2026 ATI RN Pharmacology Proctored
Exam | Complete Study Guide
1. A nurse is preparing to administer morphine sulfate 10 mg IV to a client with severe
postoperative pain. The client’s respiratory rate is 10 breaths/min and oxygen saturation
is 92% on room air. Which action should the nurse take first?
A. Proceed with the scheduled dose and reassess in 15 minutes.
B. Administer the dose with supplemental oxygen via nasal cannula.
C. Hold the dose and notify the provider about the low respiratory rate.
D. Decrease the dose to 5 mg and administer slowly over 5 minutes.
Answer: C
2. A client is receiving gentamicin IV twice daily for a complicated urinary tract infection.
Which laboratory result should the nurse report to the provider immediately?
A. White blood cell count 14,000/mm³
B. Serum creatinine 2.8 mg/dL
C. Hemoglobin 11.1 g/dL
D. Platelet count 190,000/mm³
Answer: B
3. A nurse is teaching a client about warfarin (Coumadin). Which statement by the client
indicates correct understanding of dietary instructions?
A. “I should avoid eating green leafy vegetables.”
B. “I can take extra vitamin K if my gums start bleeding.”
C. “I should keep my vitamin K intake consistent from day to day.”
D. “I will stop the medication if I have dark green stools.”
Answer: C
4. A client is prescribed lisinopril for hypertension. Which adverse effect should the nurse
monitor for as a priority?
A. Hypokalemia
B. Persistent dry cough
C. Weight gain
D. Hyperglycemia
Answer: B
5. A client is receiving IV potassium chloride infusion. Which nursing action is most
important to prevent complications?
A. Infuse the medication rapidly over 10 minutes.
B. Monitor for signs of hypokalemia while the infusion runs.
C. Avoid using a central line if the solution is less than 40 mEq/L.
D. Ensure the infusion is diluted and infused slowly through a large‑bore peripheral IV.
Answer: D
6. A nurse is caring for a client who is receiving enoxaparin (Lovenox) subcutaneously.
Which injection technique should the nurse use to ensure safety?
A. Administer the injection into the deltoid muscle.
, B. Massage the injection site after administration.
C. Pinch the skin and inject at a 90‑degree angle into the abdomen.
D. Rotate sites between the upper arms and thighs.
Answer: C
7. A client who is taking phenytoin (Dilantin) long‑term for seizure control reports puffy,
overgrown gums. Which instruction should the nurse reinforce?
A. “Stop the medication until you see your dentist.”
B. “This is a harmless side effect and requires no intervention.”
C. “Brush and floss your teeth daily and schedule regular dental checkups.”
D. “Switch to chewable vitamin C tablets to improve gum health.”
Answer: C
8. A client with atrial fibrillation is receiving digoxin. Which assessment finding should the
nurse recognize as a sign of toxicity?
A. Tachycardia and hypertension
B. Visual changes such as yellow‑green halos around objects
C. Bradycardia with a ventricular rate of 48 beats/min
D. Edema and jugular vein distention
Answer: C
9. A nurse is preparing to administer regular insulin and NPH insulin subcutaneously to a
client with type 2 diabetes. Which action should the nurse take to ensure the correct
preparation?
A. Draw up the NPH first, then the regular insulin into the same syringe.
B. Mix the insulins in the same syringe but administer at separate sites.
C. Draw up the regular insulin first, then the NPH insulin into the same syringe.
D. Administer each insulin separately using different syringes.
Answer: C
10.A client is prescribed prednisone for chronic asthma. Which statement by the client
indicates the need for further teaching?
A. “I will take this medication with food to reduce stomach upset.”
B. “I will stop taking this medication if I feel better after a week.”
C. “I will watch for signs of infection, such as fever or sore throat.”
D. “I will take this at the same time each day if possible.”
Answer: B
11.A nurse is caring for a client who has just received naloxone (Narcan) for suspected
opioid overdose. Which finding indicates the medication is effective?
A. Increased respiratory rate and depth
B. Decreased blood pressure and urinary output
C. Development of tremors and agitation
D. Worsening confusion and drowsiness
Answer: A
12.A client is prescribed acetaminophen (Tylenol) for chronic pain. The nurse should
monitor for which adverse effect that is most concerning at high doses?
