ATI RN Capstone Pharmacology 2026/2027 | ATI Capstone Pharmacology
Assessment 1 & 2 Study Guide & Exam Prep | ATI RN Capstone Pharmacology
Review | Pharmacology for Nursing, Medication Administration,
Pharmacokinetics, Pharmacodynamics, Drug Interactions, Adverse Effects,
Contraindications, Medication Safety, High-Alert Medications,
Antihypertensives, Antianginals, Anticoagulants, Antiplatelets, Diuretics,
Antiarrhythmics, Antibiotics, Antivirals, Antifungals, Analgesics, Opioids,
CNS Medications, Psychiatric Medications, Endocrine Medications, Diabetes
Drugs, Respiratory Medications, GI Medications, Maternal-Newborn
Medications, Pediatric Medications, Emergency Medications, Nursing
Assessments, Patient Education, Prioritization & Clinical Judgment | NCLEX-
Style Practice Questions & Detailed Rationales
Question 1: A nurse is preparing to administer medications to a client who has
type 1 diabetes mellitus. The client takes lispro insulin and has a new
prescription for pramlintide. Which of the following actions should the nurse
take?
A. Monitor the client for weight gain.
B. Monitor for hypoglycemia for 3 hr after pramlintide administration.
C. Inject the pramlintide in the client's upper arm.
D. Administer pramlintide 30 min prior to a meal.
E. Administer pramlintide with the lispro insulin in the same syringe.
CORRECT ANSWER: B. Monitor for hypoglycemia for 3 hr after pramlintide
administration.
Rationale: Pramlintide, when used with mealtime insulin, significantly increases
the risk of severe hypoglycemia, especially in type 1 diabetes. The risk is highest
within the first 3 hours after injection . Pramlintide should be injected into the
abdomen or thigh (not the upper arm), must be administered immediately before
each major meal, and causes weight loss (not gain) by slowing gastric emptying.
Pramlintide and insulin must be administered as separate injections .
Question 2: A nurse is caring for a client who has chemotherapy-induced
anemia. The nurse should expect to administer which of the following
medications to treat the anemia?
,A. Sargramostim
B. Filgrastim
C. Epoetin alfa
D. Romiplostim
E. Oprelvekin
CORRECT ANSWER: C. Epoetin alfa
Rationale: Epoetin alfa is a synthetic erythropoietin used to stimulate red blood
cell production and treat chemotherapy-induced anemia . Filgrastim and
sargramostim are colony-stimulating factors used for neutropenia (low white
blood cells), not anemia. Romiplostim is a thrombopoietin receptor agonist used
to treat thrombocytopenia (low platelets). Oprelvekin is used to prevent severe
thrombocytopenia .
Question 3: A nurse is assessing a client who started taking furosemide 2 days
ago and has a potassium level of 3.1 mEq/L. Which of the following findings
should the nurse expect?
A. Muscle rigidity of the extremities
B. Bounding radial pulses
C. Depressed deep tendon reflexes
D. Increased bowel motility
E. Hypertension
CORRECT ANSWER: C. Depressed deep tendon reflexes
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to
hypokalemia. Signs of hypokalemia include muscle weakness, depressed or
absent deep tendon reflexes, fatigue, constipation (decreased bowel motility),
weak pulses, and cardiac dysrhythmias . Muscle rigidity and bounding pulses are
not associated with hypokalemia.
Question 4: A nurse is caring for a client who has diabetic ketoacidosis. During
the shift, the client received 0.45% sodium chloride IV at 500 mL/hr for 3 hr, and
then dextrose 5% in water at 75 mL/hr for 2 hr. What is the total volume the
nurse should document as IV fluid intake?
,A. 1500 mL
B. 1650 mL
C. 1725 mL
D. 2075 mL
E. 1800 mL
CORRECT ANSWER: C. 1725 mL
Rationale: Calculation: 0.45% NaCl: 500 mL/hr × 3 hr = 1500 mL. D5W: 75 mL/hr ×
3 hr = 225 mL. Total = 1500 + 225 = 1725 mL . Always document all IV fluid
sources in intake and output records.
Question 5: A nurse is caring for a client who has a prescription for a hypotonic
IV fluid. Which of the following solutions should the nurse administer?
A. Lactated Ringer's
B. 0.9% sodium chloride
C. 3% sodium chloride
D. 0.45% sodium chloride
E. Dextrose 5% in 0.9% sodium chloride
CORRECT ANSWER: D. 0.45% sodium chloride
Rationale: 0.45% sodium chloride (half-normal saline) is a hypotonic solution — it
has a lower osmolarity than blood and causes fluid to shift into cells . Isotonic
solutions include 0.9% NaCl and Lactated Ringer's. Hypertonic solutions include
3% NaCl, D10W, and D5 in 0.9% NaCl. Hypotonic fluids are used for cellular
dehydration.
