ATI RN PHARMACOLOGY PROCTORED EXAM |
2025/2026
Actual ATI Nursing Pharmacology Proctored Exam with Complete Questions & Verified
Answers | NCLEX-RN® Aligned
Overview
This 2025/2026 updated resource contains the actual ATI RN Pharmacology Proctored
Exam with the exact 100 questions and verified answers, following current ATI testing
standards, NCLEX-RN® test plans, and evidence-based pharmacological nursing practice.
Key Features
● Actual ATI proctored exam format with the official 100 questions
● Comprehensive coverage of all pharmacological classifications and nursing
implications
● NCLEX-style questions including calculation, prioritization, and select-all-that-apply
items
● Updated 2025/2026 medication safety standards and FDA-approved drugs
● Detailed rationales for correct and incorrect answer choices
Core Content Areas (100 Total Questions)
Pharmacokinetics, Dynamics & Nursing Responsibilities (10 Qs)
Autonomic Nervous System & Cardiovascular Medications (20 Qs)
Central Nervous System & Psychotropic Medications (15 Qs)
Endocrine, Immune & Anti-infective Agents (18 Qs)
Gastrointestinal, Respiratory & Renal Medications (15 Qs)
Cancer Therapy, Pain Management & Anesthetics (12 Qs)
Herbals, Vitamins & Complementary Therapies (5 Qs)
, Medication Administration & Safety Protocols (5 Qs)
Answer Format
Correct answers are marked in bold green and include:
● Drug classification and mechanism of action explanations
● Therapeutic vs. toxic serum level ranges
● Nursing assessment priorities for medication monitoring
● Dosage calculation steps with dimensional analysis
● Patient education points for safe medication use
● Adverse effect recognition and intervention strategies
Updates for 2025/2026
Reflects 2025-2026 ATI Pharmacology content revisions
Includes latest FDA-approved medications and withdrawn drugs
Updated opioid prescribing guidelines and pain management protocols
Enhanced focus on pharmacogenomics and personalized medicine
New insulin and anticoagulant protocols with safety monitoring
Revised medication reconciliation standards and error prevention strategies
Integrated Next Generation NCLEX (NGN) pharmacology items
Question 1
A nurse is caring for a client prescribed lisinopril for hypertension. Which assessment finding
requires immediate follow-up?
A. Heart rate of 72 bpm
, B. Potassium level of 5.8 mEq/L
C. Blood pressure of 138/86 mm Hg
D. Urine output of 60 mL/hr
Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia due to reduced
aldosterone secretion. A potassium level >5.5 mEq/L is critical and may lead to cardiac
dysrhythmias. Normal potassium is 3.5–5.0 mEq/L. The nurse should notify the provider
immediately.
Question 2
The nurse is preparing to administer insulin glargine to a client with type 1 diabetes. Which
action is appropriate?
A. Mix it with regular insulin in the same syringe
B. Administer it intravenously for rapid effect
C. Inject it once daily at the same time each day
D. Shake the vial vigorously before drawing up the dose
Rationale: Insulin glargine (Lantus) is a long-acting basal insulin with no peak and a duration
of up to 24 hours. It should never be mixed with other insulins, must be given subcutaneously,
and administered at the same time daily. Shaking causes denaturation—roll gently instead.
Question 3
A client is receiving vancomycin IV for MRSA pneumonia. Which finding indicates a potential
adverse effect?
, A. Clear yellow urine
B. Tinnitus and dizziness
C. Mild dry cough
D. Serum creatinine of 0.9 mg/dL
Rationale: Vancomycin can cause ototoxicity (tinnitus, hearing loss) and nephrotoxicity. The
nurse should monitor peak and trough levels (trough goal: 10–20 mcg/mL for serious
infections) and renal function. Tinnitus is an early sign of ototoxicity and requires dose
evaluation.
Question 4
The nurse is teaching a client about alendronate for osteoporosis. Which statement by the client
indicates understanding?
A. “I’ll take it with a glass of milk before bed.”
B. “I can lie down right after taking it to rest.”
C. “I’ll take it on an empty stomach with a full glass of water and stay upright
for 30 minutes.”
D. “I’ll crush the tablet if it’s hard to swallow.”
Rationale: Alendronate (Fosamax) can cause esophageal irritation or ulceration. It must be
taken first thing in the morning with 8 oz of plain water, 30–60 minutes before food or other
meds, and the client must remain upright to prevent reflux. Tablets should never be crushed.
