RN ATI pharmacology 2016 Form C proctor Pharmacology and Pain
Management (Howard Community College)
1. A nurse is caring for a client who is taking phenytoin. For which of the following adverse
effects should the nurse monitor and report to the provider?
a. Cognitive impairment
b. Tachycardia
c. Elevated Blood Pressure
d. Tinnitus
Answer: a. Cognitive impairment
2. A nurse is teaching a client who has a history of acute myocardial infarction about taking
metoprolol to treat angina. Which of the following instructions should the nurse include?
a. “Stop taking the medication if you become dizzy.”
b. “Check your pulse rate daily.”
c. “Expect to see an increase in your urinary output.”
d. “Call your provider if you lose more than 1 lb per week.”
Answer: b. “Check your pulse rate daily.”
3. A nurse is caring for a client who develops an anaphylactic reaction to IV antibiotic
administration. After assessing the client’s respiratory status and stopping the medication
infusion, which of the following actions should the nurse take next?
a. Elevate the client’s legs and feet
b. Administer epinephrine IM
c. Replace the infusion with 0.9% sodium chloride
d. Give diphenhydramine IM
Answer: b. Administer epinephrine IM
4. A nurse is assessing a client who is receiving oxytocin via continuous IV infusion for labor
augmentation. The nurse notes six contractions in a 10-min period with a nonreassuring FHR.
Which of the following actions should the nurse take first?
a. Administer terbutaline 0.25mg subq
b. Discontinue the oxytocin IV infusion
c. Turn the client to her left side
d. Apply O2 at 10L/min via face mask
Answer: c. Turn the client to her left side
5. A nurse is preparing to administer lactated ringer’s solution at 100ml/hr. The drop factor of
the manual IV tubing is 15gtt/mL. The nurse should set the manual IV infusion to deliver
how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it
applies. Do not use a trailing zero.)
Answer: 25 gtt/min
a. (100 mL/hr)(15 gtt/mL) = 1500 gtt/hr /60min = 25 gtt/min
6. A client who has active tuberculosis and is taking rifampin reports that his urine and sweat
have developed a red-orange tinge. Which of the following actions should the nurse take?
a. Prepare the client for dialysis
b. Instruct the client to increase his fluid intake
c. Check the client’s liver function test results
d. Document this as an expected finding
Answer: d. Document this as an expected finding
7. A nurse is teaching a client about self-administration of enoxaparin (Lovenox) . Which of
the following instructions should the nurse include? SATA
a. “Grasp the skin between the thumb and forefinger while injecting the medication.”
b. “Alternate injection sites between the sides of the abdomen.”
c. “Expel the air bubble from the prefilled syringe.”
d. “Massage the insertion site after injecting the medication.”
e. “Insert the entire length of the needle into the skin during injection.”
Answer: a. “Grasp the skin between the thumb and forefinger while injecting the
medication.”
b. “Alternate injection sites between the sides of the abdomen.”
e. “Insert the entire length of the needle into the skin during injection.”
8. A nurse is caring for a client who is receiving warfarin to treat atrial fibrillation. Which of
the following laboratory values should the nurse identify as outside the expected reference
range for this client?
a. aPTT 36 seconds
b. Hgb 15.2 g/dL
c. Hct 43%
d. INR 4.5
Answer: d. INR 4.5
9. A nurse is caring for a client who is receiving ondansetron IV. Which of the following
findings is an indication that the ondansetron is effective?
a. Increased urinary output
b. Decreased nausea
c. Absence of peripheral neuropathy
d. Reduced dizziness
Answer: b. Decreased nausea
10. A nurse is caring for a client who has major depression and a new prescription for
citalopram. Which of the following adverse effects is priority of the nurse to report to the
provider?
a. Confusion
b. Insomnia
c. Bruxism
d. Weight loss
Answer: a. Confusion
11. A nurse is planning care for a client who is experiencing acute cocaine toxicity . The
nurse should plan to provide which of the following treatments?
a. Gastric lavage
b. Saline cathartic
c. Naloxone
d. Diazepam
Answer: d. Diazepam
12. A nurse is providing teaching to a client who has diabetes insipidus and is receiving
desmopressin. Which of the following statements should the nurse include in the teaching?
a. “Your urine might have a reddish tint while taking this medication.”
b. “You will need to check your blood glucose every morning while taking this medication.”
c. “You can expect to have less urine output when you are taking this medication.”
d. “You will need weekly laboratory work to determine your blood clotting time.”
