ATI CMS Pharmacology Proctored Exam 2026 -
Comprehensive Practice Exam Questions with Verified
Correct Answers and Rationales || Latest Update!!
Question 1
A provider prescribes phenobarbital for a client who has a seizure disorder. The
medication has a long half-life of 4 days. How many times per day should the nurse
expect to administer this medication?
A. One
B. Two
C. Three
D. Four
Correct Answer: A
Rationale: Phenobarbital has a long half-life (approximately 4 days), which allows for
once-daily dosing. Medications with long half-lives require less frequent administration
because they remain in the body for extended periods. Once-daily dosing improves
adherence and maintains therapeutic levels. Twice, three times, or four times daily
would be unnecessary due to the long half-life.
Question 2
A nurse educator is reviewing medication metabolism at an in-service presentation.
Which of the following factors should the educator include as a reason to administer
lower medication dosages? (Select all that apply)
A. Increased renal excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication the same pathway metabolizes
Correct Answer: C, E
Rationale: Liver failure reduces medication metabolism, requiring lower dosages to
prevent toxicity. Concurrent use of medications that compete for the same metabolic
pathway can decrease metabolism, requiring dosage adjustments. Increased renal
excretion would typically require higher doses (not lower). Increased metabolizing
pg. 1
,enzymes would increase metabolism, requiring higher doses. Peripheral vascular
disease does not directly affect medication metabolism.
Question 3
A nurse is preparing to administer eye drops to a client. Which of the following actions
should the nurse take? (Select all that apply)
A. Have the client lie on one side
B. Ask the client to look up at the ceiling
C. Tell the client to blink when the drops enter the eyes
D. Drop the medication into the client's conjunctival sac
E. Instruct the client to close the eye gently after instillation
Correct Answer: B, D, E
Rationale: The client should look up at the ceiling to expose the conjunctival sac. The
medication should be dropped into the conjunctival sac (not directly on the cornea). The
client should close the eye gently after instillation to distribute the medication and
prevent it from draining out. The client should not lie on one side (that is for ear drops).
The client should not blink immediately as this would expel the medication.
Question 4
A nurse is teaching a client about transdermal patches. Which of the following
statements should the nurse identify as an indication that the client understands?
A. "I will clean the site with an alcohol swab before I apply the patch"
B. "I will rotate the application sites weekly"
C. "I will apply the patch to an area of skin with no hair"
D. "I will place the new patch on the site of the old patch"
Correct Answer: C
Rationale: Transdermal patches should be applied to hairless areas of skin to ensure
proper adhesion and absorption. Sites should be rotated with each application (not
weekly). Alcohol swabs may irritate the skin and affect absorption. New patches should
not be placed on the site of the old patch; sites should be rotated. Applying to hairless
skin is the correct understanding.
Question 5
pg. 2
,A nurse reviewing a client's medical record notes a new prescription for verifying the
trough level of the client's medication. Which of the following actions should the nurse
take?
A. Obtain a blood specimen immediately prior to administering the next dose of
medication.
B. Verify that the client has been taking the medication for 24 hr before obtaining a
blood specimen.
C. Ask the client to provide a urine specimen after the next dose of medication.
D. Administer the medication, and obtain a blood specimen 30 min later.
Correct Answer: A
Rationale: Trough levels are drawn immediately before the next dose of medication to
measure the lowest concentration in the blood. This ensures the medication is still at
therapeutic levels and not accumulating to toxic levels. It is typically drawn just prior to
administration of the next dose. A trough level should not be drawn after the dose or
without the client being on a steady state of the medication.
Question 6
A nurse is preparing a client's medications. Which of the following actions should the
nurse take in following legal practice guidelines? (Select all that apply)
A. Teach the client about the med
B. Determine the dosage
C. Monitor for adverse effects
D. Prescribe the medication
E. Change the medication dose
Correct Answer: A, C
Rationale: The nurse is legally responsible for teaching the client about the medication
and monitoring for adverse effects. Determining the dosage and prescribing medications
are the provider's responsibilities. Changing the medication dose requires a provider's
order. The nurse's role includes safe administration, client education, and monitoring
for effectiveness and side effects.
