ACTUAL EXAM ATI CAPSTONE
PHARMACOLOGY 1 & 2 — QUESTIONS 1-100
AND ANSWERS UPDATED 2026/2027 | DETAILED
RATIONALES | INSTANT DOWNLOAD
INTRODUCTION
This original ATI Capstone Pharmacology 1 & 2 practice question bank is designed for nursing
students preparing to strengthen their pharmacology knowledge and clinical decision-making
skills. The material focuses on medication administration, pharmacokinetics and
pharmacodynamics, adverse effects, contraindications, drug interactions, patient education,
safety considerations, and clinical prioritization across major medication classes.
The questions emphasize application rather than simple memorization. Clinical scenarios require
the learner to interpret assessment findings, laboratory results, medication histories, therapeutic
responses, and potential adverse reactions before selecting the safest nursing action. This
approach is intended to reinforce the type of clinical reasoning commonly required in nursing
pharmacology examinations.
Each question contains four answer choices and one best answer, followed by a detailed rationale
explaining the correct choice and why the alternatives are less appropriate. Students can use the
bank for active recall, remediation, and timed practice while identifying areas requiring
additional review.
Note: These are original practice questions, not actual ATI examination items, and they are not
affiliated with or endorsed by ATI.
CONTENT AREA OVERVIEW
Approx.
Content Area Questions Key Topics
Weight
Pharmacokinetics & Absorption, distribution, metabolism,
1–10 10%
Pharmacodynamics excretion, therapeutic effects
Medication Safety & Safe administration, interactions, high-
11–20 10%
Administration alert medications, reconciliation
Antihypertensives, antianginals,
Cardiovascular Medications 21–35 15%
anticoagulants, antiarrhythmics
Insulins, thyroid medications,
Endocrine Medications 36–48 13%
corticosteroids, diabetes therapies
Antibiotics, antivirals, antifungals,
Anti-Infective Medications 49–62 14%
adverse effects
1|Page
, Approx.
Content Area Questions Key Topics
Weight
CNS & Psychiatric Antidepressants, antipsychotics,
63–75 13%
Medications anxiolytics, anticonvulsants
Bronchodilators, corticosteroids,
Respiratory Medications 76–82 7%
respiratory safety
GI & Other System Acid suppression, antiemetics,
83–90 8%
Medications laxatives, analgesics
Pediatrics, older adults, pregnancy,
Special Populations 91–95 5%
renal/hepatic impairment
Clinical Prioritization & Medication-related emergencies and
96–100 5%
Integrated Pharmacology clinical judgment
QUESTIONS 1–100
Q1:
A client with chronic kidney disease is prescribed a medication that is primarily eliminated
unchanged through the kidneys. The client’s serum creatinine has increased substantially since
the previous visit. Which nursing action is most appropriate?
A) Administer the medication because renal impairment increases absorption.
B) Hold administration and notify the provider for possible dosage adjustment.
C) Administer the medication and encourage increased fluid intake.
D) Give the medication with food to decrease renal elimination.
Rationale: The correct answer is B because reduced renal function can decrease medication
clearance and increase drug accumulation and toxicity. A is incorrect because impaired renal
function does not necessarily increase gastrointestinal absorption. C is inappropriate because
increasing fluids does not automatically correct impaired renal clearance and may be unsafe in
some clients with renal disease. D is incorrect because food primarily affects gastrointestinal
absorption rather than correcting impaired renal elimination.
Q2:
A nurse is reviewing a medication with a narrow therapeutic index. Which finding should cause
the nurse to be most concerned about toxicity?
A) The client reports that the medication is easier to swallow with water.
B) The serum drug concentration is approaching the toxic range.
2|Page
,C) The client takes the medication at the same time each day.
D) The medication is prescribed at a consistent dose.
Rationale: The correct answer is B because medications with a narrow therapeutic index have a
small difference between therapeutic and toxic concentrations, making serum levels approaching
the toxic range clinically significant. A, C, and D describe routine administration characteristics
and do not independently indicate toxicity.
Q3:
A client taking a newly prescribed medication develops severe dizziness and nearly falls when
standing. Which assessment should the nurse perform first?
A) Determine the client’s preferred pharmacy.
B) Obtain orthostatic blood pressure and heart rate measurements.
C) Ask whether the client prefers tablets or capsules.
