2023 ATI PHARMACOLOGY PRACTICE
1. Which assessment is most important for the nurse to monitor in a client receiving metoprolol?
A. Serum uric acid only
B. Peak expiratory flow only
C. Heart rate, blood pressure, and signs of worsening heart failure
D. INR before meals
Correct Answer: C. Heart rate, blood pressure, and signs of worsening heart failure
Rationale: Heart rate, blood pressure, and signs of worsening heart failure is directly related to the major
therapeutic and safety considerations for metoprolol.
2. A nurse discovers that a client received the wrong dose of a medication. What is the nurse's first action?
A. Complete an incident report before seeing the client.
B. Call the pharmacy before assessing the client.
C. Wait to see whether symptoms develop.
D. Assess the client for effects of the medication error.
Correct Answer: D. Assess the client for effects of the medication error.
Rationale: Client safety comes first. After assessment and needed interventions, the nurse follows notification,
documentation, and reporting procedures.
3. Which assessment is most important for the nurse to monitor in a client receiving sublingual
nitroglycerin?
A. Serum lithium level
B. INR
C. Serum TSH
D. Chest pain response and blood pressure
Correct Answer: D. Chest pain response and blood pressure
Rationale: Chest pain response and blood pressure is directly related to the major therapeutic and safety
considerations for sublingual nitroglycerin.
4. Which finding best indicates that lithium is having the intended therapeutic effect?
A. Rapid relief of acute bronchospasm
B. Fewer manic episodes and improved mood stability
C. Lower fasting LDL
D. Resolution of heartburn after meals
Correct Answer: B. Fewer manic episodes and improved mood stability
Rationale: Fewer manic episodes and improved mood stability is the expected therapeutic outcome of lithium for
its intended use. The other findings reflect effects of unrelated therapies.
5. Which client statement shows correct understanding of teaching about gentamicin?
A. I can share leftover medication with a family member who has similar symptoms.
B. I will report ringing in my ears, hearing changes, balance problems, or reduced urine output.
C. I will crush any extended-release tablet if it is difficult to swallow.
D. I can take herbal supplements without checking for interactions.
Correct Answer: B. I will report ringing in my ears, hearing changes, balance problems, or reduced urine output.
Rationale: This statement reflects an important safety or adherence principle for gentamicin. The other
statements could increase the risk of treatment failure, interaction, or medication-related harm.
6. Which action best supports safe medication use in a client who may become pregnant while taking a
potentially teratogenic drug?
A. Stop all medications without medical advice before each menstrual period.
B. Use only herbal alternatives during pregnancy planning.
C. Delay pregnancy testing until symptoms of pregnancy occur.
D. Discuss pregnancy prevention requirements and the need to contact the prescriber before conception.
Correct Answer: D. Discuss pregnancy prevention requirements and the need to contact the prescriber before
conception.
Rationale: For teratogenic medications, pregnancy prevention and preconception planning are key safety
measures.
,7. The nurse plans ongoing monitoring for a client taking lisinopril. Which assessment is most important?
A. INR and aPTT
B. Blood pressure, serum potassium, and renal function
C. Peak expiratory flow only
D. Serum amylase
Correct Answer: B. Blood pressure, serum potassium, and renal function
Rationale: Blood pressure, serum potassium, and renal function is directly related to the major therapeutic and
safety considerations for lisinopril.
8. Which client outcome is most consistent with the expected therapeutic action of methimazole?
A. Rapid bronchodilation
B. Correction of anemia
C. Lower gastric acid output
D. Reduced hyperthyroid symptoms with thyroid hormone levels moving toward target
Correct Answer: D. Reduced hyperthyroid symptoms with thyroid hormone levels moving toward target
Rationale: Reduced hyperthyroid symptoms with thyroid hormone levels moving toward target is the expected
therapeutic outcome of methimazole for its intended use. The other findings reflect effects of unrelated therapies.
9. The nurse provides discharge teaching about phenytoin. Which statement indicates that the teaching was
effective?