Answer: c. “You can expect to have less urine output when you are taking this medication.”
13. A nurse is teaching a client who has pernicious anemia to self-administer nasal
cyanocobalamin. Which of the following information should the nurse include in the
teaching?
a. “Plan to self-administer this medication for the next 6 months.”
b. “Administer the medication into the nostril once per week.”
c. “Use a nasal decongestant 15 minutes before the mediation if you have a stuffy nose.”
d. “Lie down for 1 hour after administering the medication.”
Answer: b. “Administer the medication into the nostril once per week.”
14. A nurse is planning to teach a client who has a gout allopurinol. Which of the following
instructions should the nurse include in the teaching?
a. Take after meals
b. Take an iron supplement
c. Limit daily fluid intake to 1 liter
d. Increase calcium intake
Answer: a. Take after meals
15. A nurse is assessing a client who has a heart failure and is taking digoxin. Which of the
following findings should the nurse identify as an early indication of medication toxicity?
a. Visual disturbances
b. Insomnia
c. Potassium 4.4 mEq/L
d. Sudden weight gain
Answer: a. Visual disturbances
16. A nurse is reviewing the medical record of a client who is taking clozapine. Which of the
following findings should the nurse report to the provider immediately?
a. LDL 220 mg/dL
b. WBC 2,500/mm3
c. Fasting blood glucose 180 mg/dL
d. BMI of 28
Answer: b. WBC 2,500/mm3
17. A nurse is reviewing the medications of a client. The nurse should recognize that which of
the following medications increases the client’s risk for constipation?
a. Hydrocodone
b. Neomycin sulfate
c. Prednisone
d. Lactulose
Answer: a. Hydrocodone
18. A nurse is caring for a client who is receiving IV amphotericin B . which of the following
findings should the nurse identify as an acute infusion reaction?
a. Dry cough
b. Fever
c. Pedal edema
d. Hyperglycemia
Answer: b. Fever
19. A nurse is providing teaching to a client who has a new prescription for bumetanide for
heart failure. Which of the following instructions should the nurse include in the teaching?
a. “You should monitor for hearing difficulties.”
b. “You should take this medication on an empty stomach.”
c. “You should take the medication at bedtime.”
d. “You should decrease your intake of foods high in potassium.”
Answer: a. “You should monitor for hearing difficulties.”
20. A nurse is evaluating a client’s response to a new prescription for phenazopyridine. Which
of the following outcomes of the medication should the nurse expect?
a. Decreased manifestations of GERD
b. Improved movements of joints
c. Increased ability to cough up secretions
d. Relieved burning upon urination
Answer: d. Fluid retention
21. A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The
nurse should plan to monitor the client for which of the following adverse effects?
a. Insomnia
b. Tinnitus
c. Orthostatic hypotension
d. Fluid retention
Answer: d. Fluid retention
22. A nurse is caring for a client who has a new prescription for tetracycline. Which of the
following statements by the client indicates an understanding of the teaching?
a. “I will avoid drinking milk when i take this medication.”
b. “I should take an iron supplement with this medication.”
c. “I won’t worry if i experience diarrhea while taking this medications.”
d. “I will discontinue this medication when my symptoms go away.”
Answer: a. “I will avoid drinking milk when i take this medication.”
23. A nurse is preparing to administer phenytoin suspension 2.5 mg/kg PO twice a day to a
toddler. The toddler weighs 22 lb. how many mg should the nurse administer per dose?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a
trailing zero.)