Question 5
2025/2026
Actual ATI Nursing Pharmacology Proctored Exam with Complete Questions & Verified
Answers | NCLEX-RN® Aligned
Overview
This 2025/2026 updated resource contains the actual ATI RN Pharmacology Proctored
Exam with the exact 100 questions and verified answers, following current ATI testing
standards, NCLEX-RN® test plans, and evidence-based pharmacological nursing practice.
Key Features
● Actual ATI proctored exam format with the official 100 questions
● Comprehensive coverage of all pharmacological classifications and nursing
implications
● NCLEX-style questions including calculation, prioritization, and select-all-that-apply
items
● Updated 2025/2026 medication safety standards and FDA-approved drugs
● Detailed rationales for correct and incorrect answer choices
Core Content Areas (100 Total Questions)
Pharmacokinetics, Dynamics & Nursing Responsibilities (10 Qs)
Autonomic Nervous System & Cardiovascular Medications (20 Qs)
Central Nervous System & Psychotropic Medications (15 Qs)
Endocrine, Immune & Anti-infective Agents (18 Qs)
Gastrointestinal, Respiratory & Renal Medications (15 Qs)
Cancer Therapy, Pain Management & Anesthetics (12 Qs)
Herbals, Vitamins & Complementary Therapies (5 Qs)
, Medication Administration & Safety Protocols (5 Qs)
Answer Format
Correct answers are marked in bold green and include:
● Drug classification and mechanism of action explanations
● Therapeutic vs. toxic serum level ranges
● Nursing assessment priorities for medication monitoring
● Dosage calculation steps with dimensional analysis
● Patient education points for safe medication use
● Adverse effect recognition and intervention strategies
Updates for 2025/2026
Reflects 2025-2026 ATI Pharmacology content revisions
Includes latest FDA-approved medications and withdrawn drugs
Updated opioid prescribing guidelines and pain management protocols
Enhanced focus on pharmacogenomics and personalized medicine
New insulin and anticoagulant protocols with safety monitoring
Revised medication reconciliation standards and error prevention strategies
Integrated Next Generation NCLEX (NGN) pharmacology items
Question 1
A nurse is caring for a client prescribed lisinopril for hypertension. Which assessment finding
requires immediate follow-up?
A. Heart rate of 72 bpm
, B. Potassium level of 5.8 mEq/L
C. Blood pressure of 138/86 mm Hg
D. Urine output of 60 mL/hr
Rationale: Lisinopril is an ACE inhibitor that can cause hyperkalemia due to reduced
aldosterone secretion. A potassium level >5.5 mEq/L is critical and may lead to cardiac
dysrhythmias. Normal potassium is 3.5–5.0 mEq/L. The nurse should notify the provider
immediately.
Question 2
The nurse is preparing to administer insulin glargine to a client with type 1 diabetes. Which
action is appropriate?
A. Mix it with regular insulin in the same syringe
B. Administer it intravenously for rapid effect
C. Inject it once daily at the same time each day
D. Shake the vial vigorously before drawing up the dose
Rationale: Insulin glargine (Lantus) is a long-acting basal insulin with no peak and a duration
of up to 24 hours. It should never be mixed with other insulins, must be given subcutaneously,
and administered at the same time daily. Shaking causes denaturation—roll gently instead.
Question 3
A client is receiving vancomycin IV for MRSA pneumonia. Which finding indicates a potential
adverse effect?
, A. Clear yellow urine
B. Tinnitus and dizziness
C. Mild dry cough
D. Serum creatinine of 0.9 mg/dL
Rationale: Vancomycin can cause ototoxicity (tinnitus, hearing loss) and nephrotoxicity. The
nurse should monitor peak and trough levels (trough goal: 10–20 mcg/mL for serious
infections) and renal function. Tinnitus is an early sign of ototoxicity and requires dose
evaluation.
Question 4
The nurse is teaching a client about alendronate for osteoporosis. Which statement by the client
indicates understanding?
A. “I’ll take it with a glass of milk before bed.”
B. “I can lie down right after taking it to rest.”
C. “I’ll take it on an empty stomach with a full glass of water and stay upright
for 30 minutes.”
D. “I’ll crush the tablet if it’s hard to swallow.”
Rationale: Alendronate (Fosamax) can cause esophageal irritation or ulceration. It must be
taken first thing in the morning with 8 oz of plain water, 30–60 minutes before food or other
meds, and the client must remain upright to prevent reflux. Tablets should never be crushed.
Question 5
