100 Original NGN-Style ATI RN
Pharmacology Proctored Exam Practice
Questions with Detailed Answers and
Rationales for 2026 Proctored and
Retake Preparation, Covering High-Alert
Medications, Dosage Calculations, Drug
Classes, Safety, Clinical Judgment,
Prioritization Skills, Ultimate
Comprehensive Exam-Focused Nursing
Student Review Guide
1. A nurse is preparing to administer
digoxin. Which finding should cause the
,nurse to hold the dose and notify the
provider?
Answer: Heart rate 52/min.
Rationale: Digoxin slows the heart rate.
Hold for adult HR <60/min and assess for
toxicity (nausea, visual changes,
confusion).
2. A client on heparin has a critically
elevated aPTT and signs of bleeding.
Which antidote does the nurse
anticipate?
Answer: Protamine sulfate.
Rationale: Protamine sulfate reverses
heparin. Vitamin K reverses warfarin.
3. A client taking warfarin has an INR of
5.8. Which action is priority?
,Answer: Hold warfarin and prepare to
administer vitamin K.
Rationale: INR >5 increases bleeding
risk. Vitamin K is the antidote; fresh
frozen plasma may be used for severe
bleeding.
4. A client is scheduled for a CT scan with
contrast. Which medication should the
nurse question continuing?
Answer: Metformin.
Rationale: Metformin is held
before/after contrast due to risk of lactic
acidosis, especially if renal impairment
occurs.
5. A client started on lisinopril reports a
persistent dry cough. Which action is
, best?
Answer: Notify the provider; an ARB may
be substituted.
Rationale: ACE inhibitors commonly
cause dry cough. ARBs are less likely to
cause cough.
6. A nurse is teaching a client about
furosemide. Which instruction is
correct?
Answer: “Take it in the morning and eat
potassium-rich foods.”
Rationale: Furosemide is a loop diuretic
that can cause hypokalemia and nocturia
if taken late.
7. A client on insulin glargine asks when
the medication will peak. The nurse
Pharmacology Proctored Exam Practice
Questions with Detailed Answers and
Rationales for 2026 Proctored and
Retake Preparation, Covering High-Alert
Medications, Dosage Calculations, Drug
Classes, Safety, Clinical Judgment,
Prioritization Skills, Ultimate
Comprehensive Exam-Focused Nursing
Student Review Guide
1. A nurse is preparing to administer
digoxin. Which finding should cause the
,nurse to hold the dose and notify the
provider?
Answer: Heart rate 52/min.
Rationale: Digoxin slows the heart rate.
Hold for adult HR <60/min and assess for
toxicity (nausea, visual changes,
confusion).
2. A client on heparin has a critically
elevated aPTT and signs of bleeding.
Which antidote does the nurse
anticipate?
Answer: Protamine sulfate.
Rationale: Protamine sulfate reverses
heparin. Vitamin K reverses warfarin.
3. A client taking warfarin has an INR of
5.8. Which action is priority?
,Answer: Hold warfarin and prepare to
administer vitamin K.
Rationale: INR >5 increases bleeding
risk. Vitamin K is the antidote; fresh
frozen plasma may be used for severe
bleeding.
4. A client is scheduled for a CT scan with
contrast. Which medication should the
nurse question continuing?
Answer: Metformin.
Rationale: Metformin is held
before/after contrast due to risk of lactic
acidosis, especially if renal impairment
occurs.
5. A client started on lisinopril reports a
persistent dry cough. Which action is
, best?
Answer: Notify the provider; an ARB may
be substituted.
Rationale: ACE inhibitors commonly
cause dry cough. ARBs are less likely to
cause cough.
6. A nurse is teaching a client about
furosemide. Which instruction is
correct?
Answer: “Take it in the morning and eat
potassium-rich foods.”
Rationale: Furosemide is a loop diuretic
that can cause hypokalemia and nocturia
if taken late.
7. A client on insulin glargine asks when
the medication will peak. The nurse
