ATI RN Pharmacology Proctored Exam
2026/2027 – Actual Exam 130 Questions
with Verified Answers & Expert
Rationales Graded A+ | 100% Correct |
Pass Guaranteed
Q1 A nurse is caring for a client who has a new prescription for lisinopril. Which of the
following adverse effects should the nurse instruct the client to report immediately?
Answer: Swelling of the face, lips, or tongue
Rationale: Angioedema is a life-threatening adverse effect of ACE inhibitors (lisinopril) caused
by increased bradykinin levels. It requires immediate discontinuation and medical attention.
Q2 A client is prescribed warfarin. The nurse should instruct the client to report which of the
following symptoms?
Answer: Unusual bruising or pink-tinged urine
Rationale: These are signs of bleeding, which is the most serious adverse effect of warfarin due
to its anticoagulant action.
Q3 A nurse is preparing to administer digoxin to a client. Which of the following findings should
the nurse withhold the medication and notify the provider?
Answer: Apical pulse rate 52 beats per minute
Rationale: Digoxin should be withheld if the apical pulse is less than 60 beats per minute in
adults due to risk of bradycardia and toxicity.
Q4 A client is prescribed furosemide. The nurse should monitor for which of the following
adverse effects?
Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in the distal
tubule, leading to hypokalemia.
,Q5 A nurse is reinforcing teaching to a client who has a new prescription for metformin. Which
of the following instructions should the nurse include?
Answer: "Take this medication with meals."
Rationale: Taking metformin with food reduces gastrointestinal side effects (nausea, diarrhea,
abdominal discomfort).
Q6 A client who has type 2 diabetes mellitus is starting insulin glargine. The nurse should
instruct the client to:
Answer: "Do not mix this insulin with any other insulin."
Rationale: Insulin glargine is a long-acting insulin and must not be mixed with other insulins to
preserve its 24-hour duration of action.
Q7 A nurse is caring for a client who is receiving IV heparin. The aPTT is 90 seconds
(therapeutic range 60–80 seconds). Which of the following actions should the nurse take?
Answer: Decrease the heparin infusion rate
Rationale: aPTT above the therapeutic range indicates increased risk of bleeding; the infusion
rate should be decreased per protocol.
Q8 A client is prescribed enoxaparin for deep vein thrombosis prophylaxis. The nurse should
instruct the client to administer the medication:
Answer: In the abdomen, at least 2 inches away from the umbilicus
Rationale: The abdomen is the preferred site for subcutaneous low-molecular-weight heparin
injections due to consistent absorption and lower risk of bruising.
Q9 A nurse is caring for a client who has a new prescription for clopidogrel. The nurse should
instruct the client to avoid taking which of the following medications?
Answer: Omeprazole
Rationale: Omeprazole inhibits CYP2C19, reducing the conversion of clopidogrel to its active
metabolite and decreasing its antiplatelet effectiveness.
Q10 A client is prescribed spironolactone for heart failure. The nurse should monitor for which
of the following adverse effects?
Answer: Hyperkalemia
, Rationale: Spironolactone is a potassium-sparing diuretic and can cause hyperkalemia,
especially when combined with ACE inhibitors or ARBs.
Q11 A nurse is caring for a client who has a prescription for theophylline. The nurse should
monitor serum theophylline levels to prevent which of the following adverse effects?
Answer: Tachycardia and dysrhythmias
Rationale: Theophylline has a narrow therapeutic index; toxicity can cause serious cardiac
effects, including tachycardia and dysrhythmias.
Q12 A client is prescribed methotrexate for rheumatoid arthritis. The nurse should instruct the
client to report which of the following symptoms immediately?
Answer: Sore throat and fever
Rationale: Methotrexate is myelosuppressive; sore throat and fever may indicate infection due
to leukopenia.
Q13 A nurse is caring for a client who has a new prescription for levothyroxine. Which of the
following instructions should the nurse include?
Answer: "Take this medication on an empty stomach 30 to 60 minutes before breakfast."
Rationale: Food significantly reduces levothyroxine absorption; it should be taken on an empty
stomach.
Q14 A client is prescribed amiodarone for atrial fibrillation. The nurse should monitor for which
of the following adverse effects?
Answer: Pulmonary toxicity
Rationale: Amiodarone can cause potentially fatal pulmonary toxicity (interstitial
pneumonitis/fibrosis); clients should be monitored for dyspnea and cough.
Q15 A nurse is caring for a client who has a prescription for vancomycin. The nurse should
monitor for which of the following adverse effects?
Answer: Red man syndrome
Rationale: Rapid infusion of vancomycin can cause red man syndrome (flushing, hypotension,
rash) due to histamine release.
Q16 A client is prescribed lithium for bipolar disorder. The nurse should instruct the client to:
Answer: "Maintain consistent salt and fluid intake."
