ATI RN Pharmacology 2026 Retake
Exam Guide | Comprehensive NGN-
Style Level 1, 2, & 3 Pass Bank (400
Verified Q&As) 💊
Crush your ATI Pharmacology Proctored Exam with
this definitive, high-yield mastery bank featuring 400
elite practice questions meticulously mapped to
Level 1, 2, and 3 blueprint standards. This
comprehensive digital resource delivers realistic
Next Generation NCLEX (NGN) clinical scenarios,
bolded test questions, and thoroughly detailed,
italicized rationales engineered to cement critical
drug classifications and mechanism concepts.
Maximize your study efficiency, secure your verified
Level 3 proficiency rating, and upload this flawlessly
pre-formatted study package directly to your Stuvia
store for instant student success!
,1. A nurse is preparing to mix short-acting regular insulin with NPH insulin drawn
from two vials. Which of the following actions should the nurse take?
A) Administer the insulin within 20 minutes of preparing it.
B) Ensure the NPH insulin is drawn into the syringe first.
C) Inject air into the vial to withdraw the short-acting insulin first.
D) Use two separate syringes to mix the insulin.
Correct Answer: C) Inject air into the vial to withdraw the short-acting insulin first.
Rationale: The correct sequence is to inject air into the NPH vial (cloudy), then inject air
into the short-acting vial (clear) and withdraw the short-acting insulin first. This prevents
contaminating the clear short-acting insulin with the intermediate-acting cloudy insulin.
2. A nurse is caring for a client who is receiving a continuous intravenous heparin
infusion. Which of the following laboratory values should the nurse monitor to
adjust the heparin dosage?
A) Prothrombin time (PT)
B) International Normalized Ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Correct Answer: C) Activated partial thromboplastin time (aPTT)
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor the
therapeutic effect of heparin. PT and INR are used to monitor oral warfarin therapy.
Platelet counts are monitored to check for heparin-induced thrombocytopenia, but not
for adjusting the therapeutic dosage.
3. A nurse is providing teaching to a client who has a new prescription for lithium
carbonate to treat bipolar disorder. Which of the following instructions should the
nurse include?
A) Limit your daily fluid intake to less than 1 liter.
B) Maintain a consistent dietary intake of sodium.
C) Take the medication on an empty stomach to increase absorption.
D) Discontinue the medication immediately if hand tremors occur.
Correct Answer: B) Maintain a consistent dietary intake of sodium.
Rationale: Lithium is a salt, and its excretion is closely tied to sodium levels. A drop in
sodium intake causes the kidneys to reabsorb lithium, potentially leading to toxic
accumulation. Clients should maintain normal sodium and fluid intake.
4. A nurse is monitoring a client who is receiving an intravenous infusion of
vancomycin. The nurse notes that the client has developed flushing of the neck
,and chest, along with a pruritic rash. Which of the following actions should the
nurse take first?
A) Administer a dose of diphenhydramine intravenously.
B) Slow or stop the infusion rate of the vancomycin.
C) Notify the healthcare provider immediately.
D) Document the reaction as an expected side effect.
Correct Answer: B) Slow or stop the infusion rate of the vancomycin.
Rationale: The client is experiencing vancomycin flushing syndrome (formerly known as
red man syndrome), which is caused by rapid infusion of vancomycin triggering
histamine release. The first and most critical action is to slow down or temporarily halt
the infusion.
5. A nurse is teaching a client who has a new prescription for spironolactone to
treat hypertension. Which of the following foods should the nurse instruct the
client to avoid?
A) Apples
B) Bananas
C) White rice
D) Green beans
Correct Answer: B) Bananas
Rationale: Spironolactone is a potassium-sparing diuretic that blocks aldosterone,
causing the retention of potassium. Consuming foods high in potassium, such as
bananas, oranges, or salt substitutes, increases the risk of developing life-threatening
hyperkalemia.
6. A nurse is reviewing the laboratory results of a client who takes digoxin daily
for heart failure. Which of the following findings places the client at the highest
risk for developing digoxin toxicity?
A) Serum calcium 9.5 mg/dL
B) Serum potassium 3.2 mEq/L
C) Serum sodium 138 mEq/L
D) Serum magnesium 2.0 mEq/L
Correct Answer: B) Serum potassium 3.2 mEq/L
Rationale: Hypokalemia (serum potassium below 3.5 mEq/L) enhances the effects of
digoxin at its myocardial binding sites, significantly increasing the risk of digoxin toxicity.
Serum calcium, sodium, and magnesium values listed are within normal references.
7. A nurse is preparing to administer a new prescription for levothyroxine to a
client who has primary hypothyroidism. Which of the following administration
schedules should the nurse use?
