RN ATI Pharmacology Proctored Exam 2025/2026
Version 4 – 150 Real Questions with Verified Answers and Detailed Rationales for NCLEX-RN Prep
1. 1) A nurse is caring for a client with 3. Calcitonin (Miacalcin)
hyperparathyroidism and notes that the Rationale:
client's serum calcium level is 13 mg/dL. The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
Which medication should the nurse prepare hypercalcemia. Calcium gluconate and calcium chloride are medications used for
to administer as prescribed to the client? the treatment of tetany, which occurs as a result of acute hypocalcemia. In
1. Calcium chloride hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
2. Calcium gluconate hormone, decreases the plasma calcium level by inhibiting bone resorption and
3. Calcitonin (Miacalcin) lowering the serum calcium concentration.
4. Large doses of vitamin D
2. 2.) Oral iron supplements are prescribed for 4. Orange juice
a 6-year-old child with iron deficiency Rationale:
anemia. The nurse instructs the mother to Vitamin C increases the absorption of iron by the body. The mother should be
administer the iron with which best food instructed to administer the medication with a citrus fruit or a juice that is high in
C
item? vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption.
1. Milk Orange juice contains a greater amount of vitamin C than apple juice.
2. Water
3. Apple juice
4. Orange juice
1. Tinnitus
LE
3. 3.) Salicylic acid is prescribed for a client
Rationale:
with a diagnosis of psoriasis. The nurse
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)
monitors the client, knowing that which of
can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
ST
the following would indicate the presence
disturbances. Constipation and diarrhea are not associated with salicylism.
of systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
BE
4. At least 30 minutes beforeexposure to the sun
4. 4.) The camp nurse asks the children
Rationale:
preparing to swim in the lake if they have
Sunscreens are most effective when applied at least 30 minutes beforeexposure to
applied sunscreen. The nurse reminds the
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
children that chemical sunscreens are most
swimming or sweating.
effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to
the sun
5. 5.) Mafenide acetate (Sulfamylon) is 3. Informing the client that this is normal
prescribed for the client with a burn injury. Rationale:
When applying the medication, the client Mafenideacetateis bacteriostatic forgram-negativeand gram-positive organisms
complains of local discomfort and burning. and is used to treatburns to reducebacteria present in avascular tissues. The client
Which of the following is the most should be informed that the medication will causelocal discomfort and burning and
appropriate nursing action? that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed
to the burn site
,6. 6.) The burn client is receiving treatments of 1. Hyperventilation
topical mafenide acetate(Sulfamylon) tothe Rationale:
site of injury. The nurse monitors the client, Mafenideacetate is a carbonic anhydraseinhibitor and can suppress renalexcretion
knowing that which of the following indicates of acid, thereby causing acidosis. Clients receiving this treatment should be
that a systemic effect has occurred? monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the
1. Hyperventilation medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local
2. Elevated blood pressure rather than systemic effects. An elevated blood pressure may be expected from the
3. Local pain at the burn site pain that occurs with a burn injury.
4. Local rash at the burn site
2. Triglyceride level
7. 7.) Isotretinoin is prescribed for a client with
Rationale:
severe acne. Before the administration of this
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
medication, the nurse anticipates that which
measured before treatment and periodically thereafter until the effect on the
laboratory test will be prescribed?
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
1. Platelet count
specifically during this treatment.
2. Triglyceride level
3. Complete blood count
4. White blood cell count
1. Vitamin A
8. 8.) A client with severe acne is seen in the Rationale:
clinic and the health care provider (HCP) Isotretinoinis ametabolite of vitamin Aand canproducegeneralizedintensification
prescribes isotretinoin. The nurse reviews the of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
client's medication record and would contact supplements should be discontinued beforeisotretinointherapy.Options 2, 3, and 4
the (HCP) if the client is taking which are not contraindicated with the use of isotretinoin.
