ATI CMS PHARMACOLOGY RETAKE 2023
ACTUAL EXAM LATEST QUESTION AND
CORRECT ANSWERS WITH RATIONALES
RATED AGRADE.
Section 1: Medication Administration & Safety
1. A nurse is preparing to administer digoxin to an adult client. Which assessment finding
should the nurse report before giving the dose?
A. Heart rate 58 beats/min
B. Blood pressure 118/76 mm Hg
C. Respiratory rate 18 breaths/min
D. Temperature 37.1°C (98.8°F)
Correct Answer: A
Rationale: Digoxin should be withheld and the provider notified for an adult heart rate
below 60 beats/min because digoxin slows conduction and can worsen bradycardia. The other
values are within normal limits.
2. Which of the following are appropriate nursing actions to prevent medication errors?
(Select all that apply.)
A. Verify the client using two identifiers
B. Clarify illegible prescriptions with the prescriber
C. Administer medications prepared by another nurse without verification
D. Document the dose after administration
E. Use the rights of medication administration
Correct Answer: A, B, D, E
Rationale: Two identifiers, clarifying illegible orders, documenting after administration, and
following the rights of medication administration all reduce errors. Administering a medication
prepared by another nurse without verification increases risk.
,3. A nurse is administering a medication via a nasogastric tube. Which action is correct?
A. Administer crushed extended-release tablets
B. Flush with 15–30 mL of water before and after
C. Mix medication with enteral feeding
D. Use sterile water for all flushes
Correct Answer: B
Rationale: Flushing with 15–30 mL of water before and after prevents clogging and ensures
delivery. Extended-release tablets should not be crushed, and medications should not be mixed
with enteral formula.
4. A client is prescribed a medication that is highly protein bound. The nurse should monitor
for which effect if the client also takes another highly protein-bound drug?
A. Decreased therapeutic effect
B. Increased risk of toxicity
C. No interaction
D. Increased renal excretion
Correct Answer: B
Rationale: Two highly protein-bound drugs compete for binding sites, increasing free drug
levels and the risk of toxicity.
5. Which route provides the most rapid onset of action?
A. Oral
B. Subcutaneous
C. Intravenous
D. Intramuscular
Correct Answer: C
Rationale: IV administration bypasses absorption and delivers the drug directly into the
bloodstream, producing the most rapid onset.
6. A nurse is teaching a client about sublingual nitroglycerin. Which statement indicates
understanding?
A. "I should swallow the tablet with water."
B. "I should place it under my tongue and let it dissolve."
,C. "I should chew it for faster relief."
D. "I should take it with food."
Correct Answer: B
Rationale: Sublingual tablets are placed under the tongue to dissolve for rapid absorption.
Swallowing or chewing reduces effectiveness.
7. A nurse is reviewing a prescription for a client with a history of falls. Which medication
class increases fall risk the most?
A. Benzodiazepines
B. Antacids
C. Laxatives
D. Topical antibiotics
Correct Answer: A
Rationale: Benzodiazepines cause sedation, dizziness, and impaired coordination, increasing
fall risk.
8. A nurse is calculating a pediatric dose. The child weighs 22 lb. The ordered dose is 10
mg/kg/day divided every 12 hours. How many mg per dose? (Round to the nearest tenth.)
A. 50 mg
B. 100 mg
C. 25 mg
D. 75 mg
Correct Answer: A
Rationale: 22 lb ÷ 2.2 = 10 kg. 10 mg/kg/day × 10 kg = 100 mg/day ÷ 2 doses = 50 mg/dose.
9. Which is a high-alert medication requiring independent double-check?
A. Acetaminophen
B. Insulin
C. Loratadine
D. Calcium carbonate
, Correct Answer: B
Rationale: Insulin is a high-alert medication due to the risk of severe hypoglycemia if dosed
incorrectly.
10. A nurse is preparing to give an intramuscular injection to an infant. Which site is
preferred?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
Correct Answer: C
Rationale: The vastus lateralis is the preferred IM site in infants because it is well developed
and avoids major nerves and blood vessels.
11. A client refuses a medication. What is the nurse's priority action?
A. Force the medication
B. Document the refusal and notify the provider
C. Hide it in food
D. Skip documentation
Correct Answer: B
Rationale: Respecting client autonomy, the nurse documents the refusal and informs the
provider.
12. Which action is correct when administering eye drops and ointment together?
A. Give ointment first
B. Give drops first, then ointment
C. Mix them together
D. Give only one at a time
Correct Answer: B
Rationale: Drops are instilled first, then ointment, because ointment can impede absorption
of drops.
