ATI Pharmacology Exam 2026/2027 | ACTUAL-Style Practice
Questions & Answers, Medication Administration, Drug Classes,
Pharmacological Nursing Interventions, and Detailed Rationales
Question 1: A nurse is preparing to administer phenobarbital to a client
who has a seizure disorder. The medication has a long half-life of 4
days. How many times per day should the nurse expect to administer
this medication?
A. One
B. Two
C. Three
D. Four
CORRECT ANSWER: A. One
Rationale: Medications with long half-lives remain at therapeutic levels
between doses for extended periods. Phenobarbital's half-life of 4 days
means the nurse should expect to administer this medication once daily to
maintain therapeutic serum concentrations.
Question 2: A staff educator is reviewing factors that influence
medication metabolism. Which of the following factors should the
educator include as a reason to administer lower medication dosages?
A. Increased renal secretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
CORRECT ANSWER: C. Liver failure
Rationale: Liver failure decreases metabolism and thus increases the
concentration of a medication in the body. This requires decreasing the
dosage to prevent toxicity. Increased medication-metabolizing enzymes
would actually require higher dosages, not lower ones.
Question 3: A nurse is preparing to administer eye drops to a client.
Which of the following actions should the nurse take to promote proper
distribution of the medication?
A. Have the client lie on her side
B. Ask the client to look up at the ceiling
C. Tell the client to blink forcefully when the drops enter her eye
D. Drop the medication onto the center of the client's cornea
,CORRECT ANSWER: B. Ask the client to look up at the ceiling
Rationale: The client should look upward to keep the drops from falling
onto the cornea. The nurse should drop the medication into the center of
the conjunctival sac and instruct the client to close the eye gently to
promote distribution.
Question 4: A nurse is completing discharge teaching for a client who
has a new prescription for transdermal patches. Which of the following
statements should the nurse identify as an indication that the client
understands the instructions?
A. "I will clean the site with an alcohol swab before I apply the patch."
B. "I will rotate the application sites weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch."
CORRECT ANSWER: C. "I will apply the patch to an area of skin with no
hair."
Rationale: The client should apply the patch to a hairless area of skin to
promote absorption of the medication. The site should be clean and dry,
but alcohol swabs may irritate the skin. Sites should be rotated with each
application, not weekly.
Question 5: A nurse is reviewing a client's medical record and notes a
new prescription for verifying the trough level of the client's
medication. Which of the following actions should the nurse take?
A. Obtain a blood specimen immediately prior to administering the next
dose of medication
B. Verify that the client has been taking the medication for 24 hours before
obtaining a blood specimen
C. Ask the client to provide a urine specimen after the next dose of
medication
D. Administer the medication and obtain a blood specimen 30 minutes
later
CORRECT ANSWER: A. Obtain a blood specimen immediately prior to
administering the next dose of medication
Rationale: To verify trough levels of a medication, the nurse should obtain a
blood specimen immediately before administering the next dose. The
,trough level represents the lowest concentration of the medication in the
client's bloodstream.
Question 6: A nurse is preparing a client's medications. Which of the
following actions should the nurse take in following legal practice
guidelines?
A. Maintain skill competency
B. Determine the dosage independently
C. Monitor for adverse effects
D. Safeguard medications
CORRECT ANSWER: C. Monitor for adverse effects
Rationale: A nurse is legally responsible for monitoring for side and adverse
effects of medication. Maintaining skill competency and safeguarding
medications are also legal responsibilities, but among the options
provided, monitoring for adverse effects is a core legal practice guideline.
Question 7: A nurse is reviewing a client's health record and notes a
new prescription for Lisinopril 10 mg PO once every day. The nurse
should identify this as which of the following types of prescription?
A. Single
B. Stat
C. Routine
D. PRN
CORRECT ANSWER: C. Routine
Rationale: A routine or standard prescription identifies medications to give
on a regular schedule with or without a termination date or a specific
number of doses. The nurse will administer this medication every day until
the provider discontinues it.
Question 8: A nurse is reviewing a new prescription for Ondansetron 4
mg PO PRN for nausea and vomiting for a client who has Hyperemesis
Gravidarum. The nurse should clarify which of the following parts of the
prescription with the provider?
A. Name
B. Dosage
, C. Route
D. Frequency
CORRECT ANSWER: D. Frequency
Rationale: This prescription does not include the time or frequency of
medication administration (how often the PRN medication may be given).
The nurse must clarify this with the prescribing provider before
administering the medication.
Question 9: 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.
Question 10: A 65-year-old client with hypertension is started on
lisinopril, an ACE inhibitor. What is the primary mechanism of action
for this drug class?
A. Blocks beta-adrenergic receptors on the heart
B. Inhibits angiotensin-converting enzyme, preventing formation of
angiotensin II
C. Directly relaxes vascular smooth muscle
D. Increases sodium and water excretion by blocking aldosterone
CORRECT ANSWER: B. Inhibits angiotensin-converting enzyme,
preventing formation of angiotensin II
Rationale: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, a potent vasoconstrictor. By preventing angiotensin II
formation, these drugs reduce vasoconstriction and aldosterone-mediated
sodium and water retention, thereby lowering blood pressure.