Answer: 25mg/dose
24. A nurse is reviewing the medication administration record of a client who received
propranolol from a nurse on the previous shift. The nurse notes the client had an apical heart
rate of 50/min prior to administer of the medication. Which of the following actions should
the nurse take?
a. Notify the ethics committee
b. Notify the pharmacy
c. Call the nurse to return to the facility
d. File an incident report
Answer: c. Call the nurse to return to the facility
25. A nurse is caring for a client who has acute heart failure and is receiving furosemide via
IV bolus. The nurse should identify that which of the following findings indicates a desired
therapeutic effects?
a. Decreased weight
b. Decreased blood glucose level
c. Increased blood pressure
d. Increased sputum production
Answer: a. Decreased weight
26. A charge nurse is supervising nursing care for four clients. The nurse should recognize
that which of the following situations requires an incident report?
a. A client receives an acetaminophen suppository in place of an oral prescription
b. A nurse administers an antibiotic to a client 30 min after it is due
c. A nurse administers albuterol to a client who has a heart rate of 55/min
d. A client vomits after receiving an oral medication
Answer: a. A client receives an acetaminophen suppository in place of an oral prescription
27. A nurse is caring for a client who has peptic ulcer disease and is to start antacid therapy.
Which of the following information should the nurse give the client?
a. Take antacids to help inactivate Helicobacter pylori
b. Take chewable tablets rather than suspensions
c. Take antacids within 30 min of other medications
d. Take antacids 1hr after meals, 3hr after meals, and at bedtime
Answer: d. Take antacids 1hr after meals, 3hr after meals, and at bedtime
28. A nurse is teaching a client who has a prescription for ferrous gluconate . Which of the
following statements by the client indicates an understanding of the teaching?
a. “I should stay upright for at least 15 minutes after taking this medication.”
b. “I should notify my provider if my stools turn black.”
c. “I should take this medication with 8 ounces of milk.”
d. “I should take an antacid with this medication to prevent stomach upset.”
Answer: a. “I should stay upright for at least 15 minutes after taking this medication.”
29. A nurse is providing teaching to a client who is to receive a series of allergy tests . The
nurse should instruct the client to avoid which of the following medications for up to 4 weeks
before the procedure?
a. Diphenhydramine
b. Albuterol
c. Acetaminophen
d. Pseudoephedrine hydrochloride
Answer: a. Diphenhydramine
30. A nurse is caring for a client who has cancer and is undergoing chemotherapy. The client
is receiving filgrastim before each chemotherapy dose. The nurse should monitor for an
increase in which of the following types of cells to determine the effectiveness of the
medication?
a. Thrombocytes
b. Erythrocytes
c. Reticulocytes
d. Granulocytes
Answer: d. Granulocytes
31. A nurse is assessing a client who takes levothyroxine for hypothyroidism. The nurse
should identify that which of the following findings indicates the need for an increase in
dosage? (SATA)
a. Impaired short-term memory
b. BP 178/30 mmHg
c. Cold intolerance
d. Heart rate 46/min
e. Diaphoresis
Answer: a. Impaired short-term memory
c. Cold intolerance
d. Heart rate 46/min
32. A nurse recently administered filgrastim intravenously to a client who has a cancer and is
receiving cytotoxic chemotherapy. For which of the following data. Discovered after the
medication was administered, should the nurse file an incident report?
a. The client’s absolute neutrophil count was 2,500/mm3 before the medication was
administered.
b. The client had chemotherapy 12hr before the medication was administered
c. The nurse flushed the client’s IV line with dextrose 5% in water before and after the
medication was administered.
d. The medication vial sat at room temperature for 2hr before it was administered.
