# **ATI RN PHARMACOLOGY 2023 RETAKE 1
QUESTIONS WITH ANSWERS AND EXPLANATIONS /
RATIONALE – 90 QUESTIONS**
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1) A nurse is administering digoxin to a client with heart failure. Which of the following laboratory values
should the nurse monitor to assess for an increased risk of toxicity?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
💡 RATIONALE -- Hypokalemia (low potassium) increases the risk of digoxin toxicity because digoxin
binds to the same site on the sodium‑potassium ATPase pump. Normal potassium is 3.5‑5.0 mEq/L.
✔️ ANSWER -- B) Serum potassium
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2) A client is prescribed warfarin. The nurse notes that the client's INR is 4.5. The client has no signs of
bleeding. Which of the following actions should the nurse take?
A) Administer vitamin K
B) Hold the next dose and notify the provider
C) Continue the warfarin as prescribed
D) Increase the warfarin dose
,💡 RATIONALE -- An INR of 4.5 is above therapeutic range (2‑3) but not critical (>5). The nurse should
hold the next dose and notify the provider for dose adjustment. Vitamin K is reserved for bleeding or
INR >10.
✔️ ANSWER -- B) Hold the next dose and notify the provider
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3) 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. Massage is not recommended as
it can cause bruising. It is not given IM or orally.
✔️ ANSWER -- C) "I will inject this medication into my abdomen."
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4) A client receiving IV vancomycin reports flushing, a rash on the neck and chest, and hypotension.
Which of the following actions should the nurse take first?
A) Stop the infusion
B) Slow the infusion rate
C) Administer diphenhydramine
D) Notify the provider
,💡 RATIONALE -- These symptoms indicate red man syndrome, a histamine‑mediated reaction to rapid
vancomycin infusion. Slowing the infusion rate is the first intervention. Antihistamines and provider
notification follow.
✔️ ANSWER -- B) Slow the infusion rate
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5) 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. The
other statements are correct.
✔️ ANSWER -- C) "I can drink alcohol while taking this medication."
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6) 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 weakness and cardiac dysrhythmias.
, ✔️ ANSWER -- A) Hypokalemia
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7) 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. It does not cause hypoglycemia or hypotension.
✔️ ANSWER -- C) Osteoporosis
---
8) A client with asthma is prescribed albuterol and fluticasone inhalers. Which of the following
instructions should the nurse provide regarding the order of administration?
A) Use fluticasone first, then albuterol
B) Use albuterol first, then fluticasone
C) Use both at the same time
D) Use only one inhaler per day
💡 RATIONALE -- Albuterol (bronchodilator) should be used first to open airways, then fluticasone
(inhaled corticosteroid) to allow deeper penetration.
✔️ ANSWER -- B) Use albuterol first, then fluticasone
QUESTIONS WITH ANSWERS AND EXPLANATIONS /
RATIONALE – 90 QUESTIONS**
---
1) A nurse is administering digoxin to a client with heart failure. Which of the following laboratory values
should the nurse monitor to assess for an increased risk of toxicity?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
💡 RATIONALE -- Hypokalemia (low potassium) increases the risk of digoxin toxicity because digoxin
binds to the same site on the sodium‑potassium ATPase pump. Normal potassium is 3.5‑5.0 mEq/L.
✔️ ANSWER -- B) Serum potassium
---
2) A client is prescribed warfarin. The nurse notes that the client's INR is 4.5. The client has no signs of
bleeding. Which of the following actions should the nurse take?
A) Administer vitamin K
B) Hold the next dose and notify the provider
C) Continue the warfarin as prescribed
D) Increase the warfarin dose
,💡 RATIONALE -- An INR of 4.5 is above therapeutic range (2‑3) but not critical (>5). The nurse should
hold the next dose and notify the provider for dose adjustment. Vitamin K is reserved for bleeding or
INR >10.
✔️ ANSWER -- B) Hold the next dose and notify the provider
---
3) 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. Massage is not recommended as
it can cause bruising. It is not given IM or orally.
✔️ ANSWER -- C) "I will inject this medication into my abdomen."
---
4) A client receiving IV vancomycin reports flushing, a rash on the neck and chest, and hypotension.
Which of the following actions should the nurse take first?
A) Stop the infusion
B) Slow the infusion rate
C) Administer diphenhydramine
D) Notify the provider
,💡 RATIONALE -- These symptoms indicate red man syndrome, a histamine‑mediated reaction to rapid
vancomycin infusion. Slowing the infusion rate is the first intervention. Antihistamines and provider
notification follow.
✔️ ANSWER -- B) Slow the infusion rate
---
5) 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. The
other statements are correct.
✔️ ANSWER -- C) "I can drink alcohol while taking this medication."
---
6) 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 weakness and cardiac dysrhythmias.
, ✔️ ANSWER -- A) Hypokalemia
---
7) 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. It does not cause hypoglycemia or hypotension.
✔️ ANSWER -- C) Osteoporosis
---
8) A client with asthma is prescribed albuterol and fluticasone inhalers. Which of the following
instructions should the nurse provide regarding the order of administration?
A) Use fluticasone first, then albuterol
B) Use albuterol first, then fluticasone
C) Use both at the same time
D) Use only one inhaler per day
💡 RATIONALE -- Albuterol (bronchodilator) should be used first to open airways, then fluticasone
(inhaled corticosteroid) to allow deeper penetration.
✔️ ANSWER -- B) Use albuterol first, then fluticasone
