# **ATI RN Pharmacology Retake Exam 1 (2025) –
90 Questions with Rationales & Answers**
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1) A nurse is caring for a client who is receiving a continuous IV infusion of heparin. The client's aPTT is
120 seconds (therapeutic range 60‑80). Which of the following actions should the nurse take first?
A) Decrease the heparin infusion rate
B) Administer protamine sulfate
C) Notify the provider
D) Obtain a stat platelet count
💡 RATIONALE -- An aPTT of 120 seconds is well above the therapeutic range, indicating a high risk of
bleeding. The first action is to decrease the infusion rate. Protamine is for severe bleeding. Notifying the
provider and checking platelets are important but not the immediate first step.
✔️ ANSWER -- A) Decrease the heparin infusion rate
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2) A client with heart failure is prescribed digoxin. Which of the following findings should the nurse
report to the provider immediately?
A) Heart rate 62/min
B) Serum potassium 3.2 mEq/L
C) Blood pressure 118/76 mm Hg
D) Respiratory rate 18/min
💡 RATIONALE -- Hypokalemia (serum potassium below 3.5 mEq/L) increases the risk of digoxin toxicity.
The nurse should report this finding and withhold the medication.
,✔️ ANSWER -- B) Serum potassium 3.2 mEq/L
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3) A client is prescribed warfarin for atrial fibrillation. Which of the following laboratory values should
the nurse monitor to evaluate therapeutic effect?
A) aPTT
B) INR
C) Platelet count
D) Bleeding time
💡 RATIONALE -- Warfarin's therapeutic effect is monitored by INR (international normalized ratio), with
a target of 2-3 for atrial fibrillation.
✔️ ANSWER -- B) INR
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4) A nurse is providing discharge teaching to a client with a new prescription for enoxaparin. Which of
the following statements indicates understanding?
A) "I will inject this medication into my thigh muscle."
B) "I will massage the injection site to prevent bruising."
C) "I will inject this medication into my abdomen."
D) "I will take this medication by mouth with food."
💡 RATIONALE -- Enoxaparin is given subcutaneously in the abdomen. Do not massage. Not oral or IM.
✔️ ANSWER -- C) "I will inject this medication into my abdomen."
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5) A client receiving IV vancomycin reports flushing, rash on the neck and chest, and hypotension. Which
of the following conditions should the nurse suspect?
A) Anaphylaxis
B) Red man syndrome
C) Stevens‑Johnson syndrome
D) Serum sickness
💡 RATIONALE -- Red man syndrome is a histamine‑mediated reaction to rapid vancomycin infusion.
Slowing the infusion rate usually resolves it.
✔️ ANSWER -- B) Red man syndrome
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6) A client with type 2 diabetes is prescribed 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 will report any muscle pain or weakness to my provider."
C) "I can drink alcohol while taking this medication."
D) "I will stop taking metformin before having an MRI with contrast."
💡 RATIONALE -- Alcohol increases the risk of lactic acidosis with metformin and should be avoided.
✔️ ANSWER -- C) "I can drink alcohol while taking this medication."
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, 7) A client is prescribed furosemide. Which of the following laboratory values should the nurse monitor
as an adverse effect?
A) Hypokalemia
B) Hyperkalemia
C) Hypernatremia
D) Hypermagnesemia
💡 RATIONALE -- Furosemide (loop diuretic) causes hypokalemia (low potassium), which can lead to
muscle cramps, weakness, and dysrhythmias.
✔️ ANSWER -- A) Hypokalemia
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8) A nurse is teaching a client about the adverse effects of prednisone. Which of the following should
the nurse include?
A) Hypoglycemia
B) Weight loss
C) Osteoporosis
D) Hypotension
💡 RATIONALE -- Long‑term prednisone use causes osteoporosis, weight gain, hyperglycemia, and
hypertension.
✔️ ANSWER -- C) Osteoporosis
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9) A client with asthma is prescribed albuterol and fluticasone inhalers. Which of the following
instructions should the nurse provide regarding the order of administration?
