ATI COMPREHENSIVE PN PHARMACOLOGY
EXAM 2025/2026 – 140 QUESTIONS WITH
NGN & SOLUTIONS (GRADED A+)
EXAM
1. A nurse is preparing to administer enoxaparin subcutaneously. Which action is
correct?
A. Aspirate before injecting to check for blood return
B. Insert the needle at a 15-degree angle
C. Administer into the abdomen while pinching a skinfold
D. Massage the injection site after administration
Correct answer: C – ✓✓ Administer into the abdomen while pinching a skinfold.
Rationale: *Enoxaparin is given subcutaneously into the abdomen, pinching a
skinfold to ensure proper delivery. Do not aspirate (risk of hematoma), use a 90-
degree angle, and never massage the site.*
2. A client is prescribed metoprolol succinate. Which finding indicates the
medication is effective?
A. Heart rate 110 bpm
B. Blood pressure 150/92 mmHg
C. Heart rate 65 bpm with controlled blood pressure
D. Wheezing on auscultation
Correct answer: C – ✓✓ Heart rate 65 bpm with controlled blood pressure.
Rationale: Metoprolol is a beta-blocker used for hypertension and heart failure.
Therapeutic effect includes lowered heart rate and blood pressure. Wheezing
suggests bronchospasm, an adverse effect.
3. NGN – A client with chronic kidney disease is prescribed sevelamer. Which three
findings indicate the medication is working? (Select all that apply)
A. Serum phosphorus level decreases from 6.5 to 4.2 mg/dL
B. Calcium level remains stable
C. Patient reports less pruritus
D. Blood glucose improves
E. Serum potassium decreases
, Correct answers: A, B, C – ✓✓ Decreased serum phosphorus, stable calcium, and
less pruritus.
Rationale: Sevelamer is a phosphate binder. Therapeutic effect is lowering
phosphorus, which also reduces itching (pruritus) and prevents calcium-phosphorus
imbalances. It does not affect glucose or potassium directly.
4. A client is prescribed amoxicillin for strep throat. Which statement by the client
indicates a need for further teaching?
A. “I should take the full course even if I feel better.”
B. “I can stop the medication when my fever goes away.”
C. “I should report any rash or difficulty breathing.”
D. “I can take this medication with food to reduce stomach upset.”
Correct answer: B – ✓✓ “I can stop the medication when my fever goes away.”
Rationale: Antibiotics must be taken for the full prescribed course to prevent
resistance and ensure eradication of infection. Stopping early when symptoms
improve risks relapse.
5. A client is prescribed fentanyl patch for chronic pain. Which instruction is most
important?
A. “Apply heat to the patch site to increase effectiveness.”
B. “Change the patch every 24 hours.”
C. “Avoid exposing the patch to direct heat sources like heating pads.”
D. “Cut the patch in half if you need a lower dose.”
Correct answer: C – ✓✓ “Avoid exposing the patch to direct heat sources like
heating pads.”
Rationale: Heat increases fentanyl absorption, leading to potentially fatal
overdose. Patches are changed every 72 hours, never cut, and should not be
exposed to heat.
6. A nurse is administering IV vancomycin. The client reports flushing and a rash on
the neck and chest. Which action should the nurse take first?
A. Stop the infusion immediately
B. Slow the infusion rate
C. Administer diphenhydramine as ordered
D. Notify the provider
Correct answer: B – ✓✓ Slow the infusion rate.
Rationale: These symptoms indicate red man syndrome, a rate-related reaction to
vancomycin. Slowing the infusion often resolves symptoms. Stopping is not
necessary unless severe; diphenhydramine may be given after slowing.
,7. A client with type 2 diabetes is prescribed sitagliptin. The nurse should teach that
this medication works by:
A. Increasing insulin release from the pancreas
B. Decreasing glucose absorption from the intestines
C. Increasing incretin levels to enhance insulin secretion
D. Blocking glucose reabsorption in the kidneys
Correct answer: C – ✓✓ Increasing incretin levels to enhance insulin secretion.
Rationale: *Sitagliptin is a DPP-4 inhibitor that increases incretin hormones,
which enhance insulin secretion and reduce glucagon. It does not directly affect
intestinal absorption or kidney reabsorption.*
8. A client is prescribed lithium. Which lab value should the nurse monitor most
closely?
A. Serum calcium
B. Serum sodium
C. Serum magnesium
D. Serum creatinine
Correct answer: D – ✓✓ Serum creatinine.
Rationale: Lithium is excreted by the kidneys and can cause nephrotoxicity. Serum
creatinine is essential to monitor renal function. Sodium levels affect lithium levels
but creatinine monitors damage.
9. A client is taking warfarin and reports black, tarry stools. Which action should the
nurse take first?
A. Check the INR
B. Administer vitamin K orally
C. Hold the next dose of warfarin and notify the provider
D. Instruct the client to eat more green vegetables
Correct answer: C – ✓✓ Hold the next dose of warfarin and notify the provider.
