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2025 ATI RN Pharmacology
Proctored Exam – Actual Questions
with 100% Verified Answers &
Expert Rationales | Graded A+
Question 1
A nurse is preparing to administer warfarin to a client with atrial fibrillation. Which laboratory
value should the nurse monitor closely?
A) Hemoglobin
B) International Normalized Ratio (INR)
C) Serum creatinine
D) Blood urea nitrogen
Correct Answer: International Normalized Ratio (INR)
Rationale: Warfarin, an anticoagulant, requires monitoring of INR to assess therapeutic effect
and bleeding risk. INR typically ranges from 2.0–3.0 for atrial fibrillation. Hemoglobin monitors
anemia, while creatinine and BUN assess renal function, which are not primary for warfarin.
Question 2
A client is prescribed furosemide 40 mg IV for heart failure. What is the priority nursing action
before administration?
A) Assess blood pressure
B) Check serum potassium levels
C) Monitor blood glucose
D) Evaluate liver function tests
Correct Answer: Check serum potassium levels
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, increasing the risk of
arrhythmias in heart failure clients. Checking serum potassium is critical before administration.
Blood pressure, glucose, and liver function are not the primary concerns.
Question 3
, 2
A nurse is teaching a client about metformin for type 2 diabetes. Which side effect should the
client report immediately?
A) Nausea
B) Muscle pain and weakness
C) Diarrhea
D) Metallic taste
Correct Answer: Muscle pain and weakness
Rationale: Muscle pain and weakness may indicate lactic acidosis, a rare but serious
complication of metformin. Nausea, diarrhea, and metallic taste are common side effects but less
urgent. Per 2025 ATI guidelines, clients should report symptoms of lactic acidosis immediately.
Question 4
A client receiving heparin therapy has a partial thromboplastin time (aPTT) of 90 seconds. What
is the nurse’s priority action?
A) Administer the next dose as scheduled
B) Notify the provider immediately
C) Increase the heparin infusion rate
D) Draw a repeat aPTT in 4 hours
Correct Answer: Notify the provider immediately
Rationale: An aPTT of 90 seconds is above the therapeutic range (1.5–2.5 times control,
typically 60–80 seconds), indicating a risk of bleeding. The nurse should notify the provider to
adjust or hold the dose. Continuing or increasing the infusion is unsafe, and delaying action is
inappropriate.
Question 5
A nurse is administering insulin glargine to a client with diabetes. When is the best time to
administer this medication?
A) With breakfast
B) At bedtime
C) Before exercise
D) After meals
Correct Answer: At bedtime
Rationale: Insulin glargine, a long-acting insulin, is typically administered at bedtime to provide
consistent basal coverage for 24 hours. Administering with meals or exercise is more appropriate
for rapid-acting insulins, per 2025 ATI guidelines.
Question 6
A client is prescribed albuterol via inhaler for asthma. Which instruction should the nurse
include in client teaching?
, 3
A) Inhale deeply and hold breath for 1–2 seconds
B) Inhale deeply and hold breath for 10 seconds
C) Exhale fully during inhalation
D) Use the inhaler every 2 hours routinely
Correct Answer: Inhale deeply and hold breath for 10 seconds
Rationale: Holding the breath for 10 seconds after inhaling albuterol allows optimal drug
deposition in the lungs. A 1–2 second hold is insufficient, exhaling during inhalation is incorrect,
and routine use every 2 hours is not standard unless prescribed.
Question 7
A nurse is caring for a client receiving IV vancomycin for MRSA. Which adverse effect should
the nurse monitor for?
A) Hypoglycemia
B) Ototoxicity
C) Hyperkalemia
D) Photosensitivity
Correct Answer: Ototoxicity
Rationale: Vancomycin can cause ototoxicity, manifesting as tinnitus or hearing loss, requiring
monitoring of auditory function. Hypoglycemia, hyperkalemia, and photosensitivity are not
primary adverse effects of vancomycin.
Question 8
A client with hypertension is prescribed lisinopril. What should the nurse teach the client to
avoid?
A) Calcium-rich foods
B) Potassium supplements
C) High-fiber foods
D) Caffeine
Correct Answer: Potassium supplements
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia by reducing aldosterone
secretion. Clients should avoid potassium supplements unless prescribed. Calcium, fiber, and
caffeine are not contraindicated.
Question 9
A nurse is preparing to administer digoxin to a client with heart failure. Which finding requires
holding the dose?
