ATI RN Pharmacology Proctored Exam 2025 with NGN –
Average Score 90% – Fully Rationalized – Original Copy
Instructions
This exam contains 80 challenging, NCLEX-aligned pharmacology questions covering various
medication categories, safe dosage ranges, and adverse effects. Each question includes verified
answers with full rationales. Read each question carefully and select the best answer.
Questions
Question 1: A nurse is preparing to administer digoxin 0.25 mg PO to a client with heart failure. The
client’s heart rate is 52 beats per minute. What should the nurse do first?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider.
C. Check the client’s serum potassium level.
D. Recheck the heart rate in 15 minutes.
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. A heart rate below 60
beats per minute indicates potential bradycardia, a contraindication for digoxin admin-
istration. The nurse should withhold the medication and notify the provider to prevent
toxicity or worsening bradycardia. Checking potassium levels or rechecking the heart
rate may be relevant later, but withholding the medication is the priority.
Question 2: A client is receiving heparin 5,000 units subcutaneously every 12 hours. Which labora-
tory value should the nurse monitor to assess the therapeutic effect?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Answer: B
Rationale: Heparin’s therapeutic effect is monitored using aPTT, which assesses the in-
trinsic clotting pathway. The therapeutic range for aPTT is typically 1.5–2.5 times the
control value. PT and INR are used for warfarin, and platelet count monitors for heparin-
induced thrombocytopenia but not therapeutic effect.
Question 3: A nurse is teaching a client about warfarin therapy. Which food should the client limit to
avoid interfering with the medication?
A. Broccoli
B. Apples
C. Chicken
1
, D. Rice
Answer: A
Rationale: Warfarin is a vitamin K antagonist, and foods high in vitamin K, such as
broccoli, can reduce its anticoagulant effect. Consistent intake is key, but limiting high-
vitamin K foods helps maintain therapeutic INR levels. Apples, chicken, and rice do not
significantly affect warfarin.
Question 4: A client with type 2 diabetes is prescribed metformin 1,000 mg PO twice daily. The client
reports nausea and diarrhea. What should the nurse advise?
A. Stop the medication immediately.
B. Take the medication with food.
C. Double the dose to build tolerance.
D. Take the medication at bedtime only.
Answer: B
Rationale: Metformin commonly causes gastrointestinal side effects like nausea and di-
arrhea, which can be minimized by taking it with food. Stopping the medication or alter-
ing the dose without provider consultation is unsafe. Taking it only at bedtime does not
address the issue.
Question 5: A nurse is administering furosemide 40 mg IV to a client with pulmonary edema. Which
finding indicates the medication is effective?
A. Decreased blood pressure
B. Increased urine output
C. Increased respiratory rate
D. Decreased heart rate
Answer: B
Rationale: Furosemide is a loop diuretic that promotes diuresis to reduce fluid overload
in pulmonary edema. Increased urine output indicates effective fluid removal. Decreased
blood pressure may occur but is not the primary indicator. Increased respiratory rate or
decreased heart rate are not directly related to furosemide’s action.
Question 6: A client is prescribed lisinopril 10 mg PO daily. Which adverse effect should the nurse
monitor for?
A. Hyperkalemia
B. Hypoglycemia
C. Hypertension
D. Bradycardia
Answer: A
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia by reducing aldosterone
secretion, which decreases potassium excretion. Hypoglycemia, hypertension, and brady-
cardia are not typical adverse effects of lisinopril.
2
, Question 7: A nurse is preparing to administer insulin glargine to a client. When is the best time to
administer this medication?
A. 30 minutes before breakfast
B. At bedtime
C. With the evening meal
D. At noon
Answer: B
Rationale: Insulin glargine is a long-acting insulin with a steady effect over 24 hours. It is
typically administered at bedtime to provide consistent blood glucose control throughout
the day and night. Timing with meals or at noon is more appropriate for short-acting
insulins.
Question 8: A client with asthma is prescribed albuterol via inhaler. The nurse should instruct the
client to report which adverse effect?
A. Drowsiness
B. Tremors
C. Constipation
D. Weight loss
Answer: B
Rationale: Albuterol, a beta-2 agonist, can cause tremors as a common side effect due
to stimulation of the nervous system. Drowsiness, constipation, and weight loss are not
typically associated with albuterol use.
Question 9: A nurse is calculating the safe dosage of amoxicillin for a child weighing 20 kg. The
recommended dose is 25 mg/kg/day in two divided doses. What is the total daily dose?
A. 250 mg
B. 500 mg
C. 750 mg
D. 1,000 mg
Answer: B
Rationale: To calculate the total daily dose: 25 mg/kg/day × 20 kg = 500 mg/day. The
dose is divided into two, so each dose is 250 mg. The total daily dose is 500 mg.
Question 10: A client is receiving vancomycin IV. Which laboratory value should the nurse monitor to
prevent toxicity?
