**ATI RN Pharmacology Proctored Assessment:
125-Question Comprehensive Examination**
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Question 1
A nurse is administering IV furosemide to a client with heart failure. Which of the following findings
should the nurse report to the provider as an adverse effect of the medication?
A. Increased urine output
B. Serum potassium 3.1 mEq/L
C. Weight loss of 2 lbs in 24 hours
D. Blood pressure 128/76 mmHg
💫ANSWER✔️✔️: B. Serum potassium 3.1 mEq/L
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that causes hypokalemia; a level of 3.1 mEq/L is
critically low and increases the risk of cardiac dysrhythmias.
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Question 2
A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following
statements by the client indicates understanding?
A. "I will take ibuprofen for my occasional headaches."
B. "I will have my INR checked regularly as scheduled."
C. "I can stop taking this medication if I have no symptoms."
D. "I will eat a large salad every day to get vitamin K."
💫ANSWER✔️✔️: B. "I will have my INR checked regularly as scheduled."
💫RATIONALE✔️✔️: INR monitoring is essential to maintain therapeutic anticoagulation (INR 2-3 for most
indications) and prevent bleeding or clotting complications.
---
Question 3
A nurse is administering digoxin to a client with heart failure. Which of the following findings indicates
digoxin toxicity?
,A. Heart rate 72/min
B. Yellow-tinged vision
C. Blood pressure 128/76 mmHg
D. Weight gain of 2 lbs
💫ANSWER✔️✔️: B. Yellow-tinged vision
💫RATIONALE✔️✔️: Yellow-tinged vision (xanthopsia) is a classic sign of digoxin toxicity, along with
nausea, vomiting, and arrhythmias.
---
Question 4
A nurse is providing teaching to a client who has a new prescription for metformin. Which of the
following statements by the client indicates a need for further teaching?
A. "I will take this medication with meals to prevent stomach upset."
B. "I should not drink alcohol while taking this medication."
C. "This medication can cause my urine to turn orange."
D. "I will report any muscle pain to my provider."
💫ANSWER✔️✔️: C. "This medication can cause my urine to turn orange."
💫RATIONALE✔️✔️: Metformin does not cause orange urine; this is a side effect of rifampin or
phenazopyridine. Metformin can cause lactic acidosis (muscle pain) and GI upset.
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Question 5
A nurse is administering IV vancomycin to a client for MRSA. The client reports a flushing sensation on
the face and neck. Which of the following actions should the nurse take first?
A. Stop the vancomycin infusion
B. Slow the vancomycin infusion rate
C. Document the finding as a common side effect
D. Notify the healthcare provider
💫ANSWER✔️✔️: A. Stop the vancomycin infusion
💫RATIONALE✔️✔️: Flushing, rash, and hypotension indicate Red Man Syndrome, a rate-related infusion
reaction; the infusion must be stopped immediately.
---
,Question 6
A nurse is teaching a client about a new prescription for alendronate for osteoporosis. Which of the
following instructions should the nurse include?
A. "Take this medication with a full glass of orange juice."
B. "Remain upright for 30 minutes after taking the medication."
C. "Take this medication at bedtime with a snack."
D. "Crush the tablet if you have difficulty swallowing."
💫ANSWER✔️✔️: B. "Remain upright for 30 minutes after taking the medication."
💫RATIONALE✔️✔️: Alendronate causes esophageal irritation; remaining upright prevents esophagitis; it
should be taken on an empty stomach with water.
---
Question 7
A nurse is caring for a client who is receiving a continuous heparin infusion for DVT. The client's aPTT is
110 seconds, and the control is 30 seconds. Which of the following actions should the nurse take?
A. Increase the heparin infusion rate
B. Decrease the heparin infusion rate
C. Administer protamine sulfate
D. Continue the infusion at the same rate
💫ANSWER✔️✔️: B. Decrease the heparin infusion rate
💫RATIONALE✔️✔️: Therapeutic aPTT is 1.5-2.5 times control (45-75 seconds); 110 seconds is
supratherapeutic and requires rate reduction.
