ATI Pharmacology CMS Exam 2026-
Complete Exam with Real Questions, Verified
Correct Answers and Detailed Rationales |
Already Graded A+
Question 1
A client has a new prescription for spironolactone (Aldactone). Which of the following
laboratory values should the nurse recognize as a reason to withhold the morning dose
of the medication and notify the provider?
a. Serum sodium 138 mEq/L
b. Serum potassium 5.2 mEq/L
c. Serum creatinine 1.2 mEq/L
d. Serum chloride 106 mEq/L
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that can cause
hyperkalemia. A serum potassium level of 5.2 mEq/L is above the normal range (3.5-5.0
mEq/L) and is a reason to withhold the medication and notify the provider.
Hyperkalemia can lead to cardiac arrhythmias. The other values are within normal
limits: sodium 136-145 mEq/L, creatinine 0.6-1.2 mg/dL, and chloride 98-106 mEq/L.
Question 2
A nurse is caring for a client who is prescribed daily doses of both digoxin (Lanoxin) and
furosemide (Lasix). The client's potassium level is 3.2 mEq/L. For which of the following
medication interaction is the client at risk?
a. Toxic levels of furosemide
b. Toxic levels of digoxin
c. Sub-therapeutic levels of furosemide
d. Sub-therapeutic levels of digoxin
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. Hypokalemia
(potassium 3.2 mEq/L) increases the risk of digoxin toxicity because digoxin competes
pg. 1
,with potassium for binding sites on the sodium-potassium pump. Low potassium levels
allow more digoxin to bind, leading to toxicity. The client is at risk for toxic levels of
digoxin, not sub-therapeutic levels. Furosemide levels are not affected by potassium.
Question 3
Propranolol (Inderal) is contraindicated for a client who has which of the following
conditions?
a. Asthma
b. Diabetes
c. Angina
d. Dementia
Correct Answer: A
Rationale: Propranolol is a non-selective beta-blocker that blocks both beta-1 (cardiac)
and beta-2 (bronchial) receptors. Beta-2 blockade can cause bronchoconstriction,
making it contraindicated in clients with asthma. It is also relatively contraindicated in
diabetes because it can mask hypoglycemic symptoms. It is actually used to treat angina
(chest pain). Dementia is not a contraindication.
Question 4
A nurse is reinforcing teaching for a client who has a prescription for verapamil (Calan).
Which of the following statements by the client indicates a need for further teaching?
a. "I should increase the amount of fiber in my diet"
b. "I should decrease the amount of calcium in my diet while taking the medication."
c. "I should report shortness of breath to my provider."
d. "I should avoid drinking grapefruit juice."
Correct Answer: B
Rationale: Verapamil is a calcium channel blocker. Decreasing dietary calcium is not
necessary and indicates a need for further teaching. Increasing fiber helps prevent
constipation (a common side effect). Shortness of breath should be reported as it may
indicate heart failure. Grapefruit juice increases verapamil levels and should be avoided.
The client should not decrease calcium intake.
Question 5
pg. 2
,A nurse is caring for a client with prescription for nifedipine (Procardia) to treat angina
pectoris. The nurse should plan to monitor the client for which of the following
findings?
a. Weight loss
b. Reflex tachycardia
c. Grand mal seizures
d. Urinary Retention
Correct Answer: B
Rationale: Nifedipine is a calcium channel blocker that causes vasodilation, leading to
a decrease in blood pressure. The body responds with reflex tachycardia (increased
heart rate) to compensate. This is a common side effect of nifedipine, especially with
rapid-onset formulations. Weight loss, seizures, and urinary retention are not typical
adverse effects of nifedipine.
Question 6
A nurse is caring for a client on a medical unit who takes regular doses of propranolol
(Inderal) for hypertension. Before administering the client's morning dose of
propranolol, which of the following should the nurse plan to monitor? (Select all that
apply)
a. Urinary output
b. Pulse rate
c. Temperature
d. Blood pressure
e. Deep tendon reflexes
Correct Answer: B, D
Rationale: Propranolol is a beta-blocker that decreases heart rate and blood pressure.