A. Serum creatinine
B. Blood glucose
C. Hemoglobin
D. White blood cell count
3
Average Score 90% – Fully Rationalized – Original Copy
Instructions
This exam contains 80 challenging, NCLEX-aligned pharmacology questions covering various
medication categories, safe dosage ranges, and adverse effects. Each question includes verified
answers with full rationales. Read each question carefully and select the best answer.
Questions
Question 1: A nurse is preparing to administer digoxin 0.25 mg PO to a client with heart failure. The
client’s heart rate is 52 beats per minute. What should the nurse do first?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider.
C. Check the client’s serum potassium level.
D. Recheck the heart rate in 15 minutes.
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. A heart rate below 60
beats per minute indicates potential bradycardia, a contraindication for digoxin admin-
istration. The nurse should withhold the medication and notify the provider to prevent
toxicity or worsening bradycardia. Checking potassium levels or rechecking the heart
rate may be relevant later, but withholding the medication is the priority.
Question 2: A client is receiving heparin 5,000 units subcutaneously every 12 hours. Which labora-
tory value should the nurse monitor to assess the therapeutic effect?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Answer: B
Rationale: Heparin’s therapeutic effect is monitored using aPTT, which assesses the in-
trinsic clotting pathway. The therapeutic range for aPTT is typically 1.5–2.5 times the
control value. PT and INR are used for warfarin, and platelet count monitors for heparin-
induced thrombocytopenia but not therapeutic effect.
Question 3: A nurse is teaching a client about warfarin therapy. Which food should the client limit to
avoid interfering with the medication?
A. Broccoli
B. Apples
C. Chicken
1
, D. Rice
Answer: A
Rationale: Warfarin is a vitamin K antagonist, and foods high in vitamin K, such as
broccoli, can reduce its anticoagulant effect. Consistent intake is key, but limiting high-
vitamin K foods helps maintain therapeutic INR levels. Apples, chicken, and rice do not
significantly affect warfarin.
Question 4: A client with type 2 diabetes is prescribed metformin 1,000 mg PO twice daily. The client
reports nausea and diarrhea. What should the nurse advise?
A. Stop the medication immediately.
B. Take the medication with food.
C. Double the dose to build tolerance.
D. Take the medication at bedtime only.
Answer: B
Rationale: Metformin commonly causes gastrointestinal side effects like nausea and di-
arrhea, which can be minimized by taking it with food. Stopping the medication or alter-
ing the dose without provider consultation is unsafe. Taking it only at bedtime does not
address the issue.
Question 5: A nurse is administering furosemide 40 mg IV to a client with pulmonary edema. Which
finding indicates the medication is effective?
A. Decreased blood pressure
B. Increased urine output
C. Increased respiratory rate
D. Decreased heart rate
Answer: B
Rationale: Furosemide is a loop diuretic that promotes diuresis to reduce fluid overload
in pulmonary edema. Increased urine output indicates effective fluid removal. Decreased
blood pressure may occur but is not the primary indicator. Increased respiratory rate or
decreased heart rate are not directly related to furosemide’s action.
Question 6: A client is prescribed lisinopril 10 mg PO daily. Which adverse effect should the nurse
monitor for?
A. Hyperkalemia
B. Hypoglycemia
C. Hypertension
D. Bradycardia
Answer: A
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia by reducing aldosterone
secretion, which decreases potassium excretion. Hypoglycemia, hypertension, and brady-
cardia are not typical adverse effects of lisinopril.
2
, Question 7: A nurse is preparing to administer insulin glargine to a client. When is the best time to
administer this medication?
A. 30 minutes before breakfast
B. At bedtime
C. With the evening meal
D. At noon
Answer: B
Rationale: Insulin glargine is a long-acting insulin with a steady effect over 24 hours. It is
typically administered at bedtime to provide consistent blood glucose control throughout
the day and night. Timing with meals or at noon is more appropriate for short-acting
insulins.
Question 8: A client with asthma is prescribed albuterol via inhaler. The nurse should instruct the
client to report which adverse effect?
A. Drowsiness
B. Tremors
C. Constipation
D. Weight loss
Answer: B
Rationale: Albuterol, a beta-2 agonist, can cause tremors as a common side effect due
to stimulation of the nervous system. Drowsiness, constipation, and weight loss are not
typically associated with albuterol use.
Question 9: A nurse is calculating the safe dosage of amoxicillin for a child weighing 20 kg. The
recommended dose is 25 mg/kg/day in two divided doses. What is the total daily dose?
A. 250 mg
B. 500 mg
C. 750 mg
D. 1,000 mg
Answer: B
Rationale: To calculate the total daily dose: 25 mg/kg/day × 20 kg = 500 mg/day. The
dose is divided into two, so each dose is 250 mg. The total daily dose is 500 mg.
Question 10: A client is receiving vancomycin IV. Which laboratory value should the nurse monitor to
prevent toxicity?
A. Serum creatinine
B. Blood glucose
C. Hemoglobin
D. White blood cell count
3