Question 7
The nurse is preparing to administer digoxin to a client who states, "I don't want to take
that medication. I do not want one more pill." Which of the following responses should
the nurse make?
pg. 3
, A. "Your physician prescribes it for you, so you really should take it."
B. "Well, let's just get it over quickly then."
C. "Okay, I'll just give you your other medications."
D. "Tell me your concerns about taking this medication."
Correct Answer: D
Rationale: The nurse should explore the client's concerns about the medication. This is
patient-centered care that respects the client's autonomy and allows the nurse to
address specific issues. Telling the client what to do is paternalistic. Ignoring the refusal
is not appropriate. The nurse should validate the client's feelings and gather more
information about the refusal.
Question 8
The nurse is reviewing a client's prescribed medications. Which of the following
situations represents a contraindication to medication administration?
A. The client drank grapefruit juice, which could reduce a medication's effectiveness.
B. The medication has orthostatic hypotension as an adverse effect.
C. A medication is approved for ages 12 and older, and the client is 8 years old.
D. An anti-anxiety medication has an adverse effect of drowsiness and is prescribed as a
preoperative sedative.
Correct Answer: C
Rationale: A contraindication is a situation in which a medication should not be
administered because it could cause harm. Administering a medication to a client
outside the approved age range (8 years old for a medication approved for 12 and older)
is a contraindication. Grapefruit juice may interact but is not necessarily a
contraindication. Orthostatic hypotension is an adverse effect, not a contraindication.
Drowsiness as a preoperative sedative is an expected therapeutic effect, not a
contraindication.
Question 9
The nurse is assessing a client before administering medications. Which of the following
data should the nurse obtain? (Select all that apply)
A. Use of herbal products
B. Daily fluid intake
C. Ability to swallow
pg. 4
Comprehensive Practice Exam Questions with Verified
Correct Answers and Rationales || Latest Update!!
Question 1
A provider prescribes phenobarbital for a client who has a seizure disorder. The
medication has a long half-life of 4 days. How many times per day should the nurse
expect to administer this medication?
A. One
B. Two
C. Three
D. Four
Correct Answer: A
Rationale: Phenobarbital has a long half-life (approximately 4 days), which allows for
once-daily dosing. Medications with long half-lives require less frequent administration
because they remain in the body for extended periods. Once-daily dosing improves
adherence and maintains therapeutic levels. Twice, three times, or four times daily
would be unnecessary due to the long half-life.
Question 2
A nurse educator is reviewing medication metabolism at an in-service presentation.
Which of the following factors should the educator include as a reason to administer
lower medication dosages? (Select all that apply)
A. Increased renal excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication the same pathway metabolizes
Correct Answer: C, E
Rationale: Liver failure reduces medication metabolism, requiring lower dosages to
prevent toxicity. Concurrent use of medications that compete for the same metabolic
pathway can decrease metabolism, requiring dosage adjustments. Increased renal
excretion would typically require higher doses (not lower). Increased metabolizing
pg. 1
,enzymes would increase metabolism, requiring higher doses. Peripheral vascular
disease does not directly affect medication metabolism.
Question 3
A nurse is preparing to administer eye drops to a client. Which of the following actions
should the nurse take? (Select all that apply)
A. Have the client lie on one side
B. Ask the client to look up at the ceiling
C. Tell the client to blink when the drops enter the eyes
D. Drop the medication into the client's conjunctival sac
E. Instruct the client to close the eye gently after instillation
Correct Answer: B, D, E
Rationale: The client should look up at the ceiling to expose the conjunctival sac. The
medication should be dropped into the conjunctival sac (not directly on the cornea). The
client should close the eye gently after instillation to distribute the medication and
prevent it from draining out. The client should not lie on one side (that is for ear drops).
