ATI Pharmacology Study Guide-Original Practice
Question Bank & Clinical Rationales Graded A+
This specialized clinical test-preparation resource provides a comprehensive practice
question bank and verified answers modeled directly after the ATI Pharmacology
Content Mastery Series for . It delivers extensive pre-licensure coverage of high-alert
drug classifications, mechanism of action profiles, intricate therapeutic drug monitoring,
and safe dosage calculations across the lifespan. Nursing students will master critical
client care prioritization methods, advanced pharmacokinetic properties, and high-yield
physiological monitoring indicators to ensure an optimal proficiency level on their
proctored assessment.
1. A nurse is preparing to administer intravenous immune globulin (IVIG). Which
premedication should the nurse anticipate administering to prevent adverse
reactions?
A) Acetaminophen and diphenhydramine
B) Acetaminophen and diphenhydramine
C) Meperidine and hydroxyzine
D) Methylprednisolone and famotidine
Rationale: Premedication with acetaminophen and diphenhydramine is common to reduce
infusion-related reactions such as fever, chills, and urticaria.
2. A client is prescribed azathioprine. Which laboratory value should the nurse
monitor most closely?
A) Serum potassium
B) White blood cell count
C) Serum calcium
D) Serum magnesium
Rationale: Azathioprine can cause bone marrow suppression; monitoring WBC count helps
detect leukopenia and infection risk.
,3. A nurse is teaching a client about tacrolimus. Which instruction is most
important to include?
A) Avoid all sources of vitamin K
B) Report any new-onset tremor or headache immediately
C) Take with grapefruit juice to enhance absorption
D) Double the dose if a dose is missed
Rationale: Tacrolimus can cause neurotoxicity and nephrotoxicity; tremors and headaches
may indicate toxicity and require immediate evaluation.
4. A client receiving cyclosporine reports gum tenderness and swelling. Which
action should the nurse take?
A) Advise the client to stop the medication
B) Document the finding and notify the provider
C) Recommend increasing oral hygiene frequency
D) Administer an antibiotic
Rationale: Gingival hyperplasia is a common adverse effect of cyclosporine; the provider
may need to adjust therapy, but the nurse should not stop the drug independently.
5. A nurse is administering mycophenolate mofetil. Which precaution is essential?
A) Crush the medication and mix with food
B) Avoid handling crushed tablets or opening capsules
C) Administer with antacids
D) Give with grapefruit juice
Rationale: Mycophenolate is teratogenic and hazardous; nurses should avoid direct contact
with crushed tablets or capsule contents.
,6. A client is prescribed methotrexate for rheumatoid arthritis. Which supplement
should the nurse expect to be prescribed concurrently?
A) Vitamin D
B) Folic acid
C) Vitamin B12
D) Iron
Rationale: Folic acid supplementation reduces methotrexate-related side effects such as
mucositis and anemia.
7. A nurse is teaching a client about leflunomide. Which adverse effect should the
nurse include?
A) Bradycardia
B) Hepatotoxicity
C) Hyperkalemia
D) Hypotension
Rationale: Leflunomide can cause hepatotoxicity; liver function tests should be monitored
regularly.
8. A client receiving hydroxychloroquine should be monitored for which serious
adverse effect?
A) Ototoxicity
B) Retinopathy
C) Nephrotoxicity
D) Cardiotoxicity
Rationale: Hydroxychloroquine can cause irreversible retinopathy; regular ophthalmologic
exams are required.
9. A nurse is administering sulfasalazine. Which instruction should the nurse
include in the teaching?
, A) Take with a high-protein meal
B) Expect orange-yellow discoloration of urine
C) Avoid all fluids for 1 hour after taking
D) Take at bedtime to reduce GI upset
Rationale: Sulfasalazine can cause harmless orange-yellow discoloration of urine and skin.
10. A client is prescribed infliximab. Which screening test must be completed
before initiating therapy?
A) Serum potassium
B) Tuberculosis (TB) test
C) Serum calcium
D) Thyroid function tests
Rationale: TNF inhibitors like infliximab increase the risk of reactivating latent TB;
screening is mandatory before starting therapy.
11. A nurse is teaching a client about etanercept. Which instruction is correct?
A) Take the medication orally once daily
B) Rotate injection sites and report signs of infection
C) Take with grapefruit juice
D) Stop the medication if you feel better
Rationale: Etanercept is given subcutaneously; rotating sites reduces irritation, and
reporting infections is crucial due to immunosuppression.
12. A client is prescribed adalimumab. Which adverse effect requires immediate
notification of the provider?
