ATI PN PHARMACOLOGY
2023–2026 PROCTORED
EXAM WITH NGN ]
ACTUAL QUESTIONS AND
CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
Section 1: Safe Medication Administration & Safety
1. A nurse is preparing to administer medication to a client. Which action is the
MOST important to ensure the "Six Rights" of medication administration?
A. Confirm the medication route by reading the MAR
B. Check the medication expiration date
C. Use at least two patient identifiers before administration
D. Verify the calculation with another nurse
,Rationale: While all steps are important, identifying the patient using two identifiers
(e.g., name and date of birth) is the final safety check to ensure the right patient receives
the medication. This is the most critical step before administering any medication.
2. A nurse discovers a medication error. Which of the following should be the
nurse's priority action?
A. Complete an incident report
B. Notify the provider
C. Assess the client for adverse effects
D. Report the error to the nurse manager
Rationale: Client safety is the priority. The nurse must first assess the client for any harm
or potential complications from the error before notifying the provider or completing
documentation. The client's physiological status takes precedence over paperwork.
3. A nurse is reinforcing teaching with a client regarding how to mix regular
insulin and NPH insulin in the same syringe. Which action, if performed by the
client, indicates the need for further teaching?
A. Withdraws the NPH insulin first
B. Withdraws the regular insulin first
C. Injects air into the NPH insulin vial first
D. Injects an amount of air equal to the desired dose of insulin into the vial
Rationale: When preparing a mixture of regular insulin with another insulin preparation,
the regular insulin is drawn into the syringe FIRST. This sequence avoids contaminating
the vial of regular insulin with insulin of another type. Options B, C, and D identify
correct actions.
4. Which of the following actions is essential when using the Z-track method for
intramuscular injection?
,A. Inject the medication slowly over 30 seconds after releasing the skin
B. Massage the injection site vigorously for 60 seconds after removing the needle
C. Insert the needle at a 45-degree angle into the subcutaneous tissue
D. Pull the skin laterally before inserting the needle and hold until after injection
and needle removal
Rationale: The Z-track method requires pulling the skin laterally before needle insertion
and maintaining that displacement throughout injection and needle withdrawal. This
creates a zigzag path that seals the medication within muscle tissue and prevents
leakage into subcutaneous tissue. Massaging the site would force medication into
subcutaneous tissue, defeating the purpose.
5. A nurse is performing the third check before administering hydromorphone to a
client. After opening the unit-dose packet, the client tells the nurse they do not
want to take the medication now. Which of the following actions should the nurse
take?
A. Return the medication to the medication cart unopened
B. Dispose of the medication with a second nurse as a witness
C. Save the medication for the client to take later
D. Document refusal and keep medication at bedside
Rationale: Hydromorphone is a controlled substance that must be wasted and
witnessed by another nurse to comply with legal regulations when not administered.
6. A nurse is preparing to administer enoxaparin to a client. Which action should
the nurse take to ensure safe administration?
A. Inject the medication subcutaneously into the lateral anterior or posterior
abdominal wall
B. Massage the injection site after administration
C. Administer intramuscularly into the deltoid
D. Aspirate before injecting the medication
Rationale: Enoxaparin is given subcutaneously in the abdomen, not IM. Do not aspirate
or massage the site after injection.
, 7. A nurse is administering a medication via the intradermal route. Which angle
should the nurse use to insert the needle?
A. 5-15 degrees
B. 45 degrees
C. 90 degrees
D. 30 degrees
Rationale: Intradermal injections require a shallow angle (5-15 degrees) with the bevel
up to deposit medication under the epidermis. This route is used for skin testing (e.g.,
TB, allergy testing).
Section 2: Cardiovascular & Diuretic Medications
8. A nurse is preparing to administer a daily dose of warfarin to a client. Which of
the following laboratory values should the nurse check prior to administration?
A. aPTT
B. INR
C. WBC
D. Platelets
Rationale: The International Normalized Ratio (INR) is crucial for monitoring the
anticoagulation effect of warfarin. Maintaining an appropriate INR level helps prevent
thromboembolic events while minimizing the risk of bleeding. aPTT is used to monitor
heparin therapy.
9. A client taking digoxin has an apical pulse of 56 beats per minute. What is the
priority action?