The nurse should monitor pulse rate (for bradycardia) and blood pressure (for
hypotension) before administering the medication. If the pulse is <60 bpm or systolic
BP is <90 mmHg, the dose should be withheld and the provider notified. Urinary
output, temperature, and deep tendon reflexes are not directly affected by propranolol.
Question 7
A nurse is reinforcing teaching for a client who is prescribed digoxin (Lanoxin). Which
of the following should the nurse instruct the client to report to the provider? (Select all
that apply)
pg. 3
, a. Fatigue
b. Muscle aches
c. Anorexia
d. Insomnia
e. Diplopia
Correct Answer: A, C, E
Rationale: Signs of digoxin toxicity include fatigue (early sign), anorexia (loss of
appetite), and diplopia (double vision). Other signs include nausea, vomiting, visual
disturbances (blurred vision, yellow-green halos), bradycardia, and confusion. Muscle
aches and insomnia are not typical signs of digoxin toxicity. Clients should be instructed
to report these symptoms promptly.
Question 8
A nurse is caring for a client who is prescribed isosorbide mononitrate (Imdur) for
chronic stable angina. The nurse should plan to monitor the client for which of the
following findings?
a. Bradycardia
b. Fever
c. Hypertension
d. Headache
Correct Answer: D
Rationale: Isosorbide mononitrate is a nitrate used for angina. A common side effect is
headache, caused by vasodilation. The headache often diminishes with continued use. It
can also cause hypotension, not hypertension, and tachycardia, not bradycardia. Fever is
not a typical side effect. The headache is an expected effect, but severe headache may
need to be reported.
Question 9
A nurse is obtaining a medication history from a client who is to start a new prescription
for warfarin (Coumadin). Which of the following over-the-counter medications should
the nurse instruct the client to avoid?
a. Ranitidine (Zantac)
b. Docusate sodium (Colace)
c. Acetaminophen
d. Aspirin
pg. 4
Complete Exam with Real Questions, Verified
Correct Answers and Detailed Rationales |
Already Graded A+
Question 1
A client has a new prescription for spironolactone (Aldactone). Which of the following
laboratory values should the nurse recognize as a reason to withhold the morning dose
of the medication and notify the provider?
a. Serum sodium 138 mEq/L
b. Serum potassium 5.2 mEq/L
c. Serum creatinine 1.2 mEq/L
d. Serum chloride 106 mEq/L
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that can cause
hyperkalemia. A serum potassium level of 5.2 mEq/L is above the normal range (3.5-5.0
mEq/L) and is a reason to withhold the medication and notify the provider.
Hyperkalemia can lead to cardiac arrhythmias. The other values are within normal
limits: sodium 136-145 mEq/L, creatinine 0.6-1.2 mg/dL, and chloride 98-106 mEq/L.
Question 2
A nurse is caring for a client who is prescribed daily doses of both digoxin (Lanoxin) and
furosemide (Lasix). The client's potassium level is 3.2 mEq/L. For which of the following
medication interaction is the client at risk?
a. Toxic levels of furosemide
b. Toxic levels of digoxin
c. Sub-therapeutic levels of furosemide
d. Sub-therapeutic levels of digoxin
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium loss. Hypokalemia
(potassium 3.2 mEq/L) increases the risk of digoxin toxicity because digoxin competes
pg. 1
,with potassium for binding sites on the sodium-potassium pump. Low potassium levels
allow more digoxin to bind, leading to toxicity. The client is at risk for toxic levels of
digoxin, not sub-therapeutic levels. Furosemide levels are not affected by potassium.
Question 3
Propranolol (Inderal) is contraindicated for a client who has which of the following
conditions?
a. Asthma
b. Diabetes
c. Angina
d. Dementia
Correct Answer: A
Rationale: Propranolol is a non-selective beta-blocker that blocks both beta-1 (cardiac)
and beta-2 (bronchial) receptors. Beta-2 blockade can cause bronchoconstriction,
making it contraindicated in clients with asthma. It is also relatively contraindicated in
diabetes because it can mask hypoglycemic symptoms. It is actually used to treat angina
(chest pain). Dementia is not a contraindication.