A. Bruising and prolonged bleeding time
B. Dark urine and flank pain
, C. Nausea and vomiting
D. Hearing loss and tinnitus
Answer: B
13.A nurse is teaching a client about statin therapy (atorvastatin). Which symptom should
the client report immediately?
A. Mild headache and fatigue
B. Muscle pain, tenderness, or weakness
C. Occasional bloating and gas
D. Increased urination and thirst
Answer: B
14.A client is receiving heparin infusion for deep vein thrombosis. The provider orders
protamine sulfate. For which adverse effect of heparin is this medication an antidote?
A. Hypertension
B. Hypocoagulability and bleeding
C. Hyperglycemia
D. Urinary retention
Answer: B
15.A nurse is administering flumazenil (Romazicon) to a client who has overdosed on
benzodiazepines. Which assessment should the nurse prioritize after administration?
A. Blood glucose level
B. Respiratory rate and depth
C. Bowel sounds
D. Skin turgor
Answer: B
16.A client is prescribed albuterol inhaler and beclomethasone inhaler for asthma. Which
instruction should the nurse give about the correct sequence?
A. Use the beclomethasone inhaler first, then the albuterol.
B. Use the albuterol inhaler first, wait several minutes, then use the beclomethasone.
C. Use both inhalers at the same time, alternating puffs.
D. Use the spacer only with the beclomethasone.
Answer: B
17.A nurse is teaching a client about proton pump inhibitor (PPI) therapy. Which long‑term
risk should the nurse mention?
A. Increased risk of osteoporosis‑related fractures
B. Hypoglycemia
C. Hyperkalemia
D. Increased risk of cataracts
Answer: A
18.A client is prescribed ranitidine for gastroesophageal reflux disease (GERD). Which
statement by the client indicates understanding of administration safety?
A. “I will take this medication with antacids to speed up relief.”
B. “I can stop this medication once my heartburn goes away.”
C. “I will take this medication exactly as prescribed, even if I feel better.”
Exam | Complete Study Guide
1. A nurse is preparing to administer morphine sulfate 10 mg IV to a client with severe
postoperative pain. The client’s respiratory rate is 10 breaths/min and oxygen saturation
is 92% on room air. Which action should the nurse take first?
A. Proceed with the scheduled dose and reassess in 15 minutes.
B. Administer the dose with supplemental oxygen via nasal cannula.
C. Hold the dose and notify the provider about the low respiratory rate.
D. Decrease the dose to 5 mg and administer slowly over 5 minutes.
Answer: C
2. A client is receiving gentamicin IV twice daily for a complicated urinary tract infection.
Which laboratory result should the nurse report to the provider immediately?
A. White blood cell count 14,000/mm³
B. Serum creatinine 2.8 mg/dL
C. Hemoglobin 11.1 g/dL
D. Platelet count 190,000/mm³
Answer: B
3. A nurse is teaching a client about warfarin (Coumadin). Which statement by the client
indicates correct understanding of dietary instructions?
A. “I should avoid eating green leafy vegetables.”
B. “I can take extra vitamin K if my gums start bleeding.”
C. “I should keep my vitamin K intake consistent from day to day.”
D. “I will stop the medication if I have dark green stools.”
Answer: C
4. A client is prescribed lisinopril for hypertension. Which adverse effect should the nurse
monitor for as a priority?
A. Hypokalemia
B. Persistent dry cough
C. Weight gain
D. Hyperglycemia
Answer: B
5. A client is receiving IV potassium chloride infusion. Which nursing action is most
important to prevent complications?
A. Infuse the medication rapidly over 10 minutes.
B. Monitor for signs of hypokalemia while the infusion runs.
C. Avoid using a central line if the solution is less than 40 mEq/L.
D. Ensure the infusion is diluted and infused slowly through a large‑bore peripheral IV.
Answer: D
6. A nurse is caring for a client who is receiving enoxaparin (Lovenox) subcutaneously.
Which injection technique should the nurse use to ensure safety?