A. Administer the medication
B. Hold the dose and notify the provider
2023–2026 PROCTORED
EXAM WITH NGN ]
ACTUAL QUESTIONS AND
CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
Section 1: Safe Medication Administration & Safety
1. A nurse is preparing to administer medication to a client. Which action is the
MOST important to ensure the "Six Rights" of medication administration?
A. Confirm the medication route by reading the MAR
B. Check the medication expiration date
C. Use at least two patient identifiers before administration
D. Verify the calculation with another nurse
,Rationale: While all steps are important, identifying the patient using two identifiers
(e.g., name and date of birth) is the final safety check to ensure the right patient receives
the medication. This is the most critical step before administering any medication.
2. A nurse discovers a medication error. Which of the following should be the
nurse's priority action?
A. Complete an incident report
B. Notify the provider
C. Assess the client for adverse effects
D. Report the error to the nurse manager
Rationale: Client safety is the priority. The nurse must first assess the client for any harm
or potential complications from the error before notifying the provider or completing
documentation. The client's physiological status takes precedence over paperwork.
3. A nurse is reinforcing teaching with a client regarding how to mix regular
insulin and NPH insulin in the same syringe. Which action, if performed by the
client, indicates the need for further teaching?
A. Withdraws the NPH insulin first
B. Withdraws the regular insulin first
C. Injects air into the NPH insulin vial first
D. Injects an amount of air equal to the desired dose of insulin into the vial
Rationale: When preparing a mixture of regular insulin with another insulin preparation,
the regular insulin is drawn into the syringe FIRST. This sequence avoids contaminating
the vial of regular insulin with insulin of another type. Options B, C, and D identify
correct actions.
4. Which of the following actions is essential when using the Z-track method for
intramuscular injection?
,A. Inject the medication slowly over 30 seconds after releasing the skin
B. Massage the injection site vigorously for 60 seconds after removing the needle
C. Insert the needle at a 45-degree angle into the subcutaneous tissue
D. Pull the skin laterally before inserting the needle and hold until after injection
and needle removal
Rationale: The Z-track method requires pulling the skin laterally before needle insertion
and maintaining that displacement throughout injection and needle withdrawal. This
creates a zigzag path that seals the medication within muscle tissue and prevents
leakage into subcutaneous tissue. Massaging the site would force medication into
subcutaneous tissue, defeating the purpose.
5. A nurse is performing the third check before administering hydromorphone to a
client. After opening the unit-dose packet, the client tells the nurse they do not
want to take the medication now. Which of the following actions should the nurse
take?
A. Return the medication to the medication cart unopened
B. Dispose of the medication with a second nurse as a witness
C. Save the medication for the client to take later
D. Document refusal and keep medication at bedside
Rationale: Hydromorphone is a controlled substance that must be wasted and
witnessed by another nurse to comply with legal regulations when not administered.
6. A nurse is preparing to administer enoxaparin to a client. Which action should
the nurse take to ensure safe administration?
A. Inject the medication subcutaneously into the lateral anterior or posterior
abdominal wall
B. Massage the injection site after administration
C. Administer intramuscularly into the deltoid
D. Aspirate before injecting the medication
Rationale: Enoxaparin is given subcutaneously in the abdomen, not IM. Do not aspirate
or massage the site after injection.
, 7. A nurse is administering a medication via the intradermal route. Which angle
should the nurse use to insert the needle?
A. 5-15 degrees
B. 45 degrees
C. 90 degrees
D. 30 degrees
Rationale: Intradermal injections require a shallow angle (5-15 degrees) with the bevel
up to deposit medication under the epidermis. This route is used for skin testing (e.g.,
TB, allergy testing).
Section 2: Cardiovascular & Diuretic Medications
8. A nurse is preparing to administer a daily dose of warfarin to a client. Which of
the following laboratory values should the nurse check prior to administration?
A. aPTT
B. INR
C. WBC
D. Platelets
Rationale: The International Normalized Ratio (INR) is crucial for monitoring the
anticoagulation effect of warfarin. Maintaining an appropriate INR level helps prevent
thromboembolic events while minimizing the risk of bleeding. aPTT is used to monitor
heparin therapy.
9. A client taking digoxin has an apical pulse of 56 beats per minute. What is the
priority action?
A. Administer the medication
B. Hold the dose and notify the provider