Questions & Answers, Medication Administration, Drug Classes,
Pharmacological Nursing Interventions, and Detailed Rationales
Question 1: A nurse is preparing to administer phenobarbital to a client
who has a seizure disorder. The medication has a long half-life of 4
days. How many times per day should the nurse expect to administer
this medication?
A. One
B. Two
C. Three
D. Four
CORRECT ANSWER: A. One
Rationale: Medications with long half-lives remain at therapeutic levels
between doses for extended periods. Phenobarbital's half-life of 4 days
means the nurse should expect to administer this medication once daily to
maintain therapeutic serum concentrations.
Question 2: A staff educator is reviewing factors that influence
medication metabolism. Which of the following factors should the
educator include as a reason to administer lower medication dosages?
A. Increased renal secretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
CORRECT ANSWER: C. Liver failure
Rationale: Liver failure decreases metabolism and thus increases the
concentration of a medication in the body. This requires decreasing the
dosage to prevent toxicity. Increased medication-metabolizing enzymes
would actually require higher dosages, not lower ones.
Question 3: A nurse is preparing to administer eye drops to a client.
Which of the following actions should the nurse take to promote proper
distribution of the medication?
A. Have the client lie on her side
B. Ask the client to look up at the ceiling
C. Tell the client to blink forcefully when the drops enter her eye
D. Drop the medication onto the center of the client's cornea
,CORRECT ANSWER: B. Ask the client to look up at the ceiling
Rationale: The client should look upward to keep the drops from falling
onto the cornea. The nurse should drop the medication into the center of
the conjunctival sac and instruct the client to close the eye gently to
promote distribution.
Question 4: A nurse is completing discharge teaching for a client who
has a new prescription for transdermal patches. Which of the following
statements should the nurse identify as an indication that the client
understands the instructions?
A. "I will clean the site with an alcohol swab before I apply the patch."
B. "I will rotate the application sites weekly."
C. "I will apply the patch to an area of skin with no hair."
D. "I will place the new patch on the site of the old patch."
CORRECT ANSWER: C. "I will apply the patch to an area of skin with no
hair."
Rationale: The client should apply the patch to a hairless area of skin to
promote absorption of the medication. The site should be clean and dry,
but alcohol swabs may irritate the skin. Sites should be rotated with each
application, not weekly.
Question 5: A nurse is reviewing a client's medical record and notes a
new prescription for verifying the trough level of the client's
medication. Which of the following actions should the nurse take?
A. Obtain a blood specimen immediately prior to administering the next
dose of medication
B. Verify that the client has been taking the medication for 24 hours before
obtaining a blood specimen
C. Ask the client to provide a urine specimen after the next dose of
medication
D. Administer the medication and obtain a blood specimen 30 minutes
later
CORRECT ANSWER: A. Obtain a blood specimen immediately prior to
administering the next dose of medication
Rationale: To verify trough levels of a medication, the nurse should obtain a
blood specimen immediately before administering the next dose. The
,trough level represents the lowest concentration of the medication in the
client's bloodstream.
Question 6: A nurse is preparing a client's medications. Which of the
following actions should the nurse take in following legal practice
guidelines?
A. Maintain skill competency
B. Determine the dosage independently
C. Monitor for adverse effects
D. Safeguard medications
CORRECT ANSWER: C. Monitor for adverse effects
Rationale: A nurse is legally responsible for monitoring for side and adverse
effects of medication. Maintaining skill competency and safeguarding
medications are also legal responsibilities, but among the options
provided, monitoring for adverse effects is a core legal practice guideline.
Question 7: A nurse is reviewing a client's health record and notes a
new prescription for Lisinopril 10 mg PO once every day. The nurse
should identify this as which of the following types of prescription?
A. Single
B. Stat
C. Routine
D. PRN
CORRECT ANSWER: C. Routine
Rationale: A routine or standard prescription identifies medications to give
on a regular schedule with or without a termination date or a specific
number of doses. The nurse will administer this medication every day until
the provider discontinues it.
Question 8: A nurse is reviewing a new prescription for Ondansetron 4
mg PO PRN for nausea and vomiting for a client who has Hyperemesis
Gravidarum. The nurse should clarify which of the following parts of the
prescription with the provider?
A. Name
B. Dosage
, C. Route
D. Frequency
CORRECT ANSWER: D. Frequency
Rationale: This prescription does not include the time or frequency of
medication administration (how often the PRN medication may be given).
The nurse must clarify this with the prescribing provider before
administering the medication.
Question 9: 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.
Question 10: A 65-year-old client with hypertension is started on
lisinopril, an ACE inhibitor. What is the primary mechanism of action
for this drug class?
A. Blocks beta-adrenergic receptors on the heart
B. Inhibits angiotensin-converting enzyme, preventing formation of
angiotensin II
C. Directly relaxes vascular smooth muscle
D. Increases sodium and water excretion by blocking aldosterone
CORRECT ANSWER: B. Inhibits angiotensin-converting enzyme,
preventing formation of angiotensin II
Rationale: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, a potent vasoconstrictor. By preventing angiotensin II
formation, these drugs reduce vasoconstriction and aldosterone-mediated
sodium and water retention, thereby lowering blood pressure.
