2026 ATI RN PHARMACOLOGY PROCTORED
EXAM STUDY GUIDE | ACTUAL-STYLE, RETAKE
AND CMS REVIEW | 70 NGN SCREENSHOT
QUESTIONS WITH ANSWERS AND RATIONALES
2026 ATI RN Pharmacology Practice Bank
Section 1 — Questions 1–10 of 70
Topics: Medication safety, adverse drug reactions, nursing interventions,
patient education, and dosage calculations.
Question 1 — Digoxin safety
A nurse is preparing to administer digoxin to an adult patient with heart
failure. The patient's apical pulse is 54 beats/min. What should the
nurse do first?
A. Administer the medication with food. B. Withhold the medication
and assess the patient according to the prescription and facility
protocol. C. Administer half the prescribed dose. D. Encourage the
patient to ambulate before administration.
Correct answer: B. Withhold the medication and assess the patient
according to the prescription and facility protocol.
Rationale: Digoxin can slow the heart rate. A pulse of 54 beats/min may
indicate clinically significant bradycardia. The nurse should withhold the
dose when indicated by the order or protocol, assess the patient, and
,contact the prescribing clinician as appropriate. The nurse should not
independently reduce the dose.
Question 2 — Warfarin and bleeding
A patient taking warfarin reports black, tarry stools and dizziness. Which
action should the nurse take?
A. Reassure the patient that this is an expected effect. B. Recommend
increasing dietary vitamin K without further assessment. C. Arrange
urgent assessment for possible gastrointestinal bleeding. D. Tell the
patient to take the next dose with milk.
Correct answer: C. Arrange urgent assessment for possible
gastrointestinal bleeding.
Rationale: Black, tarry stools can indicate gastrointestinal bleeding, and
dizziness may signal blood loss. This combination requires urgent
evaluation. The nurse should assess the patient's condition, notify the
appropriate clinician, and facilitate emergency care if instability is
suspected.
Question 3 — Rapid-acting insulin
A nurse is preparing to administer insulin lispro before breakfast. The
meal tray has not arrived. What is the most appropriate action?
A. Coordinate administration with meal availability according to the
prescription and facility protocol. B. Administer the insulin and tell the
patient to eat when the tray arrives. C. Substitute long-acting insulin at
the same dose. D. Hold all insulin for the rest of the day.
Correct answer: A. Coordinate administration with meal availability
according to the prescription and facility protocol.
,Rationale: Insulin lispro is rapid acting and is generally administered
close to mealtime. Giving it without timely food intake can cause
hypoglycemia. The nurse should coordinate with dietary services and
follow the prescribed timing and institutional policy rather than
independently changing the insulin regimen.
Question 4 — ACE inhibitor emergency
A patient taking lisinopril develops swelling of the lips and tongue and
has difficulty breathing. What should the nurse do first?
A. Offer oral fluids and reassess in 30 minutes. B. Document the findings
and continue routine monitoring. C. Administer the next scheduled
dose to prevent rebound hypertension. D. Activate emergency
assistance and support the patient's airway and breathing.
Correct answer: D. Activate emergency assistance and support the
patient's airway and breathing.
Rationale: Lip and tongue swelling with breathing difficulty may
indicate angioedema, a potentially life-threatening reaction to an ACE
inhibitor. The nurse should activate emergency care, prioritize airway
and breathing, and withhold further lisinopril pending urgent clinical
evaluation.
Question 5 — Loop diuretic adverse effect
A patient receiving furosemide reports muscle weakness. The serum
potassium level is 2.9 mEq/L. Which interpretation is most appropriate?
A. The potassium level is expected and needs no follow-up. B. The
patient has significant hypokalemia requiring prompt assessment and
management. C. The patient is experiencing hyperkalemia. D. The nurse
, should encourage the patient to restrict all dietary potassium
permanently.
Correct answer: B. The patient has significant hypokalemia requiring
prompt assessment and management.
Rationale: Furosemide increases potassium excretion. A potassium level
of 2.9 mEq/L is low and can contribute to weakness and potentially
dangerous cardiac dysrhythmias. The nurse should promptly notify the
clinician, assess cardiac status as indicated, and implement prescribed
electrolyte replacement and monitoring.
Question 6 — Nitroglycerin education
A patient prescribed sublingual nitroglycerin for angina asks how to take
it when chest pain begins. Which instruction is most appropriate?
A. Stand up and walk around while waiting for relief. B. Take it with a
medication for erectile dysfunction to improve circulation. C. Sit down,
follow the prescribed emergency instructions, and seek emergency help
for persistent or worsening chest pain. D. Swallow the tablet whole with
a full glass of water.
Correct answer: C. Sit down, follow the prescribed emergency
instructions, and seek emergency help for persistent or worsening chest
pain.
