ATI RN PHARMACOLOGY 2026 PROCTORED
EXAM WITH NGN: 200 ADVANCED MULTIPLE-
CHOICE QUESTIONS WITH VERIFIED
ANSWERS AND DETAILED RATIONALES FOR
SCORING 98% AND ABOVE
SECTION 1: PHARMACOKINETICS, PHARMACODYNAMICS, AND SAFE MEDICATION
ADMINISTRATION (Questions 1-25)
1. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the
following findings should the nurse identify as a contraindication to administering the
medication?
A. Heart rate of 88/min
B. Potassium level of 3.2 mEq/L
C. Blood pressure of 128/76 mm Hg
D. Digoxin level of 0.8 ng/mL
Correct Answer: B
Rationale: Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin toxicity and is a
contraindication to administration. Digoxin should be withheld and the provider notified. HR 88
is within normal limits for digoxin administration (hold if <60). BP 128/76 is acceptable. Digoxin
level of 0.8 ng/mL is within therapeutic range (0.5-2.0 ng/mL) .
,2. A nurse is reviewing a client's medication administration record and notes a prescription for
a medication the client is allergic to. Which of the following actions should the nurse take
FIRST?
A. Administer the medication as prescribed
B. Withhold the medication and notify the provider immediately
C. Ask the client if they want to take the medication anyway
D. Document the allergy and give the medication
Correct Answer: B
Rationale: The nurse must withhold the medication and notify the provider immediately.
Administering a medication to which the client is allergic could cause a life-threatening reaction.
The nurse acts as the client's advocate and prevents harm .
3. Which pharmacokinetic process describes movement of a medication from the
bloodstream into tissues?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: B
,Rationale: Distribution is the movement of medication from the circulation to tissues and
organs. Absorption is movement from the site of administration into the bloodstream.
Metabolism is biotransformation, and excretion is elimination .
4. A client has severe hepatic impairment. Which medication process is most likely affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: C
Rationale: The liver is a major site of medication metabolism. Hepatic dysfunction can prolong
medication effects and increase the risk of toxicity because drugs are not metabolized efficiently
.
5. Which organ is primarily responsible for renal medication excretion?
A. Heart
B. Liver
C. Kidneys
D. Lungs
, Correct Answer: C
Rationale: The kidneys eliminate many medications and their metabolites. Renal impairment
decreases drug clearance and increases the risk of toxicity .
6. A nurse is preparing to administer a medication to a client with a history of renal failure.
Which pharmacokinetic process should the nurse expect to be most affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: D
Rationale: The kidneys are the primary organs responsible for excreting drugs and their
metabolites. Impaired renal function leads to decreased drug clearance and a high risk for
toxicity, often requiring dosage adjustments .
7. A nurse is teaching a client about the "first-pass effect." Which route of administration is
most affected by this process?
A. Intravenous
B. Subcutaneous
EXAM WITH NGN: 200 ADVANCED MULTIPLE-
CHOICE QUESTIONS WITH VERIFIED
ANSWERS AND DETAILED RATIONALES FOR
SCORING 98% AND ABOVE
SECTION 1: PHARMACOKINETICS, PHARMACODYNAMICS, AND SAFE MEDICATION
ADMINISTRATION (Questions 1-25)
1. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the
following findings should the nurse identify as a contraindication to administering the
medication?
A. Heart rate of 88/min
B. Potassium level of 3.2 mEq/L
C. Blood pressure of 128/76 mm Hg
D. Digoxin level of 0.8 ng/mL
Correct Answer: B
Rationale: Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin toxicity and is a
contraindication to administration. Digoxin should be withheld and the provider notified. HR 88
is within normal limits for digoxin administration (hold if <60). BP 128/76 is acceptable. Digoxin
level of 0.8 ng/mL is within therapeutic range (0.5-2.0 ng/mL) .
,2. A nurse is reviewing a client's medication administration record and notes a prescription for
a medication the client is allergic to. Which of the following actions should the nurse take
FIRST?
A. Administer the medication as prescribed
B. Withhold the medication and notify the provider immediately
C. Ask the client if they want to take the medication anyway
D. Document the allergy and give the medication
Correct Answer: B
Rationale: The nurse must withhold the medication and notify the provider immediately.
Administering a medication to which the client is allergic could cause a life-threatening reaction.
The nurse acts as the client's advocate and prevents harm .
3. Which pharmacokinetic process describes movement of a medication from the
bloodstream into tissues?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: B
,Rationale: Distribution is the movement of medication from the circulation to tissues and
organs. Absorption is movement from the site of administration into the bloodstream.
Metabolism is biotransformation, and excretion is elimination .
4. A client has severe hepatic impairment. Which medication process is most likely affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: C
Rationale: The liver is a major site of medication metabolism. Hepatic dysfunction can prolong
medication effects and increase the risk of toxicity because drugs are not metabolized efficiently
.
5. Which organ is primarily responsible for renal medication excretion?
A. Heart
B. Liver
C. Kidneys
D. Lungs
, Correct Answer: C
Rationale: The kidneys eliminate many medications and their metabolites. Renal impairment
decreases drug clearance and increases the risk of toxicity .
6. A nurse is preparing to administer a medication to a client with a history of renal failure.
Which pharmacokinetic process should the nurse expect to be most affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: D
Rationale: The kidneys are the primary organs responsible for excreting drugs and their
metabolites. Impaired renal function leads to decreased drug clearance and a high risk for
toxicity, often requiring dosage adjustments .
7. A nurse is teaching a client about the "first-pass effect." Which route of administration is
most affected by this process?
A. Intravenous
B. Subcutaneous
