RN ATI PHARMACOLOGY PROCTORED EXAM NEWEST
2026 2 VERSIONS EACH VERSION WITH 70 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY GRADED A+
ATI PHARM VERSION 1
A nurse is preparing to administer heparin subcutaneously to a client. Which of the
following actions should the nurse plan to take?
a. administer the medication outside the 5 cm (2 in) radius of the umbilicus
b. aspirate for blood return before injecting
c. rub vigorously after the injection to promote absorption
d. place a pressure dressing on the injection site to prevent bleeding -
---Answer--- administer the medication outside the 5 cm (2 in) radius of the umbilicus
RATIONALE: -the nurse should administer the heparin by subcutaneous injection to the
abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away from the
umbilicus
-the nurse should not aspirate by pulling back on the plunger of the heparin syringe to check
for a blood return, because this will cause the injection site to bruise
-the nurse should apply firm pressure to the injection site for 1-2 min after the administration
of the heparin to prevent bruising
A nurse at an urgent care clinic is collecting a history from a female client who has a urinary
tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should
identify that which of the following client statements indicates a contraindication for
administering this medication?
a. "I have tendonitis, so I haven't been able to exercise."
b. "I take a stool softener for chronic constipation."
c. "I take medicine for my thyroid."
d. "I am allergic to sulfa." - ---Answer--- "I have tendonitis, so I haven't been able to
exercise."
RATIONALE: -the nurse should identify tendonitis as a contraindication for taking
ciprofloxacin due to the risk of tendon rupture
-diarrhea is an adverse effect of this medication
-ciprofloxacin is a quinolone antibiotic
A nurse is reviewing the laboratory results for a client who is receiving heparin via
continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the
medication infusion for which of the following client findings?
a. potassium 5.0 mEq/L
b. aPTT 2 times the control
c. hemoglobin 15 g/dL
d. platelets 96,000 mm3 - ---Answer---d. platelets 96,000 mm3 RATIONALE: -a platelet
count of 96,000 mm3 is below the expected range of 150,000-400,000 mm3. A platelet
countless than 100,000 mm3 while receiving heparin can indicate heparin-induced
,thrombocytopenia, a potentially fatal condition that requires stopping the infusion
-an Hgb of 15 g/dL is within the expected range or 14-18 g/dL for a male and 12-16 g/dL for
a female and is not an indication to stop the heparin infusion
A nurse is caring for a client who is in labor. The client is receiving oxytocin by
continuous IV infusion with a maintenance IV solution. The external FHR monitor
indicates late decelerations. Which of the following actions should the nurse take first?
a. turn the client to a side-lying position
b. disconnect the clients oxytocin from the maintenance IV
c. apply oxygen to the client by face mask
d. increase the client's maintenance IV infusion rate - ---Answer--- turn the client to a side-
lying position
RATIONALE: -the greatest risk to the fetus experiencing late decelerations is injury from
uteroplacental insufficiency. Therefore,
the priority action the nurse should take is to place the client in a lateral position
-the nurse should increase the client's maintenance IV infusion rate to maintain adequate
blood flow and promote placental perfusion.
However, another action is the nurse's priority
-all of these answers are correct, however, turning the client to the side is the nurse's priority
A nurse is preparing to administer medications to a client who tells the nurse, "I don't want
to take my fluid pill until I get home today." Which of the following actions should the nurse
take?
a. document the refusal and inform the client's provider
b. file an incident report with the risk manager
c. contact the pharmacist to pick up the medication
d. give the client the medication to take home and document that it was administered - ---
Answer--- document the refusal and inform the client's provider
RATIONALE: -the nurse has the responsibility to verify that the client understands the
risks of refusing the medication so that an informed decision can be made. The nurse should
then document the refusal in the client's medical record and notify the HCP
-an incident report is necessary for a medication error
-the nurse should follow protocols for discarding the medication. It is not the role of the
pharmacist to retrieve medications that a client refuses to take
-the nurse should not give the client a scheduled medication to take at home and then
document that it was administered, because this violates the ethical principle of
accountability
A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for
depression. Which of the following findings should the nurse identify as an adverse effect of
the medication?