Rationale: Nitroglycerin can lower blood pressure and cause dizziness,
so sitting down reduces the risk of falls. Sublingual tablets should
dissolve under the tongue rather than be swallowed whole. Patients
should follow their prescribed emergency plan and seek emergency
help for persistent or worsening symptoms. Nitroglycerin must not be
EXAM STUDY GUIDE | ACTUAL-STYLE, RETAKE
AND CMS REVIEW | 70 NGN SCREENSHOT
QUESTIONS WITH ANSWERS AND RATIONALES
2026 ATI RN Pharmacology Practice Bank
Section 1 — Questions 1–10 of 70
Topics: Medication safety, adverse drug reactions, nursing interventions,
patient education, and dosage calculations.
Question 1 — Digoxin safety
A nurse is preparing to administer digoxin to an adult patient with heart
failure. The patient's apical pulse is 54 beats/min. What should the
nurse do first?
A. Administer the medication with food. B. Withhold the medication
and assess the patient according to the prescription and facility
protocol. C. Administer half the prescribed dose. D. Encourage the
patient to ambulate before administration.
Correct answer: B. Withhold the medication and assess the patient
according to the prescription and facility protocol.
Rationale: Digoxin can slow the heart rate. A pulse of 54 beats/min may
indicate clinically significant bradycardia. The nurse should withhold the
dose when indicated by the order or protocol, assess the patient, and
,contact the prescribing clinician as appropriate. The nurse should not
independently reduce the dose.
Question 2 — Warfarin and bleeding
A patient taking warfarin reports black, tarry stools and dizziness. Which
action should the nurse take?
A. Reassure the patient that this is an expected effect. B. Recommend
increasing dietary vitamin K without further assessment. C. Arrange
urgent assessment for possible gastrointestinal bleeding. D. Tell the
patient to take the next dose with milk.
Correct answer: C. Arrange urgent assessment for possible
gastrointestinal bleeding.
Rationale: Black, tarry stools can indicate gastrointestinal bleeding, and
dizziness may signal blood loss. This combination requires urgent
evaluation. The nurse should assess the patient's condition, notify the
appropriate clinician, and facilitate emergency care if instability is
suspected.
Question 3 — Rapid-acting insulin
A nurse is preparing to administer insulin lispro before breakfast. The
meal tray has not arrived. What is the most appropriate action?
A. Coordinate administration with meal availability according to the
prescription and facility protocol. B. Administer the insulin and tell the
patient to eat when the tray arrives. C. Substitute long-acting insulin at
the same dose. D. Hold all insulin for the rest of the day.
Correct answer: A. Coordinate administration with meal availability
according to the prescription and facility protocol.
,Rationale: Insulin lispro is rapid acting and is generally administered
close to mealtime. Giving it without timely food intake can cause
hypoglycemia. The nurse should coordinate with dietary services and
follow the prescribed timing and institutional policy rather than
independently changing the insulin regimen.
Question 4 — ACE inhibitor emergency
A patient taking lisinopril develops swelling of the lips and tongue and
has difficulty breathing. What should the nurse do first?
A. Offer oral fluids and reassess in 30 minutes. B. Document the findings
and continue routine monitoring. C. Administer the next scheduled
dose to prevent rebound hypertension. D. Activate emergency
assistance and support the patient's airway and breathing.
Correct answer: D. Activate emergency assistance and support the
patient's airway and breathing.
Rationale: Lip and tongue swelling with breathing difficulty may
indicate angioedema, a potentially life-threatening reaction to an ACE
inhibitor. The nurse should activate emergency care, prioritize airway
and breathing, and withhold further lisinopril pending urgent clinical
evaluation.
Question 5 — Loop diuretic adverse effect
A patient receiving furosemide reports muscle weakness. The serum
potassium level is 2.9 mEq/L. Which interpretation is most appropriate?
A. The potassium level is expected and needs no follow-up. B. The
patient has significant hypokalemia requiring prompt assessment and
management. C. The patient is experiencing hyperkalemia. D. The nurse
, should encourage the patient to restrict all dietary potassium
permanently.
Correct answer: B. The patient has significant hypokalemia requiring
prompt assessment and management.
Rationale: Furosemide increases potassium excretion. A potassium level
of 2.9 mEq/L is low and can contribute to weakness and potentially
dangerous cardiac dysrhythmias. The nurse should promptly notify the
clinician, assess cardiac status as indicated, and implement prescribed
electrolyte replacement and monitoring.
Question 6 — Nitroglycerin education
A patient prescribed sublingual nitroglycerin for angina asks how to take
it when chest pain begins. Which instruction is most appropriate?
A. Stand up and walk around while waiting for relief. B. Take it with a
medication for erectile dysfunction to improve circulation. C. Sit down,
follow the prescribed emergency instructions, and seek emergency help
for persistent or worsening chest pain. D. Swallow the tablet whole with
a full glass of water.
Correct answer: C. Sit down, follow the prescribed emergency
instructions, and seek emergency help for persistent or worsening chest
pain.
Rationale: Nitroglycerin can lower blood pressure and cause dizziness,
so sitting down reduces the risk of falls. Sublingual tablets should
dissolve under the tongue rather than be swallowed whole. Patients
should follow their prescribed emergency plan and seek emergency
help for persistent or worsening symptoms. Nitroglycerin must not be
