ATI PN Pharmacology Proctored Exam
(2025/2026) – Actual Test Bank with
Verified Questions & Rationales | Fully
Updated | 100% Correct
Q1. A client is prescribed levothyroxine 75 mcg PO daily. Which lab value should the nurse
monitor? TSH. Rationale: Levothyroxine replaces thyroid hormone; TSH is the most sensitive
indicator of therapy effectiveness.
Q2. A client receiving heparin IV develops bleeding gums. What is the nurse’s first action?
Stop the heparin infusion. Rationale: Heparin has a short half-life; immediate discontinuation
is required for bleeding.
Q3. Which medication should the nurse question for a client with sulfa allergy? Furosemide
(Lasix). Rationale: Furosemide contains a sulfonamide group; cross-sensitivity can occur.
Q4. A client taking warfarin (Coumadin) has an INR of 4.8. What should the nurse anticipate?
Hold warfarin and notify provider. Rationale: Therapeutic INR 2.0–3.0; >4.5 increases
bleeding risk.
Q5. The nurse is teaching a client about metformin. Which statement indicates understanding?
“I should take it with meals to prevent stomach upset.” Rationale: Food reduces GI upset
and risk of lactic acidosis.
Q6. A client is prescribed digoxin 0.25 mg PO daily. Which finding requires immediate
notification? Serum digoxin level 2.4 ng/mL. Rationale: Therapeutic range 0.5–2.0 ng/mL;
toxicity risk above 2.0.
, Q7. Which antidote reverses benzodiazepine overdose? Flumazenil. Rationale: Competitive
GABA antagonist.
Q8. A client on lisinopril reports a dry cough. What is the nurse’s best response? “This is a
common side effect; notify the provider for possible medication change.” Rationale: ACE
inhibitor cough is due to bradykinin buildup.
Q9. A client with myasthenia gravis is prescribed pyridostigmine. What is the most important
teaching point? “Take on an empty stomach for best absorption.” Rationale: Food decreases
absorption of cholinesterase inhibitors.
Q10. Which medication requires peak and trough levels? Vancomycin. Rationale: Narrow
therapeutic index; prevents nephrotoxicity/ototoxicity.
Q11. A client taking alendronate (Fosamax) should be taught to: Remain upright for 30
minutes after taking. Rationale: Prevents esophageal irritation/ulceration.
Q12. The nurse identifies which medication as a potassium-sparing diuretic? Spironolactone.
Rationale: Blocks aldosterone → retains K+.
Q13. A client on morphine via PCA pump reports nausea. What should the nurse do first?
Administer ondansetron (Zofran) as ordered. Rationale: Opioids commonly cause nausea via
chemoreceptor trigger zone.
Q14. Which lab should be monitored for a client on carbamazepine (Tegretol)? CBC (risk of
agranulocytosis/aplastic anemia). Rationale: Bone marrow suppression is a black box
warning.
(2025/2026) – Actual Test Bank with
Verified Questions & Rationales | Fully
Updated | 100% Correct
Q1. A client is prescribed levothyroxine 75 mcg PO daily. Which lab value should the nurse
monitor? TSH. Rationale: Levothyroxine replaces thyroid hormone; TSH is the most sensitive
indicator of therapy effectiveness.
Q2. A client receiving heparin IV develops bleeding gums. What is the nurse’s first action?
Stop the heparin infusion. Rationale: Heparin has a short half-life; immediate discontinuation
is required for bleeding.
Q3. Which medication should the nurse question for a client with sulfa allergy? Furosemide
(Lasix). Rationale: Furosemide contains a sulfonamide group; cross-sensitivity can occur.
Q4. A client taking warfarin (Coumadin) has an INR of 4.8. What should the nurse anticipate?
Hold warfarin and notify provider. Rationale: Therapeutic INR 2.0–3.0; >4.5 increases
bleeding risk.
Q5. The nurse is teaching a client about metformin. Which statement indicates understanding?
“I should take it with meals to prevent stomach upset.” Rationale: Food reduces GI upset
and risk of lactic acidosis.
Q6. A client is prescribed digoxin 0.25 mg PO daily. Which finding requires immediate
notification? Serum digoxin level 2.4 ng/mL. Rationale: Therapeutic range 0.5–2.0 ng/mL;
toxicity risk above 2.0.
, Q7. Which antidote reverses benzodiazepine overdose? Flumazenil. Rationale: Competitive
GABA antagonist.
Q8. A client on lisinopril reports a dry cough. What is the nurse’s best response? “This is a
common side effect; notify the provider for possible medication change.” Rationale: ACE
inhibitor cough is due to bradykinin buildup.
Q9. A client with myasthenia gravis is prescribed pyridostigmine. What is the most important
teaching point? “Take on an empty stomach for best absorption.” Rationale: Food decreases
absorption of cholinesterase inhibitors.
Q10. Which medication requires peak and trough levels? Vancomycin. Rationale: Narrow
therapeutic index; prevents nephrotoxicity/ototoxicity.
Q11. A client taking alendronate (Fosamax) should be taught to: Remain upright for 30
minutes after taking. Rationale: Prevents esophageal irritation/ulceration.
Q12. The nurse identifies which medication as a potassium-sparing diuretic? Spironolactone.
Rationale: Blocks aldosterone → retains K+.
Q13. A client on morphine via PCA pump reports nausea. What should the nurse do first?
Administer ondansetron (Zofran) as ordered. Rationale: Opioids commonly cause nausea via
chemoreceptor trigger zone.
Q14. Which lab should be monitored for a client on carbamazepine (Tegretol)? CBC (risk of
agranulocytosis/aplastic anemia). Rationale: Bone marrow suppression is a black box
warning.