D) Determine whether the medication is available as a generic formulation.
Rationale: The correct answer is B because severe dizziness associated with standing may
indicate orthostatic hypotension, which increases fall risk and requires immediate assessment. A
and D are administrative concerns that do not address the acute safety issue. C is unrelated to
the immediate problem.
Q4:
A client taking a medication metabolized extensively by the liver develops jaundice, dark urine,
and right-upper-quadrant discomfort. Which laboratory test is most important for evaluating the
suspected medication-related complication?
A) Serum sodium
B) Hepatic transaminase levels
C) Hemoglobin A1c
D) Serum calcium
Rationale: The correct answer is B because elevated hepatic transaminases can indicate
hepatocellular injury. Jaundice, dark urine, and right-upper-quadrant discomfort are concerning
for hepatic dysfunction. Sodium, HbA1c, and calcium do not directly evaluate hepatocellular
injury.
3|Page
, Q5:
A nurse discovers that a client received a medication dose twice because of a documentation
error. The client is currently asymptomatic. What is the nurse’s priority action?
A) Wait until symptoms develop before taking action.
B) Assess the client and immediately follow the facility’s medication-error protocol.
C) Document only the originally prescribed dose.
D) Ask the next shift to monitor the client.
Rationale: The correct answer is B because a medication error requires prompt assessment,
notification according to policy, appropriate monitoring, and accurate documentation. Waiting
for symptoms could delay treatment. Altering documentation is unsafe and unethical. Delegating
the entire response to the next shift delays appropriate intervention.
Q6:
A client taking warfarin reports several new bruises and bleeding gums. Which laboratory result
should the nurse review first?
A) Serum potassium
B) International normalized ratio (INR)
C) Serum glucose
D) White blood cell count
Rationale: The correct answer is B because INR evaluates the therapeutic effect of warfarin and
helps identify excessive anticoagulation. Potassium, glucose, and white blood cell count do not
directly measure warfarin's anticoagulant effect.
Q7:
A client receiving an opioid analgesic becomes difficult to arouse and has respirations of 7/min.
Which medication should the nurse anticipate administering?
A) Flumazenil
B) Naloxone
C) Protamine sulfate
4|Page
PHARMACOLOGY 1 & 2 — QUESTIONS 1-100
AND ANSWERS UPDATED 2026/2027 | DETAILED
RATIONALES | INSTANT DOWNLOAD
INTRODUCTION
This original ATI Capstone Pharmacology 1 & 2 practice question bank is designed for nursing
students preparing to strengthen their pharmacology knowledge and clinical decision-making
skills. The material focuses on medication administration, pharmacokinetics and
pharmacodynamics, adverse effects, contraindications, drug interactions, patient education,
safety considerations, and clinical prioritization across major medication classes.
The questions emphasize application rather than simple memorization. Clinical scenarios require
the learner to interpret assessment findings, laboratory results, medication histories, therapeutic
responses, and potential adverse reactions before selecting the safest nursing action. This
approach is intended to reinforce the type of clinical reasoning commonly required in nursing
pharmacology examinations.
Each question contains four answer choices and one best answer, followed by a detailed rationale
explaining the correct choice and why the alternatives are less appropriate. Students can use the
bank for active recall, remediation, and timed practice while identifying areas requiring
additional review.
Note: These are original practice questions, not actual ATI examination items, and they are not
affiliated with or endorsed by ATI.
CONTENT AREA OVERVIEW
Approx.
Content Area Questions Key Topics
Weight
Pharmacokinetics & Absorption, distribution, metabolism,
1–10 10%
Pharmacodynamics excretion, therapeutic effects
Medication Safety & Safe administration, interactions, high-
11–20 10%
Administration alert medications, reconciliation
Antihypertensives, antianginals,
Cardiovascular Medications 21–35 15%
anticoagulants, antiarrhythmics
Insulins, thyroid medications,
Endocrine Medications 36–48 13%
corticosteroids, diabetes therapies
Antibiotics, antivirals, antifungals,
Anti-Infective Medications 49–62 14%
adverse effects
1|Page
, Approx.
