ATI Pharmacology 2026/2027 | ACTUAL-Style Practice Questions & Answers, ATI RN Nursing Exam Prep, Drug Classes, Pharmacokinetics, Medication Safety, Dosage Calculations, Adverse Effects, and Detailed Rationales

ATI Pharmacology 2026/2027 | ACTUAL-Style
Practice Questions & Answers, ATI RN Nursing
Exam Prep, Drug Classes, Pharmacokinetics,
Medication Safety, Dosage Calculations, Adverse
Effects, and Detailed Rationales
ATI Pharmacology Proctored Exam — 200 Multiple-Choice Questions


Question 1: A nurse is preparing to administer IV morphine sulfate to a
post-operative client. The client is alert, reports pain rated 8/10, has a
respiratory rate of 9 breaths/min, SpO2 of 94%, and BP of 110/70 mm
Hg. The provider prescribed morphine for pain greater than 6/10. What
is the nurse's priority action?
A. Administer the morphine and monitor every 15 minutes
B. Reassess pain in 30 minutes before proceeding
C. Hold the medication and notify the provider of respiratory depression
D. Administer naloxone concurrently to prevent adverse effects
CORRECT ANSWER: C. Hold the medication and notify the provider of
respiratory depression
Rationale: The client's respiratory rate of 9 breaths/min is below the
expected reference range of 12 to 20 breaths/min and indicates opioid-
induced respiratory depression, a life-threatening complication.
Administering morphine at this point could worsen respiratory status and
lead to respiratory arrest. The nurse must withhold the dose and notify the
provider immediately.


Question 2: A nurse is teaching a client recently diagnosed with
tuberculosis who has been prescribed isoniazid and rifampin. Which
statement should the nurse include in the teaching?
A. "Rifampin may cause yellowing of the eyes or skin, which is harmless."
B. "You should notify your provider if you experience numbness or tingling
in your hands or feet."
C. "You can stop taking isoniazid if you feel better after a few weeks."
D. "Take the medications with food to increase absorption."
CORRECT ANSWER: B. "You should notify your provider if you
experience numbness or tingling in your hands or feet."

,Rationale: Isoniazid can cause peripheral neuropathy manifested by
numbness or tingling due to vitamin B6 depletion. Clients must report
these symptoms promptly. Rifampin causes orange-red discoloration of
body fluids, which is harmless, but yellowing of eyes or skin indicates
hepatotoxicity. TB medications require strict adherence to prevent
resistance.


Question 3: A nurse is caring for a client with heart failure receiving
digoxin 0.125 mg orally daily. The client reports nausea, anorexia, and
blurred vision. Vital signs: HR 56 bpm, BP 118/76, RR 16. Labs:
potassium 3.1 mEq/L, digoxin level 2.2 ng/mL. What is the nurse's
priority intervention?
A. Document findings and reassess in 1 hour
B. Administer potassium supplements and continue digoxin
C. Notify the provider of digoxin toxicity and hold the dose
D. Encourage intake of potassium-rich foods and fluids
CORRECT ANSWER: C. Notify the provider of digoxin toxicity and hold
the dose
Rationale: A digoxin level greater than 2.0 ng/mL with symptoms such as
nausea, anorexia, bradycardia, and visual changes strongly indicates
digoxin toxicity. Hypokalemia further increases sensitivity to digoxin and the
risk of arrhythmias. The nurse should hold the medication and notify the
provider immediately.


Question 4: A nurse is caring for a client with hypertension prescribed
lisinopril. On the third day of therapy, the client develops a persistent,
dry cough. Which response by the nurse is most appropriate?
A. "This is a common adverse effect of ACE inhibitors and can be treated
with an antitussive."
B. "You should stop taking the medication immediately and call your
provider."
C. "This cough may indicate a serious allergic reaction and requires
emergency care."

,D. "ACE inhibitors commonly cause a dry cough due to bradykinin
accumulation; contact your provider for a possible medication change."
CORRECT ANSWER: D. "ACE inhibitors commonly cause a dry cough
due to bradykinin accumulation; contact your provider for a possible
medication change."
Rationale: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, which also prevents the breakdown of bradykinin.
Accumulation of bradykinin causes a persistent dry cough in approximately
10% to 20% of clients. This is not life-threatening, but the provider may
switch to an ARB if the cough becomes intolerable.


Question 5: A client is prescribed metformin for type 2 diabetes
mellitus. Which mechanism of action best describes how this
medication works?
A. Stimulates insulin secretion from pancreatic beta cells
B. Decreases hepatic glucose production and improves insulin sensitivity
C. Inhibits alpha-glucosidase enzymes in the small intestine
D. Increases glucose reabsorption in the renal tubules
CORRECT ANSWER: B. Decreases hepatic glucose production and
improves insulin sensitivity
Rationale: Metformin is a biguanide that works primarily by decreasing
hepatic glucose production and improving peripheral insulin sensitivity.
Unlike sulfonylureas, it does not stimulate insulin secretion. It is often used
as a first-line agent for type 2 diabetes because it does not cause weight
gain or hypoglycemia when used alone.


Question 6: A client taking warfarin for atrial fibrillation asks the nurse
about alcohol consumption. Which statement is most accurate?
A. Alcohol has no effect on warfarin metabolism
B. Occasional alcohol consumption is safe; chronic use may increase
anticoagulation effect
C. Alcohol should be completely avoided as it always decreases warfarin

, effectiveness
D. Moderate alcohol consumption enhances warfarin's therapeutic effect
CORRECT ANSWER: B. Occasional alcohol consumption is safe;
chronic use may increase anticoagulation effect
Rationale: Warfarin is metabolized by the liver via cytochrome P450
enzymes. Chronic alcohol consumption induces hepatic enzymes,
potentially increasing warfarin metabolism and decreasing its
anticoagulant effect. However, acute alcohol ingestion may inhibit
metabolism and increase anticoagulation effects. Clients should be
counseled about consistent alcohol consumption patterns and the need
for INR monitoring.


Question 7: A client is prescribed cephalexin for a respiratory tract
infection. Which assessment finding would contraindicate this
medication?
A. History of seasonal allergies treated with antihistamines
B. History of penicillin anaphylaxis
C. Mild gastrointestinal upset with dairy products
D. Current use of acetaminophen for pain management
CORRECT ANSWER: B. History of penicillin anaphylaxis
Rationale: Cephalosporins have a 1% to 3% cross-reactivity with
penicillins, particularly if the client has experienced anaphylaxis to
penicillins. A history of penicillin anaphylaxis is a significant
contraindication, and cephalosporins should be avoided or used with
extreme caution. Seasonal allergies, GI upset with dairy, and
acetaminophen use do not preclude cephalosporin use.


Question 8: A nurse is reviewing a client's medication record and notes
a prescription for a "trough level." When should the nurse schedule the
blood draw?
A. 30 minutes after the dose is administered
B. Exactly mid-way between doses