The client should not blink immediately as this would expel the medication.
Question 4
A nurse is teaching a client about transdermal patches. Which of the following
statements should the nurse identify as an indication that the client understands?
A. "I will clean the site with an alcohol swab before I apply the patch"
B. "I will rotate the application sites weekly"
C. "I will apply the patch to an area of skin with no hair"
D. "I will place the new patch on the site of the old patch"
Correct Answer: C
Rationale: Transdermal patches should be applied to hairless areas of skin to ensure
proper adhesion and absorption. Sites should be rotated with each application (not
weekly). Alcohol swabs may irritate the skin and affect absorption. New patches should
not be placed on the site of the old patch; sites should be rotated. Applying to hairless
skin is the correct understanding.
Question 5
pg. 2
,A nurse reviewing a client's medical record notes a new prescription for verifying the
trough level of the client's medication. Which of the following actions should the nurse
take?
A. Obtain a blood specimen immediately prior to administering the next dose of
medication.
B. Verify that the client has been taking the medication for 24 hr before obtaining a
blood specimen.
C. Ask the client to provide a urine specimen after the next dose of medication.
D. Administer the medication, and obtain a blood specimen 30 min later.
Correct Answer: A
Rationale: Trough levels are drawn immediately before the next dose of medication to
measure the lowest concentration in the blood. This ensures the medication is still at
therapeutic levels and not accumulating to toxic levels. It is typically drawn just prior to
administration of the next dose. A trough level should not be drawn after the dose or
without the client being on a steady state of the medication.
Question 6
A nurse is preparing a client's medications. Which of the following actions should the
nurse take in following legal practice guidelines? (Select all that apply)
A. Teach the client about the med
B. Determine the dosage
C. Monitor for adverse effects
D. Prescribe the medication
E. Change the medication dose
Correct Answer: A, C
Rationale: The nurse is legally responsible for teaching the client about the medication
and monitoring for adverse effects. Determining the dosage and prescribing medications
are the provider's responsibilities. Changing the medication dose requires a provider's
order. The nurse's role includes safe administration, client education, and monitoring
for effectiveness and side effects.
Question 7
The nurse is preparing to administer digoxin to a client who states, "I don't want to take
that medication. I do not want one more pill." Which of the following responses should
the nurse make?
pg. 3
, A. "Your physician prescribes it for you, so you really should take it."
B. "Well, let's just get it over quickly then."
C. "Okay, I'll just give you your other medications."
D. "Tell me your concerns about taking this medication."
Correct Answer: D
Rationale: The nurse should explore the client's concerns about the medication. This is
patient-centered care that respects the client's autonomy and allows the nurse to
address specific issues. Telling the client what to do is paternalistic. Ignoring the refusal
is not appropriate. The nurse should validate the client's feelings and gather more
information about the refusal.
Question 8
The nurse is reviewing a client's prescribed medications. Which of the following
situations represents a contraindication to medication administration?
A. The client drank grapefruit juice, which could reduce a medication's effectiveness.
B. The medication has orthostatic hypotension as an adverse effect.
C. A medication is approved for ages 12 and older, and the client is 8 years old.
D. An anti-anxiety medication has an adverse effect of drowsiness and is prescribed as a
preoperative sedative.
Correct Answer: C
Rationale: A contraindication is a situation in which a medication should not be
administered because it could cause harm. Administering a medication to a client
outside the approved age range (8 years old for a medication approved for 12 and older)
is a contraindication. Grapefruit juice may interact but is not necessarily a
contraindication. Orthostatic hypotension is an adverse effect, not a contraindication.
Drowsiness as a preoperative sedative is an expected therapeutic effect, not a
contraindication.
Question 9
The nurse is assessing a client before administering medications. Which of the following
data should the nurse obtain? (Select all that apply)
A. Use of herbal products
B. Daily fluid intake
C. Ability to swallow
pg. 4
