1
ATI RN Pharmacology Proctored
Exam 2025 – Actual Test Bank with
100% Verified Questions and
Rationales | Graded A+
Comprehensive Pharmacology Topics: Medication
Administration, Drug Classifications, Side Effects,
Monitoring, and Client Education
1. A nurse is preparing to administer furosemide 40 mg IV to a client with heart
failure. Which laboratory value should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
B) Serum potassium
Rationale: Furosemide, a loop diuretic, increases potassium excretion, risking
hypokalemia, which can lead to arrhythmias in heart failure clients. Monitoring serum
potassium is critical. Sodium (A), calcium (C), and magnesium (D) are less directly
affected but may be monitored.
2. A client with hypertension is prescribed lisinopril. The nurse should instruct the
client to report which side effect?
A) Dry cough
B) Weight loss
C) Insomnia
D) Tachycardia
A) Dry cough
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry cough due to bradykinin
accumulation. This may require switching to an ARB. Weight loss (B), insomnia (C), and
tachycardia (D) are not typical side effects.
3. A nurse is administering heparin 5,000 units subcutaneously. Which action ensures
safe administration?
A) Inject into the deltoid muscle
B) Aspirate before injection
C) Use a 25-gauge needle in the abdomen
D) Massage the site after injection
C) Use a 25-gauge needle in the abdomen
Rationale: Heparin is administered subcutaneously in the abdomen using a small-gauge
, 2
needle (e.g., 25-gauge) to minimize tissue trauma and bleeding. Deltoid injection (A) is
incorrect, aspiration (B) is unnecessary, and massaging (D) increases bleeding risk.
4. A client with type 2 diabetes is prescribed metformin. When should the nurse
instruct the client to take this medication?
A) On an empty stomach
B) With meals
C) At bedtime only
D) Before exercise
B) With meals
Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects
like nausea and diarrhea. Empty stomach (A) increases GI upset, bedtime only (C) is
incorrect, and exercise (D) is unrelated to timing.
5. A nurse is caring for a client receiving warfarin. Which laboratory value is most
important to monitor?
A) Platelet count
B) INR
C) aPTT
D) Hemoglobin
B) INR
Rationale: Warfarin’s anticoagulant effect is monitored via the International Normalized
Ratio (INR), typically maintained between 2.0–3.0 for conditions like atrial fibrillation.
Platelet count (A), aPTT (C), and hemoglobin (D) are not primary indicators for warfarin.
6. A client with asthma is prescribed albuterol via inhaler. What should the nurse
teach the client about this medication?
A) Rinse mouth after use
B) Expect tachycardia
C) Take with meals
D) Monitor for weight gain
B) Expect tachycardia
Rationale: Albuterol, a beta-2 agonist, commonly causes tachycardia as a side effect due
to sympathetic stimulation. Rinsing the mouth (A) is for inhaled corticosteroids, meals
(C) are irrelevant for inhalers, and weight gain (D) is not typical.
7. A nurse is administering digoxin to a client with heart failure. Which symptom
indicates possible toxicity?
A) Bradycardia
B) Hypertension
C) Hyperglycemia
D) Weight gain
A) Bradycardia
Rationale: Digoxin toxicity can cause bradycardia, nausea, and visual disturbances due
to its narrow therapeutic index. Hypertension (B), hyperglycemia (C), and weight gain
(D) are not typical signs of toxicity.
8. A client with a urinary tract infection is prescribed ciprofloxacin. What should the
nurse include in client teaching?
A) Take with milk to reduce GI upset
B) Avoid sun exposure
, 3
C) Expect red-colored urine
D) Take with antacids
B) Avoid sun exposure
Rationale: Ciprofloxacin, a fluoroquinolone, increases photosensitivity, risking severe
sunburn. Milk (A) and antacids (D) reduce absorption, and red urine (C) is not a side
effect.
9. A nurse is preparing to administer insulin glargine to a client with diabetes. When is
the best time to administer this medication?
A) With meals
B) At bedtime
C) Before exercise
D) Every 6 hours
B) At bedtime
Rationale: Insulin glargine, a long-acting insulin, is typically administered at bedtime to
provide basal glucose control. It is not meal-dependent (A), exercise-related (C), or given
every 6 hours (D).
10. A client with bipolar disorder is prescribed lithium. Which symptom should the
nurse instruct the client to report immediately?
A) Tremors
B) Weight loss
C) Increased appetite
D) Improved mood
A) Tremors
Rationale: Tremors are an early sign of lithium toxicity, along with nausea, confusion,
and ataxia, requiring immediate reporting. Weight loss (B) and increased appetite (C) are
not typical, and improved mood (D) is a therapeutic effect.
11. A nurse is administering enoxaparin to a client with a deep vein thrombosis. How
should this medication be given?
A) Intramuscularly
B) Subcutaneously
C) Intravenously
D) Orally
B) Subcutaneously
Rationale: Enoxaparin, a low-molecular-weight heparin, is administered subcutaneously
in the abdomen for optimal absorption and anticoagulant effect. IM (A), IV (C), and oral
(D) routes are incorrect.
