ATI Pharmacology PN
Proctored Exam 2025/2026 –
100% Correct Answers & Full
Rationales
Cardiovascular Pharmacology (Questions 1-20)
1. A nurse is administering lisinopril to a client with hypertension. The client reports a dry,
persistent cough. What is the nurse's priority action?
A. Administer diphenhydramine for symptom relief B. Monitor blood pressure and continue the
medication C. Assess for angioedema and hold the next dose D. Educate the client on increasing
fluid intake
C
Rationale: Lisinopril, an ACE inhibitor, can cause a nonproductive cough due to bradykinin
accumulation; however, angioedema is a life-threatening adverse effect requiring immediate
assessment and holding the dose per ATI 2025 guidelines. Safe administration involves
monitoring for hypersensitivity, and nursing implications include educating on reporting
swelling to prevent escalation.
2. A client with heart failure is prescribed furosemide. The nurse should monitor for which
electrolyte imbalance as a nursing implication?
A. Hyperkalemia B. Hypokalemia C. Hypernatremia D. Hypocalcemia
B
Rationale: Furosemide, a loop diuretic, promotes potassium excretion, risking hypokalemia,
which can lead to arrhythmias. ATI 2025 emphasizes serial electrolyte monitoring for safe
administration, with nursing implications including dietary potassium education and ECG
assessment to maintain cardiac stability.
3. When administering nitroglycerin sublingually for angina, the nurse instructs the client
to repeat the dose if pain persists after how many minutes?
A. 2 minutes B. 5 minutes C. 10 minutes D. 15 minutes
,B
Rationale: Nitroglycerin relieves angina within 3 minutes; if unresolved after 5 minutes, repeat
up to three doses, then seek emergency care per AHA/ATI 2025. Safe administration requires
verifying no recent PDE-5 inhibitors, and nursing implications include headache education and
vital sign monitoring.
4. A client on warfarin therapy has an INR of 4.5. What is the nurse's immediate action for
safe medication administration?
A. Administer the next dose as scheduled B. Hold the dose and notify the provider C. Increase
the dose to normalize INR D. Switch to low-molecular-weight heparin
B
Rationale: Therapeutic INR for most indications is 2-3; 4.5 indicates supratherapeutic levels
risking bleeding per ATI 2025. Nursing implications include holding doses, assessing for
hemorrhage, and educating on dietary vitamin K consistency.
5. A nurse is preparing to administer digoxin to a client with atrial fibrillation. What
assessment finding requires withholding the dose?
A. Heart rate of 68 bpm B. Potassium level of 4.2 mEq/L C. Heart rate of 52 bpm D. Blood
pressure of 130/80 mm Hg
C
Rationale: Digoxin toxicity risk increases with bradycardia (<60 bpm); withhold and notify
provider per ATI 2025. Safe administration involves apical pulse check, and nursing implications
include ECG monitoring and client education on toxicity symptoms like nausea.
6. For a client prescribed clopidogrel post-stent placement, the nurse educates on avoiding
which over-the-counter medication due to interaction risk?
A. Ibuprofen B. Acetaminophen C. Aspirin (low-dose) D. Antacids
A
Rationale: NSAIDs like ibuprofen increase bleeding risk with antiplatelets per ATI 2025.
Nursing implications for safe administration include medication reconciliation and patient
education on alternative pain relief to prevent hemorrhagic complications.
7. A client with hypertension is started on amlodipine. The nurse monitors for which
common side effect?
A. Orthostatic hypotension B. Peripheral edema C. Bradycardia D. Hyperglycemia
, B
Rationale: Calcium channel blockers like amlodipine cause vasodilation leading to ankle edema;
monitor and elevate legs per ATI 2025. Patient-centered nursing implications include
reassurance and weight monitoring for fluid retention.
8. When administering IV heparin, the nurse uses the weight-based formula and prepares
for which lab monitoring?
A. aPTT every 6 hours B. PT/INR daily C. Platelet count weekly D. All of the above
A
Rationale: Heparin dosing requires aPTT monitoring (1.5-2.5 times control) for therapeutic
anticoagulation per ATI 2025. Safe administration involves continuous infusion adjustments,
with implications for bleeding risk education.
9. A client on beta-blocker therapy (metoprolol) experiences exercise intolerance. The
nurse recognizes this as due to:
A. Increased heart rate response B. Blunted heart rate response C. Vasodilation D. Diuretic effect
B
Rationale: Beta-blockers reduce sympathetic response, limiting HR increase during activity per
ATI 2025. Nursing implications include advising gradual exercise and monitoring for fatigue to
support safe cardiac rehabilitation.
10. For a client with hyperlipidemia prescribed atorvastatin, the nurse advises avoiding
which food to prevent interaction?
A. Grapefruit juice B. Leafy greens C. Dairy products D. Whole grains
A
Rationale: Grapefruit inhibits CYP3A4, increasing statin levels and myopathy risk per ATI
2025. Safe administration counseling emphasizes dietary education as a key nursing implication
for adherence.
