ATI CMS PHARMACOLOGY RETAKE
2023 COMPREHENSIVE EXAMINATION
STUDY GUIDE Questions with Detailed
Rationales Latest Version | Verified Answers
| Grade A+ Preparation
SECTION 1: CARDIOVASCULAR PHARMACOLOGY
1. A nurse is reinforcing teaching with a client who has a new prescription for
verapamil PO. Which of the following beverages should the client avoid while
taking this medication?
A. Orange juice
B. Grapefruit juice
C. Milk
D. Coffee
Answer: B
Rationale: Grapefruit juice inhibits CYP3A4 enzymes in the intestine, increasing
verapamil bioavailability and potentially causing toxicity including hypotension
and bradycardia.
2. A client with chronic hypertension has vital signs including BP 140/80
mmHg, heart rate 54/min, and respiratory rate 18/min. Which of the
following medications should the nurse plan to administer?
A. Lisinopril
B. Atenolol
C. Amlodipine
D. Clonidine
Answer: B
Rationale: Atenolol is a beta-blocker that lowers heart rate; it would be
appropriate for this patient with tachycardia. The HR of 54 is already bradycardic,
so another class may be considered.
,3. A nurse is monitoring a client who recently began taking lisinopril for
hypertension. Which of the following findings is an adverse effect to report to
the provider?
A. Dry cough
B. Diarrhea
C. Headache
D. Dizziness
Answer: A
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors
like lisinopril due to accumulation of bradykinin. This should be reported as it may
require switching to an ARB.
4. A nurse is preparing to administer an IV dose of furosemide to a client with
heart failure. Which of the following laboratory values should the nurse
review before administration?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum sodium
Answer: A
Rationale: Furosemide is a loop diuretic that causes significant potassium wasting.
Hypokalemia can precipitate cardiac arrhythmias, especially in patients on
digoxin.
5. A client is prescribed digoxin for heart failure. Which of the following
findings indicates digoxin toxicity?
A. Heart rate 62 bpm
B. Yellow-green halos around lights
C. Serum potassium 4.2 mEq/L
D. BP 120/80 mmHg
Answer: B
Rationale: Visual disturbances including yellow-green halos around lights are
,classic signs of digoxin toxicity. Other signs include nausea, vomiting, confusion,
and bradycardia.
6. A nurse is caring for a client receiving heparin IV. Which of the following
laboratory values should the nurse monitor to evaluate therapeutic
effectiveness?
A. INR
B. Platelet count
C. aPTT
D. PT
Answer: C
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
heparin therapy. The therapeutic range is typically 1.5-2.5 times the normal
control value.
7. A nurse is caring for a client who has a prescription for warfarin. Which of
the following statements indicates the client understands the teaching?
A. "I will avoid foods high in vitamin K"
B. "I will take an aspirin daily for pain"
C. "I will use a soft-bristle toothbrush"
D. "I will increase my intake of green leafy vegetables"
Answer: C
Rationale: Patients on warfarin should use a soft-bristle toothbrush and gentle
flossing to minimize bleeding risk. Vitamin K intake should remain consistent, not
avoided or increased excessively.
8. A nurse is reinforcing teaching with a client who has a new prescription for
nitroglycerin sublingual tablets. Which of the following statements indicates
the client understands the teaching?
A. "I will take a tablet every 5 minutes until my pain is gone"
B. "I will take one tablet at the onset of chest pain"
C. "I will swallow the tablet with water"
D. "I will take a tablet 30 minutes before exercise"
, Answer: B
Rationale: Sublingual nitroglycerin should be taken at the onset of chest pain. If
pain persists after one tablet, take a second in 5 minutes and a third in another 5
minutes, then seek emergency care.
9. A client with angina is prescribed nitroglycerin patches. Which of the
following instructions should the nurse include?
A. Apply the patch to the same site each time
B. Remove the patch for 8-12 hours each day
C. Apply the patch to a hairy area for better adhesion
D. Shower with the patch in place
Answer: B
Rationale: Nitroglycerin patches require a drug-free period of 8-12 hours daily to
prevent tolerance development. Apply to a hairless area and rotate sites.
10. A nurse is administering verapamil to a client with atrial fibrillation.
Which of the following is a potential adverse effect of this medication?
A. Tachycardia
B. Hypotension
C. Bronchospasm
D. Hypoglycemia
Answer: B
Rationale: Verapamil is a calcium channel blocker that causes vasodilation, which
can lead to hypotension. It also decreases heart rate and AV conduction.
SECTION 2: CENTRAL NERVOUS SYSTEM PHARMACOLOGY
11. The nurse is collecting data from a client who has been taking diazepam
daily but recently ran out of the medication. Which of the following should the
nurse recognize as a manifestation of withdrawal?
