ATI PhArmAcology ExAm: 100 % corrEcT
QuEsTIons wITh AnswErs & rATIonAlEs
AlrEADy grADED A+
Section 1: Medication Safety & Administration (Questions 1-20)
1. A nurse is administering morphine to a postoperative client. Which assessment is the
priority before giving the dose?
A) Heart rate
B) Respiratory rate
C) Temperature
D) Blood glucose
Answer: B
Rationale: Opioids can cause respiratory depression. The nurse should assess the respiratory
rate before administration and hold the dose if the rate is <12/min . Respiratory depression is
the most life-threatening adverse effect of opioids.
2. A nurse is preparing to administer medications to four clients. Which action demonstrates
the BEST practice for client identification?
A) Checking the client's room number on the door
B) Asking the client to state their full name and date of birth
C) Checking the name on the client's armband AND asking the client to state their name and
DOB
D) Verifying the client's identity with the family member at bedside
Answer: C
Rationale: The Joint Commission's National Patient Safety Goals require two client identifiers
before any medication administration. The gold standard is: 1) Check the ID armband and 2)
Have the client verbally state their name and DOB. Room numbers are NEVER acceptable
identifiers, and family members are not reliable .
3. A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral
capsules. Which instruction should the nurse include?
1
, A) Chew the medication thoroughly before swallowing
B) Swallow the medication whole
C) Crush the capsules and mix with food
D) Take the medication with an antacid
Answer: B
Rationale: Omeprazole capsules should be swallowed whole as they are in delayed-release
form . Chewing or crushing destroys the enteric coating and reduces effectiveness. Omeprazole
is a proton pump inhibitor that blocks gastric acid secretion.
4. A nurse is performing the third check before administering hydromorphone to a client.
After opening the unit-dose packet, the client says they do not want to take the medication
now. Which action should the nurse take?
A) Return the medication to the medication cart unopened
B) Dispose of the medication with a second nurse as a witness
C) Save the medication for the client to take later
D) Document refusal and keep medication at bedside
Answer: B
Rationale: Hydromorphone is a controlled substance that must be wasted and witnessed by
another nurse to comply with legal regulations when not administered .
5. A client reports no allergies but has experienced mild itching while taking amoxicillin in the
past. Which response should the nurse make?
A) "Itching is an expected adverse effect."
B) "Itching can indicate toxicity."
C) "Itching can indicate a hypersensitivity."
D) "Itching can result from dry skin, which is caused by amoxicillin."
Answer: C
Rationale: Mild itching while taking a medication can indicate a hypersensitivity reaction . While
it may not be a severe allergy, it should be documented and the provider should be notified.
6. Which of the following findings indicates an anaphylactic reaction? (Select all that apply)
A) Low blood pressure
B) Wheezing
C) Bradycardia
2
, D) Peripheral edema
E) Difficulty swallowing
Answer: A, B, E
Rationale: Anaphylaxis is a severe allergic reaction presenting with hypotension, wheezing
(bronchospasm), and difficulty swallowing (angioedema) . Tachycardia, not bradycardia, is
expected. Peripheral edema is not an acute anaphylactic sign.
7. A nurse is reviewing drugs in a drug reference. Drugs in the same class share which
similarity?
A) Similar mechanisms of action
B) Same half-life
C) Same route
D) Similar availability
Answer: A
Rationale: Drugs in the same pharmacological class share similar mechanisms of action . They
may have different half-lives, routes, and availability.
8. A client is prescribed an antidepressant based on its ability to prevent the reuptake of
neurotransmitters. Which term describes why the drug was prescribed?
A) Pharmacologic action
B) Chemical stability
C) Route
D) Adverse effects
Answer: A
Rationale: Pharmacologic action refers to the mechanism by which a drug produces its effects .
The ability to prevent neurotransmitter reuptake is the pharmacologic action of the drug.
9. A nurse is caring for a client who is having difficulty remembering to take their prescribed
drug three times each day. Which alternate form of the drug can help promote adherence?
A) Liquid suspension
B) Immediate-release
C) Extended-release
D) Powder form
3
, Answer: C
Rationale: Extended-release formulations reduce dosing frequency, which can improve
adherence for clients who have difficulty remembering multiple daily doses .
10. In which section of a drug handbook should the nurse look to determine if the drug has
more than one use?
A) Adverse effects
B) Indications
C) Pharmacokinetics
D) Nursing implications
Answer: B
Rationale: The indications section lists all conditions for which the drug is approved and used .
11. Grapefruit juice inhibits an enzyme in the liver that metabolizes sertraline. The client is at
risk for which complication?
A) Reduced drug absorption
B) Drug dependence
C) Altered drug distribution
D) Drug toxicity
Answer: D
Rationale: Inhibition of liver enzymes used for drug metabolism can lead to increased serum
drug levels and toxicity . Grapefruit juice inhibits CYP3A4, which metabolizes many drugs.
12. What should the nurse include in education for a drug with a high potential for toxicity?
(Select all that apply)
A) Periodic lab tests are essential to measure serum levels
B) Monitoring for toxicity indications is important
C) Taking the drug with an inducing agent will increase toxicity
D) Taking the smallest effective dose is crucial
E) Increase fluids to avoid toxicity
Answer: A, B, D
Rationale: Drugs with high toxicity risk require serum level monitoring, symptom monitoring,
and use of the lowest effective dose . Taking with an inducing agent would decrease, not
increase, toxicity.