a. tingling toes
b. sexual dysfunction
c. absence of dreams
d. pica - ---Answer---b. sexual dysfunction
,RATIONALE: -sexual dysfunction, including a decreased libido, impotence, and delayed
orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of
clients who take this SSRI antidepressant
-fluoxetine is an SSRI that can cause muscle twitching
-fluoxetine can cause CNS adverse effect including abnormal dreaming, sedation, delusions,
hallucinations, and psychosis
-fluoxetine can cause neurologic adverse effects such as agitation, euphoria, and sedation
A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has
hyperkalemia. Which of the following actions should the nurse plan to take?
a. hold the client's other oral medication for 8 hr post administration
b. inform the client that his medication can turn stool a light tan color
c. keep the client's solution in the refrigerator for up to 72 hours
d. monitor the client for constipation - ---Answer---d. monitor the client for constipation
RATIONALE: -the nurse should monitor the client for the adverse effect of constipation
and report it to the provider because this can lead to fecal impaction
-the nurse should hold the client's other medications for 6 hr before and after administration
of sodium polystyrene sulfonate
-sodium polystyrene sulfonate will not alter the color of the client's stool and is stable for 24
hr when refrigerated
A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the
antibiotic is not present in the client's medication drawer. The nurse should identify that
administration of the medication can occur at which of the following time periods without
requiring an incident report?
a. 1000
b. 0900
c. 0830
d. 1200 - ---Answer---c. 0830
RATIONALE:-the nurse should identify that an antibiotic can be administered 30 min
before or after the scheduled time to maintain therapeutic blood levels without requiring an
incident report
A nurse is planning care for a client who is prescribed metoclopramide following bowel
surgery. For which of the following adverse effects should the nurse monitor?
a. muscle weakness
b. sedation
c. tinnitus
d. peripheral edema - ---Answer---b. sedation
RATIONALE: -metoclopramide has multiple CNS adverse effects, including dizziness,
fatigue, and sedation
-metoclopramide is a central dopamine receptor antagonist that increased GI motility and
prevents nausea. Tardive dyskinesia is an adverse effect of metoclopramide
A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets
for pain. Which of the following information should the nurse include in the teaching?
a. the medication should be taken 1 hr prior to eating
b. it takes 48 hr for therapeutic effects to occur
, c. tablets should not be crushed or chewed
d. decreased respirations might occur - ---Answer---d. decreased respirations might
occur
RATIONALE: -the nurse should instruct the client that hydrocodone with acetaminophen
might cause respiratory depression, which is an adverse effect of the medication. The client
should avoid taking over-the-counter medications or newly prescribed medications without
consulting their provider to avoid increased respiratory depression
-the client should take hydrocodone and acetaminophen with food or milk to decrease gastric
irritation
-the nurse should instruct the client that they should experience the effects of hydrocodone
with acetaminophen within 20 min of administration and that pain relief should last 4-6 hr
-can be crushed if needed
A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking.
Which of the following findings should the nurse identify as an adverse effect of the
medication?
a. cough
b. joint pain
c. alopecia
d. insomnia - ---Answer---d. insomnia
RATIONALE: -bupropion, an atypical antidepressant, has stimulant properties, which can
result in agitation, tremors, mania, and insomnia
-bupropion can cause neurologic adverse effects such as bradykinesia
-bupropion can cause adverse effects such as changes in vision and hearing
A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the
following findings should the nurse report to the provider immediately?
a. dyspepsia
b. diarrhea
c. dizziness
d. dyspnea - ---Answer---d. dyspnea
RATIONALE: -when using the airway, breathing, circulation approach to client care, the
nurse should report the adverse effect of dyspnea, caused by bronchoconstriction, to the
provider first.
Bronchospasm, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine
levels, which is a primary effect of donepezil
-all of these answers should be reported to the provider, but dyspnea should be reported first
A nurse is teaching a client about warfarin. The client asks if they can take aspirin while
taking the warfarin. Which of the following responses should the nurse make?
a. "It is safe to take an enteric-coated aspirin."
b. "Aspirin will increase the risk of bleeding."
c. "Acetaminophen mat be substituted for aspirin."
d. "The INR lab work must be monitored more frequently if aspirin is taken." - ---Answer---
b. "Aspirin will increase the risk of bleeding."
RATIONALE: -aspirin inhibits platelet aggregation and can potentiate the action of the
anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases
the risk for bleeding
-salicylates inhibit platelet aggregation and increase the potential for hemorrhage.