Content Area Questions Key Topics
Weight
CNS & Psychiatric Antidepressants, antipsychotics,
63–75 13%
Medications anxiolytics, anticonvulsants
Bronchodilators, corticosteroids,
Respiratory Medications 76–82 7%
respiratory safety
GI & Other System Acid suppression, antiemetics,
83–90 8%
Medications laxatives, analgesics
Pediatrics, older adults, pregnancy,
Special Populations 91–95 5%
renal/hepatic impairment
Clinical Prioritization & Medication-related emergencies and
96–100 5%
Integrated Pharmacology clinical judgment
QUESTIONS 1–100
Q1:
A client with chronic kidney disease is prescribed a medication that is primarily eliminated
unchanged through the kidneys. The client’s serum creatinine has increased substantially since
the previous visit. Which nursing action is most appropriate?
A) Administer the medication because renal impairment increases absorption.
B) Hold administration and notify the provider for possible dosage adjustment.
C) Administer the medication and encourage increased fluid intake.
D) Give the medication with food to decrease renal elimination.
Rationale: The correct answer is B because reduced renal function can decrease medication
clearance and increase drug accumulation and toxicity. A is incorrect because impaired renal
function does not necessarily increase gastrointestinal absorption. C is inappropriate because
increasing fluids does not automatically correct impaired renal clearance and may be unsafe in
some clients with renal disease. D is incorrect because food primarily affects gastrointestinal
absorption rather than correcting impaired renal elimination.
Q2:
A nurse is reviewing a medication with a narrow therapeutic index. Which finding should cause
the nurse to be most concerned about toxicity?
A) The client reports that the medication is easier to swallow with water.
B) The serum drug concentration is approaching the toxic range.
2|Page
,C) The client takes the medication at the same time each day.
D) The medication is prescribed at a consistent dose.
Rationale: The correct answer is B because medications with a narrow therapeutic index have a
small difference between therapeutic and toxic concentrations, making serum levels approaching
the toxic range clinically significant. A, C, and D describe routine administration characteristics
and do not independently indicate toxicity.
Q3:
A client taking a newly prescribed medication develops severe dizziness and nearly falls when
standing. Which assessment should the nurse perform first?
A) Determine the client’s preferred pharmacy.
B) Obtain orthostatic blood pressure and heart rate measurements.
C) Ask whether the client prefers tablets or capsules.
D) Determine whether the medication is available as a generic formulation.
Rationale: The correct answer is B because severe dizziness associated with standing may
indicate orthostatic hypotension, which increases fall risk and requires immediate assessment. A
and D are administrative concerns that do not address the acute safety issue. C is unrelated to
the immediate problem.
Q4:
A client taking a medication metabolized extensively by the liver develops jaundice, dark urine,
and right-upper-quadrant discomfort. Which laboratory test is most important for evaluating the
suspected medication-related complication?
A) Serum sodium
B) Hepatic transaminase levels
C) Hemoglobin A1c
D) Serum calcium
Rationale: The correct answer is B because elevated hepatic transaminases can indicate
hepatocellular injury. Jaundice, dark urine, and right-upper-quadrant discomfort are concerning
for hepatic dysfunction. Sodium, HbA1c, and calcium do not directly evaluate hepatocellular
injury.
3|Page
, Q5:
A nurse discovers that a client received a medication dose twice because of a documentation
error. The client is currently asymptomatic. What is the nurse’s priority action?
A) Wait until symptoms develop before taking action.
B) Assess the client and immediately follow the facility’s medication-error protocol.
C) Document only the originally prescribed dose.
D) Ask the next shift to monitor the client.
Rationale: The correct answer is B because a medication error requires prompt assessment,
notification according to policy, appropriate monitoring, and accurate documentation. Waiting
for symptoms could delay treatment. Altering documentation is unsafe and unethical. Delegating
the entire response to the next shift delays appropriate intervention.
Q6:
A client taking warfarin reports several new bruises and bleeding gums. Which laboratory result
should the nurse review first?
A) Serum potassium
B) International normalized ratio (INR)
C) Serum glucose
D) White blood cell count
Rationale: The correct answer is B because INR evaluates the therapeutic effect of warfarin and
helps identify excessive anticoagulation. Potassium, glucose, and white blood cell count do not
directly measure warfarin's anticoagulant effect.
Q7:
A client receiving an opioid analgesic becomes difficult to arouse and has respirations of 7/min.
Which medication should the nurse anticipate administering?
A) Flumazenil
B) Naloxone
C) Protamine sulfate
4|Page