A. If I develop a new rash, I will wait a week before reporting it.
B. Alcohol is safe as long as I take it several hours after the medication.
C. I can skip follow-up laboratory testing when I am feeling well.
D. I will perform good oral hygiene and will not stop the medication suddenly.
Correct Answer: D. I will perform good oral hygiene and will not stop the medication suddenly.
Rationale: This statement reflects an important safety or adherence principle for phenytoin. The other statements
could increase the risk of treatment failure, interaction, or medication-related harm.
10. A medication has a half-life of 8 hr. If 100 mg is present in the body, approximately how much remains
after 16 hr?
A. 25 mg
B. 12.5 mg
C. 50 mg
D. 75 mg
Correct Answer: A. 25 mg
Rationale: After one half-life, 50 mg remains. After a second half-life, 25 mg remains.
11. A heparin infusion contains 25,000 units in 500 mL. The prescription is 1,200 units/hr. What pump rate
should the nurse use? 25,000 units Heparin 500 mL Volume 1,200 units/hr Ordered rate
A. 24 mL/hr
B. 12 mL/hr
C. 50 mL/hr
D. 60 mL/hr
Correct Answer: A. 24 mL/hr
Rationale: 25,000 units / 500 mL = 50 units/mL. 1,200 units/hr / 50 units/mL = 24 mL/hr.
12. The nurse plans ongoing monitoring for a client taking methylphenidate. Which assessment is most
important?
A. Blood pressure, heart rate, appetite, weight, and growth in children
B. INR and fibrinogen
C. Serum bilirubin only
D. Peak expiratory flow as the main test
Correct Answer: A. Blood pressure, heart rate, appetite, weight, and growth in children
Rationale: Blood pressure, heart rate, appetite, weight, and growth in children is directly related to the major
therapeutic and safety considerations for methylphenidate.
13. The nurse provides discharge teaching about metformin. Which statement indicates that the teaching
was effective?
A. I will double the next dose if I forget a dose.
B. I can stop the medication as soon as I feel better.
,C. I do not need to mention over-the-counter products to my provider.
D. I will take the medication with meals and follow instructions about kidney testing and temporary holds around
some contrast studies.
Correct Answer: D. I will take the medication with meals and follow instructions about kidney testing and
temporary holds around some contrast studies.
Rationale: This statement reflects an important safety or adherence principle for metformin. The other statements
could increase the risk of treatment failure, interaction, or medication-related harm.
14. A client has been prescribed ibuprofen. Which new finding should the nurse report promptly?
A. Mild dyspepsia
B. Mild nausea
C. Black, tarry stool with a rising serum creatinine
D. Reduced inflammatory pain
Correct Answer: C. Black, tarry stool with a rising serum creatinine
Rationale: Black, tarry stool with a rising serum creatinine can indicate a serious adverse effect or toxicity
associated with ibuprofen and requires prompt evaluation. The other findings are expected or less urgent in the
context given.
15. Before and during therapy with carbidopa-levodopa, which parameter is most important to evaluate?
A. INR every morning
B. Serum amylase after each dose
C. Peak expiratory flow before meals
D. Mobility, dyskinesias, blood pressure, and mental status
Correct Answer: D. Mobility, dyskinesias, blood pressure, and mental status
Rationale: Mobility, dyskinesias, blood pressure, and mental status is directly related to the major therapeutic and
safety considerations for carbidopa-levodopa.
16. Which client statement shows correct understanding of teaching about regular insulin?
A. I will match insulin timing with meals as instructed and carry a fast-acting glucose source.
B. If symptoms worsen, I will take an extra dose without contacting the prescriber.
C. I can keep expired medication for emergencies.
D. I only need to take the medication on days when symptoms are severe.
Correct Answer: A. I will match insulin timing with meals as instructed and carry a fast-acting glucose source.
Rationale: This statement reflects an important safety or adherence principle for regular insulin. The other
statements could increase the risk of treatment failure, interaction, or medication-related harm.
17. The nurse evaluates a client after administration of vancomycin. Which finding is most concerning?
A. Mild infusion-site irritation
B. Mild nausea
C. Stable hearing
D. Rapid creatinine rise with reduced urine output
Correct Answer: D. Rapid creatinine rise with reduced urine output
Rationale: Rapid creatinine rise with reduced urine output can indicate a serious adverse effect or toxicity
associated with vancomycin and requires prompt evaluation. The other findings are expected or less urgent in the
context given.
