ATI RN Pharmacology Proctored
Exam 2025/2026 – Actual Exam
Questions with Verified Answers &
Expert Rationales | Graded A+
Question 1 A client is prescribed warfarin (Coumadin). Which lab value requires immediate
notification of the provider? Answer: INR 5.8 Rationale: Therapeutic INR 2.0–3.0 (or 2.5–3.5
for mechanical valves). INR >5 significantly increases bleeding risk → hold warfarin and give
vitamin K per protocol.
Question 2 A client receiving IV heparin has an aPTT of 120 seconds. What is the nurse’s
priority action? Answer: Stop the heparin infusion immediately Rationale: Therapeutic aPTT
is usually 1.5–2.5 × control (60–80 sec). 120 sec = high bleeding risk.
Question 3 A client on digoxin (Lanoxin) has a serum digoxin level of 2.8 ng/mL. The nurse
should: Answer: Hold the dose and notify the provider Rationale: Therapeutic range 0.5–2.0
ng/mL. >2.0 = toxicity (nausea, vomiting, yellow vision, arrhythmias).
Question 4 First sign of digoxin toxicity the nurse should teach the client to report: Answer:
Nausea and vomiting Rationale: GI symptoms appear before cardiac changes.
Question 5 A client is prescribed furosemide (Lasix) 40 mg IV. Which lab must be checked
before administration? Answer: Potassium Rationale: Loop diuretics cause hypokalemia → risk
of ventricular dysrhythmias.
Question 6 A client taking spironolactone (Aldactone) should be taught to avoid which foods?
Answer: Bananas, oranges, salt substitutes Rationale: Potassium-sparing diuretic →
hyperkalemia risk.
Question 7 A client receiving gentamicin (Garamycin). The nurse monitors for which major
adverse effect? Answer: Ototoxicity (hearing loss/tinnitus) Rationale: Aminoglycosides are
vestibulotoxic and ototoxic; monitor peak/trough levels.
Question 8 A client is prescribed levothyroxine (Synthroid). The nurse teaches the client to take
it: Answer: Every morning on an empty stomach Rationale: Maximizes absorption; food
decreases absorption by 40%.
Exam 2025/2026 – Actual Exam
Questions with Verified Answers &
Expert Rationales | Graded A+
Question 1 A client is prescribed warfarin (Coumadin). Which lab value requires immediate
notification of the provider? Answer: INR 5.8 Rationale: Therapeutic INR 2.0–3.0 (or 2.5–3.5
for mechanical valves). INR >5 significantly increases bleeding risk → hold warfarin and give
vitamin K per protocol.
Question 2 A client receiving IV heparin has an aPTT of 120 seconds. What is the nurse’s
priority action? Answer: Stop the heparin infusion immediately Rationale: Therapeutic aPTT
is usually 1.5–2.5 × control (60–80 sec). 120 sec = high bleeding risk.
Question 3 A client on digoxin (Lanoxin) has a serum digoxin level of 2.8 ng/mL. The nurse
should: Answer: Hold the dose and notify the provider Rationale: Therapeutic range 0.5–2.0
ng/mL. >2.0 = toxicity (nausea, vomiting, yellow vision, arrhythmias).
Question 4 First sign of digoxin toxicity the nurse should teach the client to report: Answer:
Nausea and vomiting Rationale: GI symptoms appear before cardiac changes.
Question 5 A client is prescribed furosemide (Lasix) 40 mg IV. Which lab must be checked
before administration? Answer: Potassium Rationale: Loop diuretics cause hypokalemia → risk
of ventricular dysrhythmias.
Question 6 A client taking spironolactone (Aldactone) should be taught to avoid which foods?
Answer: Bananas, oranges, salt substitutes Rationale: Potassium-sparing diuretic →
hyperkalemia risk.
Question 7 A client receiving gentamicin (Garamycin). The nurse monitors for which major
adverse effect? Answer: Ototoxicity (hearing loss/tinnitus) Rationale: Aminoglycosides are
vestibulotoxic and ototoxic; monitor peak/trough levels.
Question 8 A client is prescribed levothyroxine (Synthroid). The nurse teaches the client to take
it: Answer: Every morning on an empty stomach Rationale: Maximizes absorption; food
decreases absorption by 40%.
