ATI RN PHARMACOLOGY PROCTORED
EXAM PREP 100 Q ULTIMATE FULL
ANSWERS AND DETAILED ITALICIZED
RATIONALES
ATI RN Pharmacology Proctored Practice Exam
(Questions 1–50)
1. Cardiac Glycosides and Toxicity
A nurse is preparing to administer digoxin 0.25 mg PO to an adult
client who has heart failure. Which of the following actions should
the nurse take first before administering the medication?
A) Measure the client's blood pressure in both arms.
B) Check the client's apical pulse rate for one full minute.
C) Review the client's most recent serum creatinine clearance.
D) Assess the client for the presence of bilateral peripheral edema.
CorreCt Answer: B
rAtionAle: The nurse must check the apical pulse for 1 full
minute prior to administering digoxin. The medication should be
withheld, and the provider notified, if the heart rate is less than
60/min in an adult, as bradycardia is a primary sign of digoxin
toxicity.
2. Antimicrobial Adverse Effects
A nurse is caring for a client who is receiving intravenous
gentamicin intermittent bolus infusions for a severe pseudomonal
infection. Which of the following laboratory values should the
nurse monitor closely to prevent medication-induced toxicities?
,A) Serum alanine aminotransferase (ALT) and aspartate
aminotransferase (AST).
B) Serum creatinine and blood urea nitrogen (BUN).
C) Prothrombin time (PT) and International Normalized Ratio
(INR).
D) Serum amylase and lipase levels.
CorreCt Answer: B
rAtionAle: Aminoglycoside antibiotics like gentamicin are
highly nephrotoxic and ototoxic. Monitoring kidney function
indicators, such as serum creatinine and BUN, alongside trough
drug levels, is essential to mitigate renal injury.
3. Endocrine and Thyroid Management
A nurse is reinforcing teaching with a client who has
hypothyroidism and a new prescription for levothyroxine. Which
of the following instructions should the nurse include in the
teaching?
A) Take the medication with a high-calcium snack right before
bedtime.
B) Expect the maximum therapeutic effect of the drug to occur
within 24 hours.
C) Take the medication on an empty stomach with a full glass of
water 30 to 60 minutes before breakfast.
D) Decrease the dose if tremors, sweating, or palpitations occur.
CorreCt Answer: C
rAtionAle: Levothyroxine absorption is increased when
taken on an empty stomach in the morning. Taking it with food
or calcium-containing substances decreases bioavailability.
,Tremors or palpitations indicate over-dosage (hyperthyroidism)
and must be reported to the provider rather than self-adjusted.
4. Blood Coagulation Antagonists
A nurse is caring for a client who is receiving a continuous
intravenous heparin infusion for a deep vein thrombosis (DVT).
The client's activated partial thromboplastin time (aPTT) is 110
seconds, and the nurse notes epistaxis and hematuria. Which of
the following medications should the nurse prepare to
administer?
A) Vitamin K
B) Protamine sulfate
C) Aminocaproic acid
D) Deferoxamine
CorreCt Answer: B
rAtionAle: Protamine sulfate is the specific antidote used to
reverse the anticoagulant effects of heparin in cases of severe
overdose or active hemorrhage. Vitamin K is the antidote for
warfarin.
5. Respiratory System Agents
A nurse is providing discharge teaching to a client with asthma
who has been prescribed an albuterol metered-dose inhaler (MDI)
and a beclomethasone MDI. Which of the following instructions
should the nurse give regarding the sequence of administration?
A) Inhale the beclomethasone first, wait 5 minutes, and then
inhale the albuterol.
B) Inhale the albuterol first, wait 5 minutes, and then inhale the
beclomethasone.
C) Mix both medications into a single nebulizer chamber for
, simultaneous inhalation.
D) Administer the beclomethasone only during acute
bronchospasm episodes.
CorreCt Answer: B
rAtionAle: The bronchodilator (albuterol, a short-acting
beta-2 agonist) must be inhaled first to open the airways. This
dilation allows for deeper and more effective penetration of the
corticosteroid (beclomethasone) into the bronchial tree 5 minutes
later.
6. Electrolyte Supplements
A nurse is preparing to administer intravenous potassium
chloride to a client who has a serum potassium level of 3.0
mEq/L. Which of the following administration techniques
represents a safe nursing practice?
A) Administer the potassium chloride via rapid IV push over 1 to 2
minutes.
B) Dilute the potassium chloride and infuse it at a rate not to
exceed 10 mEq/hr via an infusion pump.
C) Inject the medication directly into an ongoing fluid line without
a secondary pump.
D) Add the potassium chloride to a 50 mL bag and infuse it over 5
minutes through a central line.
CorreCt Answer: B
rAtionAle: Intravenous potassium must always be diluted
and administered slowly using an infusion pump. Intermittent
IV infusion should not exceed 10 mEq/hr in standard medical-
surgical units to avoid fatal cardiac arrhythmias. IV push
potassium is lethal.
