ATI Pharmacology Proctored Exam 2025–
Page | 1
2026 | 130 Verified Questions with NGN
Rationales | Graded A+ Test Bank
Question 1: Amlodipine (Calcium Channel Blocker)
Q: A nurse is caring for a client who is prescribed amlodipine to manage
hypertension. Which of the following adverse effects should the nurse
monitor for?
A. Constipation
B. Hypotension
C. Bradycardia
D. Peripheral edema
Correct Answer: D. Peripheral edema
Rationale:
Amlodipine is a dihydropyridine calcium channel blocker that causes
peripheral arterial vasodilation by inhibiting the influx of calcium into
vascular smooth muscle cells. This vasodilation reduces blood pressure but
often leads to fluid shifting into interstitial spaces, resulting in peripheral
, edema, especially in the lower extremities. While hypotension may occur
with excessive vasodilation, it is less commonly reported as a primary
Page | 2 concern compared to edema. Bradycardia is typically associated with non-
dihydropyridine calcium channel blockers such as verapamil or diltiazem,
not amlodipine. Constipation is not a common adverse effect of this
particular medication. Therefore, the most notable and expected adverse
effect the nurse should monitor for is peripheral edema.
Question 2: Heparin-Induced Thrombocytopenia (HIT)
Q: A nurse is reviewing laboratory values for a client receiving intravenous
heparin and notes a sudden drop in the platelet count from 200,000/mm³ to
85,000/mm³. What action should the nurse take first?
A. Continue the heparin and recheck the labs in an hour
B. Stop the heparin infusion immediately
C. Administer vitamin K
D. Check the client’s INR level
Correct Answer: B. Stop the heparin infusion immediately
Rationale:
A sudden and significant decrease in platelet count during heparin therapy
is a strong indicator of heparin-induced thrombocytopenia, a serious
, immune-mediated adverse effect that can lead to life-threatening
thromboembolic complications. In this situation, the nurse’s immediate
Page | 3 priority is to stop the heparin infusion to prevent further platelet activation
and thrombosis. Continuing the medication, even temporarily, increases the
client's risk of developing deep vein thrombosis or pulmonary embolism.
Administering vitamin K would not be effective because vitamin K reverses
warfarin, not heparin. Checking the INR is also irrelevant in this case, as
the INR is not used to monitor heparin therapy. The correct initial nursing
intervention is to discontinue heparin and notify the provider promptly.
Question 3: Digoxin Toxicity
Q: A nurse is assessing a client who is receiving digoxin therapy for heart
failure. Which of the following findings should the nurse recognize as a sign
of digoxin toxicity?
A. Hypertension
B. Yellow-tinged vision
C. Increased appetite
D. Hyponatremia
Correct Answer: B. Yellow-tinged vision
, Rationale:
One of the hallmark signs of digoxin toxicity is visual disturbances,
Page | 4 particularly yellow-tinged or blurred vision, and seeing halos around lights.
Digoxin has a narrow therapeutic index, and toxicity can occur even with
small elevations in serum levels, especially in older adults or those with
renal impairment. Other early signs of toxicity may include nausea,
vomiting, fatigue, and bradycardia. Hypertension and hyponatremia are not
characteristic indicators of digoxin toxicity, and an increased appetite would
be unusual; rather, clients often report anorexia. Recognizing yellow-tinged
vision as an early manifestation of toxicity allows for prompt intervention to
prevent serious cardiac complications such as arrhythmias.
Question 4: Insulin Glargine Administration
Q: A nurse is educating a client who has type 1 diabetes about insulin
glargine. Which of the following statements by the client indicates
understanding of the teaching?
A. “I will mix this insulin with regular insulin in the same syringe.”
B. “I will inject this insulin twice daily with my meals.”
C. “I will take this insulin at the same time every day.”
D. “I will shake the vial to make sure it is properly mixed.”
Page | 1
2026 | 130 Verified Questions with NGN
Rationales | Graded A+ Test Bank
Question 1: Amlodipine (Calcium Channel Blocker)
Q: A nurse is caring for a client who is prescribed amlodipine to manage
hypertension. Which of the following adverse effects should the nurse
monitor for?
A. Constipation
B. Hypotension
C. Bradycardia
D. Peripheral edema
Correct Answer: D. Peripheral edema
Rationale:
Amlodipine is a dihydropyridine calcium channel blocker that causes
peripheral arterial vasodilation by inhibiting the influx of calcium into
vascular smooth muscle cells. This vasodilation reduces blood pressure but
often leads to fluid shifting into interstitial spaces, resulting in peripheral
, edema, especially in the lower extremities. While hypotension may occur
with excessive vasodilation, it is less commonly reported as a primary
Page | 2 concern compared to edema. Bradycardia is typically associated with non-
dihydropyridine calcium channel blockers such as verapamil or diltiazem,
not amlodipine. Constipation is not a common adverse effect of this
particular medication. Therefore, the most notable and expected adverse
effect the nurse should monitor for is peripheral edema.
Question 2: Heparin-Induced Thrombocytopenia (HIT)
Q: A nurse is reviewing laboratory values for a client receiving intravenous
heparin and notes a sudden drop in the platelet count from 200,000/mm³ to
85,000/mm³. What action should the nurse take first?
A. Continue the heparin and recheck the labs in an hour
B. Stop the heparin infusion immediately
C. Administer vitamin K
D. Check the client’s INR level
Correct Answer: B. Stop the heparin infusion immediately
Rationale:
A sudden and significant decrease in platelet count during heparin therapy
is a strong indicator of heparin-induced thrombocytopenia, a serious
, immune-mediated adverse effect that can lead to life-threatening
thromboembolic complications. In this situation, the nurse’s immediate
Page | 3 priority is to stop the heparin infusion to prevent further platelet activation
and thrombosis. Continuing the medication, even temporarily, increases the
client's risk of developing deep vein thrombosis or pulmonary embolism.
Administering vitamin K would not be effective because vitamin K reverses
warfarin, not heparin. Checking the INR is also irrelevant in this case, as
the INR is not used to monitor heparin therapy. The correct initial nursing
intervention is to discontinue heparin and notify the provider promptly.
Question 3: Digoxin Toxicity
Q: A nurse is assessing a client who is receiving digoxin therapy for heart
failure. Which of the following findings should the nurse recognize as a sign
of digoxin toxicity?
A. Hypertension
B. Yellow-tinged vision
C. Increased appetite
D. Hyponatremia
Correct Answer: B. Yellow-tinged vision
, Rationale:
One of the hallmark signs of digoxin toxicity is visual disturbances,
Page | 4 particularly yellow-tinged or blurred vision, and seeing halos around lights.
Digoxin has a narrow therapeutic index, and toxicity can occur even with
small elevations in serum levels, especially in older adults or those with
renal impairment. Other early signs of toxicity may include nausea,
vomiting, fatigue, and bradycardia. Hypertension and hyponatremia are not
characteristic indicators of digoxin toxicity, and an increased appetite would
be unusual; rather, clients often report anorexia. Recognizing yellow-tinged
vision as an early manifestation of toxicity allows for prompt intervention to
prevent serious cardiac complications such as arrhythmias.
Question 4: Insulin Glargine Administration
Q: A nurse is educating a client who has type 1 diabetes about insulin
glargine. Which of the following statements by the client indicates
understanding of the teaching?
A. “I will mix this insulin with regular insulin in the same syringe.”
B. “I will inject this insulin twice daily with my meals.”
C. “I will take this insulin at the same time every day.”
D. “I will shake the vial to make sure it is properly mixed.”