12. A client with rheumatoid arthritis is prescribed methotrexate. What should the
nurse teach the client to monitor for?
A) Fever
B) Weight gain
C) Tachycardia
D) Insomnia
A) Fever
Rationale: Methotrexate can cause bone marrow suppression, increasing infection risk,
so fever should be reported. Weight gain (B), tachycardia (C), and insomnia (D) are not
primary concerns.
, 4
13. A nurse is caring for a client receiving total parenteral nutrition (TPN). Which
complication should the nurse monitor for?
A) Hypoglycemia
B) Hyperglycemia
C) Hypokalemia
D) Hyponatremia
B) Hyperglycemia
Rationale: TPN contains high glucose concentrations, risking hyperglycemia, especially
in diabetic clients. Hypoglycemia (A) is less likely, and electrolyte imbalances like
hypokalemia (C) or hyponatremia (D) are possible but less common.
14. A client with schizophrenia is prescribed risperidone. Which side effect should the
nurse monitor for?
A) Tremors
B) Weight loss
C) Hypotension
D) Insomnia
A) Tremors
Rationale: Risperidone, an antipsychotic, can cause extrapyramidal side effects (EPS)
like tremors. Weight loss (B) is less common (weight gain is more typical), hypotension
(C) is possible but less frequent, and insomnia (D) is not EPS-related.
15. A nurse is administering vancomycin IV to a client with an infection. What should
the nurse monitor for?
A) Nephrotoxicity
B) Hyperglycemia
C) Bradycardia
D) Weight gain
A) Nephrotoxicity
Rationale: Vancomycin can cause nephrotoxicity, requiring monitoring of renal function
(e.g., serum creatinine). Hyperglycemia (B), bradycardia (C), and weight gain (D) are not
typical side effects.
16. A client with depression is prescribed sertraline. How long should the nurse inform
the client it takes to see therapeutic effects?
A) 1–2 days
B) 1–2 weeks
C) 2–4 weeks
D) 6–8 weeks
C) 2–4 weeks
Rationale: Sertraline, an SSRI, typically takes 2–4 weeks to achieve therapeutic effects
for depression. Shorter (A, B) or longer (D) timeframes are inaccurate for initial
response.
17. A nurse is preparing to administer morphine to a client for pain. Which assessment
is the priority before administration?
A) Blood pressure
B) Respiratory rate
C) Blood glucose
D) Temperature
ATI RN Pharmacology Proctored
Exam 2025 – Actual Test Bank with
100% Verified Questions and
Rationales | Graded A+
Comprehensive Pharmacology Topics: Medication
Administration, Drug Classifications, Side Effects,
Monitoring, and Client Education
1. A nurse is preparing to administer furosemide 40 mg IV to a client with heart
failure. Which laboratory value should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
B) Serum potassium
Rationale: Furosemide, a loop diuretic, increases potassium excretion, risking
hypokalemia, which can lead to arrhythmias in heart failure clients. Monitoring serum
potassium is critical. Sodium (A), calcium (C), and magnesium (D) are less directly
affected but may be monitored.
2. A client with hypertension is prescribed lisinopril. The nurse should instruct the
client to report which side effect?
A) Dry cough
B) Weight loss
C) Insomnia
D) Tachycardia
A) Dry cough
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry cough due to bradykinin
accumulation. This may require switching to an ARB. Weight loss (B), insomnia (C), and
tachycardia (D) are not typical side effects.
3. A nurse is administering heparin 5,000 units subcutaneously. Which action ensures
safe administration?
A) Inject into the deltoid muscle
B) Aspirate before injection
C) Use a 25-gauge needle in the abdomen
D) Massage the site after injection
C) Use a 25-gauge needle in the abdomen
Rationale: Heparin is administered subcutaneously in the abdomen using a small-gauge
, 2
needle (e.g., 25-gauge) to minimize tissue trauma and bleeding. Deltoid injection (A) is
incorrect, aspiration (B) is unnecessary, and massaging (D) increases bleeding risk.
4. A client with type 2 diabetes is prescribed metformin. When should the nurse
instruct the client to take this medication?
A) On an empty stomach
B) With meals
C) At bedtime only
D) Before exercise
B) With meals
Rationale: Metformin should be taken with meals to reduce gastrointestinal side effects
like nausea and diarrhea. Empty stomach (A) increases GI upset, bedtime only (C) is
incorrect, and exercise (D) is unrelated to timing.
5. A nurse is caring for a client receiving warfarin. Which laboratory value is most
important to monitor?
A) Platelet count
B) INR
C) aPTT
D) Hemoglobin
B) INR
Rationale: Warfarin’s anticoagulant effect is monitored via the International Normalized
Ratio (INR), typically maintained between 2.0–3.0 for conditions like atrial fibrillation.
Platelet count (A), aPTT (C), and hemoglobin (D) are not primary indicators for warfarin.