Answer: b. The client had chemotherapy 12hr before the medication was administered
33. A nurse is caring for a client who has heart failure and is taking digoxin and
hydrochlorothiazide. The nurse should monitor of the following adverse effects of
hydrochlorothiazide?
a. Hypernatremia
b. Hypophosphatemia
c. Hypermagnesemia
d. Hypokalemia
Answer: d. Hypokalemia
34. A nurse is assessing a client who is receiving morphine for pain control. Which of the
following findings should the nurse report to the provider?
a. Drowsiness
b. Bladder distention
c. BP 100/76 mmHg
d. Pupillary constriction
Answer: b. Bladder distention
35. A nurse is teaching a client who has angina about a new prescription for sublingual
nitroglycerin tablets. Which of the following instructions should the nurse include in the
teaching?
a. “Take one tablet each morning 30 minutes prior to eating.”
b. “Keep the tablets at room temperature in their original glass bottle.”
c. “Place the tablet between your cheek and gum to dissolve.”
d. “Discard any tablets you do not use every 6 months.”
Answer: b. “Keep the tablets at room temperature in their original glass bottle.”
36. A nurse is caring for a client who is taking triamterene. For which of the following
laboratory values should the nurse withhold the medication?
a. Sodium 142 mEq/L
b. BUN 16 mg/dL
c. Potassium 5.3 mEq/L
d. Albumin 4 g/dL
Answer: c. Potassium 5.3 mEq/L
37. A nurse is caring for a client who is taking broad spectrum antibiotics for pneumonia. The
nurse should identify that the client is at risk for developing which of the following types of
infection?
a. Nosocomial infection
b. Systemic infection
c. Superinfection
d. Resistant infection
Answer: c. Superinfection
38. A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of
the following laboratory values indicates that the treatment has been effective ?
a. BUN 15 mg/dL
b. Blood glucose 90 mg/dL
c. LDL 120 mg/dL
d. Urine specific gravity 1.020
Answer: c. LDL 120 mg/dL
39. A nurse is preparing to titrate a continuous nitroprusside infusion for a client. The nurse
should plan to titrate the infusion according to which of the following assessments?
a. Stroke volume
b. Blood pressure
c. Cardiac output
d. Urine output
Answer: b. Blood pressure
40. A nurse is assessing a client’s IV infusion site that notes that the site is cool and
edematous . Which of the following actions should the nurse take?
a. Slow the IV solution rate
b. Maintain the extremity below the level of the heart
c. Apply warm, moist compress
d. Initiate a new IV distal to the initial site
Answer: c. Apply warm, moist compress
41. A nurse is providing teaching to a client who has a new prescription for tetracycline. The
nurse should instruct the client to take which of the following dietary supplements at a
different time than the tetracycline?
a. Vitamin C
b. Folic acid
c. Calcium carbonate
d. Fish oil
Answer: c. Calcium carbonate
42. A nurse is caring for a client who has a life-threatening ventricular dysrhythmia . Which
of the following medications should the nurse anticipate administering?
a. Dopamine
b. Digoxin
c. Verapamil
d. Amiodarone
Answer: d. Amiodarone
43. A nurse is teaching a client who has HIV and a new prescription for efavirenz. Which of
the following instructions should the nurse include in the teaching?
a. Take a double dose of this medication if a dose is missed
b. Expect severe nausea and vomiting for the first week of therapy
c. Notify the provider for the appearance of a skin rash
d. Swallow the medication with milk upon awakening in the morning
Answer: c. Notify the provider for the appearance of a skin rash
44. A nurse is a reviewing the laboratory results of a client who has diabetes mellitus and is
taking glipizide. Which of the following values indicates that the client is adhering to the
treatment plan?
a. Creatinine 1.0 mg/dL
b. HbA1c 6.8%
c. Total cholesterol 225 mg/dL
d. Positive urinary ketones
Answer: b. HbA1c 6.8%
45. A nurse is reviewing medication prescriptions for a client. Which of the entries on the
client’s medication administration record should the nurse request clarification?