Question 6: A nurse is providing teaching to a client who is starting to take
finasteride for the treatment of male pattern baldness. Which of the following
statements by the client indicates an understanding of the teaching?
A. "This medication can increase the size of my prostate gland."
B. "This medication can increase my risk for impotence."
C. "This medication might increase the amount of ejaculate."
D. "This medication should increase my hair growth in 1 month."
E. "I should expect immediate results after the first dose."
CORRECT ANSWER: B. "This medication can increase my risk for impotence."
, Rationale: Finasteride is a 5-alpha reductase inhibitor used for male pattern
baldness and BPH. Its sexual side effects include decreased libido, impotence, and
decreased ejaculate volume . It shrinks the prostate (used for BPH), not enlarges
it. Hair growth results typically take 3–6 months to become apparent.
Question 7: A nurse is obtaining vital signs for a client who has been taking
propranolol. Which of the following findings should the nurse identify as an
adverse effect of the medication?
A. Respiratory rate 24/min
B. Oral temperature 38.1°C
C. Heart rate 52/min
D. Blood pressure 148/92 mm Hg
E. Oxygen saturation 98%
CORRECT ANSWER: C. Heart rate 52/min
Rationale: Propranolol is a nonselective beta-adrenergic blocker that reduces
heart rate and blood pressure. Bradycardia (heart rate below 60/min) is a
common adverse effect . The nurse should monitor for symptomatic bradycardia
and hold the medication if the heart rate is below prescribed parameters.
Respiratory rate of 24/min and elevated temperature are not typical adverse
effects of propranolol.
Question 8: A nurse is caring for a client who is receiving morphine sulfate for
pain management. Which of the following assessments is the priority?
A. Blood pressure
B. Respiratory rate
C. Pain level
D. Bowel sounds
E. Level of consciousness
CORRECT ANSWER: B. Respiratory rate
Rationale: Morphine sulfate is an opioid analgesic that can cause respiratory
depression, the most life-threatening adverse effect . The nurse must assess
respiratory rate first, as it is the priority assessment for detecting opioid-induced
Assessment 1 & 2 Study Guide & Exam Prep | ATI RN Capstone Pharmacology
Review | Pharmacology for Nursing, Medication Administration,
Pharmacokinetics, Pharmacodynamics, Drug Interactions, Adverse Effects,
Contraindications, Medication Safety, High-Alert Medications,
Antihypertensives, Antianginals, Anticoagulants, Antiplatelets, Diuretics,
Antiarrhythmics, Antibiotics, Antivirals, Antifungals, Analgesics, Opioids,
CNS Medications, Psychiatric Medications, Endocrine Medications, Diabetes
Drugs, Respiratory Medications, GI Medications, Maternal-Newborn
Medications, Pediatric Medications, Emergency Medications, Nursing
Assessments, Patient Education, Prioritization & Clinical Judgment | NCLEX-
Style Practice Questions & Detailed Rationales
Question 1: A nurse is preparing to administer medications to a client who has
type 1 diabetes mellitus. The client takes lispro insulin and has a new
prescription for pramlintide. Which of the following actions should the nurse
take?
A. Monitor the client for weight gain.
B. Monitor for hypoglycemia for 3 hr after pramlintide administration.
C. Inject the pramlintide in the client's upper arm.
D. Administer pramlintide 30 min prior to a meal.
E. Administer pramlintide with the lispro insulin in the same syringe.
CORRECT ANSWER: B. Monitor for hypoglycemia for 3 hr after pramlintide
administration.
Rationale: Pramlintide, when used with mealtime insulin, significantly increases
the risk of severe hypoglycemia, especially in type 1 diabetes. The risk is highest
within the first 3 hours after injection . Pramlintide should be injected into the
abdomen or thigh (not the upper arm), must be administered immediately before
each major meal, and causes weight loss (not gain) by slowing gastric emptying.
Pramlintide and insulin must be administered as separate injections .
Question 2: A nurse is caring for a client who has chemotherapy-induced
anemia. The nurse should expect to administer which of the following
medications to treat the anemia?