18. A nurse is reinforcing teaching for a client who is starting amlodipine. Which statement by the client
indicates understanding?
A. If I develop a new rash, I will wait a week before reporting it.
B. Alcohol is safe as long as I take it several hours after the medication.
C. I will rise slowly and report swelling that becomes severe or is associated with shortness of breath.
D. I can skip follow-up laboratory testing when I am feeling well.
Correct Answer: C. I will rise slowly and report swelling that becomes severe or is associated with shortness of
breath.
Rationale: This statement reflects an important safety or adherence principle for amlodipine. The other
statements could increase the risk of treatment failure, interaction, or medication-related harm.
19. A nurse is reviewing monitoring needs for ipratropium. Which assessment should receive priority?
A. Serum INR
B. Respiratory status and anticholinergic adverse effects such as urinary retention
, C. Thyroid-stimulating hormone
D. Serum lithium concentration
Correct Answer: B. Respiratory status and anticholinergic adverse effects such as urinary retention
Rationale: Respiratory status and anticholinergic adverse effects such as urinary retention is directly related to
the major therapeutic and safety considerations for ipratropium.
20. An older adult who takes several medications reports new dizziness when standing. Which nursing
action is the priority?
A. Encourage the client to stop all medications until the next appointment.
B. Assume the symptom is a normal part of aging.
C. Recommend taking all medications at bedtime without review.
D. Assess orthostatic vital signs and review the medication list for drugs that can lower blood pressure.
Correct Answer: D. Assess orthostatic vital signs and review the medication list for drugs that can lower blood
pressure.
Rationale: Older adults are at increased risk for medication-related orthostatic hypotension and falls. Assessment
and medication review are appropriate first steps.
21. The nurse reviews the response to prednisone. Which finding demonstrates the desired effect?
A. Immediate correction of hypothyroidism
B. Increased platelet aggregation
C. Reduced inflammation and immune-mediated symptoms
D. Lower LDL as the primary effect
Correct Answer: C. Reduced inflammation and immune-mediated symptoms
Rationale: Reduced inflammation and immune-mediated symptoms is the expected therapeutic outcome of
prednisone for its intended use. The other findings reflect effects of unrelated therapies.
22. The nurse evaluates a client after administration of inhaled fluticasone. Which finding is most
concerning?
A. Mild hoarseness
B. White oral plaques with painful swallowing
C. Throat irritation
D. Cough after inhalation
Correct Answer: B. White oral plaques with painful swallowing
Rationale: White oral plaques with painful swallowing can indicate a serious adverse effect or toxicity associated
with inhaled fluticasone and requires prompt evaluation. The other findings are expected or less urgent in the
context given.
23. Which assessment is most important for the nurse to monitor in a client receiving morphine?
A. Serum TSH
B. Respiratory rate, sedation, blood pressure, pain, and bowel function
C. Peak expiratory flow as the main opioid test
D. INR for routine dosing
Correct Answer: B. Respiratory rate, sedation, blood pressure, pain, and bowel function
Rationale: Respiratory rate, sedation, blood pressure, pain, and bowel function is directly related to the major
therapeutic and safety considerations for morphine.
24. Which change would best support that therapy with hydrochlorothiazide is effective?
A. Immediate relief of acute psychosis
B. Lower blood pressure and less fluid retention
C. Rapid reversal of opioid toxicity
D. Increased thyroid hormone production
Correct Answer: B. Lower blood pressure and less fluid retention
Rationale: Lower blood pressure and less fluid retention is the expected therapeutic outcome of
hydrochlorothiazide for its intended use. The other findings reflect effects of unrelated therapies.