a. Morphine 4mg IV every 4 hr PRN for pain
b. Simvastatin 40mg PO at bedtime
c. Levothyroxine 100mcg PO every morning
d. Acetaminophen 500 mg every 4hr PRN for fever
Answer: d. Acetaminophen 500 mg every 4hr PRN for fever
46. A nurse is providing teaching to a client who has a new prescription for paroxetine. The
nurse should instruct the client monitor for which the following adverse effects?
a. Tinnitus
b. Peripheral edema
c. Drowsiness
d. Alopecia (sudden hair loss)
Answer: c. Hematuria
47. A nurse is providing teaching about the adverse effects of ergotamine to a client who has
migraine headaches.
Which of the following adverse effects should the nurse include in the teaching?
a. Blurred vision
b. Tinnitus
c. Hematuria
d. Parethesias
Answer: d. Parethesias
48. A nurse is assessing a client who has a prescription for cefaclor. Which of the following
findings should the nurse recognize as an indication of an allergic reaction?
a. Hematuria
b. Slurred speech
c. Pruritus
d. Tremor
Answer: c. Pruritus
49. A nurse is providing teaching to a client who has a new prescription for theophylline, a
sustained-release capsule. Which of the following statements by the client indicates an
understanding of the teaching?
a. “I may sprinkle the medication in applesauce.”
b. “I should limit my fluid intake while on this medication.’
c. “I will need to have blood levels drawn.”
d. “I can take my medication in the morning with my coffee.”
Answer: c. “I will need to have blood levels drawn.”
50. A nurse is teaching client who has active pulmonary tuberculosis about management of
medication for the disease. Which of the following statements is appropriate for the nurse to
make?
a. “You will need to undergo tuberculin skin tests every 6 months while taking medication for
your disease.”
b. “You will need to take two or more medications to treat your disease.”
c. “You should anticipate taking medication to treat your disease for at least the next 3 years.”
d. “You should report monthly to have your blood drawn to monitor kidney function while
taking medication.”
Answer: b. “You will need to take two or more medications to treat your disease.”
51. A nurse is reviewing the medication administration record of a client who is to receive
phenytoin 300 mg PO daily. The medication sent by the pharmacy is a vial of phenytoin 50
mg/mL for injection. Which of the following actions should the nurse take?
a. Check medication calculations with the second nurse.
b. Refer to the original medication order.
c. Administer 6mL of the medication intravenously
d. Ask the client what route he usually takes the medication
Answer: b. Refer to the original medication order.
52. A nurse is teaching a client who has stable angina and a new prescription for nitroglycerin
transdermal patches
0.8 mg/hr daily. Which of the following statements by the client indicates an understanding of
the teaching?
a. “I will apply a new patch to the same site whenever i replace it.”
b. “I can put a second patch on if I have chest pain.”
c. “I can cut the patches in half to save money.”
d. “I will take the patch off after dinner every night.”
Answer: d. “I will take the patch off after dinner every night.”
53. A nurse is preparing to administer enoxaparin 1mg/kg subq every 12hr. The client’s
weight is 121lb. Available is enoxaparin 60mg/0.6mL. How many mL should the nurse
administer per dose? (Round the answer to the nearest tenth. Use leading zero if it applies. Do
not use the trailing zero.)
Answer: a. 0.6
54. A nurse is assessing a client who has muscarinic agonist poisoning. Following
administration of atropine, which of the following findings should indicate to the nurse that
the treatment has been effective?
a. BP 90/50 mmHg
b. Hyperactive bowel sounds
c. Heart rate 90/min
d. Increased salivation
Answer: c. Heart rate 90/min
55. A nurse is preparing to administer subcutaneous heparin to a client. Which of the
following actions should the nurse take?
a. Insert the needle at least 5cm (2in) from the umbilicus
b. Massage the site after administering the medication
c. Use a 21-gauge needle for the injection
d. Aspirate before injecting the medication.
