ATI Pharmacology Study Guide-Original Practice
Question Bank & Clinical Rationales
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.
SECTION 1: CARDIOVASCULAR MEDICATIONS (Questions 1–
50)
1. A nurse is administering digoxin to a client. Which assessment finding should
cause the nurse to withhold the dose?
A) Blood pressure 110/70 mm Hg
B) Apical pulse 52 beats/min
C) Respiratory rate 18/min
D) Temperature 99.2°F
Rationale: Digoxin should be withheld when the apical pulse is below 60 beats/min in
adults because bradycardia may indicate toxicity.
2. A client taking warfarin has an INR of 6.2. Which action should the nurse take
first?
A) Administer the next dose as prescribed
B) Hold the warfarin and notify the provider
C) Encourage the client to eat more green vegetables
D) Document the finding and reassess in 24 hours
Rationale: An INR of 6.2 is supratherapeutic and places the client at high risk for bleeding;
hold the drug and notify the provider immediately.
,3. A nurse is teaching a client about lisinopril. Which adverse effect should the
nurse include?
A) Hyperkalemia
B) Dry, persistent cough
C) Bradycardia
D) Hyperglycemia
Rationale: ACE inhibitors like lisinopril commonly cause a dry, persistent cough due to
bradykinin accumulation.
4. A client is prescribed metoprolol. Which instruction should the nurse include in
the teaching?
A) Stop the medication if you feel better
B) Do not stop this medication abruptly
C) Take the medication with grapefruit juice
D) Double the dose if a dose is missed
Rationale: Abrupt discontinuation of beta-blockers can cause rebound hypertension,
tachycardia, and angina.
5. A nurse is administering amlodipine. Which finding indicates a therapeutic
response?
A) Heart rate decreased from 100 to 72 beats/min
B) Blood pressure decreased from 160/95 to 128/82 mm Hg
C) Urine output increased
D) Blood glucose decreased
Rationale: Amlodipine is a calcium channel blocker used to lower blood pressure; a
reduction toward normal range indicates therapeutic effect.
6. A client receiving furosemide reports muscle weakness and palpitations. Which
laboratory value should the nurse check first?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Rationale: Furosemide causes potassium loss; hypokalemia can cause muscle weakness
and cardiac dysrhythmias.
7. A nurse is teaching a client about spironolactone. Which food should the nurse
instruct the client to avoid?
A) Apples
B) Bananas
C) White rice
,D) Bread
Rationale: Spironolactone is potassium-sparing; clients should avoid high-potassium foods
to prevent hyperkalemia.
8. A client is receiving intravenous heparin. Which laboratory value should the
nurse monitor?
A) INR
B) aPTT
C) Platelet count
D) Bleeding time
Rationale: aPTT is used to monitor heparin therapy; therapeutic range is 1.5–2.5 times the
control value.
9. A nurse is preparing to administer enoxaparin. Which action is correct?
A) Massage the injection site after administration
B) Inject into the fatty tissue of the abdomen
C) Aspirate before injecting
D) Administer intramuscularly
Rationale: Enoxaparin is given subcutaneously into the abdomen; do not aspirate or
massage to prevent hematoma.
10. A client is prescribed atorvastatin. Which instruction should the nurse include?
A) Take the medication in the morning
B) Report muscle pain or weakness immediately
C) Avoid all dairy products
D) Take with grapefruit juice
Rationale: Statins can cause rhabdomyolysis; clients should report muscle pain, tenderness,
or weakness immediately.
11. A nurse is administering carvedilol to a client with heart failure. Which
assessment finding requires immediate intervention?
A) Blood pressure 110/70 mm Hg
B) Heart rate 48 beats/min
C) Respiratory rate 18/min
D) Weight loss of 1 lb
Rationale: Carvedilol can cause bradycardia; a heart rate below 50–60 beats/min requires
immediate intervention.
12. A client is receiving nitroglycerin intravenously. Which finding indicates a
therapeutic response?
A) Increased heart rate
, B) Relief of chest pain
C) Increased blood pressure
D) Decreased urine output
Rationale: Nitroglycerin is used to relieve chest pain by dilating coronary arteries; relief of
pain indicates therapeutic effect.
13. A nurse is teaching a client about sublingual nitroglycerin. Which instruction is
correct?
A) Swallow the tablet with water
B) Place the tablet under the tongue and let it dissolve
C) Chew the tablet for faster relief
D) Take with food
Rationale: Sublingual nitroglycerin should be placed under the tongue and allowed to
dissolve for rapid absorption.
14. A client taking digoxin reports nausea and visual changes. Which action should
the nurse take?
A) Administer the next dose as prescribed
B) Hold the digoxin and notify the provider
C) Encourage the client to eat
D) Document and reassess in 4 hours
Rationale: Nausea and visual changes (yellow-green halos) are signs of digoxin toxicity;
hold the drug and notify the provider.
15. A nurse is administering hydralazine. Which adverse effect should the nurse
monitor for?
A) Bradycardia
B) Reflex tachycardia
C) Hypertension
D) Hyperkalemia
Rationale: Hydralazine is a direct vasodilator that can cause reflex tachycardia as the body
compensates for decreased blood pressure.
16. A client is prescribed clopidogrel. Which instruction should the nurse include?
A) Take with food
B) Avoid omeprazole while taking this medication
C) Take at bedtime
D) Double the dose if a dose is missed
Rationale: Omeprazole inhibits CYP2C19, reducing clopidogrel activation; use
pantoprazole if a PPI is needed.