A) Give the medication first thing in the morning on an empty stomach.
B) Administer the medication with a full glass of milk at bedtime.
C) Give the medication immediately following a high-protein lunch.
D) Schedule the medication to be taken concurrently with an antacid.
, Correct Answer: A) Give the medication first thing in the morning on an empty stomach.
Rationale: Levothyroxine should be taken in the morning on an empty stomach, at least
30 to 60 minutes before breakfast, to maximize absorption. Food, calcium-rich products,
and antacids can significantly impair the absorption of thyroid hormone.
8. A nurse is evaluating a client who has been taking furosemide daily for
peripheral edema. Which of the following assessment findings indicates a
therapeutic response to the medication?
A) Increased blood pressure
B) Decreased weight and reduced lower extremity swelling
C) Increased serum potassium levels
D) Decreased urinary output
Correct Answer: B) Decreased weight and reduced lower extremity swelling
Rationale: Furosemide is a potent loop diuretic that increases the excretion of water and
electrolytes to reduce fluid overload. A therapeutic effect is demonstrated by weight
loss, increased urine output, and decreased peripheral edema.
9. A nurse is providing teaching to a client who has a new prescription for
atorvastatin to treat hypercholesterolemia. Which of the following adverse effects
should the nurse instruct the client to report to the provider immediately?
A) Mild headache
B) Muscle pain or tenderness
C) Flushing of the face
D) Dry cough
Correct Answer: B) Muscle pain or tenderness
Rationale: Muscle pain, tenderness, or weakness can be a manifestation of myopathy
or rhabdomyolysis, a rare but life-threatening adverse effect of statin medications that
can lead to acute kidney injury. This finding must be evaluated immediately.
10. A nurse is preparing to administer iron dextran intravenously to a client.
Which of the following actions should the nurse perform during administration to
ensure safety?
A) Infuse the entire dose rapidly over 1 minute.
B) Administer a small test dose before infusing the full therapeutic amount.
C) Mix the iron dextran with a dextrose solution.
D) Ensure the client is in a prone position during the infusion.
Correct Answer: B) Administer a small test dose before infusing the full therapeutic
amount.
Rationale: Iron dextran carries a high risk of severe anaphylactic reactions. A small test
dose must be administered slowly over a few minutes, and the client monitored closely,
before the remainder of the therapeutic dose is safely infused.
11. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following over-the-counter medications
Exam Guide | Comprehensive NGN-
Style Level 1, 2, & 3 Pass Bank (400
Verified Q&As) 💊
Crush your ATI Pharmacology Proctored Exam with
this definitive, high-yield mastery bank featuring 400
elite practice questions meticulously mapped to
Level 1, 2, and 3 blueprint standards. This
comprehensive digital resource delivers realistic
Next Generation NCLEX (NGN) clinical scenarios,
bolded test questions, and thoroughly detailed,
italicized rationales engineered to cement critical
drug classifications and mechanism concepts.
Maximize your study efficiency, secure your verified
Level 3 proficiency rating, and upload this flawlessly
pre-formatted study package directly to your Stuvia
store for instant student success!
,1. A nurse is preparing to mix short-acting regular insulin with NPH insulin drawn
from two vials. Which of the following actions should the nurse take?
A) Administer the insulin within 20 minutes of preparing it.
B) Ensure the NPH insulin is drawn into the syringe first.
C) Inject air into the vial to withdraw the short-acting insulin first.
D) Use two separate syringes to mix the insulin.
Correct Answer: C) Inject air into the vial to withdraw the short-acting insulin first.
Rationale: The correct sequence is to inject air into the NPH vial (cloudy), then inject air
into the short-acting vial (clear) and withdraw the short-acting insulin first. This prevents
contaminating the clear short-acting insulin with the intermediate-acting cloudy insulin.
2. A nurse is caring for a client who is receiving a continuous intravenous heparin
infusion. Which of the following laboratory values should the nurse monitor to
adjust the heparin dosage?
A) Prothrombin time (PT)
B) International Normalized Ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Correct Answer: C) Activated partial thromboplastin time (aPTT)
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor the
therapeutic effect of heparin. PT and INR are used to monitor oral warfarin therapy.
Platelet counts are monitored to check for heparin-induced thrombocytopenia, but not
for adjusting the therapeutic dosage.
3. A nurse is providing teaching to a client who has a new prescription for lithium
carbonate to treat bipolar disorder. Which of the following instructions should the
nurse include?
A) Limit your daily fluid intake to less than 1 liter.
B) Maintain a consistent dietary intake of sodium.
C) Take the medication on an empty stomach to increase absorption.
D) Discontinue the medication immediately if hand tremors occur.