A) Blood pressure 140/90 mmHg
B) Heart rate 55 bpm
2025 ATI RN Pharmacology
Proctored Exam – Actual Questions
with 100% Verified Answers &
Expert Rationales | Graded A+
Question 1
A nurse is preparing to administer warfarin to a client with atrial fibrillation. Which laboratory
value should the nurse monitor closely?
A) Hemoglobin
B) International Normalized Ratio (INR)
C) Serum creatinine
D) Blood urea nitrogen
Correct Answer: International Normalized Ratio (INR)
Rationale: Warfarin, an anticoagulant, requires monitoring of INR to assess therapeutic effect
and bleeding risk. INR typically ranges from 2.0–3.0 for atrial fibrillation. Hemoglobin monitors
anemia, while creatinine and BUN assess renal function, which are not primary for warfarin.
Question 2
A client is prescribed furosemide 40 mg IV for heart failure. What is the priority nursing action
before administration?
A) Assess blood pressure
B) Check serum potassium levels
C) Monitor blood glucose
D) Evaluate liver function tests
Correct Answer: Check serum potassium levels
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, increasing the risk of
arrhythmias in heart failure clients. Checking serum potassium is critical before administration.
Blood pressure, glucose, and liver function are not the primary concerns.
Question 3
, 2
A nurse is teaching a client about metformin for type 2 diabetes. Which side effect should the
client report immediately?
A) Nausea
B) Muscle pain and weakness
C) Diarrhea
D) Metallic taste
Correct Answer: Muscle pain and weakness
Rationale: Muscle pain and weakness may indicate lactic acidosis, a rare but serious
complication of metformin. Nausea, diarrhea, and metallic taste are common side effects but less
urgent. Per 2025 ATI guidelines, clients should report symptoms of lactic acidosis immediately.
Question 4
A client receiving heparin therapy has a partial thromboplastin time (aPTT) of 90 seconds. What
is the nurse’s priority action?
A) Administer the next dose as scheduled
B) Notify the provider immediately
C) Increase the heparin infusion rate
D) Draw a repeat aPTT in 4 hours
Correct Answer: Notify the provider immediately
Rationale: An aPTT of 90 seconds is above the therapeutic range (1.5–2.5 times control,
typically 60–80 seconds), indicating a risk of bleeding. The nurse should notify the provider to
adjust or hold the dose. Continuing or increasing the infusion is unsafe, and delaying action is
inappropriate.
Question 5
A nurse is administering insulin glargine to a client with diabetes. When is the best time to
administer this medication?
A) With breakfast
B) At bedtime
C) Before exercise
D) After meals
Correct Answer: At bedtime
Rationale: Insulin glargine, a long-acting insulin, is typically administered at bedtime to provide
consistent basal coverage for 24 hours. Administering with meals or exercise is more appropriate
for rapid-acting insulins, per 2025 ATI guidelines.
Question 6
A client is prescribed albuterol via inhaler for asthma. Which instruction should the nurse
include in client teaching?
, 3
A) Inhale deeply and hold breath for 1–2 seconds
B) Inhale deeply and hold breath for 10 seconds
C) Exhale fully during inhalation
D) Use the inhaler every 2 hours routinely
Correct Answer: Inhale deeply and hold breath for 10 seconds
Rationale: Holding the breath for 10 seconds after inhaling albuterol allows optimal drug
deposition in the lungs. A 1–2 second hold is insufficient, exhaling during inhalation is incorrect,
and routine use every 2 hours is not standard unless prescribed.
Question 7
A nurse is caring for a client receiving IV vancomycin for MRSA. Which adverse effect should
the nurse monitor for?
A) Hypoglycemia
B) Ototoxicity
C) Hyperkalemia
D) Photosensitivity
Correct Answer: Ototoxicity
Rationale: Vancomycin can cause ototoxicity, manifesting as tinnitus or hearing loss, requiring
monitoring of auditory function. Hypoglycemia, hyperkalemia, and photosensitivity are not
primary adverse effects of vancomycin.
Question 8
A client with hypertension is prescribed lisinopril. What should the nurse teach the client to
avoid?
A) Calcium-rich foods
B) Potassium supplements
C) High-fiber foods
D) Caffeine
Correct Answer: Potassium supplements
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia by reducing aldosterone
secretion. Clients should avoid potassium supplements unless prescribed. Calcium, fiber, and
caffeine are not contraindicated.
Question 9
A nurse is preparing to administer digoxin to a client with heart failure. Which finding requires
holding the dose?
A) Blood pressure 140/90 mmHg
B) Heart rate 55 bpm
