ATI Pharmacology Proctored Exam
Question: 1
A nurse is assessing a client who has heart failure and is taking digoxin. Which of the
following findings should the nurse identify as an early indication of medication toxicity?
A. Sudden weight gain
B. Potassium 4.4 mEq/L
C. Insomnia
D. Visual disturbances
Answer: D. Visual disturbances
Question: 2
A nurse is caring for a client who has pancreatic cancer and reports severe pain. Which of the
following medications should the nurse expect to administer?
A. Hydromorphone
B. Caldolor
C. Aspirin
D. Meloxicam
Answer: A. Hydromorphone
Question: 3
A nurse is reviewing the laboratory data of a client who is receiving filgrastim. Which of the
following laboratory values should the nurse monitor to evaluate the effectiveness of the
treatment?
A. Potassium level
B. BUN
C. WBC count
D. INR
Answer: B. BUN
Question: 4
A nurse in the emergency department is admitting a client who has diabetic ketoacidosis and
a blood glucose level of 800 mg/dL. Which of the following interventions should the nurse
initiate first?
A. Subcutaneous insulin injections
B. Bicarbonate by IV infusion
C. 0.9% sodium chloride 15 mL/kg/hr
D. Potassium chloride 10 mEq/hr
Answer: C. 0.9% sodium chloride 15 mL/kg/hr
Question: 5
A nurse is caring for a client who has heart failure and is taking hydrochlorothiazide. The
nurse should monitor the client for which of the following manifestations as an adverse effect
of the medication?
A. Hypocalcemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: B. Hypokalemia
Question: 6
A nurse is caring for a client who requires a re-insertion of a short peripheral venous catheter.
In which of the following locations should the nurse place the catheter?
A. A vein on the client’s wrist
B. A vein in the client's dominant arm
C. A vein proximal to the previous site
D. A vein that feels hard to the touch
Answer: A. A vein on the client’s wrist
Question: 7
A nurse is caring for a client who is receiving ceftriaxone intravenously. Which of the
following manifestations should the nurse identify as an allergic reaction?
A. Bradycardia
B. Nausea
C. Polyuria
D. Hypotension
Answer: D. Hypotension
Question: 8
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 decrease your intake of foods high in potassium.”
C. "You should take the medication at bedtime.”
D. "You should take this medication on an empty stomach.”
Answer: A. "You should monitor for hearing difficulties.”
Question: 9
A charge nurse is teaching a newly licensed nurse about administering heparin to a client.
Which of the following statements by the newly licensed nurse indicates an understanding of
the teaching?
A. "I will aspirate before administering the heparin.”
B. “I will check the client's INR before administering the heparin.”
C. "I will massage the site after the injecting the heparin.”
D. “I will apply pressure for 1 minute after the injection.”
Answer: B. “I will check the client's INR before administering the heparin.”
Question: 10
A nurse is caring for a client who is receiving 0.9% sodium chloride solution to treat
dehydration. Which of the following findings should the nurse identify as an adverse effect of
the solution?
A. Increased bowel sounds
B. Pink, frothy sputum
C. Dark amber urine
D. Decreased skin turgor
Answer: B. Pink, frothy sputum
Question: 11
A nurse is reviewing the laboratory results of a client who has atrial fibrillation and a
prescription for warfarin. After informing the provider that the INR is 2.5, the nurse should
expect which of the following prescriptions?
A. Withhold the medication.
B. Decrease the dose of the medication.
C. Increase the dose of the medication.
D. Administer the current dose of the medication.
Answer: D. Administer the current dose of the medication.
Question: 12
A nurse is applying a nitroglycerin transdermal patch for a client who has angina. Which of
the following actions should the nurse take?
A. Apply the patch to a hairless area of the skin.
B. Apply the patch to a bony prominence on the chest.
C. Apply a 4 × 4 dressing over the patch.
D. Apply the patch to the same site every 24 hr.
Answer: A. Apply the patch to a hairless area of the skin.
Question: 13
A nurse is monitoring the laboratory values of a client who is receiving heparin. Which of the
following values should the nurse report to the provider?
A. PT 11 Seconds
B. Platelets 300,000/mm3
C. aPTT 50 seconds
D. Hematocrit 45%
Answer: C. aPTT 50 seconds
Question: 14
A nurse is reviewing the plan of care with a client who has a new prescription for lovastatin.
Which of the following statements by the client should indicate to the nurse a need for further
assessment?