2026/2027 – Actual Exam 130 Questions
with Verified Answers & Expert
Rationales Graded A+ | 100% Correct |
Pass Guaranteed
Q1 A nurse is caring for a client who has a new prescription for lisinopril. Which of the
following adverse effects should the nurse instruct the client to report immediately?
Answer: Swelling of the face, lips, or tongue
Rationale: Angioedema is a life-threatening adverse effect of ACE inhibitors (lisinopril) caused
by increased bradykinin levels. It requires immediate discontinuation and medical attention.
Q2 A client is prescribed warfarin. The nurse should instruct the client to report which of the
following symptoms?
Answer: Unusual bruising or pink-tinged urine
Rationale: These are signs of bleeding, which is the most serious adverse effect of warfarin due
to its anticoagulant action.
Q3 A nurse is preparing to administer digoxin to a client. Which of the following findings should
the nurse withhold the medication and notify the provider?
Answer: Apical pulse rate 52 beats per minute
Rationale: Digoxin should be withheld if the apical pulse is less than 60 beats per minute in
adults due to risk of bradycardia and toxicity.
Q4 A client is prescribed furosemide. The nurse should monitor for which of the following
adverse effects?
Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in the distal
tubule, leading to hypokalemia.
,Q5 A nurse is reinforcing teaching to a client who has a new prescription for metformin. Which
of the following instructions should the nurse include?
Answer: "Take this medication with meals."
Rationale: Taking metformin with food reduces gastrointestinal side effects (nausea, diarrhea,
abdominal discomfort).
Q6 A client who has type 2 diabetes mellitus is starting insulin glargine. The nurse should
instruct the client to:
Answer: "Do not mix this insulin with any other insulin."
Rationale: Insulin glargine is a long-acting insulin and must not be mixed with other insulins to
preserve its 24-hour duration of action.
Q7 A nurse is caring for a client who is receiving IV heparin. The aPTT is 90 seconds
(therapeutic range 60–80 seconds). Which of the following actions should the nurse take?
Answer: Decrease the heparin infusion rate
Rationale: aPTT above the therapeutic range indicates increased risk of bleeding; the infusion
rate should be decreased per protocol.
Q8 A client is prescribed enoxaparin for deep vein thrombosis prophylaxis. The nurse should
instruct the client to administer the medication:
Answer: In the abdomen, at least 2 inches away from the umbilicus
Rationale: The abdomen is the preferred site for subcutaneous low-molecular-weight heparin
injections due to consistent absorption and lower risk of bruising.
Q9 A nurse is caring for a client who has a new prescription for clopidogrel. The nurse should
instruct the client to avoid taking which of the following medications?
Answer: Omeprazole
Rationale: Omeprazole inhibits CYP2C19, reducing the conversion of clopidogrel to its active
metabolite and decreasing its antiplatelet effectiveness.
Q10 A client is prescribed spironolactone for heart failure. The nurse should monitor for which
of the following adverse effects?
Answer: Hyperkalemia
, Rationale: Spironolactone is a potassium-sparing diuretic and can cause hyperkalemia,
especially when combined with ACE inhibitors or ARBs.
Q11 A nurse is caring for a client who has a prescription for theophylline. The nurse should
monitor serum theophylline levels to prevent which of the following adverse effects?
Answer: Tachycardia and dysrhythmias
Rationale: Theophylline has a narrow therapeutic index; toxicity can cause serious cardiac
effects, including tachycardia and dysrhythmias.
Q12 A client is prescribed methotrexate for rheumatoid arthritis. The nurse should instruct the
client to report which of the following symptoms immediately?
Answer: Sore throat and fever
Rationale: Methotrexate is myelosuppressive; sore throat and fever may indicate infection due
to leukopenia.
Q13 A nurse is caring for a client who has a new prescription for levothyroxine. Which of the
following instructions should the nurse include?
Answer: "Take this medication on an empty stomach 30 to 60 minutes before breakfast."
Rationale: Food significantly reduces levothyroxine absorption; it should be taken on an empty
stomach.
Q14 A client is prescribed amiodarone for atrial fibrillation. The nurse should monitor for which
of the following adverse effects?
Answer: Pulmonary toxicity
Rationale: Amiodarone can cause potentially fatal pulmonary toxicity (interstitial
pneumonitis/fibrosis); clients should be monitored for dyspnea and cough.
Q15 A nurse is caring for a client who has a prescription for vancomycin. The nurse should
monitor for which of the following adverse effects?
Answer: Red man syndrome
Rationale: Rapid infusion of vancomycin can cause red man syndrome (flushing, hypotension,
rash) due to histamine release.
Q16 A client is prescribed lithium for bipolar disorder. The nurse should instruct the client to:
Answer: "Maintain consistent salt and fluid intake."