A) Mild injection site redness
B) Fever and productive cough
C) Fatigue
D) Headache
Question Bank & Clinical Rationales Graded A+
This specialized clinical test-preparation resource provides a comprehensive practice
question bank and verified answers modeled directly after the ATI Pharmacology
Content Mastery Series for . It delivers extensive pre-licensure coverage of high-alert
drug classifications, mechanism of action profiles, intricate therapeutic drug monitoring,
and safe dosage calculations across the lifespan. Nursing students will master critical
client care prioritization methods, advanced pharmacokinetic properties, and high-yield
physiological monitoring indicators to ensure an optimal proficiency level on their
proctored assessment.
1. A nurse is preparing to administer intravenous immune globulin (IVIG). Which
premedication should the nurse anticipate administering to prevent adverse
reactions?
A) Acetaminophen and diphenhydramine
B) Acetaminophen and diphenhydramine
C) Meperidine and hydroxyzine
D) Methylprednisolone and famotidine
Rationale: Premedication with acetaminophen and diphenhydramine is common to reduce
infusion-related reactions such as fever, chills, and urticaria.
2. A client is prescribed azathioprine. Which laboratory value should the nurse
monitor most closely?
A) Serum potassium
B) White blood cell count
C) Serum calcium
D) Serum magnesium
Rationale: Azathioprine can cause bone marrow suppression; monitoring WBC count helps
detect leukopenia and infection risk.
,3. A nurse is teaching a client about tacrolimus. Which instruction is most
important to include?
A) Avoid all sources of vitamin K
B) Report any new-onset tremor or headache immediately
C) Take with grapefruit juice to enhance absorption
D) Double the dose if a dose is missed
Rationale: Tacrolimus can cause neurotoxicity and nephrotoxicity; tremors and headaches
may indicate toxicity and require immediate evaluation.
4. A client receiving cyclosporine reports gum tenderness and swelling. Which
action should the nurse take?
A) Advise the client to stop the medication
B) Document the finding and notify the provider
C) Recommend increasing oral hygiene frequency
D) Administer an antibiotic
Rationale: Gingival hyperplasia is a common adverse effect of cyclosporine; the provider
may need to adjust therapy, but the nurse should not stop the drug independently.
5. A nurse is administering mycophenolate mofetil. Which precaution is essential?
A) Crush the medication and mix with food
B) Avoid handling crushed tablets or opening capsules
C) Administer with antacids
D) Give with grapefruit juice
Rationale: Mycophenolate is teratogenic and hazardous; nurses should avoid direct contact
with crushed tablets or capsule contents.
,6. A client is prescribed methotrexate for rheumatoid arthritis. Which supplement
should the nurse expect to be prescribed concurrently?
A) Vitamin D
B) Folic acid
C) Vitamin B12
D) Iron
Rationale: Folic acid supplementation reduces methotrexate-related side effects such as
mucositis and anemia.
7. A nurse is teaching a client about leflunomide. Which adverse effect should the
nurse include?
A) Bradycardia
B) Hepatotoxicity
C) Hyperkalemia
D) Hypotension
Rationale: Leflunomide can cause hepatotoxicity; liver function tests should be monitored
regularly.
8. A client receiving hydroxychloroquine should be monitored for which serious
adverse effect?
A) Ototoxicity
B) Retinopathy
C) Nephrotoxicity
D) Cardiotoxicity
Rationale: Hydroxychloroquine can cause irreversible retinopathy; regular ophthalmologic
exams are required.
9. A nurse is administering sulfasalazine. Which instruction should the nurse
include in the teaching?
, A) Take with a high-protein meal
B) Expect orange-yellow discoloration of urine
C) Avoid all fluids for 1 hour after taking
D) Take at bedtime to reduce GI upset
Rationale: Sulfasalazine can cause harmless orange-yellow discoloration of urine and skin.
10. A client is prescribed infliximab. Which screening test must be completed
before initiating therapy?
A) Serum potassium
B) Tuberculosis (TB) test
C) Serum calcium
D) Thyroid function tests
Rationale: TNF inhibitors like infliximab increase the risk of reactivating latent TB;
screening is mandatory before starting therapy.
11. A nurse is teaching a client about etanercept. Which instruction is correct?
A) Take the medication orally once daily
B) Rotate injection sites and report signs of infection
C) Take with grapefruit juice
D) Stop the medication if you feel better
Rationale: Etanercept is given subcutaneously; rotating sites reduces irritation, and
reporting infections is crucial due to immunosuppression.
12. A client is prescribed adalimumab. Which adverse effect requires immediate
notification of the provider?
A) Mild injection site redness
B) Fever and productive cough
C) Fatigue
D) Headache