A. "I should avoid drinking grapefruit juice.”
B. "I take metformin for my diabetes.”
C. "I am trying to decrease my dietary fat intake.”
D. "I was just diagnosed with hepatitis B.”
Answer: D. "I was just diagnosed with hepatitis B.”
Question: 15
A nurse is caring for a client who is receiving intravenous therapy and observes redness and
inflammation along the vein. The nurse should identify this finding as which of the following
complications of IV therapy?
A. Phlebitis
B. Extravasation
C. Venous spasm
D. Infiltration
Answer: A. Phlebitis
Question: 16
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 take an antacid with this medication to prevent stomach upset.”
C. "I should notify my provider if my stools turn black.”
D. "I should take this medication with 8 ounces of milk.”
Answer: A. “I should stay upright for at least 15 minutes after taking this medication.”
Question: 17
A nurse is teaching a client who is pregnant and has iron-deficiency anemia about taking
ferrous sulfate elixir. Which of the following instructions should the nurse include in the
teaching? (Select all that apply.)
A. “Drink the elixir using a straw to prevent staining your teeth.”
B. “Take the medication with an antacid if it upsets your stomach.”
C. “Increase your intake of dairy products to increase the absorption of this medication.”
D. “Increase your fiber intake to prevent constipation.”
E. “Stop taking the medication if your stools become green or black.”
Answer: D. “Increase your fiber intake to prevent constipation.”
Question: 18
A nurse is providing discharge dietary teaching to a client who has a new prescription for
theophylline. Which of the following instructions should the nurse include?
A. “Take the medication with meals.”
B. “Limit your sodium intake.”
C. “Restrict milk products.”
D. “Avoid caffeinated beverages.”
Answer: D. “Avoid caffeinated beverages.”
Question: 19
A nurse is monitoring a client who is receiving a blood transfusion. Which of the following
findings indicates that the nurse should administer epinephrine?
A. Distended jugular vein
B. Urticaria
C. Bounding pulse
D. Confusion
Answer: B. Urticaria
Question: 20
A nurse is caring for a client who is taking lithium and reports starting a new exercise
program. The nurse should assess the client for which of the following electrolyte
imbalances?
A. Hypomagnesemia
B. Hyponatremia
C. Hypokalemia
D. Hypocalcemia
Answer: B. Hyponatremia
Question: 21
A nurse is preparing to administer clindamycin to a client who states she forgot to report to
the provider that she is allergic to penicillin. Which of the following actions should the nurse
take?
A. Obtain a prescription for an alternative antibiotic.
B. Premedicate the client with epinephrine before administering the antibiotic.
C. Give the client the prescribed dose of the clindamycin.
D. Administer the clindamycin using a desensitization schedule.
Answer: C. Give the client the prescribed dose of the clindamycin.
Question: 22
A nurse is monitoring a client who has a head injury and is receiving mannitol 25% via IV
infusion. The nurse should identify which of the following as an adverse effect of the
medication and report to the provider?
A. Crackles on auscultation
B. Increase in urinary output
C. Glasgow coma scale rating of 15
D. Intracranial pressure reading of 12 mm Hg
Answer: A. Crackles on auscultation
Question: 23
A nurse is preparing to administer lidocaine via continuous IV infusion at 4 mg/min.
Available is lidocaine 2 g dextrose 5% in water 500 mL. The nurse should set the IV pump to
deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading
zero if it applies. Do not use a trailing zero.)
A. 60 mL/hr
B. 50 mL/hr
C. 40 mL/hr
D. 20 mL/hr
Answer: A. 60 mL/hr
Question: 24
A nurse realizes that they failed to administer a medication that was due 4 hr ago to a client.
Which of the following actions should the nurse take first?
A. Assess the client for adverse reactions.
B. File an incident report.
C. Determine factors that led to the omission.
D. Report the missed dosage to the client's provider.
Answer: A. Assess the client for adverse reactions.
Question: 25
A nurse is preparing to administer medication to a client who has a prescription for epoetin
alfa. Which of the following routes of administration should the nurse plan to use?
A. Intravenous
B. Transdermal
C. Inhalation
D. Oral
Answer: A. Intravenous
Question: 26
A nurse in a provider's office is preparing to teach a middle adult client who has a new
diagnosis of metabolic syndrome and an HbA1c of 6.5%. Which of the following
medications should the nurse plan to teach the client about first?
A. Insulin glargine
B. Regular insulin
C. Metformin
D. Exenatide
Answer: C. Metformin
Question: 27
A nurse is reviewing the medication administration record for a client who has cancer and is
receiving morphine via a PCA pump. Which of the following prescriptions should the nurse
clarify with the provider?