Rationale: Black, tarry stools indicate gastrointestinal bleeding. The nurse should
hold warfarin and notify the provider immediately. Checking INR is important but
not the first action; vitamin K may be ordered later.
10. NGN – A client is receiving IV furosemide. Which three findings indicate the need
to hold the next dose? (Select all that apply)
A. Urine output 400 mL in 8 hours
B. Serum potassium 2.9 mEq/L
C. Blood pressure 85/50 mmHg
D. Weight loss of 1 kg in 24 hours
E. Dizziness when standing
Correct answers: B, C, E – ✓✓ *Hypokalemia (2.9), hypotension (85/50), and
, orthostatic dizziness.*
Rationale: *Severe hypokalemia, hypotension, and symptomatic orthostasis are
signs of excessive diuresis. Urine output 400 mL in 8 hours (50 mL/hr) is
therapeutic; weight loss of 1 kg is expected.*
11. A client is prescribed metronidazole for bacterial vaginosis. Which instruction is
most important?
A. “Take with a full glass of milk.”
B. “Avoid alcohol for at least 48 hours after finishing the medication.”
C. “This medication may turn your urine blue.”
D. “You may stop taking it once symptoms improve.”
Correct answer: B – ✓✓ “Avoid alcohol for at least 48 hours after finishing the
medication.”
Rationale: *Metronidazole causes a disulfiram-like reaction with alcohol
(flushing, vomiting, tachycardia). Alcohol must be avoided during and for 48
hours after treatment. Urine may turn dark, not blue.*
12. A client is prescribed clozapine. Which monitoring is required weekly at the start
of therapy?
A. Blood glucose
B. Absolute neutrophil count (ANC)
C. Liver function tests
D. ECG
Correct answer: B – ✓✓ Absolute neutrophil count (ANC).
Rationale: Clozapine causes agranulocytosis; ANC must be monitored weekly for
the first 6 months, then every 2 weeks. Glucose and LFTs are monitored but not
weekly.
13. A nurse is teaching a client about sublingual nitroglycerin. Which statement
indicates correct understanding?
A. “I will take one tablet every 5 minutes up to 3 doses for chest pain.”
B. “I will swallow the tablet with a sip of water.”
C. “I will store the tablets in the refrigerator.”
D. “I will take the tablet only when I am lying down.”
Correct answer: A – ✓✓ “I will take one tablet every 5 minutes up to 3 doses for
chest pain.”
Rationale: Standard dosing for sublingual nitroglycerin is one tablet every 5
minutes for up to three doses; if pain persists, call 911. Tablets are placed under the
tongue, not swallowed. Store in original container at room temperature.
EXAM 2025/2026 – 140 QUESTIONS WITH
NGN & SOLUTIONS (GRADED A+)
EXAM
1. A nurse is preparing to administer enoxaparin subcutaneously. Which action is
correct?
A. Aspirate before injecting to check for blood return
B. Insert the needle at a 15-degree angle
C. Administer into the abdomen while pinching a skinfold
D. Massage the injection site after administration
Correct answer: C – ✓✓ Administer into the abdomen while pinching a skinfold.
Rationale: *Enoxaparin is given subcutaneously into the abdomen, pinching a
skinfold to ensure proper delivery. Do not aspirate (risk of hematoma), use a 90-
degree angle, and never massage the site.*
2. A client is prescribed metoprolol succinate. Which finding indicates the
medication is effective?
A. Heart rate 110 bpm
B. Blood pressure 150/92 mmHg
C. Heart rate 65 bpm with controlled blood pressure
D. Wheezing on auscultation
Correct answer: C – ✓✓ Heart rate 65 bpm with controlled blood pressure.
Rationale: Metoprolol is a beta-blocker used for hypertension and heart failure.
Therapeutic effect includes lowered heart rate and blood pressure. Wheezing
suggests bronchospasm, an adverse effect.
3. NGN – A client with chronic kidney disease is prescribed sevelamer. Which three
findings indicate the medication is working? (Select all that apply)
A. Serum phosphorus level decreases from 6.5 to 4.2 mg/dL
B. Calcium level remains stable
C. Patient reports less pruritus
D. Blood glucose improves
E. Serum potassium decreases
, Correct answers: A, B, C – ✓✓ Decreased serum phosphorus, stable calcium, and
less pruritus.
Rationale: Sevelamer is a phosphate binder. Therapeutic effect is lowering
phosphorus, which also reduces itching (pruritus) and prevents calcium-phosphorus
imbalances. It does not affect glucose or potassium directly.
4. A client is prescribed amoxicillin for strep throat. Which statement by the client
indicates a need for further teaching?
A. “I should take the full course even if I feel better.”
B. “I can stop the medication when my fever goes away.”
C. “I should report any rash or difficulty breathing.”
D. “I can take this medication with food to reduce stomach upset.”
Correct answer: B – ✓✓ “I can stop the medication when my fever goes away.”
Rationale: Antibiotics must be taken for the full prescribed course to prevent
resistance and ensure eradication of infection. Stopping early when symptoms
improve risks relapse.