Therefore, the client should avoid taking enteric-coated aspirin
2026 2 VERSIONS EACH VERSION WITH 70 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
ALREADY GRADED A+
ATI PHARM VERSION 1
A nurse is preparing to administer heparin subcutaneously to a client. Which of the
following actions should the nurse plan to take?
a. administer the medication outside the 5 cm (2 in) radius of the umbilicus
b. aspirate for blood return before injecting
c. rub vigorously after the injection to promote absorption
d. place a pressure dressing on the injection site to prevent bleeding -
---Answer--- administer the medication outside the 5 cm (2 in) radius of the umbilicus
RATIONALE: -the nurse should administer the heparin by subcutaneous injection to the
abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away from the
umbilicus
-the nurse should not aspirate by pulling back on the plunger of the heparin syringe to check
for a blood return, because this will cause the injection site to bruise
-the nurse should apply firm pressure to the injection site for 1-2 min after the administration
of the heparin to prevent bruising
A nurse at an urgent care clinic is collecting a history from a female client who has a urinary
tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should
identify that which of the following client statements indicates a contraindication for
administering this medication?
a. "I have tendonitis, so I haven't been able to exercise."
b. "I take a stool softener for chronic constipation."
c. "I take medicine for my thyroid."
d. "I am allergic to sulfa." - ---Answer--- "I have tendonitis, so I haven't been able to
exercise."
RATIONALE: -the nurse should identify tendonitis as a contraindication for taking
ciprofloxacin due to the risk of tendon rupture
-diarrhea is an adverse effect of this medication
-ciprofloxacin is a quinolone antibiotic
A nurse is reviewing the laboratory results for a client who is receiving heparin via
continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the
medication infusion for which of the following client findings?
a. potassium 5.0 mEq/L
b. aPTT 2 times the control
c. hemoglobin 15 g/dL
d. platelets 96,000 mm3 - ---Answer---d. platelets 96,000 mm3 RATIONALE: -a platelet
count of 96,000 mm3 is below the expected range of 150,000-400,000 mm3. A platelet
countless than 100,000 mm3 while receiving heparin can indicate heparin-induced
,thrombocytopenia, a potentially fatal condition that requires stopping the infusion
-an Hgb of 15 g/dL is within the expected range or 14-18 g/dL for a male and 12-16 g/dL for
a female and is not an indication to stop the heparin infusion
A nurse is caring for a client who is in labor. The client is receiving oxytocin by
continuous IV infusion with a maintenance IV solution. The external FHR monitor
indicates late decelerations. Which of the following actions should the nurse take first?
a. turn the client to a side-lying position
b. disconnect the clients oxytocin from the maintenance IV
c. apply oxygen to the client by face mask
d. increase the client's maintenance IV infusion rate - ---Answer--- turn the client to a side-
lying position
RATIONALE: -the greatest risk to the fetus experiencing late decelerations is injury from
uteroplacental insufficiency. Therefore,
the priority action the nurse should take is to place the client in a lateral position
-the nurse should increase the client's maintenance IV infusion rate to maintain adequate
blood flow and promote placental perfusion.
However, another action is the nurse's priority
-all of these answers are correct, however, turning the client to the side is the nurse's priority
A nurse is preparing to administer medications to a client who tells the nurse, "I don't want
to take my fluid pill until I get home today." Which of the following actions should the nurse
take?
a. document the refusal and inform the client's provider
b. file an incident report with the risk manager
c. contact the pharmacist to pick up the medication
d. give the client the medication to take home and document that it was administered - ---
Answer--- document the refusal and inform the client's provider
RATIONALE: -the nurse has the responsibility to verify that the client understands the
risks of refusing the medication so that an informed decision can be made. The nurse should
then document the refusal in the client's medical record and notify the HCP
-an incident report is necessary for a medication error
-the nurse should follow protocols for discarding the medication. It is not the role of the
pharmacist to retrieve medications that a client refuses to take
-the nurse should not give the client a scheduled medication to take at home and then
document that it was administered, because this violates the ethical principle of
accountability
A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for
depression. Which of the following findings should the nurse identify as an adverse effect of
the medication?