---
Question 8
A nurse is providing discharge teaching to a client who has a new prescription for lisinopril. Which of the
following adverse effects should the nurse instruct the client to report immediately?
A. Dry, non-productive cough
B. Swelling of the lips and tongue
C. Dizziness when standing
D. Loss of taste sensation
💫ANSWER✔️✔️: B. Swelling of the lips and tongue
, 💫RATIONALE✔️✔️: Angioedema (swelling of lips, tongue, larynx) is a life-threatening allergic reaction to
ACE inhibitors; requires immediate medical attention.
---
Question 9
A nurse is administering a dose of enoxaparin subcutaneously. Which of the following techniques is
correct?
A. Aspirate before injecting the medication
B. Massage the injection site after administration
C. Inject into the lateral abdominal tissue
D. Use a 21-gauge, 1.5-inch needle
💫ANSWER✔️✔️: C. Inject into the lateral abdominal tissue
💫RATIONALE✔️✔️: Enoxaparin is given subcutaneously in the abdomen; do not aspirate or rub the site
to prevent bruising.
---
Question 10
A nurse is providing teaching to a client who has a new prescription for phenytoin for a seizure disorder.
Which of the following statements by the client indicates understanding?
A. "I will take this medication with milk to prevent stomach upset."
B. "I should report any bruising or bleeding to my doctor."
C. "I can stop this medication if I am seizure-free for 1 year."
D. "I will take this medication at bedtime only."
💫ANSWER✔️✔️: B. "I should report any bruising or bleeding to my doctor."
💫RATIONALE✔️✔️: Phenytoin can cause blood dyscrasias (thrombocytopenia, leukopenia); bruising or
bleeding requires evaluation.
---
Question 11
A nurse is caring for a client receiving IV potassium chloride. Which of the following findings requires
immediate intervention?
A. Serum potassium 3.8 mEq/L
B. Infusion site pain and redness
C. Urine output 50 mL/hr
125-Question Comprehensive Examination**
---
Question 1
A nurse is administering IV furosemide to a client with heart failure. Which of the following findings
should the nurse report to the provider as an adverse effect of the medication?
A. Increased urine output
B. Serum potassium 3.1 mEq/L
C. Weight loss of 2 lbs in 24 hours
D. Blood pressure 128/76 mmHg
💫ANSWER✔️✔️: B. Serum potassium 3.1 mEq/L
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that causes hypokalemia; a level of 3.1 mEq/L is
critically low and increases the risk of cardiac dysrhythmias.
---
Question 2
A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following
statements by the client indicates understanding?
A. "I will take ibuprofen for my occasional headaches."
B. "I will have my INR checked regularly as scheduled."
C. "I can stop taking this medication if I have no symptoms."
D. "I will eat a large salad every day to get vitamin K."
💫ANSWER✔️✔️: B. "I will have my INR checked regularly as scheduled."
💫RATIONALE✔️✔️: INR monitoring is essential to maintain therapeutic anticoagulation (INR 2-3 for most
indications) and prevent bleeding or clotting complications.
---
Question 3
A nurse is administering digoxin to a client with heart failure. Which of the following findings indicates
digoxin toxicity?
,A. Heart rate 72/min
B. Yellow-tinged vision
C. Blood pressure 128/76 mmHg
D. Weight gain of 2 lbs
💫ANSWER✔️✔️: B. Yellow-tinged vision
💫RATIONALE✔️✔️: Yellow-tinged vision (xanthopsia) is a classic sign of digoxin toxicity, along with
nausea, vomiting, and arrhythmias.
---
Question 4
A nurse is providing teaching to a client who has a new prescription for metformin. Which of the
following statements by the client indicates a need for further teaching?
A. "I will take this medication with meals to prevent stomach upset."
B. "I should not drink alcohol while taking this medication."
C. "This medication can cause my urine to turn orange."
D. "I will report any muscle pain to my provider."
💫ANSWER✔️✔️: C. "This medication can cause my urine to turn orange."
