, which reduces digoxin clearance and
, increases toxicity risk. D) Nausea and visual disturbances (yellow-green
halos) are classic signs of digoxin toxicity. C) A digoxin level of 1.8 ng/mL is
within the therapeutic range (0.8–2.0 ng/mL). E) Heart rate 62/min is
normal and not a toxicity indicator .
Question 2
A nurse is administering furosemide to a client with pulmonary edema. Which laboratory
value should the nurse monitor most closely?
A) Serum calcium
B) Serum sodium
C) Serum potassium
D) Serum magnesium
Correct Answer: C) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
Hypokalemia is a common and potentially dangerous adverse effect that
can lead to cardiac arrhythmias. While sodium, calcium, and magnesium
may also be affected, potassium monitoring is the priority .
Question 3
A nurse is caring for a client receiving IV furosemide. Which finding requires immediate
action?
A) Urine output 200 mL in 1 hour
B) Serum potassium 3.8 mEq/L
C) Tinnitus and hearing loss
D) Blood pressure 130/85 mmHg
Correct Answer: C) Tinnitus and hearing loss
, Rationale: Tinnitus and hearing loss indicate ototoxicity, a serious adverse
effect of furosemide, especially when given IV rapidly or in high doses. This
requires immediate provider notification. Urine output of 200 mL/hr is
therapeutic; K+ 3.8 is normal; BP is acceptable .
Question 4
A client with heart failure is prescribed lisinopril. Which finding indicates a therapeutic
effect?
A) Heart rate 110 bpm
B) Blood pressure 150/95 mmHg
C) Blood pressure 125/80 mmHg
D) Swelling of the lips
Correct Answer: C) Blood pressure 125/80 mmHg
Rationale: Lisinopril is an ACE inhibitor used to treat hypertension and heart
failure. A therapeutic effect is demonstrated by blood pressure control
within target range. Swelling of the lips indicates angioedema, a serious
adverse effect requiring immediate intervention. Tachycardia and elevated
BP indicate lack of therapeutic effect .
Question 5
A nurse is evaluating the laboratory results of four clients. Which laboratory result
should the nurse report to the provider?
A) A client receiving heparin with an aPTT of 90 seconds (normal 30–40 seconds)
B) A client receiving heparin with an aPTT of 65 seconds (normal 30–40 seconds)
C) A client receiving warfarin with an INR of 3.0 (normal 0.8–1.1)
D) A client receiving warfarin with an INR of 2.0 (normal 0.8–1.1)
Correct Answer: A) A client receiving heparin with an aPTT of 90 seconds
Rationale: An aPTT of 90 seconds is significantly elevated above the
therapeutic range (typically 1.5–2.5 times the control or 60–80 seconds). This
places the client at high risk for bleeding complications and requires
, immediate provider notification. The INR of 3.0 is within therapeutic range
for warfarin (2.0–3.0), and an INR of 2.0 is also therapeutic .
Question 6
A nurse is preparing to administer a daily dose of warfarin to a client. Which laboratory
value should the nurse check prior to administration?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
Correct Answer: B) INR
Rationale: Warfarin therapy is monitored by PT/INR (prothrombin
time/international normalized ratio). The therapeutic INR range for most
indications is 2.0–3.0. aPTT is used to monitor heparin therapy. Platelet
count and hemoglobin are important but not specific to warfarin
monitoring .
Question 7
A client is prescribed warfarin. The nurse should instruct the client to avoid which over-
the-counter medication?