25. A nurse sees an insulin order written as "regular insulin 8 U subcut." Which action is best?
A. Interpret U as mL.
B. Administer 80 units because U resembles a zero.
C. Rewrite the order as 8.0 U.
D. Clarify the order and use the word "units" rather than the error-prone abbreviation "U."
1. Which assessment is most important for the nurse to monitor in a client receiving metoprolol?
A. Serum uric acid only
B. Peak expiratory flow only
C. Heart rate, blood pressure, and signs of worsening heart failure
D. INR before meals
Correct Answer: C. Heart rate, blood pressure, and signs of worsening heart failure
Rationale: Heart rate, blood pressure, and signs of worsening heart failure is directly related to the major
therapeutic and safety considerations for metoprolol.
2. A nurse discovers that a client received the wrong dose of a medication. What is the nurse's first action?
A. Complete an incident report before seeing the client.
B. Call the pharmacy before assessing the client.
C. Wait to see whether symptoms develop.
D. Assess the client for effects of the medication error.
Correct Answer: D. Assess the client for effects of the medication error.
Rationale: Client safety comes first. After assessment and needed interventions, the nurse follows notification,
documentation, and reporting procedures.
3. Which assessment is most important for the nurse to monitor in a client receiving sublingual
nitroglycerin?
A. Serum lithium level
B. INR
C. Serum TSH
D. Chest pain response and blood pressure
Correct Answer: D. Chest pain response and blood pressure
Rationale: Chest pain response and blood pressure is directly related to the major therapeutic and safety
considerations for sublingual nitroglycerin.
4. Which finding best indicates that lithium is having the intended therapeutic effect?
A. Rapid relief of acute bronchospasm
B. Fewer manic episodes and improved mood stability
C. Lower fasting LDL
D. Resolution of heartburn after meals
Correct Answer: B. Fewer manic episodes and improved mood stability
Rationale: Fewer manic episodes and improved mood stability is the expected therapeutic outcome of lithium for
its intended use. The other findings reflect effects of unrelated therapies.
5. Which client statement shows correct understanding of teaching about gentamicin?
A. I can share leftover medication with a family member who has similar symptoms.
B. I will report ringing in my ears, hearing changes, balance problems, or reduced urine output.
C. I will crush any extended-release tablet if it is difficult to swallow.
D. I can take herbal supplements without checking for interactions.
Correct Answer: B. I will report ringing in my ears, hearing changes, balance problems, or reduced urine output.
Rationale: This statement reflects an important safety or adherence principle for gentamicin. The other
statements could increase the risk of treatment failure, interaction, or medication-related harm.
6. Which action best supports safe medication use in a client who may become pregnant while taking a
potentially teratogenic drug?
A. Stop all medications without medical advice before each menstrual period.
B. Use only herbal alternatives during pregnancy planning.
C. Delay pregnancy testing until symptoms of pregnancy occur.
D. Discuss pregnancy prevention requirements and the need to contact the prescriber before conception.
Correct Answer: D. Discuss pregnancy prevention requirements and the need to contact the prescriber before
conception.
Rationale: For teratogenic medications, pregnancy prevention and preconception planning are key safety
measures.
,7. The nurse plans ongoing monitoring for a client taking lisinopril. Which assessment is most important?
A. INR and aPTT
B. Blood pressure, serum potassium, and renal function
C. Peak expiratory flow only
D. Serum amylase
Correct Answer: B. Blood pressure, serum potassium, and renal function
Rationale: Blood pressure, serum potassium, and renal function is directly related to the major therapeutic and
safety considerations for lisinopril.
8. Which client outcome is most consistent with the expected therapeutic action of methimazole?
A. Rapid bronchodilation
B. Correction of anemia
C. Lower gastric acid output
D. Reduced hyperthyroid symptoms with thyroid hormone levels moving toward target
Correct Answer: D. Reduced hyperthyroid symptoms with thyroid hormone levels moving toward target
Rationale: Reduced hyperthyroid symptoms with thyroid hormone levels moving toward target is the expected
therapeutic outcome of methimazole for its intended use. The other findings reflect effects of unrelated therapies.
9. The nurse provides discharge teaching about phenytoin. Which statement indicates that the teaching was
effective?