💫RATIONALE✔️✔️: Metformin does not cause orange urine; this is a side effect of rifampin or
phenazopyridine. Metformin can cause lactic acidosis (muscle pain) and GI upset.
---
Question 5
A nurse is administering IV vancomycin to a client for MRSA. The client reports a flushing sensation on
the face and neck. Which of the following actions should the nurse take first?
A. Stop the vancomycin infusion
B. Slow the vancomycin infusion rate
C. Document the finding as a common side effect
D. Notify the healthcare provider
💫ANSWER✔️✔️: A. Stop the vancomycin infusion
💫RATIONALE✔️✔️: Flushing, rash, and hypotension indicate Red Man Syndrome, a rate-related infusion
reaction; the infusion must be stopped immediately.
---
,Question 6
A nurse is teaching a client about a new prescription for alendronate for osteoporosis. Which of the
following instructions should the nurse include?
A. "Take this medication with a full glass of orange juice."
B. "Remain upright for 30 minutes after taking the medication."
C. "Take this medication at bedtime with a snack."
D. "Crush the tablet if you have difficulty swallowing."
💫ANSWER✔️✔️: B. "Remain upright for 30 minutes after taking the medication."
💫RATIONALE✔️✔️: Alendronate causes esophageal irritation; remaining upright prevents esophagitis; it
should be taken on an empty stomach with water.
---
Question 7
A nurse is caring for a client who is receiving a continuous heparin infusion for DVT. The client's aPTT is
110 seconds, and the control is 30 seconds. Which of the following actions should the nurse take?
A. Increase the heparin infusion rate
B. Decrease the heparin infusion rate
C. Administer protamine sulfate
D. Continue the infusion at the same rate
💫ANSWER✔️✔️: B. Decrease the heparin infusion rate
💫RATIONALE✔️✔️: Therapeutic aPTT is 1.5-2.5 times control (45-75 seconds); 110 seconds is
supratherapeutic and requires rate reduction.
---
Question 8
A nurse is providing discharge teaching to a client who has a new prescription for lisinopril. Which of the
following adverse effects should the nurse instruct the client to report immediately?
A. Dry, non-productive cough
B. Swelling of the lips and tongue
C. Dizziness when standing
D. Loss of taste sensation
💫ANSWER✔️✔️: B. Swelling of the lips and tongue
, 💫RATIONALE✔️✔️: Angioedema (swelling of lips, tongue, larynx) is a life-threatening allergic reaction to
ACE inhibitors; requires immediate medical attention.
---
Question 9
A nurse is administering a dose of enoxaparin subcutaneously. Which of the following techniques is
correct?
A. Aspirate before injecting the medication
B. Massage the injection site after administration
C. Inject into the lateral abdominal tissue
D. Use a 21-gauge, 1.5-inch needle
💫ANSWER✔️✔️: C. Inject into the lateral abdominal tissue
💫RATIONALE✔️✔️: Enoxaparin is given subcutaneously in the abdomen; do not aspirate or rub the site
to prevent bruising.
---
Question 10
A nurse is providing teaching to a client who has a new prescription for phenytoin for a seizure disorder.
Which of the following statements by the client indicates understanding?
A. "I will take this medication with milk to prevent stomach upset."
B. "I should report any bruising or bleeding to my doctor."
C. "I can stop this medication if I am seizure-free for 1 year."
D. "I will take this medication at bedtime only."
💫ANSWER✔️✔️: B. "I should report any bruising or bleeding to my doctor."
💫RATIONALE✔️✔️: Phenytoin can cause blood dyscrasias (thrombocytopenia, leukopenia); bruising or
bleeding requires evaluation.
---
Question 11
A nurse is caring for a client receiving IV potassium chloride. Which of the following findings requires
immediate intervention?
A. Serum potassium 3.8 mEq/L
B. Infusion site pain and redness
C. Urine output 50 mL/hr