11. A nurse administers verapamil for rate control in atrial fibrillation. Contraindication
includes:
A. Heart block B. Hypertension C. Hyperkalemia D. Hypothyroidism
A
Proctored Exam 2025/2026 –
100% Correct Answers & Full
Rationales
Cardiovascular Pharmacology (Questions 1-20)
1. A nurse is administering lisinopril to a client with hypertension. The client reports a dry,
persistent cough. What is the nurse's priority action?
A. Administer diphenhydramine for symptom relief B. Monitor blood pressure and continue the
medication C. Assess for angioedema and hold the next dose D. Educate the client on increasing
fluid intake
C
Rationale: Lisinopril, an ACE inhibitor, can cause a nonproductive cough due to bradykinin
accumulation; however, angioedema is a life-threatening adverse effect requiring immediate
assessment and holding the dose per ATI 2025 guidelines. Safe administration involves
monitoring for hypersensitivity, and nursing implications include educating on reporting
swelling to prevent escalation.
2. A client with heart failure is prescribed furosemide. The nurse should monitor for which
electrolyte imbalance as a nursing implication?
A. Hyperkalemia B. Hypokalemia C. Hypernatremia D. Hypocalcemia
B
Rationale: Furosemide, a loop diuretic, promotes potassium excretion, risking hypokalemia,
which can lead to arrhythmias. ATI 2025 emphasizes serial electrolyte monitoring for safe
administration, with nursing implications including dietary potassium education and ECG
assessment to maintain cardiac stability.
3. When administering nitroglycerin sublingually for angina, the nurse instructs the client
to repeat the dose if pain persists after how many minutes?
A. 2 minutes B. 5 minutes C. 10 minutes D. 15 minutes
,B
Rationale: Nitroglycerin relieves angina within 3 minutes; if unresolved after 5 minutes, repeat
up to three doses, then seek emergency care per AHA/ATI 2025. Safe administration requires
verifying no recent PDE-5 inhibitors, and nursing implications include headache education and
vital sign monitoring.
4. A client on warfarin therapy has an INR of 4.5. What is the nurse's immediate action for
safe medication administration?
A. Administer the next dose as scheduled B. Hold the dose and notify the provider C. Increase
the dose to normalize INR D. Switch to low-molecular-weight heparin
B
Rationale: Therapeutic INR for most indications is 2-3; 4.5 indicates supratherapeutic levels
risking bleeding per ATI 2025. Nursing implications include holding doses, assessing for
hemorrhage, and educating on dietary vitamin K consistency.
5. A nurse is preparing to administer digoxin to a client with atrial fibrillation. What
assessment finding requires withholding the dose?
A. Heart rate of 68 bpm B. Potassium level of 4.2 mEq/L C. Heart rate of 52 bpm D. Blood
pressure of 130/80 mm Hg
C
Rationale: Digoxin toxicity risk increases with bradycardia (<60 bpm); withhold and notify
provider per ATI 2025. Safe administration involves apical pulse check, and nursing implications
include ECG monitoring and client education on toxicity symptoms like nausea.
6. For a client prescribed clopidogrel post-stent placement, the nurse educates on avoiding
which over-the-counter medication due to interaction risk?
A. Ibuprofen B. Acetaminophen C. Aspirin (low-dose) D. Antacids
A
Rationale: NSAIDs like ibuprofen increase bleeding risk with antiplatelets per ATI 2025.
Nursing implications for safe administration include medication reconciliation and patient
education on alternative pain relief to prevent hemorrhagic complications.
7. A client with hypertension is started on amlodipine. The nurse monitors for which
common side effect?
A. Orthostatic hypotension B. Peripheral edema C. Bradycardia D. Hyperglycemia
, B
Rationale: Calcium channel blockers like amlodipine cause vasodilation leading to ankle edema;
monitor and elevate legs per ATI 2025. Patient-centered nursing implications include
reassurance and weight monitoring for fluid retention.
8. When administering IV heparin, the nurse uses the weight-based formula and prepares
for which lab monitoring?
A. aPTT every 6 hours B. PT/INR daily C. Platelet count weekly D. All of the above
A
Rationale: Heparin dosing requires aPTT monitoring (1.5-2.5 times control) for therapeutic
anticoagulation per ATI 2025. Safe administration involves continuous infusion adjustments,
with implications for bleeding risk education.
9. A client on beta-blocker therapy (metoprolol) experiences exercise intolerance. The
nurse recognizes this as due to:
A. Increased heart rate response B. Blunted heart rate response C. Vasodilation D. Diuretic effect
B
Rationale: Beta-blockers reduce sympathetic response, limiting HR increase during activity per
ATI 2025. Nursing implications include advising gradual exercise and monitoring for fatigue to
support safe cardiac rehabilitation.
10. For a client with hyperlipidemia prescribed atorvastatin, the nurse advises avoiding
which food to prevent interaction?
A. Grapefruit juice B. Leafy greens C. Dairy products D. Whole grains
A
Rationale: Grapefruit inhibits CYP3A4, increasing statin levels and myopathy risk per ATI
2025. Safe administration counseling emphasizes dietary education as a key nursing implication
for adherence.
11. A nurse administers verapamil for rate control in atrial fibrillation. Contraindication
includes:
A. Heart block B. Hypertension C. Hyperkalemia D. Hypothyroidism
A