ACTUAL EXAM LATEST QUESTION AND
CORRECT ANSWERS WITH RATIONALES
RATED AGRADE.
Section 1: Medication Administration & Safety
1. A nurse is preparing to administer digoxin to an adult client. Which assessment finding
should the nurse report before giving the dose?
A. Heart rate 58 beats/min
B. Blood pressure 118/76 mm Hg
C. Respiratory rate 18 breaths/min
D. Temperature 37.1°C (98.8°F)
Correct Answer: A
Rationale: Digoxin should be withheld and the provider notified for an adult heart rate
below 60 beats/min because digoxin slows conduction and can worsen bradycardia. The other
values are within normal limits.
2. Which of the following are appropriate nursing actions to prevent medication errors?
(Select all that apply.)
A. Verify the client using two identifiers
B. Clarify illegible prescriptions with the prescriber
C. Administer medications prepared by another nurse without verification
D. Document the dose after administration
E. Use the rights of medication administration
Correct Answer: A, B, D, E
Rationale: Two identifiers, clarifying illegible orders, documenting after administration, and
following the rights of medication administration all reduce errors. Administering a medication
prepared by another nurse without verification increases risk.
,3. A nurse is administering a medication via a nasogastric tube. Which action is correct?
A. Administer crushed extended-release tablets
B. Flush with 15–30 mL of water before and after
C. Mix medication with enteral feeding
D. Use sterile water for all flushes
Correct Answer: B
Rationale: Flushing with 15–30 mL of water before and after prevents clogging and ensures
delivery. Extended-release tablets should not be crushed, and medications should not be mixed
with enteral formula.
4. A client is prescribed a medication that is highly protein bound. The nurse should monitor
for which effect if the client also takes another highly protein-bound drug?
A. Decreased therapeutic effect
B. Increased risk of toxicity
C. No interaction
D. Increased renal excretion
Correct Answer: B
Rationale: Two highly protein-bound drugs compete for binding sites, increasing free drug
levels and the risk of toxicity.
5. Which route provides the most rapid onset of action?
A. Oral
B. Subcutaneous
C. Intravenous
D. Intramuscular
Correct Answer: C
Rationale: IV administration bypasses absorption and delivers the drug directly into the
bloodstream, producing the most rapid onset.
6. A nurse is teaching a client about sublingual nitroglycerin. Which statement indicates
understanding?
A. "I should swallow the tablet with water."
B. "I should place it under my tongue and let it dissolve."
,C. "I should chew it for faster relief."
D. "I should take it with food."
Correct Answer: B
Rationale: Sublingual tablets are placed under the tongue to dissolve for rapid absorption.
Swallowing or chewing reduces effectiveness.
7. A nurse is reviewing a prescription for a client with a history of falls. Which medication
class increases fall risk the most?
A. Benzodiazepines
B. Antacids
C. Laxatives
D. Topical antibiotics
Correct Answer: A
Rationale: Benzodiazepines cause sedation, dizziness, and impaired coordination, increasing
fall risk.
8. A nurse is calculating a pediatric dose. The child weighs 22 lb. The ordered dose is 10
mg/kg/day divided every 12 hours. How many mg per dose? (Round to the nearest tenth.)
A. 50 mg
B. 100 mg
C. 25 mg
D. 75 mg
Correct Answer: A
Rationale: 22 lb ÷ 2.2 = 10 kg. 10 mg/kg/day × 10 kg = 100 mg/day ÷ 2 doses = 50 mg/dose.
9. Which is a high-alert medication requiring independent double-check?
A. Acetaminophen
B. Insulin
C. Loratadine
D. Calcium carbonate
, Correct Answer: B
Rationale: Insulin is a high-alert medication due to the risk of severe hypoglycemia if dosed
incorrectly.
10. A nurse is preparing to give an intramuscular injection to an infant. Which site is
preferred?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
Correct Answer: C
Rationale: The vastus lateralis is the preferred IM site in infants because it is well developed
and avoids major nerves and blood vessels.
11. A client refuses a medication. What is the nurse's priority action?
A. Force the medication
B. Document the refusal and notify the provider
C. Hide it in food
D. Skip documentation
Correct Answer: B
Rationale: Respecting client autonomy, the nurse documents the refusal and informs the
provider.
12. Which action is correct when administering eye drops and ointment together?
A. Give ointment first
B. Give drops first, then ointment
C. Mix them together
D. Give only one at a time
Correct Answer: B
Rationale: Drops are instilled first, then ointment, because ointment can impede absorption
of drops.
