Updated ATI RN
Pharmacology Proctored
Exam Actual and Retake
2026 with NGN
SECTION 1: CARDIOVASCULAR
1. A nurse is preparing to administer digoxin. Which finding requires holding the
dose?
A. HR 58/min
B. HR 92/min
C. BP 110/70
D. K+ 4.2
Answer: A — Digoxin should be held for HR <60 in adults. Report and notify
provider.
2. Which lab value increases digoxin toxicity risk?
A. K+ 5.0
B. K+ 3.0
C. Na+ 140
D. Ca+ 9.0
Answer: B — Hypokalemia potentiates digoxin toxicity.
3. A client on warfarin has an INR of 5.5. Which action is priority?
A. Administer vitamin K
B. Give next dose as scheduled
C. Encourage green leafy vegetables
D. Hold dose and notify provider
Answer: D — INR >5 requires holding warfarin and notifying the provider; vitamin
K may be ordered but only after provider notification.
,4. Which lab monitors heparin therapy?
A. PT
B. INR
C. aPTT
D. Bleeding time
Answer: C — aPTT monitors unfractionated heparin.
5. A client on enoxaparin should be taught to avoid which OTC?
A. Acetaminophen
B. Aspirin
C. Calcium carbonate
D. Vitamin C
Answer: B — Aspirin increases bleeding risk with anticoagulants.
6. Which adverse effect is most concerning with ACE inhibitors?
A. Dry cough
B. Angioedema
C. Hyperkalemia
D. Dizziness
Answer: B — Angioedema is a medical emergency (airway compromise).
7. A client on metoprolol reports fatigue and HR 52. Priority action?
A. Give next dose
B. Hold dose and assess
C. Encourage caffeine
D. Double next dose
Answer: B — Beta blockers can cause bradycardia; hold and assess.
8. Which instruction is correct for sublingual nitroglycerin?
A. Swallow with water
B. Take up to 3, 5 min apart
C. Take with food
D. Lie flat after taking
Answer: B — Up to 3 tablets, 5 minutes apart; call 911 if no relief.
, 9. A client on furosemide should be monitored for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B — Loop diuretics cause potassium loss.
10. Which client should not receive spironolactone?
A. K+ 3.2
B. K+ 5.6
C. Na+ 135
D. BP 130/80
Answer: B — Potassium-sparing diuretics are contraindicated with hyperkalemia.
11. A nurse is teaching about atorvastatin. Which statement indicates
understanding?
A. "I'll take it in the morning."
B. "I'll avoid grapefruit juice."
C. "I'll stop if I feel better."
D. "I'll take it with antacids."
Answer: B — Grapefruit increases statin levels and myopathy risk. Statins are
usually taken at night.
12. Which finding suggests statin-induced myopathy?
A. Headache
B. Muscle pain with dark urine
C. Dry cough
D. Constipation
Answer: B — Muscle pain + dark urine = rhabdomyolysis; report immediately.
13. A client on amlodipine reports ankle swelling. This is:
A. Expected adverse effect
B. Sign of heart failure
C. Allergic reaction
D. Sign of overdose
Pharmacology Proctored
Exam Actual and Retake
2026 with NGN
SECTION 1: CARDIOVASCULAR
1. A nurse is preparing to administer digoxin. Which finding requires holding the
dose?
A. HR 58/min
B. HR 92/min
C. BP 110/70
D. K+ 4.2
Answer: A — Digoxin should be held for HR <60 in adults. Report and notify
provider.
2. Which lab value increases digoxin toxicity risk?
A. K+ 5.0
B. K+ 3.0
C. Na+ 140
D. Ca+ 9.0
Answer: B — Hypokalemia potentiates digoxin toxicity.
3. A client on warfarin has an INR of 5.5. Which action is priority?
A. Administer vitamin K
B. Give next dose as scheduled
C. Encourage green leafy vegetables
D. Hold dose and notify provider
Answer: D — INR >5 requires holding warfarin and notifying the provider; vitamin
K may be ordered but only after provider notification.
,4. Which lab monitors heparin therapy?
A. PT
B. INR
C. aPTT
D. Bleeding time
Answer: C — aPTT monitors unfractionated heparin.
5. A client on enoxaparin should be taught to avoid which OTC?
A. Acetaminophen
B. Aspirin
C. Calcium carbonate
D. Vitamin C
Answer: B — Aspirin increases bleeding risk with anticoagulants.
6. Which adverse effect is most concerning with ACE inhibitors?
A. Dry cough
B. Angioedema
C. Hyperkalemia
D. Dizziness
Answer: B — Angioedema is a medical emergency (airway compromise).
7. A client on metoprolol reports fatigue and HR 52. Priority action?
A. Give next dose
B. Hold dose and assess
C. Encourage caffeine
D. Double next dose
Answer: B — Beta blockers can cause bradycardia; hold and assess.
8. Which instruction is correct for sublingual nitroglycerin?
A. Swallow with water
B. Take up to 3, 5 min apart
C. Take with food
D. Lie flat after taking
Answer: B — Up to 3 tablets, 5 minutes apart; call 911 if no relief.
, 9. A client on furosemide should be monitored for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B — Loop diuretics cause potassium loss.
10. Which client should not receive spironolactone?
A. K+ 3.2
B. K+ 5.6
C. Na+ 135
D. BP 130/80
Answer: B — Potassium-sparing diuretics are contraindicated with hyperkalemia.
11. A nurse is teaching about atorvastatin. Which statement indicates
understanding?
A. "I'll take it in the morning."
B. "I'll avoid grapefruit juice."
C. "I'll stop if I feel better."
D. "I'll take it with antacids."
Answer: B — Grapefruit increases statin levels and myopathy risk. Statins are
usually taken at night.
12. Which finding suggests statin-induced myopathy?
A. Headache
B. Muscle pain with dark urine
C. Dry cough
D. Constipation
Answer: B — Muscle pain + dark urine = rhabdomyolysis; report immediately.
13. A client on amlodipine reports ankle swelling. This is:
A. Expected adverse effect
B. Sign of heart failure
C. Allergic reaction
D. Sign of overdose