Question 4
A nurse is reinforcing teaching for a client who has a prescription for verapamil (Calan).
Which of the following statements by the client indicates a need for further teaching?
a. "I should increase the amount of fiber in my diet"
b. "I should decrease the amount of calcium in my diet while taking the medication."
c. "I should report shortness of breath to my provider."
d. "I should avoid drinking grapefruit juice."
Correct Answer: B
Rationale: Verapamil is a calcium channel blocker. Decreasing dietary calcium is not
necessary and indicates a need for further teaching. Increasing fiber helps prevent
constipation (a common side effect). Shortness of breath should be reported as it may
indicate heart failure. Grapefruit juice increases verapamil levels and should be avoided.
The client should not decrease calcium intake.
Question 5
pg. 2
,A nurse is caring for a client with prescription for nifedipine (Procardia) to treat angina
pectoris. The nurse should plan to monitor the client for which of the following
findings?
a. Weight loss
b. Reflex tachycardia
c. Grand mal seizures
d. Urinary Retention
Correct Answer: B
Rationale: Nifedipine is a calcium channel blocker that causes vasodilation, leading to
a decrease in blood pressure. The body responds with reflex tachycardia (increased
heart rate) to compensate. This is a common side effect of nifedipine, especially with
rapid-onset formulations. Weight loss, seizures, and urinary retention are not typical
adverse effects of nifedipine.
Question 6
A nurse is caring for a client on a medical unit who takes regular doses of propranolol
(Inderal) for hypertension. Before administering the client's morning dose of
propranolol, which of the following should the nurse plan to monitor? (Select all that
apply)
a. Urinary output
b. Pulse rate
c. Temperature
d. Blood pressure
e. Deep tendon reflexes
Correct Answer: B, D
Rationale: Propranolol is a beta-blocker that decreases heart rate and blood pressure.
The nurse should monitor pulse rate (for bradycardia) and blood pressure (for
hypotension) before administering the medication. If the pulse is <60 bpm or systolic
BP is <90 mmHg, the dose should be withheld and the provider notified. Urinary
output, temperature, and deep tendon reflexes are not directly affected by propranolol.
Question 7
A nurse is reinforcing teaching for a client who is prescribed digoxin (Lanoxin). Which
of the following should the nurse instruct the client to report to the provider? (Select all
that apply)
pg. 3
, a. Fatigue
b. Muscle aches
c. Anorexia
d. Insomnia
e. Diplopia
Correct Answer: A, C, E
Rationale: Signs of digoxin toxicity include fatigue (early sign), anorexia (loss of
appetite), and diplopia (double vision). Other signs include nausea, vomiting, visual
disturbances (blurred vision, yellow-green halos), bradycardia, and confusion. Muscle
aches and insomnia are not typical signs of digoxin toxicity. Clients should be instructed
to report these symptoms promptly.
Question 8
A nurse is caring for a client who is prescribed isosorbide mononitrate (Imdur) for
chronic stable angina. The nurse should plan to monitor the client for which of the
following findings?
a. Bradycardia
b. Fever
c. Hypertension
d. Headache
Correct Answer: D
Rationale: Isosorbide mononitrate is a nitrate used for angina. A common side effect is
headache, caused by vasodilation. The headache often diminishes with continued use. It
can also cause hypotension, not hypertension, and tachycardia, not bradycardia. Fever is
not a typical side effect. The headache is an expected effect, but severe headache may
need to be reported.
Question 9
A nurse is obtaining a medication history from a client who is to start a new prescription
for warfarin (Coumadin). Which of the following over-the-counter medications should
the nurse instruct the client to avoid?
a. Ranitidine (Zantac)
b. Docusate sodium (Colace)
c. Acetaminophen
d. Aspirin
pg. 4