90 Questions with Rationales & Answers**
---
1) A nurse is caring for a client who is receiving a continuous IV infusion of heparin. The client's aPTT is
120 seconds (therapeutic range 60‑80). Which of the following actions should the nurse take first?
A) Decrease the heparin infusion rate
B) Administer protamine sulfate
C) Notify the provider
D) Obtain a stat platelet count
💡 RATIONALE -- An aPTT of 120 seconds is well above the therapeutic range, indicating a high risk of
bleeding. The first action is to decrease the infusion rate. Protamine is for severe bleeding. Notifying the
provider and checking platelets are important but not the immediate first step.
✔️ ANSWER -- A) Decrease the heparin infusion rate
---
2) A client with heart failure is prescribed digoxin. Which of the following findings should the nurse
report to the provider immediately?
A) Heart rate 62/min
B) Serum potassium 3.2 mEq/L
C) Blood pressure 118/76 mm Hg
D) Respiratory rate 18/min
💡 RATIONALE -- Hypokalemia (serum potassium below 3.5 mEq/L) increases the risk of digoxin toxicity.
The nurse should report this finding and withhold the medication.
,✔️ ANSWER -- B) Serum potassium 3.2 mEq/L
---
3) A client is prescribed warfarin for atrial fibrillation. Which of the following laboratory values should
the nurse monitor to evaluate therapeutic effect?
A) aPTT
B) INR
C) Platelet count
D) Bleeding time
💡 RATIONALE -- Warfarin's therapeutic effect is monitored by INR (international normalized ratio), with
a target of 2-3 for atrial fibrillation.
✔️ ANSWER -- B) INR
---
4) A nurse is providing discharge teaching to a client with a new prescription for enoxaparin. Which of
the following statements indicates understanding?
A) "I will inject this medication into my thigh muscle."
B) "I will massage the injection site to prevent bruising."
C) "I will inject this medication into my abdomen."
D) "I will take this medication by mouth with food."
💡 RATIONALE -- Enoxaparin is given subcutaneously in the abdomen. Do not massage. Not oral or IM.
✔️ ANSWER -- C) "I will inject this medication into my abdomen."
,---
5) A client receiving IV vancomycin reports flushing, rash on the neck and chest, and hypotension. Which
of the following conditions should the nurse suspect?
A) Anaphylaxis
B) Red man syndrome
C) Stevens‑Johnson syndrome
D) Serum sickness
💡 RATIONALE -- Red man syndrome is a histamine‑mediated reaction to rapid vancomycin infusion.
Slowing the infusion rate usually resolves it.
✔️ ANSWER -- B) Red man syndrome
---
6) A client with type 2 diabetes is prescribed 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 will report any muscle pain or weakness to my provider."
C) "I can drink alcohol while taking this medication."
D) "I will stop taking metformin before having an MRI with contrast."
💡 RATIONALE -- Alcohol increases the risk of lactic acidosis with metformin and should be avoided.
✔️ ANSWER -- C) "I can drink alcohol while taking this medication."
---
, 7) A client is prescribed furosemide. Which of the following laboratory values should the nurse monitor
as an adverse effect?
A) Hypokalemia
B) Hyperkalemia
C) Hypernatremia
D) Hypermagnesemia
💡 RATIONALE -- Furosemide (loop diuretic) causes hypokalemia (low potassium), which can lead to
muscle cramps, weakness, and dysrhythmias.
✔️ ANSWER -- A) Hypokalemia
---
8) A nurse is teaching a client about the adverse effects of prednisone. Which of the following should
the nurse include?
A) Hypoglycemia
B) Weight loss
C) Osteoporosis
D) Hypotension
💡 RATIONALE -- Long‑term prednisone use causes osteoporosis, weight gain, hyperglycemia, and
hypertension.
✔️ ANSWER -- C) Osteoporosis
---
9) A client with asthma is prescribed albuterol and fluticasone inhalers. Which of the following
instructions should the nurse provide regarding the order of administration?