A. Ondansetron
B. Insulin glargine
C. Nalbuphine
D. Acetaminophen
Answer: C. Nalbuphine
Question: 28
A nurse is preparing to administer amphotericin B lipid complex via intermittent IV bolus to
a client who has infective endocarditis. Which of the following actions should the nurse take?
A. Use a gravity flow set.
B. Administer the medication over 2 hr.
C. Discard the medication if it is yellow.
D. Prime the tubing with 0.9% sodium chloride.
Answer: B. Administer the medication over 2 hr.
Question: 29
A nurse is caring for a client who has a prescription for amoxicillin. Which of the following
findings indicates the client is experiencing an allergic reaction?
A. Insomnia
B. Cardiac dysrhythmia
C. Laryngeal edema
D. Nausea
Answer: C. Laryngeal edema
Question: 30
A nurse is assessing a client who is receiving heparin via continuous IV. The client has an
aPTT of 90 seconds. The nurse should monitor the client for which of the following changes
in their vital signs?
A. Decreased temperature
B. Increased pulse rate
C. Increased blood pressure
D. Decreased respiratory rate
Answer: B. Increased pulse rate
Question: 31
A nurse is preparing to administer digoxin to a client who has heart failure. The nurse should
withhold the medication for which of the following findings?
A. Weight gain of 0.7 kg (1.5 lb) in 24 hr
B. Pulse rate 56/min
C. BP 160/90 mm Hg
D. Urinary output 30 mL/hr
Answer: B. Pulse rate 56/min
Question: 32
A nurse is preparing to initiate IV therapy for a client. Which of the following sites should the
nurse use to place the peripheral IV catheter?
A. Nondominant forearm basilic vein
B. Nondominant dorsal venous arch
C. Dominant antecubital basilic vein
D. Dominant distal dorsal vein
Answer: B. Nondominant dorsal venous arch
Question: 33
A nurse is caring for a group of clients. For which of the following situations should the nurse
complete an incident report?
A. A client received 0900 medications at 0930.
B. A client received an infusion of lipids through a central line.
C. A client who has asthma was administered tiotropium via inhalation.
D. A client received a blood transfusion with dextrose 5% in water
Answer: D. A client received a blood transfusion with dextrose 5% in water
Question: 34
A nurse is reviewing medication prescriptions for a client. For which of the following entries
on the client's medication administration record should the nurse request clarification?
A. Simvastatin 40 mg PO at bedtime
B. Levothyroxine 100 mcg PO every morning
C. Morphine 4 mg IV every 4 hr PRN for pain
D. Acetaminophen 500 mg every 4 hr PRN for fever
Answer: D. Acetaminophen 500 mg every 4 hr PRN for fever
Question: 35
A nurse is reviewing a client's laboratory results before administering furosemide 40 mg IV
bolus. For which of the following values should the nurse withhold the medication and
contact the provider?
A. WBC count 8,000/mm3
B. Sodium 141 mEq/L
C. INR 1.0
D. Potassium 2.5 mEq/L
Answer: D. Potassium 2.5 mEq/L
Question: 36
A nurse is assessing a client who has asthma and a prescription for albuterol. The nurse
should monitor the client for which of the following adverse effects?
A. Constipation
B. Fever
C. Drowsiness
D. Tachycardia
Answer: D. Tachycardia
Question: 37
A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering
it to a client who has diabetes mellitus. Which of the following actions should the nurse take
first?
A. Withdraw the NPH insulin from the vial.
B. Inject air into the regular insulin vial.
C. Withdraw the regular insulin from the vial.
D. Inject air into the NPH vial.
Answer: D. Inject air into the NPH vial.
Question: 38
A nurse is teaching a class about administering IV fluids to treat dehydration. The nurse
should include in the teaching that which of the following laboratory values indicates
effective treatment of dehydration?
A. Serum hematocrit 55%
B. Urine specific gravity 1.020
C. Serum osmolarity 310 mOsm/L
D. BUN 28 mg/dL
Answer: B. Urine specific gravity 1.020
Question: 39
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. Warmer skin
D. Increase in pulse rate
Answer: A. Increased sleeping
Question: 40
A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which
of the following findings should the nurse expect?