A) Acetaminophen
B) Ibuprofen
C) Diphenhydramine
D) Loratadine
Correct Answer: B) Ibuprofen
EXAM WITH NGN | 200 Practice Questions with
Verified Answers and Rationales Complete Study Pack
SECTION 1: CARDIOVASCULAR & ANTICOAGULANT
MEDICATIONS (Questions 1–35)
Question 1
Which of the following findings indicates a client may be at increased risk for digoxin
toxicity? (Select all that apply)
A) Serum potassium 3.1 mEq/L
B) Serum creatinine 1.9 mg/dL
C) Serum digoxin level 1.8 ng/mL
D) Client reports nausea and yellow-green halos around lights
E) Heart rate 62/min
Correct Answers: A, B, D
Rationale: A) Hypokalemia (K+ < 3.5 mEq/L) increases the risk of digoxin
toxicity by enhancing the drug's effect on cardiac muscle. B) Elevated serum
creatinine indicates renal impairment, which reduces digoxin clearance and
, increases toxicity risk. D) Nausea and visual disturbances (yellow-green
halos) are classic signs of digoxin toxicity. C) A digoxin level of 1.8 ng/mL is
within the therapeutic range (0.8–2.0 ng/mL). E) Heart rate 62/min is
normal and not a toxicity indicator .
Question 2
A nurse is administering furosemide to a client with pulmonary edema. Which laboratory
value should the nurse monitor most closely?
A) Serum calcium
B) Serum sodium
C) Serum potassium
D) Serum magnesium
Correct Answer: C) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
Hypokalemia is a common and potentially dangerous adverse effect that
can lead to cardiac arrhythmias. While sodium, calcium, and magnesium
may also be affected, potassium monitoring is the priority .
Question 3
A nurse is caring for a client receiving IV furosemide. Which finding requires immediate
action?
A) Urine output 200 mL in 1 hour
B) Serum potassium 3.8 mEq/L
C) Tinnitus and hearing loss
D) Blood pressure 130/85 mmHg
Correct Answer: C) Tinnitus and hearing loss
, Rationale: Tinnitus and hearing loss indicate ototoxicity, a serious adverse
effect of furosemide, especially when given IV rapidly or in high doses. This
requires immediate provider notification. Urine output of 200 mL/hr is
therapeutic; K+ 3.8 is normal; BP is acceptable .
Question 4
A client with heart failure is prescribed lisinopril. Which finding indicates a therapeutic
effect?
A) Heart rate 110 bpm
B) Blood pressure 150/95 mmHg
C) Blood pressure 125/80 mmHg
D) Swelling of the lips
Correct Answer: C) Blood pressure 125/80 mmHg
Rationale: Lisinopril is an ACE inhibitor used to treat hypertension and heart
failure. A therapeutic effect is demonstrated by blood pressure control
within target range. Swelling of the lips indicates angioedema, a serious
adverse effect requiring immediate intervention. Tachycardia and elevated
BP indicate lack of therapeutic effect .
Question 5
A nurse is evaluating the laboratory results of four clients. Which laboratory result
should the nurse report to the provider?
A) A client receiving heparin with an aPTT of 90 seconds (normal 30–40 seconds)
B) A client receiving heparin with an aPTT of 65 seconds (normal 30–40 seconds)
C) A client receiving warfarin with an INR of 3.0 (normal 0.8–1.1)
D) A client receiving warfarin with an INR of 2.0 (normal 0.8–1.1)
Correct Answer: A) A client receiving heparin with an aPTT of 90 seconds
Rationale: An aPTT of 90 seconds is significantly elevated above the
therapeutic range (typically 1.5–2.5 times the control or 60–80 seconds). This
places the client at high risk for bleeding complications and requires
, immediate provider notification. The INR of 3.0 is within therapeutic range
for warfarin (2.0–3.0), and an INR of 2.0 is also therapeutic .
Question 6
A nurse is preparing to administer a daily dose of warfarin to a client. Which laboratory
value should the nurse check prior to administration?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
Correct Answer: B) INR
Rationale: Warfarin therapy is monitored by PT/INR (prothrombin
time/international normalized ratio). The therapeutic INR range for most
indications is 2.0–3.0. aPTT is used to monitor heparin therapy. Platelet
count and hemoglobin are important but not specific to warfarin
monitoring .
Question 7
A client is prescribed warfarin. The nurse should instruct the client to avoid which over-
the-counter medication?
A) Acetaminophen
B) Ibuprofen
C) Diphenhydramine
D) Loratadine
Correct Answer: B) Ibuprofen