a. tingling toes
b. sexual dysfunction
c. absence of dreams
d. pica - ---Answer---b. sexual dysfunction
,RATIONALE: -sexual dysfunction, including a decreased libido, impotence, and delayed
orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of
clients who take this SSRI antidepressant
-fluoxetine is an SSRI that can cause muscle twitching
-fluoxetine can cause CNS adverse effect including abnormal dreaming, sedation, delusions,
hallucinations, and psychosis
-fluoxetine can cause neurologic adverse effects such as agitation, euphoria, and sedation
A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has
hyperkalemia. Which of the following actions should the nurse plan to take?
a. hold the client's other oral medication for 8 hr post administration
b. inform the client that his medication can turn stool a light tan color
c. keep the client's solution in the refrigerator for up to 72 hours
d. monitor the client for constipation - ---Answer---d. monitor the client for constipation
RATIONALE: -the nurse should monitor the client for the adverse effect of constipation
and report it to the provider because this can lead to fecal impaction
-the nurse should hold the client's other medications for 6 hr before and after administration
of sodium polystyrene sulfonate
-sodium polystyrene sulfonate will not alter the color of the client's stool and is stable for 24
hr when refrigerated
A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the
antibiotic is not present in the client's medication drawer. The nurse should identify that
administration of the medication can occur at which of the following time periods without
requiring an incident report?
a. 1000
b. 0900
c. 0830
d. 1200 - ---Answer---c. 0830
RATIONALE:-the nurse should identify that an antibiotic can be administered 30 min
before or after the scheduled time to maintain therapeutic blood levels without requiring an
incident report
A nurse is planning care for a client who is prescribed metoclopramide following bowel
surgery. For which of the following adverse effects should the nurse monitor?
a. muscle weakness
b. sedation
c. tinnitus
d. peripheral edema - ---Answer---b. sedation
RATIONALE: -metoclopramide has multiple CNS adverse effects, including dizziness,
fatigue, and sedation
-metoclopramide is a central dopamine receptor antagonist that increased GI motility and
prevents nausea. Tardive dyskinesia is an adverse effect of metoclopramide
A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets
for pain. Which of the following information should the nurse include in the teaching?
a. the medication should be taken 1 hr prior to eating
b. it takes 48 hr for therapeutic effects to occur
, c. tablets should not be crushed or chewed
d. decreased respirations might occur - ---Answer---d. decreased respirations might
occur
RATIONALE: -the nurse should instruct the client that hydrocodone with acetaminophen
might cause respiratory depression, which is an adverse effect of the medication. The client
should avoid taking over-the-counter medications or newly prescribed medications without
consulting their provider to avoid increased respiratory depression
-the client should take hydrocodone and acetaminophen with food or milk to decrease gastric
irritation
-the nurse should instruct the client that they should experience the effects of hydrocodone
with acetaminophen within 20 min of administration and that pain relief should last 4-6 hr
-can be crushed if needed
A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking.
Which of the following findings should the nurse identify as an adverse effect of the
medication?
a. cough
b. joint pain
c. alopecia
d. insomnia - ---Answer---d. insomnia
RATIONALE: -bupropion, an atypical antidepressant, has stimulant properties, which can
result in agitation, tremors, mania, and insomnia
-bupropion can cause neurologic adverse effects such as bradykinesia
-bupropion can cause adverse effects such as changes in vision and hearing
A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the
following findings should the nurse report to the provider immediately?
a. dyspepsia
b. diarrhea
c. dizziness
d. dyspnea - ---Answer---d. dyspnea
RATIONALE: -when using the airway, breathing, circulation approach to client care, the
nurse should report the adverse effect of dyspnea, caused by bronchoconstriction, to the
provider first.
Bronchospasm, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine
levels, which is a primary effect of donepezil
-all of these answers should be reported to the provider, but dyspnea should be reported first
A nurse is teaching a client about warfarin. The client asks if they can take aspirin while
taking the warfarin. Which of the following responses should the nurse make?
a. "It is safe to take an enteric-coated aspirin."
b. "Aspirin will increase the risk of bleeding."
c. "Acetaminophen mat be substituted for aspirin."
d. "The INR lab work must be monitored more frequently if aspirin is taken." - ---Answer---
b. "Aspirin will increase the risk of bleeding."
RATIONALE: -aspirin inhibits platelet aggregation and can potentiate the action of the
anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases
the risk for bleeding
-salicylates inhibit platelet aggregation and increase the potential for hemorrhage.
Therefore, the client should avoid taking enteric-coated aspirin