A. If I develop a new rash, I will wait a week before reporting it.
B. Alcohol is safe as long as I take it several hours after the medication.
C. I can skip follow-up laboratory testing when I am feeling well.
D. I will perform good oral hygiene and will not stop the medication suddenly.
Correct Answer: D. I will perform good oral hygiene and will not stop the medication suddenly.
Rationale: This statement reflects an important safety or adherence principle for phenytoin. The other statements
could increase the risk of treatment failure, interaction, or medication-related harm.
10. A medication has a half-life of 8 hr. If 100 mg is present in the body, approximately how much remains
after 16 hr?
A. 25 mg
B. 12.5 mg
C. 50 mg
D. 75 mg
Correct Answer: A. 25 mg
Rationale: After one half-life, 50 mg remains. After a second half-life, 25 mg remains.
11. A heparin infusion contains 25,000 units in 500 mL. The prescription is 1,200 units/hr. What pump rate
should the nurse use? 25,000 units Heparin 500 mL Volume 1,200 units/hr Ordered rate
A. 24 mL/hr
B. 12 mL/hr
C. 50 mL/hr
D. 60 mL/hr
Correct Answer: A. 24 mL/hr
Rationale: 25,000 units / 500 mL = 50 units/mL. 1,200 units/hr / 50 units/mL = 24 mL/hr.
12. The nurse plans ongoing monitoring for a client taking methylphenidate. Which assessment is most
important?
A. Blood pressure, heart rate, appetite, weight, and growth in children
B. INR and fibrinogen
C. Serum bilirubin only
D. Peak expiratory flow as the main test
Correct Answer: A. Blood pressure, heart rate, appetite, weight, and growth in children
Rationale: Blood pressure, heart rate, appetite, weight, and growth in children is directly related to the major
therapeutic and safety considerations for methylphenidate.
13. The nurse provides discharge teaching about metformin. Which statement indicates that the teaching
was effective?
A. I will double the next dose if I forget a dose.
B. I can stop the medication as soon as I feel better.
,C. I do not need to mention over-the-counter products to my provider.
D. I will take the medication with meals and follow instructions about kidney testing and temporary holds around
some contrast studies.
Correct Answer: D. I will take the medication with meals and follow instructions about kidney testing and
temporary holds around some contrast studies.
Rationale: This statement reflects an important safety or adherence principle for metformin. The other statements
could increase the risk of treatment failure, interaction, or medication-related harm.
14. A client has been prescribed ibuprofen. Which new finding should the nurse report promptly?
A. Mild dyspepsia
B. Mild nausea
C. Black, tarry stool with a rising serum creatinine
D. Reduced inflammatory pain
Correct Answer: C. Black, tarry stool with a rising serum creatinine
Rationale: Black, tarry stool with a rising serum creatinine can indicate a serious adverse effect or toxicity
associated with ibuprofen and requires prompt evaluation. The other findings are expected or less urgent in the
context given.
15. Before and during therapy with carbidopa-levodopa, which parameter is most important to evaluate?
A. INR every morning
B. Serum amylase after each dose
C. Peak expiratory flow before meals
D. Mobility, dyskinesias, blood pressure, and mental status
Correct Answer: D. Mobility, dyskinesias, blood pressure, and mental status
Rationale: Mobility, dyskinesias, blood pressure, and mental status is directly related to the major therapeutic and
safety considerations for carbidopa-levodopa.
16. Which client statement shows correct understanding of teaching about regular insulin?
A. I will match insulin timing with meals as instructed and carry a fast-acting glucose source.
B. If symptoms worsen, I will take an extra dose without contacting the prescriber.
C. I can keep expired medication for emergencies.
D. I only need to take the medication on days when symptoms are severe.
Correct Answer: A. I will match insulin timing with meals as instructed and carry a fast-acting glucose source.
Rationale: This statement reflects an important safety or adherence principle for regular insulin. The other
statements could increase the risk of treatment failure, interaction, or medication-related harm.
17. The nurse evaluates a client after administration of vancomycin. Which finding is most concerning?
A. Mild infusion-site irritation
B. Mild nausea
C. Stable hearing
D. Rapid creatinine rise with reduced urine output
Correct Answer: D. Rapid creatinine rise with reduced urine output
Rationale: Rapid creatinine rise with reduced urine output can indicate a serious adverse effect or toxicity
associated with vancomycin and requires prompt evaluation. The other findings are expected or less urgent in the
context given.