,A. Sargramostim
B. Filgrastim
C. Epoetin alfa
D. Romiplostim
E. Oprelvekin
CORRECT ANSWER: C. Epoetin alfa
Rationale: Epoetin alfa is a synthetic erythropoietin used to stimulate red blood
cell production and treat chemotherapy-induced anemia . Filgrastim and
sargramostim are colony-stimulating factors used for neutropenia (low white
blood cells), not anemia. Romiplostim is a thrombopoietin receptor agonist used
to treat thrombocytopenia (low platelets). Oprelvekin is used to prevent severe
thrombocytopenia .
Question 3: A nurse is assessing a client who started taking furosemide 2 days
ago and has a potassium level of 3.1 mEq/L. Which of the following findings
should the nurse expect?
A. Muscle rigidity of the extremities
B. Bounding radial pulses
C. Depressed deep tendon reflexes
D. Increased bowel motility
E. Hypertension
CORRECT ANSWER: C. Depressed deep tendon reflexes
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to
hypokalemia. Signs of hypokalemia include muscle weakness, depressed or
absent deep tendon reflexes, fatigue, constipation (decreased bowel motility),
weak pulses, and cardiac dysrhythmias . Muscle rigidity and bounding pulses are
not associated with hypokalemia.
Question 4: A nurse is caring for a client who has diabetic ketoacidosis. During
the shift, the client received 0.45% sodium chloride IV at 500 mL/hr for 3 hr, and
then dextrose 5% in water at 75 mL/hr for 2 hr. What is the total volume the
nurse should document as IV fluid intake?
,A. 1500 mL
B. 1650 mL
C. 1725 mL
D. 2075 mL
E. 1800 mL
CORRECT ANSWER: C. 1725 mL
Rationale: Calculation: 0.45% NaCl: 500 mL/hr × 3 hr = 1500 mL. D5W: 75 mL/hr ×
3 hr = 225 mL. Total = 1500 + 225 = 1725 mL . Always document all IV fluid
sources in intake and output records.
Question 5: A nurse is caring for a client who has a prescription for a hypotonic
IV fluid. Which of the following solutions should the nurse administer?
A. Lactated Ringer's
B. 0.9% sodium chloride
C. 3% sodium chloride
D. 0.45% sodium chloride
E. Dextrose 5% in 0.9% sodium chloride
CORRECT ANSWER: D. 0.45% sodium chloride
Rationale: 0.45% sodium chloride (half-normal saline) is a hypotonic solution — it
has a lower osmolarity than blood and causes fluid to shift into cells . Isotonic
solutions include 0.9% NaCl and Lactated Ringer's. Hypertonic solutions include
3% NaCl, D10W, and D5 in 0.9% NaCl. Hypotonic fluids are used for cellular
dehydration.
Question 6: A nurse is providing teaching to a client who is starting to take
finasteride for the treatment of male pattern baldness. Which of the following
statements by the client indicates an understanding of the teaching?
A. "This medication can increase the size of my prostate gland."
B. "This medication can increase my risk for impotence."
C. "This medication might increase the amount of ejaculate."
D. "This medication should increase my hair growth in 1 month."
E. "I should expect immediate results after the first dose."
CORRECT ANSWER: B. "This medication can increase my risk for impotence."
, Rationale: Finasteride is a 5-alpha reductase inhibitor used for male pattern
baldness and BPH. Its sexual side effects include decreased libido, impotence, and
decreased ejaculate volume . It shrinks the prostate (used for BPH), not enlarges
it. Hair growth results typically take 3–6 months to become apparent.
Question 7: A nurse is obtaining vital signs for a client who has been taking
propranolol. Which of the following findings should the nurse identify as an
adverse effect of the medication?
A. Respiratory rate 24/min
B. Oral temperature 38.1°C
C. Heart rate 52/min
D. Blood pressure 148/92 mm Hg
E. Oxygen saturation 98%
CORRECT ANSWER: C. Heart rate 52/min
Rationale: Propranolol is a nonselective beta-adrenergic blocker that reduces
heart rate and blood pressure. Bradycardia (heart rate below 60/min) is a
common adverse effect . The nurse should monitor for symptomatic bradycardia
and hold the medication if the heart rate is below prescribed parameters.
Respiratory rate of 24/min and elevated temperature are not typical adverse
effects of propranolol.
Question 8: A nurse is caring for a client who is receiving morphine sulfate for
pain management. Which of the following assessments is the priority?
A. Blood pressure
B. Respiratory rate
C. Pain level
D. Bowel sounds
E. Level of consciousness
CORRECT ANSWER: B. Respiratory rate
Rationale: Morphine sulfate is an opioid analgesic that can cause respiratory
depression, the most life-threatening adverse effect . The nurse must assess
respiratory rate first, as it is the priority assessment for detecting opioid-induced