4
QuEsTIons wITh AnswErs & rATIonAlEs
AlrEADy grADED A+
Section 1: Medication Safety & Administration (Questions 1-20)
1. A nurse is administering morphine to a postoperative client. Which assessment is the
priority before giving the dose?
A) Heart rate
B) Respiratory rate
C) Temperature
D) Blood glucose
Answer: B
Rationale: Opioids can cause respiratory depression. The nurse should assess the respiratory
rate before administration and hold the dose if the rate is <12/min . Respiratory depression is
the most life-threatening adverse effect of opioids.
2. A nurse is preparing to administer medications to four clients. Which action demonstrates
the BEST practice for client identification?
A) Checking the client's room number on the door
B) Asking the client to state their full name and date of birth
C) Checking the name on the client's armband AND asking the client to state their name and
DOB
D) Verifying the client's identity with the family member at bedside
Answer: C
Rationale: The Joint Commission's National Patient Safety Goals require two client identifiers
before any medication administration. The gold standard is: 1) Check the ID armband and 2)
Have the client verbally state their name and DOB. Room numbers are NEVER acceptable
identifiers, and family members are not reliable .
3. A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral
capsules. Which instruction should the nurse include?
1
, A) Chew the medication thoroughly before swallowing
B) Swallow the medication whole
C) Crush the capsules and mix with food
D) Take the medication with an antacid
Answer: B
Rationale: Omeprazole capsules should be swallowed whole as they are in delayed-release
form . Chewing or crushing destroys the enteric coating and reduces effectiveness. Omeprazole
is a proton pump inhibitor that blocks gastric acid secretion.
4. A nurse is performing the third check before administering hydromorphone to a client.
After opening the unit-dose packet, the client says they do not want to take the medication
now. Which action should the nurse take?
A) Return the medication to the medication cart unopened
B) Dispose of the medication with a second nurse as a witness
C) Save the medication for the client to take later
D) Document refusal and keep medication at bedside
Answer: B
Rationale: Hydromorphone is a controlled substance that must be wasted and witnessed by
another nurse to comply with legal regulations when not administered .
5. A client reports no allergies but has experienced mild itching while taking amoxicillin in the
past. Which response should the nurse make?
A) "Itching is an expected adverse effect."
B) "Itching can indicate toxicity."
C) "Itching can indicate a hypersensitivity."
D) "Itching can result from dry skin, which is caused by amoxicillin."
Answer: C
Rationale: Mild itching while taking a medication can indicate a hypersensitivity reaction . While
it may not be a severe allergy, it should be documented and the provider should be notified.
6. Which of the following findings indicates an anaphylactic reaction? (Select all that apply)
A) Low blood pressure
B) Wheezing
C) Bradycardia
2
, D) Peripheral edema
E) Difficulty swallowing
Answer: A, B, E
Rationale: Anaphylaxis is a severe allergic reaction presenting with hypotension, wheezing
(bronchospasm), and difficulty swallowing (angioedema) . Tachycardia, not bradycardia, is
expected. Peripheral edema is not an acute anaphylactic sign.
7. A nurse is reviewing drugs in a drug reference. Drugs in the same class share which
similarity?
A) Similar mechanisms of action
B) Same half-life
C) Same route
D) Similar availability
Answer: A
Rationale: Drugs in the same pharmacological class share similar mechanisms of action . They
may have different half-lives, routes, and availability.
8. A client is prescribed an antidepressant based on its ability to prevent the reuptake of
neurotransmitters. Which term describes why the drug was prescribed?
A) Pharmacologic action
B) Chemical stability
C) Route
D) Adverse effects
Answer: A
Rationale: Pharmacologic action refers to the mechanism by which a drug produces its effects .
The ability to prevent neurotransmitter reuptake is the pharmacologic action of the drug.
9. A nurse is caring for a client who is having difficulty remembering to take their prescribed
drug three times each day. Which alternate form of the drug can help promote adherence?
A) Liquid suspension
B) Immediate-release
C) Extended-release
D) Powder form
3
, Answer: C
Rationale: Extended-release formulations reduce dosing frequency, which can improve
adherence for clients who have difficulty remembering multiple daily doses .
10. In which section of a drug handbook should the nurse look to determine if the drug has
more than one use?
A) Adverse effects
B) Indications
C) Pharmacokinetics
D) Nursing implications
Answer: B
Rationale: The indications section lists all conditions for which the drug is approved and used .
11. Grapefruit juice inhibits an enzyme in the liver that metabolizes sertraline. The client is at
risk for which complication?
A) Reduced drug absorption
B) Drug dependence
C) Altered drug distribution
D) Drug toxicity
Answer: D
Rationale: Inhibition of liver enzymes used for drug metabolism can lead to increased serum
drug levels and toxicity . Grapefruit juice inhibits CYP3A4, which metabolizes many drugs.
12. What should the nurse include in education for a drug with a high potential for toxicity?
(Select all that apply)
A) Periodic lab tests are essential to measure serum levels
B) Monitoring for toxicity indications is important
C) Taking the drug with an inducing agent will increase toxicity
D) Taking the smallest effective dose is crucial
E) Increase fluids to avoid toxicity
Answer: A, B, D
Rationale: Drugs with high toxicity risk require serum level monitoring, symptom monitoring,
and use of the lowest effective dose . Taking with an inducing agent would decrease, not
increase, toxicity.
4