6. A client with asthma is prescribed albuterol via inhaler. What should the nurse
teach the client about this medication?
A) Rinse mouth after use
B) Expect tachycardia
C) Take with meals
D) Monitor for weight gain
B) Expect tachycardia
Rationale: Albuterol, a beta-2 agonist, commonly causes tachycardia as a side effect due
to sympathetic stimulation. Rinsing the mouth (A) is for inhaled corticosteroids, meals
(C) are irrelevant for inhalers, and weight gain (D) is not typical.
7. A nurse is administering digoxin to a client with heart failure. Which symptom
indicates possible toxicity?
A) Bradycardia
B) Hypertension
C) Hyperglycemia
D) Weight gain
A) Bradycardia
Rationale: Digoxin toxicity can cause bradycardia, nausea, and visual disturbances due
to its narrow therapeutic index. Hypertension (B), hyperglycemia (C), and weight gain
(D) are not typical signs of toxicity.
8. A client with a urinary tract infection is prescribed ciprofloxacin. What should the
nurse include in client teaching?
A) Take with milk to reduce GI upset
B) Avoid sun exposure
, 3
C) Expect red-colored urine
D) Take with antacids
B) Avoid sun exposure
Rationale: Ciprofloxacin, a fluoroquinolone, increases photosensitivity, risking severe
sunburn. Milk (A) and antacids (D) reduce absorption, and red urine (C) is not a side
effect.
9. A nurse is preparing to administer insulin glargine to a client with diabetes. When is
the best time to administer this medication?
A) With meals
B) At bedtime
C) Before exercise
D) Every 6 hours
B) At bedtime
Rationale: Insulin glargine, a long-acting insulin, is typically administered at bedtime to
provide basal glucose control. It is not meal-dependent (A), exercise-related (C), or given
every 6 hours (D).
10. A client with bipolar disorder is prescribed lithium. Which symptom should the
nurse instruct the client to report immediately?
A) Tremors
B) Weight loss
C) Increased appetite
D) Improved mood
A) Tremors
Rationale: Tremors are an early sign of lithium toxicity, along with nausea, confusion,
and ataxia, requiring immediate reporting. Weight loss (B) and increased appetite (C) are
not typical, and improved mood (D) is a therapeutic effect.
11. A nurse is administering enoxaparin to a client with a deep vein thrombosis. How
should this medication be given?
A) Intramuscularly
B) Subcutaneously
C) Intravenously
D) Orally
B) Subcutaneously
Rationale: Enoxaparin, a low-molecular-weight heparin, is administered subcutaneously
in the abdomen for optimal absorption and anticoagulant effect. IM (A), IV (C), and oral
(D) routes are incorrect.
12. A client with rheumatoid arthritis is prescribed methotrexate. What should the
nurse teach the client to monitor for?
A) Fever
B) Weight gain
C) Tachycardia
D) Insomnia
A) Fever
Rationale: Methotrexate can cause bone marrow suppression, increasing infection risk,
so fever should be reported. Weight gain (B), tachycardia (C), and insomnia (D) are not
primary concerns.
, 4
13. A nurse is caring for a client receiving total parenteral nutrition (TPN). Which
complication should the nurse monitor for?
A) Hypoglycemia
B) Hyperglycemia
C) Hypokalemia
D) Hyponatremia
B) Hyperglycemia
Rationale: TPN contains high glucose concentrations, risking hyperglycemia, especially
in diabetic clients. Hypoglycemia (A) is less likely, and electrolyte imbalances like
hypokalemia (C) or hyponatremia (D) are possible but less common.
14. A client with schizophrenia is prescribed risperidone. Which side effect should the
nurse monitor for?
A) Tremors
B) Weight loss
C) Hypotension
D) Insomnia
A) Tremors
Rationale: Risperidone, an antipsychotic, can cause extrapyramidal side effects (EPS)
like tremors. Weight loss (B) is less common (weight gain is more typical), hypotension
(C) is possible but less frequent, and insomnia (D) is not EPS-related.
15. A nurse is administering vancomycin IV to a client with an infection. What should
the nurse monitor for?
A) Nephrotoxicity
B) Hyperglycemia
C) Bradycardia
D) Weight gain
A) Nephrotoxicity
Rationale: Vancomycin can cause nephrotoxicity, requiring monitoring of renal function
(e.g., serum creatinine). Hyperglycemia (B), bradycardia (C), and weight gain (D) are not
typical side effects.
16. A client with depression is prescribed sertraline. How long should the nurse inform
the client it takes to see therapeutic effects?
A) 1–2 days
B) 1–2 weeks
C) 2–4 weeks
D) 6–8 weeks
C) 2–4 weeks
Rationale: Sertraline, an SSRI, typically takes 2–4 weeks to achieve therapeutic effects
for depression. Shorter (A, B) or longer (D) timeframes are inaccurate for initial
response.
17. A nurse is preparing to administer morphine to a client for pain. Which assessment
is the priority before administration?
A) Blood pressure
B) Respiratory rate
C) Blood glucose
D) Temperature