A. Administer the injection into the deltoid muscle.
, B. Massage the injection site after administration.
C. Pinch the skin and inject at a 90‑degree angle into the abdomen.
D. Rotate sites between the upper arms and thighs.
Answer: C
7. A client who is taking phenytoin (Dilantin) long‑term for seizure control reports puffy,
overgrown gums. Which instruction should the nurse reinforce?
A. “Stop the medication until you see your dentist.”
B. “This is a harmless side effect and requires no intervention.”
C. “Brush and floss your teeth daily and schedule regular dental checkups.”
D. “Switch to chewable vitamin C tablets to improve gum health.”
Answer: C
8. A client with atrial fibrillation is receiving digoxin. Which assessment finding should the
nurse recognize as a sign of toxicity?
A. Tachycardia and hypertension
B. Visual changes such as yellow‑green halos around objects
C. Bradycardia with a ventricular rate of 48 beats/min
D. Edema and jugular vein distention
Answer: C
9. A nurse is preparing to administer regular insulin and NPH insulin subcutaneously to a
client with type 2 diabetes. Which action should the nurse take to ensure the correct
preparation?
A. Draw up the NPH first, then the regular insulin into the same syringe.
B. Mix the insulins in the same syringe but administer at separate sites.
C. Draw up the regular insulin first, then the NPH insulin into the same syringe.
D. Administer each insulin separately using different syringes.
Answer: C
10.A client is prescribed prednisone for chronic asthma. Which statement by the client
indicates the need for further teaching?
A. “I will take this medication with food to reduce stomach upset.”
B. “I will stop taking this medication if I feel better after a week.”
C. “I will watch for signs of infection, such as fever or sore throat.”
D. “I will take this at the same time each day if possible.”
Answer: B
11.A nurse is caring for a client who has just received naloxone (Narcan) for suspected
opioid overdose. Which finding indicates the medication is effective?
A. Increased respiratory rate and depth
B. Decreased blood pressure and urinary output
C. Development of tremors and agitation
D. Worsening confusion and drowsiness
Answer: A
12.A client is prescribed acetaminophen (Tylenol) for chronic pain. The nurse should
monitor for which adverse effect that is most concerning at high doses?
A. Bruising and prolonged bleeding time
B. Dark urine and flank pain
, C. Nausea and vomiting
D. Hearing loss and tinnitus
Answer: B
13.A nurse is teaching a client about statin therapy (atorvastatin). Which symptom should
the client report immediately?
A. Mild headache and fatigue
B. Muscle pain, tenderness, or weakness
C. Occasional bloating and gas
D. Increased urination and thirst
Answer: B
14.A client is receiving heparin infusion for deep vein thrombosis. The provider orders
protamine sulfate. For which adverse effect of heparin is this medication an antidote?
A. Hypertension
B. Hypocoagulability and bleeding
C. Hyperglycemia
D. Urinary retention
Answer: B
15.A nurse is administering flumazenil (Romazicon) to a client who has overdosed on
benzodiazepines. Which assessment should the nurse prioritize after administration?
A. Blood glucose level
B. Respiratory rate and depth
C. Bowel sounds
D. Skin turgor
Answer: B
16.A client is prescribed albuterol inhaler and beclomethasone inhaler for asthma. Which
instruction should the nurse give about the correct sequence?
A. Use the beclomethasone inhaler first, then the albuterol.
B. Use the albuterol inhaler first, wait several minutes, then use the beclomethasone.
C. Use both inhalers at the same time, alternating puffs.
D. Use the spacer only with the beclomethasone.
Answer: B
17.A nurse is teaching a client about proton pump inhibitor (PPI) therapy. Which long‑term
risk should the nurse mention?
A. Increased risk of osteoporosis‑related fractures
B. Hypoglycemia
C. Hyperkalemia
D. Increased risk of cataracts
Answer: A
18.A client is prescribed ranitidine for gastroesophageal reflux disease (GERD). Which
statement by the client indicates understanding of administration safety?
A. “I will take this medication with antacids to speed up relief.”
B. “I can stop this medication once my heartburn goes away.”
C. “I will take this medication exactly as prescribed, even if I feel better.”