C
medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
2. Axilla
LE
9. 9.) The nurse is applying a topical Rationale:
corticosteroid to a client with eczema. The Topicalcorticosteroids can be absorbedinto the systemic circulation. Absorption is
nurse would monitor for the potential for higher from regions where the skin is especially permeable (scalp, axilla, face,
ST
increased systemic absorption of the eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
medication if the medication were being poor (back, palms, soles).
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
BE
4. Palms of the hands
1. Acne
10. 10.) The clinic nurse is performing an Rationale:
admission assessment on a client. The nurse Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
notes that the client is taking azelaic acid appears to work by suppressing the growth of Propionibacterium acnes and
(Azelex). Because of the medication decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
prescription, the nurse would suspect that the
client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex
,11.11.) The health care provider has prescribed silver 3. "The medication will permanently stain my skin."
sulfadiazine (Silvadene) for the client with a partial- Rationale:
thickness burn, which has cultured positive for gram- Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum
negative bacteria. The nurse is reinforcing of activity against gram-negativebacteria, gram-positive bacteria, and
information to the client about the medication. Which yeast. It is applied directly to the wound to assist in healing. It does not
statement made by the client indicates a lack of stain the skin.
understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the
wound."
12. 12.) Anurse is caring for a client who is receiving an
intravenous (IV) infusion of an antineoplastic 1. Notify the registered nurse.
medication. Duringtheinfusion, the client complains Rationale:
of pain at the insertion site. During an inspection of When antineoplastic medications (Chemotheraputic Agents) are
the site, the nurse notes redness and swelling and administered via IV, greatcaremust be taken to preventthe medication from
that the rate of infusion of the medication has escaping into the tissues surrounding the injection site, because pain, tissue
slowed. The nurse should take which appropriate damage, and necrosis can result. The nurse monitors for signs of
action? extravasation, such as redness or swelling at the insertion site and a
1. Notify the registered nurse. decreasedinfusion rate. If extravasationoccurs, the registerednurseneeds
to be notified; he or she will then contact the health care provider.
2. Administerpainmedicationtoreduce the
discomfort.
C
3. Apply ice and maintain the infusion rate, as
prescribed.
4. Elevate the extremity of the IV site, and slow the
infusion. LE
13. 13.)The client with squamous cell carcinoma of the
larynx is receiving bleomycin intravenously. The
4. Pulmonary function studies
nurse caring for the client anticipates that which
Rationale:
diagnostic study will be prescribed?
Bleomycin is anantineoplastic medication (Chemotheraputic Agents) that
1. Echocardiography
can cause interstitial pneumonitis, which can progress to pulmonary fibrosis.
ST
2. Electrocardiography Pulmonary function studies along with hematological, hepatic, and renal
3. Cervical radiography function tests need to be monitored. The nurse needs to monitor lung
4. Pulmonary function studies sounds for dyspnea and crackles, which indicate pulmonary toxicity. The
medication needs to be discontinued immediately if pulmonary toxicity
occurs. Options 1, 2, and 3 are unrelated to the specific use of this
medication.
BE
14. 14.)The client with acute myelocytic leukemia is
2. Uric acid level
being treated with busulfan (Myleran). Which
Rationale:
laboratory value would the nurse specifically
Busulfan (Myleran) can cause an increase in the uric acid level.
monitor during treatment with this medication?
Hyperuricemia canproduceuricacid nephropathy, renalstones, and acute
1. Clotting time
renal failure. Options 1, 3, and 4 are not specifically related to this
2. Uric acid level medication.
3. Potassium level
4. Blood glucose level
, 15.15.) The client with small cell lung cancer is 4. Orthostatic hypotension
being treated with etoposide (VePesid). The Rationale:
nurse who is assisting in caring for the client A side effect specific to etoposide is orthostatic hypotension. The client's blood
during its administration understands that which pressure is monitored during the infusion. Hair loss occurs with nearly all the
side effect is specifically associated with this antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to
medication? this medication.