Correct Answer: B) Maintain a consistent dietary intake of sodium.
Rationale: Lithium is a salt, and its excretion is closely tied to sodium levels. A drop in
sodium intake causes the kidneys to reabsorb lithium, potentially leading to toxic
accumulation. Clients should maintain normal sodium and fluid intake.
4. A nurse is monitoring a client who is receiving an intravenous infusion of
vancomycin. The nurse notes that the client has developed flushing of the neck
,and chest, along with a pruritic rash. Which of the following actions should the
nurse take first?
A) Administer a dose of diphenhydramine intravenously.
B) Slow or stop the infusion rate of the vancomycin.
C) Notify the healthcare provider immediately.
D) Document the reaction as an expected side effect.
Correct Answer: B) Slow or stop the infusion rate of the vancomycin.
Rationale: The client is experiencing vancomycin flushing syndrome (formerly known as
red man syndrome), which is caused by rapid infusion of vancomycin triggering
histamine release. The first and most critical action is to slow down or temporarily halt
the infusion.
5. A nurse is teaching a client who has a new prescription for spironolactone to
treat hypertension. Which of the following foods should the nurse instruct the
client to avoid?
A) Apples
B) Bananas
C) White rice
D) Green beans
Correct Answer: B) Bananas
Rationale: Spironolactone is a potassium-sparing diuretic that blocks aldosterone,
causing the retention of potassium. Consuming foods high in potassium, such as
bananas, oranges, or salt substitutes, increases the risk of developing life-threatening
hyperkalemia.
6. A nurse is reviewing the laboratory results of a client who takes digoxin daily
for heart failure. Which of the following findings places the client at the highest
risk for developing digoxin toxicity?
A) Serum calcium 9.5 mg/dL
B) Serum potassium 3.2 mEq/L
C) Serum sodium 138 mEq/L
D) Serum magnesium 2.0 mEq/L
Correct Answer: B) Serum potassium 3.2 mEq/L
Rationale: Hypokalemia (serum potassium below 3.5 mEq/L) enhances the effects of
digoxin at its myocardial binding sites, significantly increasing the risk of digoxin toxicity.
Serum calcium, sodium, and magnesium values listed are within normal references.
7. A nurse is preparing to administer a new prescription for levothyroxine to a
client who has primary hypothyroidism. Which of the following administration
schedules should the nurse use?
A) Give the medication first thing in the morning on an empty stomach.
B) Administer the medication with a full glass of milk at bedtime.
C) Give the medication immediately following a high-protein lunch.
D) Schedule the medication to be taken concurrently with an antacid.
, Correct Answer: A) Give the medication first thing in the morning on an empty stomach.
Rationale: Levothyroxine should be taken in the morning on an empty stomach, at least
30 to 60 minutes before breakfast, to maximize absorption. Food, calcium-rich products,
and antacids can significantly impair the absorption of thyroid hormone.
8. A nurse is evaluating a client who has been taking furosemide daily for
peripheral edema. Which of the following assessment findings indicates a
therapeutic response to the medication?
A) Increased blood pressure
B) Decreased weight and reduced lower extremity swelling
C) Increased serum potassium levels
D) Decreased urinary output
Correct Answer: B) Decreased weight and reduced lower extremity swelling
Rationale: Furosemide is a potent loop diuretic that increases the excretion of water and
electrolytes to reduce fluid overload. A therapeutic effect is demonstrated by weight
loss, increased urine output, and decreased peripheral edema.
9. A nurse is providing teaching to a client who has a new prescription for
atorvastatin to treat hypercholesterolemia. Which of the following adverse effects
should the nurse instruct the client to report to the provider immediately?
A) Mild headache
B) Muscle pain or tenderness
C) Flushing of the face
D) Dry cough
Correct Answer: B) Muscle pain or tenderness
Rationale: Muscle pain, tenderness, or weakness can be a manifestation of myopathy
or rhabdomyolysis, a rare but life-threatening adverse effect of statin medications that
can lead to acute kidney injury. This finding must be evaluated immediately.
10. A nurse is preparing to administer iron dextran intravenously to a client.
Which of the following actions should the nurse perform during administration to
ensure safety?
A) Infuse the entire dose rapidly over 1 minute.
B) Administer a small test dose before infusing the full therapeutic amount.
C) Mix the iron dextran with a dextrose solution.
D) Ensure the client is in a prone position during the infusion.
Correct Answer: B) Administer a small test dose before infusing the full therapeutic
amount.
Rationale: Iron dextran carries a high risk of severe anaphylactic reactions. A small test
dose must be administered slowly over a few minutes, and the client monitored closely,
before the remainder of the therapeutic dose is safely infused.
11. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following over-the-counter medications