A. Decrease in protein
B. PaCO2 30 mm Hg
C. Oxygen saturation 96%
D. Increase in BP
Answer: D. Increase in BP
Question: 41
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. Tinnitus
B. Orthostatic hypotension
C. Fluid retention
D. Insomnia
Answer: B. Orthostatic hypotension
Question: 42
A nurse is planning to administer a controlled substance to a client who is experiencing pain.
Which of the following actions should the nurse plan to take first?
A. Remove the medication from the medication dispensing cabinet
B. Document the administration of the medication.
C. Identify the client using two identifiers.
D. Compare the amount of medication available to the inventory record.
Answer: C. Identify the client using two identifiers.
Question: 43
A nurse is caring for a client who has a peripheral IV catheter and a prescription for IV fluid
replacement. The nurse should cover the insertion site with which of the following types of
dressing?
A. Transparent membrane dressing
B. Hydrocolloid dressing
C. Sterile gauze bandage
D. Adhesive bandage
Answer: A. Transparent membrane dressing
Question: 44
A nurse is reviewing the medical record of a client who is requesting an oral contraceptive.
Which of the following findings is a contraindication for the use of oral contraceptives?
A. History of deep-vein thrombosis
B. Anxiety disorder
C. Client age of 36 years
D. Ovarian cysts
Answer: A. History of deep-vein thrombosis
Question: 45
A nurse is providing discharge teaching to a client who has a new prescription for
furosemide. Which of the following instructions should the nurse include in the teaching?
A. “Weigh yourself on the same day each week.”
B. “Take the medication before going to bed.”
C. “This medication should be taken on an empty stomach.”
D. “Increase the amount of potassium in your diet.”
Answer: D. “Increase the amount of potassium in your diet.”
Question: 46
A nurse is teaching a 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 take two or more medications to treat your disease.”
B. “You will need to undergo tuberculin skin tests every 6 months while taking medication
for your disease.”
C. “You should report monthly to have your blood drawn to monitor kidney function while
taking medication.”
D. “You should anticipate taking medication to treat your disease for at least the next 3
years.”
Answer: A. “You will need to take two or more medications to treat your disease.”
Question: 47
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. Acetaminophen
B. Albuterol
C. Pseudoephedrine hydrochloride
D. Diphenhydramine
Answer: D. Diphenhydramine
Question: 48
A nurse is preparing to administer acyclovir 10 mg/kg IV to a client who weighs 132 lbs.
Available is acyclovir IV injectable solution 50 mg/mL. How many mL should the nurse
administer? (Round the answer to the nearest whole number. Use a leading zero if it applies.
Do not use a trailing zero.)
A. 10 mL
B. 12 mL
C. 5 mL
D. 3 mL
Answer: B. 12 mL
Question: 49
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. “Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.”
B. “Administer the medication into one nostril once per week ”
C. “Lie down for 1 hour after administering the medication.”
D. “Plan to self-administer this medication for the next 6 months.”
Answer: B. “Administer the medication into one nostril once per week ”
Question: 50
A nurse is monitoring for an infusion reaction for a client who is receiving a dose of IV
amphotericin B. Which of the following findings should indicate to the nurse that the client is
experiencing an acute infusion reaction?
A. Fever
B. Pedal edema
C. Hyperglycemia
D. Dry cough
Answer: A. Fever
Question: 51
A nurse is caring for a client who has major depression and a new prescription for citalopram.
Which of the following adverse effects is the priority for the nurse to report to the provider?
A. Bruxism
B. Weight loss
C. Confusion
D. Insomnia
Answer: C. Confusion
Question: 52
A nurse is transcribing a new prescription for a client which states. “Diphenhydramine 50 mg
NOW." Which of the following actions should the nurse take?
A. Inform the client there is a prescription available if needed.
B. Contact the provider to clarity the prescription.
C. Administer the medication within 90 min.
D. Notify the pharmacy to send the medication immediately.
Answer: D. Notify the pharmacy to send the medication immediately.
Question: 53
A nurse is providing teaching to a client who wants to stop smoking and has purchased a
transdermal smoking patch. Which of the following information should the nurse provide?
A. Rotate the application site every week.
B. The transdermal patch releases nicotine rapidly into the bloodstream.
C. The transdermal patch can cause insomnia.
D. Leave the patch in place for 8 hr each day
Answer: C. The transdermal patch can cause insomnia.
Question: 54
A nurse is planning to administer medications to an older adult client who has dysphagia.
Which of the following actions should the nurse plan to take?
A. Place the medications on the back of the client's tongue.
B. Tilt the client's head back when administering the medications.
C. Mix the medications with a semisolid food for the client.
D. Administer more than one pill to the client at a time.
Answer: C. Mix the medications with a semisolid food for the client.