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension
16. 16.) Theclinic nurse is reviewing a teaching plan 3. Consult with health care providers (HCPs) before receiving immunizations
for the client receiving an antineoplastic Rationale:
medication. When implementing the plan, the Because antineoplastic medications lower the resistance of the body, clients must
nurse tells the client: be informed not to receiveimmunizations without a HCP's approval. Clients also
1. To take aspirin (acetylsalicylic acid) as need to avoid contact with individuals who have recently received a live virus
needed for headache vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize
2. Drink beverages containing alcohol in the risk of bleeding, and they need to avoid alcohol to minimize the risk of
moderate amounts each evening toxicity and side effects.
3. Consult with health care providers (HCPs)
before receiving immunizations
4. That it is not necessary to consult HCPs
before receiving a flu vaccine at the local
health fair
C
17.17.) The client with ovarian cancer is being
treated with vincristine (Oncovin). The nurse 4. Numbness and tingling in the fingers and toes
monitors the client, knowing that which of the Rationale:
following indicates a side effect specific to this
medication?
1. Diarrhea
LE
A side effect specific to vincristine is peripheral neuropathy, which occurs in
almost every client. Peripheral neuropathy can be manifested as numbness and
tingling in the fingers and toes. Depression of the Achilles tendon reflex may be
2. Hair loss the first clinical sign indicating peripheral neuropathy. Constipation rather than
3. Chest pain diarrhea is most likely to occur with this medication, although diarrhea may occur
4. Numbness and tingling in the fingers and occasionally. Hair loss occurs with nearly all the antineoplastic medications.
ST
toes Chest pain is unrelated to this medication.
18. 18.)
The nurse is reviewing the history and
physical examination of a client who will be 1. Pancreatitis
receiving asparaginase (Elspar), an Rationale:
antineoplastic agent. The nurse consults with Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or
the registered nurse regarding the if the client has a history of pancreatitis. The medication impairs pancreatic
BE
administration of the medication if which of the function and pancreatic function tests should be performed beforetherapy begins
following is documented in the client's history? and when a week or morehas elapsed between administration of the doses. The
1. Pancreatitis client needs to be monitored for signs of pancreatitis, which include nausea,
2. Diabetes mellitus vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not
3. Myocardial infarction contraindicated with this medication.
4. Chronic obstructive pulmonary disease
Version 4 – 150 Real Questions with Verified Answers and Detailed Rationales for NCLEX-RN Prep
1. 1) A nurse is caring for a client with 3. Calcitonin (Miacalcin)
hyperparathyroidism and notes that the Rationale:
client's serum calcium level is 13 mg/dL. The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
Which medication should the nurse prepare hypercalcemia. Calcium gluconate and calcium chloride are medications used for
to administer as prescribed to the client? the treatment of tetany, which occurs as a result of acute hypocalcemia. In
1. Calcium chloride hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
2. Calcium gluconate hormone, decreases the plasma calcium level by inhibiting bone resorption and
3. Calcitonin (Miacalcin) lowering the serum calcium concentration.
4. Large doses of vitamin D
2. 2.) Oral iron supplements are prescribed for 4. Orange juice
a 6-year-old child with iron deficiency Rationale:
anemia. The nurse instructs the mother to Vitamin C increases the absorption of iron by the body. The mother should be
administer the iron with which best food instructed to administer the medication with a citrus fruit or a juice that is high in
C
item? vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption.
1. Milk Orange juice contains a greater amount of vitamin C than apple juice.
2. Water
3. Apple juice
4. Orange juice
1. Tinnitus
LE
3. 3.) Salicylic acid is prescribed for a client
Rationale:
with a diagnosis of psoriasis. The nurse
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)
monitors the client, knowing that which of
can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
ST
the following would indicate the presence
disturbances. Constipation and diarrhea are not associated with salicylism.
of systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
BE
4. At least 30 minutes beforeexposure to the sun
4. 4.) The camp nurse asks the children
Rationale:
preparing to swim in the lake if they have
Sunscreens are most effective when applied at least 30 minutes beforeexposure to
applied sunscreen. The nurse reminds the
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
children that chemical sunscreens are most
swimming or sweating.
effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to
the sun
5. 5.) Mafenide acetate (Sulfamylon) is 3. Informing the client that this is normal
prescribed for the client with a burn injury. Rationale:
When applying the medication, the client Mafenideacetateis bacteriostatic forgram-negativeand gram-positive organisms
complains of local discomfort and burning. and is used to treatburns to reducebacteria present in avascular tissues. The client
Which of the following is the most should be informed that the medication will causelocal discomfort and burning and
appropriate nursing action? that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed
to the burn site
,6. 6.) The burn client is receiving treatments of 1. Hyperventilation
topical mafenide acetate(Sulfamylon) tothe Rationale:
site of injury. The nurse monitors the client, Mafenideacetate is a carbonic anhydraseinhibitor and can suppress renalexcretion
knowing that which of the following indicates of acid, thereby causing acidosis. Clients receiving this treatment should be
that a systemic effect has occurred? monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the
1. Hyperventilation medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local
2. Elevated blood pressure rather than systemic effects. An elevated blood pressure may be expected from the
3. Local pain at the burn site pain that occurs with a burn injury.
4. Local rash at the burn site
2. Triglyceride level
7. 7.) Isotretinoin is prescribed for a client with
Rationale:
severe acne. Before the administration of this
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
medication, the nurse anticipates that which
measured before treatment and periodically thereafter until the effect on the
laboratory test will be prescribed?
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
1. Platelet count
specifically during this treatment.
2. Triglyceride level
3. Complete blood count
4. White blood cell count
1. Vitamin A
8. 8.) A client with severe acne is seen in the Rationale:
clinic and the health care provider (HCP) Isotretinoinis ametabolite of vitamin Aand canproducegeneralizedintensification
prescribes isotretinoin. The nurse reviews the of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
client's medication record and would contact supplements should be discontinued beforeisotretinointherapy.Options 2, 3, and 4
the (HCP) if the client is taking which are not contraindicated with the use of isotretinoin.
C
medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
2. Axilla
LE
9. 9.) The nurse is applying a topical Rationale:
corticosteroid to a client with eczema. The Topicalcorticosteroids can be absorbedinto the systemic circulation. Absorption is
nurse would monitor for the potential for higher from regions where the skin is especially permeable (scalp, axilla, face,
ST
increased systemic absorption of the eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
medication if the medication were being poor (back, palms, soles).
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
BE
4. Palms of the hands
1. Acne
10. 10.) The clinic nurse is performing an Rationale:
admission assessment on a client. The nurse Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
notes that the client is taking azelaic acid appears to work by suppressing the growth of Propionibacterium acnes and
(Azelex). Because of the medication decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
prescription, the nurse would suspect that the
client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex
,11.11.) The health care provider has prescribed silver 3. "The medication will permanently stain my skin."
sulfadiazine (Silvadene) for the client with a partial- Rationale:
thickness burn, which has cultured positive for gram- Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum
negative bacteria. The nurse is reinforcing of activity against gram-negativebacteria, gram-positive bacteria, and
information to the client about the medication. Which yeast. It is applied directly to the wound to assist in healing. It does not
statement made by the client indicates a lack of stain the skin.
understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the
wound."
12. 12.) Anurse is caring for a client who is receiving an
intravenous (IV) infusion of an antineoplastic 1. Notify the registered nurse.
medication. Duringtheinfusion, the client complains Rationale:
of pain at the insertion site. During an inspection of When antineoplastic medications (Chemotheraputic Agents) are
the site, the nurse notes redness and swelling and administered via IV, greatcaremust be taken to preventthe medication from
that the rate of infusion of the medication has escaping into the tissues surrounding the injection site, because pain, tissue
slowed. The nurse should take which appropriate damage, and necrosis can result. The nurse monitors for signs of
action? extravasation, such as redness or swelling at the insertion site and a
1. Notify the registered nurse. decreasedinfusion rate. If extravasationoccurs, the registerednurseneeds
to be notified; he or she will then contact the health care provider.
2. Administerpainmedicationtoreduce the
discomfort.
C
3. Apply ice and maintain the infusion rate, as
prescribed.