EXAM PREP 100 Q ULTIMATE FULL
ANSWERS AND DETAILED ITALICIZED
RATIONALES
ATI RN Pharmacology Proctored Practice Exam
(Questions 1–50)
1. Cardiac Glycosides and Toxicity
A nurse is preparing to administer digoxin 0.25 mg PO to an adult
client who has heart failure. Which of the following actions should
the nurse take first before administering the medication?
A) Measure the client's blood pressure in both arms.
B) Check the client's apical pulse rate for one full minute.
C) Review the client's most recent serum creatinine clearance.
D) Assess the client for the presence of bilateral peripheral edema.
CorreCt Answer: B
rAtionAle: The nurse must check the apical pulse for 1 full
minute prior to administering digoxin. The medication should be
withheld, and the provider notified, if the heart rate is less than
60/min in an adult, as bradycardia is a primary sign of digoxin
toxicity.
2. Antimicrobial Adverse Effects
A nurse is caring for a client who is receiving intravenous
gentamicin intermittent bolus infusions for a severe pseudomonal
infection. Which of the following laboratory values should the
nurse monitor closely to prevent medication-induced toxicities?
,A) Serum alanine aminotransferase (ALT) and aspartate
aminotransferase (AST).
B) Serum creatinine and blood urea nitrogen (BUN).
C) Prothrombin time (PT) and International Normalized Ratio
(INR).
D) Serum amylase and lipase levels.
CorreCt Answer: B
rAtionAle: Aminoglycoside antibiotics like gentamicin are
highly nephrotoxic and ototoxic. Monitoring kidney function
indicators, such as serum creatinine and BUN, alongside trough
drug levels, is essential to mitigate renal injury.
3. Endocrine and Thyroid Management
A nurse is reinforcing teaching with a client who has
hypothyroidism and a new prescription for levothyroxine. Which
of the following instructions should the nurse include in the
teaching?
A) Take the medication with a high-calcium snack right before
bedtime.
B) Expect the maximum therapeutic effect of the drug to occur
within 24 hours.
C) Take the medication on an empty stomach with a full glass of
water 30 to 60 minutes before breakfast.
D) Decrease the dose if tremors, sweating, or palpitations occur.
CorreCt Answer: C
rAtionAle: Levothyroxine absorption is increased when
taken on an empty stomach in the morning. Taking it with food
or calcium-containing substances decreases bioavailability.
,Tremors or palpitations indicate over-dosage (hyperthyroidism)
and must be reported to the provider rather than self-adjusted.
4. Blood Coagulation Antagonists
A nurse is caring for a client who is receiving a continuous
intravenous heparin infusion for a deep vein thrombosis (DVT).
The client's activated partial thromboplastin time (aPTT) is 110
seconds, and the nurse notes epistaxis and hematuria. Which of
the following medications should the nurse prepare to
administer?
A) Vitamin K
B) Protamine sulfate
C) Aminocaproic acid
D) Deferoxamine
CorreCt Answer: B
rAtionAle: Protamine sulfate is the specific antidote used to
reverse the anticoagulant effects of heparin in cases of severe
overdose or active hemorrhage. Vitamin K is the antidote for
warfarin.
5. Respiratory System Agents
A nurse is providing discharge teaching to a client with asthma
who has been prescribed an albuterol metered-dose inhaler (MDI)
and a beclomethasone MDI. Which of the following instructions
should the nurse give regarding the sequence of administration?
A) Inhale the beclomethasone first, wait 5 minutes, and then
inhale the albuterol.
B) Inhale the albuterol first, wait 5 minutes, and then inhale the
beclomethasone.
C) Mix both medications into a single nebulizer chamber for
, simultaneous inhalation.
D) Administer the beclomethasone only during acute
bronchospasm episodes.
CorreCt Answer: B
rAtionAle: The bronchodilator (albuterol, a short-acting
beta-2 agonist) must be inhaled first to open the airways. This
dilation allows for deeper and more effective penetration of the
corticosteroid (beclomethasone) into the bronchial tree 5 minutes
later.
6. Electrolyte Supplements
A nurse is preparing to administer intravenous potassium
chloride to a client who has a serum potassium level of 3.0
mEq/L. Which of the following administration techniques
represents a safe nursing practice?
A) Administer the potassium chloride via rapid IV push over 1 to 2
minutes.
B) Dilute the potassium chloride and infuse it at a rate not to
exceed 10 mEq/hr via an infusion pump.
C) Inject the medication directly into an ongoing fluid line without
a secondary pump.
D) Add the potassium chloride to a 50 mL bag and infuse it over 5
minutes through a central line.
CorreCt Answer: B
rAtionAle: Intravenous potassium must always be diluted
and administered slowly using an infusion pump. Intermittent
IV infusion should not exceed 10 mEq/hr in standard medical-
surgical units to avoid fatal cardiac arrhythmias. IV push
potassium is lethal.
