ATI CMS Pharmacology Proctored Exam 2026 – Comprehensive
Practice Exam Questions with Verified Answers & Detailed
Explanations | Latest Update | A+ Graded.
Question 1
A nurse is preparing to administer digoxin to a 78-year-old client who has
heart failure. Before administering the medication, the nurse obtains an apical
pulse of 54/min. Which action should the nurse take?
A. Administer the medication as prescribed.
B. Hold the medication and notify the provider.
C. Administer half the prescribed dose.
D. Reassess the pulse after administering the medication.
Correct Answer: B. Hold the medication and notify the provider.
Explanation:
Digoxin slows the heart rate. The medication should generally be withheld if
the adult apical pulse is less than 60/min, and the provider should be
notified because administration may worsen bradycardia.
Question 2
A client receiving warfarin asks the nurse why frequent laboratory
monitoring is necessary. Which response by the nurse is most appropriate?
A. "The test measures how well your kidneys are functioning."
B. "The INR helps determine whether your warfarin dose is effective and safe."
C. "The laboratory test measures your blood glucose."
D. "The test monitors liver enzyme levels."
1|Page
,Correct Answer: B.
Explanation:
The International Normalized Ratio (INR) monitors the effectiveness of
warfarin therapy and helps reduce the risk of bleeding or thrombosis.
Question 3
A client is receiving an intravenous infusion of heparin. Which laboratory
value should the nurse monitor to evaluate the therapeutic effect?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Troponin
Correct Answer: B. aPTT
Explanation:
Activated partial thromboplastin time (aPTT) is monitored during
unfractionated heparin therapy to maintain therapeutic anticoagulation.
Question 4
A client receiving lisinopril reports persistent dry cough. Which nursing
action is most appropriate?
A. Tell the client to discontinue the medication immediately.
B. Inform the provider because the cough may be an adverse effect of ACE
inhibitor therapy.
C. Reassure the client that the cough is unrelated to the medication.
D. Recommend an over-the-counter cough suppressant only.
2|Page
,Correct Answer: B.
Explanation:
ACE inhibitors commonly cause a persistent dry cough due to increased
bradykinin levels.
Question 5
A client receiving furosemide reports muscle weakness and leg cramps.
Which electrolyte imbalance should the nurse suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Correct Answer: B. Hypokalemia
Explanation:
Loop diuretics increase potassium excretion, placing clients at risk for
hypokalemia.
Question 6
A nurse is teaching a client prescribed nitroglycerin sublingual tablets.
Which statement indicates understanding?
A. "I'll replace the tablets every 6 months."
B. "I'll call emergency services if chest pain continues after taking the
medication as prescribed."
C. "I'll chew the tablet before swallowing."
D. "I'll keep the tablets in my weekly pill organizer."
3|Page
, Correct Answer: B.
Explanation:
If chest pain persists after the first dose and following prescribed dosing
instructions, emergency medical services should be contacted.
Question 7
A client taking metformin is scheduled for a CT scan with iodinated contrast.
Which action should the nurse anticipate?
A. Continue metformin as prescribed.
B. Hold metformin according to provider orders around the time of the
contrast study.
C. Double the metformin dose afterward.
D. Administer insulin instead without provider notification.
Correct Answer: B.
Explanation:
Metformin is commonly withheld around iodinated contrast administration
because of the risk of contrast-associated kidney injury and lactic acidosis in
susceptible patients.
Question 8
A client receiving insulin glargine asks when peak action occurs. Which
response is correct?
A. "It peaks about 2 hours after administration."
B. "It has no pronounced peak."
C. "It peaks at 8 hours."
4|Page
Practice Exam Questions with Verified Answers & Detailed
Explanations | Latest Update | A+ Graded.
Question 1
A nurse is preparing to administer digoxin to a 78-year-old client who has
heart failure. Before administering the medication, the nurse obtains an apical
pulse of 54/min. Which action should the nurse take?
A. Administer the medication as prescribed.
B. Hold the medication and notify the provider.
C. Administer half the prescribed dose.
D. Reassess the pulse after administering the medication.
Correct Answer: B. Hold the medication and notify the provider.
Explanation:
Digoxin slows the heart rate. The medication should generally be withheld if
the adult apical pulse is less than 60/min, and the provider should be
notified because administration may worsen bradycardia.
Question 2
A client receiving warfarin asks the nurse why frequent laboratory
monitoring is necessary. Which response by the nurse is most appropriate?
A. "The test measures how well your kidneys are functioning."
B. "The INR helps determine whether your warfarin dose is effective and safe."
C. "The laboratory test measures your blood glucose."
D. "The test monitors liver enzyme levels."
1|Page
,Correct Answer: B.
Explanation:
The International Normalized Ratio (INR) monitors the effectiveness of
warfarin therapy and helps reduce the risk of bleeding or thrombosis.
Question 3
A client is receiving an intravenous infusion of heparin. Which laboratory
value should the nurse monitor to evaluate the therapeutic effect?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Troponin
Correct Answer: B. aPTT
Explanation:
Activated partial thromboplastin time (aPTT) is monitored during
unfractionated heparin therapy to maintain therapeutic anticoagulation.
Question 4
A client receiving lisinopril reports persistent dry cough. Which nursing
action is most appropriate?
A. Tell the client to discontinue the medication immediately.
B. Inform the provider because the cough may be an adverse effect of ACE
inhibitor therapy.
C. Reassure the client that the cough is unrelated to the medication.
D. Recommend an over-the-counter cough suppressant only.
2|Page
,Correct Answer: B.
Explanation:
ACE inhibitors commonly cause a persistent dry cough due to increased
bradykinin levels.
Question 5
A client receiving furosemide reports muscle weakness and leg cramps.
Which electrolyte imbalance should the nurse suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Correct Answer: B. Hypokalemia
Explanation:
Loop diuretics increase potassium excretion, placing clients at risk for
hypokalemia.
Question 6
A nurse is teaching a client prescribed nitroglycerin sublingual tablets.
Which statement indicates understanding?
A. "I'll replace the tablets every 6 months."
B. "I'll call emergency services if chest pain continues after taking the
medication as prescribed."
C. "I'll chew the tablet before swallowing."
D. "I'll keep the tablets in my weekly pill organizer."
3|Page
, Correct Answer: B.
Explanation:
If chest pain persists after the first dose and following prescribed dosing
instructions, emergency medical services should be contacted.
Question 7
A client taking metformin is scheduled for a CT scan with iodinated contrast.
Which action should the nurse anticipate?
A. Continue metformin as prescribed.
B. Hold metformin according to provider orders around the time of the
contrast study.
C. Double the metformin dose afterward.
D. Administer insulin instead without provider notification.
Correct Answer: B.
Explanation:
Metformin is commonly withheld around iodinated contrast administration
because of the risk of contrast-associated kidney injury and lactic acidosis in
susceptible patients.
Question 8
A client receiving insulin glargine asks when peak action occurs. Which
response is correct?
A. "It peaks about 2 hours after administration."
B. "It has no pronounced peak."
C. "It peaks at 8 hours."
4|Page