Answer: a. Insert the needle at least 5cm (2in) from the umbilicus
56. A nurse is caring for a client who received digoxin 0.25mg instead of 0.125mg, as the
provider prescribed. The nurse administered the medication 4hr ago. Which of the following
actions should the nurse take first?
a. Notify the provider who prescribed the medication
b. Check the client’s apical heart rate
c. Initiate a medication error incident report
d. Monitor the client’s potassium level
Answer: b. Check the client’s apical heart rate
57. A nurse is preparing to administer the varicella vaccine to a group of clients. The nurse
should identify which of the following clients as having a contraindication for receiving this
immunization?
a. An older adult client living in a long-term care facility
b. A young adult who has an allergy to eggs
c. A child who recently received the human papillomavirus vaccine
d. A client who has AIDS
Answer: d. A client who has AIDS
58. A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin .
Which of the following outcomes indicates that the client is adhering to the medication
regimen?
a. The client tests negative for HIV
b. The client’s liver function test results are within the expected reference ranges
c. The client has a positive purified protein derivative test
d. The client has a negative sputum culture
Answer: d. The client has a negative sputum culture
59. A nurse is planning to teach a client who has asthma about taking montelukast. Which of
the following information should the nurse include about the purpose of this medication?
a. Controls inflammation in the airways
b. Relieves acute bronchospasms
c. Inhibits replications of neutrophils
d. Activates beta2 -receptors in smooth muscle1
Answer: a. Controls inflammation in the airways
60. A nurse is caring for a client who received succinylcholine IV bolus during an abdominal
surgery. The client develops malignant hyperthermia. The nurse should administer which of
the following medications?
a. Baclofen
b. Acetylcysteine
c. Dantrolene
d. Naloxone
Answer: c. Dantrolene
61. A nurse is assessing a client who has a prescription for levothyroxine. Which of the
following findings should the nurse recognizes as an adverse reaction?
a. Tremor
b. Lethargy
c. Nasal congestion
d. Bradycardia
Answer: a. Tremor
62. A nurse is caring for a client who reports taking propranolol for several years but has
recently stopped for financial reasons. The nurse should assess the client for which of the
following findings?
a. Tachycardia
b. Rhinitis
c. Bradypnea
d. Hyperkalemia
Answer: a. Tachycardia
63. A provider has prescribed procaine penicillin G 600,000 units IM for a client who has a
streptococcal throat infection. Which of the following actions should the nurse take?
a. Use the deltoid site for the injection
b. Inject the medication quickly over 2 to 3 seconds
c. Insert the needle at 90 degree angle
d. Ask the provider to prescribe the medication orally
Answer: c. Insert the needle at 90 degree angle
64. A nurse is teaching a client who has diabetes mellitus and a new prescription for a
combination of lispro insulin and NPH insulin. Which of the following statements by the
client indicates an understanding of the teaching?
a. “I will expect the lispro insulin to be cloudy.”
b. “I should eat within 1hr after my injection.”
c. “I should draw up the NPH insulin first.”
d. “I will mix these medications in one syringe.”
Answer: d. “I will mix these medications in one syringe.”
65. A client who has Graves’ disease is prescribed methimazole. Which of the following
effects should the nurse expect to see after the client has taken the medication for 2 months?
a. Increased sleeping
b. Weight loss
c. Increase in pulse rate
d. Warmer skin
Answer: a. Increased sleeping
66. A nurse is teaching a female adult client who has a new prescription for azathioprine to
treat active rheumatoid arthritis. The nurse should inform the client about the need for which
of the following diagnostic tests prior to starting the medication?
a. Pregnancy test
b. Electrocardiogram
c. Bone density scan
d. HbA1c
Answer: a. Pregnancy test
67. A nurse is assessing a client who has just received an initial dose of penicillin G
intramuscularly . Which of the following findings is the nurse’s priority?
a. Redness at the injection site
b. Lethargy
c. Nausea
d. Stridor
d. Stridor
Answer: d. Stridor