Question: 55
A nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. Which
of the following laboratory values indicates an adverse effect of this medication?
A. Platelets 250.000mm3
B. BUN 15 mg/dL
C. Hct 45%
D. WBC 3,000/mm3
Answer: D. WBC 3,000/mm3
Question: 56
A nurse is providing teaching to a client who has a new prescription for paroxetine. The nurse
should instruct the client to monitor for which of the following adverse effects?
A. Alopecia
B. Tinnitus
C. Peripheral edema
D. Drowsiness
Answer: D. Drowsiness
Question: 57
A nurse is preparing to administer nitroglycerin topical ointment to a client. Which of the
following actions should the nurse plan to take?
A. Apply the medication to the same site for three consecutive days.
B. Spread the medication over a 12.7 cm (5 in) area of the client's skin.
C. Cover the medication on the client's skin with a sterile gauze pad.
D. Measure the dosage of medication using the applicator paper.
Answer: D. Measure the dosage of medication using the applicator paper.
Question: 58
A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by
intermittent IV bolus. Which of the following manifestations should indicate to the nurse a
therapeutic response to the medication?
A. Decrease in urine output
B. Decrease in blood pressure
C. Increase in WBC count
D. Increase in serum glucose
Answer: A. Decrease in urine output
Question: 59
A nurse is reviewing the medication list of a client who has erectile dysfunction and is
requesting a prescription for sildenafil. The nurse should identify that which of the following
medications is a contraindication for receiving this medication?
A. Albuterol
B. Indomethacin
C. Nitroglycerin
D. Furosemide
Answer: C. Nitroglycerin
Question: 60
A nurse is caring for a client who is receiving a continuous IV infusion of magnesium sulfate
for preterm labor. The nurse should discontinue the infusion and prepare to administer
calcium gluconate if the client demonstrates which of the following findings? (Select all that
apply.)
A. Urine output 80 mL in 4 hr
B. Decreased level of consciousness
C. Absence of deep-tendon reflexes
D. Systolic blood pressure 130 mm Hg
E. Report of chills
Answer: A. Urine output 80 mL in 4 hr
B. Decreased level of consciousness
C. Absence of deep-tendon reflexes
Question: 61
A nurse is preparing to administer cimetidine 300 mg IV over 15 min to a client. Available is
cimetidine 300 mg/100 mL of 0.9% sodium chloride. The nurse should set the IV pump to
deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading
zero if it applies. Do not use a trailing zero.)
A. 400 mL/hr
B. 200 mL/hr
C. 100 mL/hr
D. 50 mL/hr
Answer: A. 400 mL/hr
Question: 62
A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of
the following laboratory values should the nurse report to the provider?
A. Total bilirubin 1.5 mg/dL
B. Hct 44%
C. Potassium 4.2 mEq/L
D. WBC count 5,000/mm3
Answer: A. Total bilirubin 1.5 mg/dL
Question: 63
A nurse is assessing a client who has heart failure and is taking furosemide. Which of the
following findings should indicate to the nurse that the client is experiencing fluid volume
deficit?
A. Weight gain
B. Elevated hematocrit level
C. Shortness of breath
D. Distended neck veins
Answer: B. Elevated hematocrit level
Question: 64
A nurse is caring for an older adult client who is taking prednisone for long-term treatment of
rheumatoid arthritis. The nurse should monitor the client for which of the following adverse
effects of this drug?
A. Bone loss
B. Hypoglycemia
C. Hemolytic anemia
D. Liver toxicity
Answer: A. Bone loss
Question: 65
A nurse is teaching a client’s partner how to administer an otic medication to the client.
Which of the following statements by the client’s partner indicates an understanding of the
teaching?
A. “I will make sure the solution is cool prior to instilling the drops.”
B. “I will have my partner tilt their head back while I am instilling the drops.”
C. “I will pull the pinna upward and outward prior to instilling the drops.”
D. “I will have my partner lie down on their back while I am instilling the drops.”
Answer: C. “I will pull the pinna upward and outward prior to instilling the drops.”
Question: 66
A nurse recently administered filgrastim intravenously to a client who has 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 medication vial sat at room temperature for 2 hr before it was administered.
B. The client had chemotherapy 12 hr 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 client's absolute neutrophil count was 2.500/mm3 before the medication was
administered.
Answer: A. The medication vial sat at room temperature for 2 hr before it was administered.