18. A nurse is reinforcing teaching for a client who is starting amlodipine. Which statement by the client
indicates understanding?
A. If I develop a new rash, I will wait a week before reporting it.
B. Alcohol is safe as long as I take it several hours after the medication.
C. I will rise slowly and report swelling that becomes severe or is associated with shortness of breath.
D. I can skip follow-up laboratory testing when I am feeling well.
Correct Answer: C. I will rise slowly and report swelling that becomes severe or is associated with shortness of
breath.
Rationale: This statement reflects an important safety or adherence principle for amlodipine. The other
statements could increase the risk of treatment failure, interaction, or medication-related harm.
19. A nurse is reviewing monitoring needs for ipratropium. Which assessment should receive priority?
A. Serum INR
B. Respiratory status and anticholinergic adverse effects such as urinary retention
, C. Thyroid-stimulating hormone
D. Serum lithium concentration
Correct Answer: B. Respiratory status and anticholinergic adverse effects such as urinary retention
Rationale: Respiratory status and anticholinergic adverse effects such as urinary retention is directly related to
the major therapeutic and safety considerations for ipratropium.
20. An older adult who takes several medications reports new dizziness when standing. Which nursing
action is the priority?
A. Encourage the client to stop all medications until the next appointment.
B. Assume the symptom is a normal part of aging.
C. Recommend taking all medications at bedtime without review.
D. Assess orthostatic vital signs and review the medication list for drugs that can lower blood pressure.
Correct Answer: D. Assess orthostatic vital signs and review the medication list for drugs that can lower blood
pressure.
Rationale: Older adults are at increased risk for medication-related orthostatic hypotension and falls. Assessment
and medication review are appropriate first steps.
21. The nurse reviews the response to prednisone. Which finding demonstrates the desired effect?
A. Immediate correction of hypothyroidism
B. Increased platelet aggregation
C. Reduced inflammation and immune-mediated symptoms
D. Lower LDL as the primary effect
Correct Answer: C. Reduced inflammation and immune-mediated symptoms
Rationale: Reduced inflammation and immune-mediated symptoms is the expected therapeutic outcome of
prednisone for its intended use. The other findings reflect effects of unrelated therapies.
22. The nurse evaluates a client after administration of inhaled fluticasone. Which finding is most
concerning?
A. Mild hoarseness
B. White oral plaques with painful swallowing
C. Throat irritation
D. Cough after inhalation
Correct Answer: B. White oral plaques with painful swallowing
Rationale: White oral plaques with painful swallowing can indicate a serious adverse effect or toxicity associated
with inhaled fluticasone and requires prompt evaluation. The other findings are expected or less urgent in the
context given.
23. Which assessment is most important for the nurse to monitor in a client receiving morphine?
A. Serum TSH
B. Respiratory rate, sedation, blood pressure, pain, and bowel function
C. Peak expiratory flow as the main opioid test
D. INR for routine dosing
Correct Answer: B. Respiratory rate, sedation, blood pressure, pain, and bowel function
Rationale: Respiratory rate, sedation, blood pressure, pain, and bowel function is directly related to the major
therapeutic and safety considerations for morphine.
24. Which change would best support that therapy with hydrochlorothiazide is effective?
A. Immediate relief of acute psychosis
B. Lower blood pressure and less fluid retention
C. Rapid reversal of opioid toxicity
D. Increased thyroid hormone production
Correct Answer: B. Lower blood pressure and less fluid retention
Rationale: Lower blood pressure and less fluid retention is the expected therapeutic outcome of
hydrochlorothiazide for its intended use. The other findings reflect effects of unrelated therapies.
25. A nurse sees an insulin order written as "regular insulin 8 U subcut." Which action is best?
A. Interpret U as mL.
B. Administer 80 units because U resembles a zero.
C. Rewrite the order as 8.0 U.
D. Clarify the order and use the word "units" rather than the error-prone abbreviation "U."