4. Elevate the extremity of the IV site, and slow the
infusion. LE
13. 13.)The client with squamous cell carcinoma of the
larynx is receiving bleomycin intravenously. The
4. Pulmonary function studies
nurse caring for the client anticipates that which
Rationale:
diagnostic study will be prescribed?
Bleomycin is anantineoplastic medication (Chemotheraputic Agents) that
1. Echocardiography
can cause interstitial pneumonitis, which can progress to pulmonary fibrosis.
ST
2. Electrocardiography Pulmonary function studies along with hematological, hepatic, and renal
3. Cervical radiography function tests need to be monitored. The nurse needs to monitor lung
4. Pulmonary function studies sounds for dyspnea and crackles, which indicate pulmonary toxicity. The
medication needs to be discontinued immediately if pulmonary toxicity
occurs. Options 1, 2, and 3 are unrelated to the specific use of this
medication.
BE
14. 14.)The client with acute myelocytic leukemia is
2. Uric acid level
being treated with busulfan (Myleran). Which
Rationale:
laboratory value would the nurse specifically
Busulfan (Myleran) can cause an increase in the uric acid level.
monitor during treatment with this medication?
Hyperuricemia canproduceuricacid nephropathy, renalstones, and acute
1. Clotting time
renal failure. Options 1, 3, and 4 are not specifically related to this
2. Uric acid level medication.
3. Potassium level
4. Blood glucose level
, 15.15.) The client with small cell lung cancer is 4. Orthostatic hypotension
being treated with etoposide (VePesid). The Rationale:
nurse who is assisting in caring for the client A side effect specific to etoposide is orthostatic hypotension. The client's blood
during its administration understands that which pressure is monitored during the infusion. Hair loss occurs with nearly all the
side effect is specifically associated with this antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to
medication? this medication.
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension
16. 16.) Theclinic nurse is reviewing a teaching plan 3. Consult with health care providers (HCPs) before receiving immunizations
for the client receiving an antineoplastic Rationale:
medication. When implementing the plan, the Because antineoplastic medications lower the resistance of the body, clients must
nurse tells the client: be informed not to receiveimmunizations without a HCP's approval. Clients also
1. To take aspirin (acetylsalicylic acid) as need to avoid contact with individuals who have recently received a live virus
needed for headache vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize
2. Drink beverages containing alcohol in the risk of bleeding, and they need to avoid alcohol to minimize the risk of
moderate amounts each evening toxicity and side effects.
3. Consult with health care providers (HCPs)
before receiving immunizations
4. That it is not necessary to consult HCPs
before receiving a flu vaccine at the local
health fair
C
17.17.) The client with ovarian cancer is being
treated with vincristine (Oncovin). The nurse 4. Numbness and tingling in the fingers and toes
monitors the client, knowing that which of the Rationale:
following indicates a side effect specific to this
medication?
1. Diarrhea
LE
A side effect specific to vincristine is peripheral neuropathy, which occurs in
almost every client. Peripheral neuropathy can be manifested as numbness and
tingling in the fingers and toes. Depression of the Achilles tendon reflex may be
2. Hair loss the first clinical sign indicating peripheral neuropathy. Constipation rather than
3. Chest pain diarrhea is most likely to occur with this medication, although diarrhea may occur
4. Numbness and tingling in the fingers and occasionally. Hair loss occurs with nearly all the antineoplastic medications.
ST
toes Chest pain is unrelated to this medication.
18. 18.)
The nurse is reviewing the history and
physical examination of a client who will be 1. Pancreatitis
receiving asparaginase (Elspar), an Rationale:
antineoplastic agent. The nurse consults with Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or
the registered nurse regarding the if the client has a history of pancreatitis. The medication impairs pancreatic
BE
administration of the medication if which of the function and pancreatic function tests should be performed beforetherapy begins
following is documented in the client's history? and when a week or morehas elapsed between administration of the doses. The
1. Pancreatitis client needs to be monitored for signs of pancreatitis, which include nausea,
2. Diabetes mellitus vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not
3. Myocardial infarction contraindicated with this medication.
4. Chronic obstructive pulmonary disease