5. A client is prescribed fentanyl patch for chronic pain. Which instruction is most
important?
A. “Apply heat to the patch site to increase effectiveness.”
B. “Change the patch every 24 hours.”
C. “Avoid exposing the patch to direct heat sources like heating pads.”
D. “Cut the patch in half if you need a lower dose.”
Correct answer: C – ✓✓ “Avoid exposing the patch to direct heat sources like
heating pads.”
Rationale: Heat increases fentanyl absorption, leading to potentially fatal
overdose. Patches are changed every 72 hours, never cut, and should not be
exposed to heat.
6. A nurse is administering IV vancomycin. The client reports flushing and a rash on
the neck and chest. Which action should the nurse take first?
A. Stop the infusion immediately
B. Slow the infusion rate
C. Administer diphenhydramine as ordered
D. Notify the provider
Correct answer: B – ✓✓ Slow the infusion rate.
Rationale: These symptoms indicate red man syndrome, a rate-related reaction to
vancomycin. Slowing the infusion often resolves symptoms. Stopping is not
necessary unless severe; diphenhydramine may be given after slowing.
,7. A client with type 2 diabetes is prescribed sitagliptin. The nurse should teach that
this medication works by:
A. Increasing insulin release from the pancreas
B. Decreasing glucose absorption from the intestines
C. Increasing incretin levels to enhance insulin secretion
D. Blocking glucose reabsorption in the kidneys
Correct answer: C – ✓✓ Increasing incretin levels to enhance insulin secretion.
Rationale: *Sitagliptin is a DPP-4 inhibitor that increases incretin hormones,
which enhance insulin secretion and reduce glucagon. It does not directly affect
intestinal absorption or kidney reabsorption.*
8. A client is prescribed lithium. Which lab value should the nurse monitor most
closely?
A. Serum calcium
B. Serum sodium
C. Serum magnesium
D. Serum creatinine
Correct answer: D – ✓✓ Serum creatinine.
Rationale: Lithium is excreted by the kidneys and can cause nephrotoxicity. Serum
creatinine is essential to monitor renal function. Sodium levels affect lithium levels
but creatinine monitors damage.
9. A client is taking warfarin and reports black, tarry stools. Which action should the
nurse take first?
A. Check the INR
B. Administer vitamin K orally
C. Hold the next dose of warfarin and notify the provider
D. Instruct the client to eat more green vegetables
Correct answer: C – ✓✓ Hold the next dose of warfarin and notify the provider.
Rationale: Black, tarry stools indicate gastrointestinal bleeding. The nurse should
hold warfarin and notify the provider immediately. Checking INR is important but
not the first action; vitamin K may be ordered later.
10. NGN – A client is receiving IV furosemide. Which three findings indicate the need
to hold the next dose? (Select all that apply)
A. Urine output 400 mL in 8 hours
B. Serum potassium 2.9 mEq/L
C. Blood pressure 85/50 mmHg
D. Weight loss of 1 kg in 24 hours
E. Dizziness when standing
Correct answers: B, C, E – ✓✓ *Hypokalemia (2.9), hypotension (85/50), and
, orthostatic dizziness.*
Rationale: *Severe hypokalemia, hypotension, and symptomatic orthostasis are
signs of excessive diuresis. Urine output 400 mL in 8 hours (50 mL/hr) is
therapeutic; weight loss of 1 kg is expected.*
11. A client is prescribed metronidazole for bacterial vaginosis. Which instruction is
most important?
A. “Take with a full glass of milk.”
B. “Avoid alcohol for at least 48 hours after finishing the medication.”
C. “This medication may turn your urine blue.”
D. “You may stop taking it once symptoms improve.”
Correct answer: B – ✓✓ “Avoid alcohol for at least 48 hours after finishing the
medication.”
Rationale: *Metronidazole causes a disulfiram-like reaction with alcohol
(flushing, vomiting, tachycardia). Alcohol must be avoided during and for 48
hours after treatment. Urine may turn dark, not blue.*
12. A client is prescribed clozapine. Which monitoring is required weekly at the start
of therapy?
A. Blood glucose
B. Absolute neutrophil count (ANC)
C. Liver function tests
D. ECG
Correct answer: B – ✓✓ Absolute neutrophil count (ANC).
Rationale: Clozapine causes agranulocytosis; ANC must be monitored weekly for
the first 6 months, then every 2 weeks. Glucose and LFTs are monitored but not
weekly.
13. A nurse is teaching a client about sublingual nitroglycerin. Which statement
indicates correct understanding?
A. “I will take one tablet every 5 minutes up to 3 doses for chest pain.”
B. “I will swallow the tablet with a sip of water.”
C. “I will store the tablets in the refrigerator.”
D. “I will take the tablet only when I am lying down.”
Correct answer: A – ✓✓ “I will take one tablet every 5 minutes up to 3 doses for
chest pain.”
Rationale: Standard dosing for sublingual nitroglycerin is one tablet every 5
minutes for up to three doses; if pain persists, call 911. Tablets are placed under the
tongue, not swallowed. Store in original container at room temperature.