Question Bank & Clinical Rationales
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.
SECTION 1: CARDIOVASCULAR MEDICATIONS (Questions 1–
50)
1. A nurse is administering digoxin to a client. Which assessment finding should
cause the nurse to withhold the dose?
A) Blood pressure 110/70 mm Hg
B) Apical pulse 52 beats/min
C) Respiratory rate 18/min
D) Temperature 99.2°F
Rationale: Digoxin should be withheld when the apical pulse is below 60 beats/min in
adults because bradycardia may indicate toxicity.
2. A client taking warfarin has an INR of 6.2. Which action should the nurse take
first?
A) Administer the next dose as prescribed
B) Hold the warfarin and notify the provider
C) Encourage the client to eat more green vegetables
D) Document the finding and reassess in 24 hours
Rationale: An INR of 6.2 is supratherapeutic and places the client at high risk for bleeding;
hold the drug and notify the provider immediately.
,3. A nurse is teaching a client about lisinopril. Which adverse effect should the
nurse include?
A) Hyperkalemia
B) Dry, persistent cough
C) Bradycardia
D) Hyperglycemia
Rationale: ACE inhibitors like lisinopril commonly cause a dry, persistent cough due to
bradykinin accumulation.
4. A client is prescribed metoprolol. Which instruction should the nurse include in
the teaching?
A) Stop the medication if you feel better
B) Do not stop this medication abruptly
C) Take the medication with grapefruit juice
D) Double the dose if a dose is missed
Rationale: Abrupt discontinuation of beta-blockers can cause rebound hypertension,
tachycardia, and angina.
5. A nurse is administering amlodipine. Which finding indicates a therapeutic
response?
A) Heart rate decreased from 100 to 72 beats/min
B) Blood pressure decreased from 160/95 to 128/82 mm Hg
C) Urine output increased
D) Blood glucose decreased
Rationale: Amlodipine is a calcium channel blocker used to lower blood pressure; a
reduction toward normal range indicates therapeutic effect.
6. A client receiving furosemide reports muscle weakness and palpitations. Which
laboratory value should the nurse check first?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Rationale: Furosemide causes potassium loss; hypokalemia can cause muscle weakness
and cardiac dysrhythmias.
7. A nurse is teaching a client about spironolactone. Which food should the nurse
instruct the client to avoid?
A) Apples
B) Bananas
C) White rice
,D) Bread
Rationale: Spironolactone is potassium-sparing; clients should avoid high-potassium foods
to prevent hyperkalemia.
8. A client is receiving intravenous heparin. Which laboratory value should the
nurse monitor?
A) INR
B) aPTT
C) Platelet count
D) Bleeding time
Rationale: aPTT is used to monitor heparin therapy; therapeutic range is 1.5–2.5 times the
control value.
9. A nurse is preparing to administer enoxaparin. Which action is correct?
A) Massage the injection site after administration
B) Inject into the fatty tissue of the abdomen
C) Aspirate before injecting
D) Administer intramuscularly
Rationale: Enoxaparin is given subcutaneously into the abdomen; do not aspirate or
massage to prevent hematoma.
10. A client is prescribed atorvastatin. Which instruction should the nurse include?
A) Take the medication in the morning
B) Report muscle pain or weakness immediately
C) Avoid all dairy products
D) Take with grapefruit juice
Rationale: Statins can cause rhabdomyolysis; clients should report muscle pain, tenderness,
or weakness immediately.
11. A nurse is administering carvedilol to a client with heart failure. Which
assessment finding requires immediate intervention?
A) Blood pressure 110/70 mm Hg
B) Heart rate 48 beats/min
C) Respiratory rate 18/min
D) Weight loss of 1 lb
Rationale: Carvedilol can cause bradycardia; a heart rate below 50–60 beats/min requires
immediate intervention.
12. A client is receiving nitroglycerin intravenously. Which finding indicates a
therapeutic response?
A) Increased heart rate
, B) Relief of chest pain
C) Increased blood pressure
D) Decreased urine output
Rationale: Nitroglycerin is used to relieve chest pain by dilating coronary arteries; relief of
pain indicates therapeutic effect.
13. A nurse is teaching a client about sublingual nitroglycerin. Which instruction is
correct?
A) Swallow the tablet with water
B) Place the tablet under the tongue and let it dissolve
C) Chew the tablet for faster relief
D) Take with food
Rationale: Sublingual nitroglycerin should be placed under the tongue and allowed to
dissolve for rapid absorption.
14. A client taking digoxin reports nausea and visual changes. Which action should
the nurse take?
A) Administer the next dose as prescribed
B) Hold the digoxin and notify the provider
C) Encourage the client to eat
D) Document and reassess in 4 hours
Rationale: Nausea and visual changes (yellow-green halos) are signs of digoxin toxicity;
hold the drug and notify the provider.
15. A nurse is administering hydralazine. Which adverse effect should the nurse
monitor for?
A) Bradycardia
B) Reflex tachycardia
C) Hypertension
D) Hyperkalemia
Rationale: Hydralazine is a direct vasodilator that can cause reflex tachycardia as the body
compensates for decreased blood pressure.
16. A client is prescribed clopidogrel. Which instruction should the nurse include?
A) Take with food
B) Avoid omeprazole while taking this medication
C) Take at bedtime
D) Double the dose if a dose is missed
Rationale: Omeprazole inhibits CYP2C19, reducing clopidogrel activation; use
pantoprazole if a PPI is needed.