A. Tremors
B. Hypothermia
C. Hypotension
D. Bradycardia
2023 COMPREHENSIVE EXAMINATION
STUDY GUIDE Questions with Detailed
Rationales Latest Version | Verified Answers
| Grade A+ Preparation
SECTION 1: CARDIOVASCULAR PHARMACOLOGY
1. A nurse is reinforcing teaching with a client who has a new prescription for
verapamil PO. Which of the following beverages should the client avoid while
taking this medication?
A. Orange juice
B. Grapefruit juice
C. Milk
D. Coffee
Answer: B
Rationale: Grapefruit juice inhibits CYP3A4 enzymes in the intestine, increasing
verapamil bioavailability and potentially causing toxicity including hypotension
and bradycardia.
2. A client with chronic hypertension has vital signs including BP 140/80
mmHg, heart rate 54/min, and respiratory rate 18/min. Which of the
following medications should the nurse plan to administer?
A. Lisinopril
B. Atenolol
C. Amlodipine
D. Clonidine
Answer: B
Rationale: Atenolol is a beta-blocker that lowers heart rate; it would be
appropriate for this patient with tachycardia. The HR of 54 is already bradycardic,
so another class may be considered.
,3. A nurse is monitoring a client who recently began taking lisinopril for
hypertension. Which of the following findings is an adverse effect to report to
the provider?
A. Dry cough
B. Diarrhea
C. Headache
D. Dizziness
Answer: A
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors
like lisinopril due to accumulation of bradykinin. This should be reported as it may
require switching to an ARB.
4. A nurse is preparing to administer an IV dose of furosemide to a client with
heart failure. Which of the following laboratory values should the nurse
review before administration?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum sodium
Answer: A
Rationale: Furosemide is a loop diuretic that causes significant potassium wasting.
Hypokalemia can precipitate cardiac arrhythmias, especially in patients on
digoxin.
5. A client is prescribed digoxin for heart failure. Which of the following
findings indicates digoxin toxicity?
A. Heart rate 62 bpm
B. Yellow-green halos around lights
C. Serum potassium 4.2 mEq/L
D. BP 120/80 mmHg
Answer: B
Rationale: Visual disturbances including yellow-green halos around lights are
,classic signs of digoxin toxicity. Other signs include nausea, vomiting, confusion,
and bradycardia.
6. A nurse is caring for a client receiving heparin IV. Which of the following
laboratory values should the nurse monitor to evaluate therapeutic
effectiveness?
A. INR
B. Platelet count
C. aPTT
D. PT
Answer: C
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor
heparin therapy. The therapeutic range is typically 1.5-2.5 times the normal
control value.
7. A nurse is caring for a client who has a prescription for warfarin. Which of
the following statements indicates the client understands the teaching?
A. "I will avoid foods high in vitamin K"
B. "I will take an aspirin daily for pain"
C. "I will use a soft-bristle toothbrush"
D. "I will increase my intake of green leafy vegetables"
Answer: C
Rationale: Patients on warfarin should use a soft-bristle toothbrush and gentle
flossing to minimize bleeding risk. Vitamin K intake should remain consistent, not
avoided or increased excessively.
8. A nurse is reinforcing teaching with a client who has a new prescription for
nitroglycerin sublingual tablets. Which of the following statements indicates
the client understands the teaching?
A. "I will take a tablet every 5 minutes until my pain is gone"
B. "I will take one tablet at the onset of chest pain"
C. "I will swallow the tablet with water"
D. "I will take a tablet 30 minutes before exercise"
, Answer: B
Rationale: Sublingual nitroglycerin should be taken at the onset of chest pain. If
pain persists after one tablet, take a second in 5 minutes and a third in another 5
minutes, then seek emergency care.
9. A client with angina is prescribed nitroglycerin patches. Which of the
following instructions should the nurse include?
A. Apply the patch to the same site each time
B. Remove the patch for 8-12 hours each day
C. Apply the patch to a hairy area for better adhesion
D. Shower with the patch in place
Answer: B
Rationale: Nitroglycerin patches require a drug-free period of 8-12 hours daily to
prevent tolerance development. Apply to a hairless area and rotate sites.
10. A nurse is administering verapamil to a client with atrial fibrillation.
Which of the following is a potential adverse effect of this medication?
A. Tachycardia
B. Hypotension
C. Bronchospasm
D. Hypoglycemia
Answer: B
Rationale: Verapamil is a calcium channel blocker that causes vasodilation, which
can lead to hypotension. It also decreases heart rate and AV conduction.
SECTION 2: CENTRAL NERVOUS SYSTEM PHARMACOLOGY
11. The nurse is collecting data from a client who has been taking diazepam
daily but recently ran out of the medication. Which of the following should the
nurse recognize as a manifestation of withdrawal?
A. Tremors
B. Hypothermia
C. Hypotension
D. Bradycardia
