ATI RN Pharmacology Proctored Exam
/RN Pharmacology ATI Proctored
Actual Exam Questions And Correct
Detailed Answers With Rationales|
Graded A+| Version 5| 2024-2025
Version 5
MULTIPLE CHOICE
1. A Nurse In A Provider's Office Is Instructing A Parent Of A Toddler How To
Administer Ear Drops. Which Of The Following Instructions Should The Nurse
Include? (Select All That Apply.)
A. "Place The Child On His Unaffected Side When You Are Ready To Administer The
Medication."
B. "Warm The Medication By Gently Rolling It Between Your Hands For A Few Minutes."
C. "Gently Shake Medication That Is In Suspension Form."
D. "Keep The Child On His Side For 5 Minutes After Instillation Of The Ear Drops."
E. "Tightly Pack The Ear With Cotton After Instillation Of The Ear Drops."
ANS: A, B, C, D
Rationale:
• A: Positioning The Child On The Unaffected Side Allows For Easier Access To The
Affected Ear And Helps The Medication Flow By Gravity Into The Ear Canal.
• B: Warming The Drops Helps Prevent Discomfort Or Dizziness That May Occur If
Cold Drops Are Used.
• C: Shaking Suspension Forms Is Essential To Ensure Even Distribution Of The
Medication, As Solids May Settle At The Bottom.
• D: Keeping The Child On Their Side For 5 Minutes Promotes Effective Absorption
And Drainage Of The Medication.
• E: Packing The Ear With Cotton Can Trap Moisture And Promote Infection, Which Is
Not Recommended.
2. A Nurse In The Operating Room Is Caring For A Client Who Received A Dose
Of Succinylcholine. During The Operation, The Client Suddenly Develops
,Rigidity, And His Body Temperature Begins To Rise. The Nurse Should
Anticipate A Prescription For Which Of The Following Medications?
A. Neostigmine
B. Naloxone
C. Dantrolene
D. Vecuronium
ANS: C. Dantrolene
Rationale: Muscle Rigidity And Elevated Body Temperature Are Classic Signs Of
Malignant Hyperthermia, A Potentially Life-Threatening Reaction To Certain Anesthetics
Like Succinylcholine. Dantrolene Is The Antidote, Acting To Reduce Muscle Contraction
And Metabolic Activity.
• A: Neostigmine Is Used To Reverse Nondepolarizing Neuromuscular Blockers, Not
For Malignant Hyperthermia.
• B: Naloxone Is An Opioid Antagonist And Is Not Relevant In This Context.
• D: Vecuronium Is Another Neuromuscular Blocker, Which Would Not Address The
Underlying Issue.
3. A Nurse In The Post-Anesthesia Care Unit Is Caring For A Client Who Is
Experiencing Malignant Hyperthermia. Which Of The Following Actions Should
The Nurse Take? (Select All That Apply.)
A. Place A Cooling Blanket On The Client.
B. Administer Oxygen At 100%.
C. Administer Iced 0.9% Sodium Chloride.
D. Administer Potassium Chloride Iv.
E. Monitor Core Body Temperature.
ANS: A, B, C, E
Rationale:
• A: Cooling Blankets Help Reduce Elevated Body Temperature In Malignant
Hyperthermia.
• B: Administering 100% Oxygen Is Critical For Addressing Hypoxia And Ensuring
Adequate Oxygenation.
• C: Iced Saline Is Used To Further Lower The Patient's Core Temperature Rapidly.
• E: Monitoring The Core Body Temperature Is Crucial To Evaluate The Effectiveness
Of Treatment And Prevent Complications.
• D: Potassium Chloride Is Not Indicated In This Situation; It Could Worsen
Hyperkalemia Associated With Muscle Damage From Malignant Hyperthermia.
,4. A Nurse Is Teaching A Client Who Has A New Prescription For Baclofen To
Treat Muscle Spasms. Which Of The Following Statements By The Client
Indicates An Understanding Of The Teaching? (Select All That Apply.)
A. "I Will Stop Taking This Medication Right Away If I Develop Dizziness."
B. "I Know The Doctor Will Gradually Increase My Dose Of This Medication For A While."
C. "I Should Increase Fiber To Prevent Constipation From This Medication."
D. "I Won't Be Able To Drink Alcohol While I'm Taking This Medication."
E. "I Should Take This Medication On An Empty Stomach Each Morning."
ANS: B, C, D
Rationale:
• B: The Provider Typically Starts With A Low Dose Of Baclofen And Gradually
Increases It To Minimize Side Effects.
• C: Baclofen Can Cause Constipation, So Increasing Fiber And Fluid Intake Is
Recommended To Mitigate This Effect.
• D: Alcohol Can Enhance Cns Depressant Effects, So It Should Be Avoided While
Taking Baclofen.
• A: Clients Should Not Abruptly Stop Baclofen; This Can Lead To Withdrawal
Symptoms. Instead, They Should Consult Their Healthcare Provider.
• E: Baclofen Can Be Taken With Or Without Food; There's No Need For It To Be
Taken On An Empty Stomach.
5. A Nurse Is Reviewing The Health Care Record Of A Client Who Reports
Urinary Incontinence And Asks About A Prescription For Oxybutynin. The Nurse
Should Recognize That Oxybutynin Is Contraindicated In The Presence Of Which
Of The Following Conditions?
A. Bursitis
B. Sinusitis
C. Depression
D. Glaucoma
ANS: D. Glaucoma
Rationale: Oxybutynin Is An Anticholinergic Medication That Can Increase Intraocular
Pressure, Making It Contraindicated For Patients With Glaucoma.
• A, B, C: Bursitis, Sinusitis, And Depression Are Not Contraindications For
Oxybutynin Use.
6. A Nurse Is Caring For A Client Who Has A Prescription For Bethanechol To
Treat Urinary Retention. The Nurse Should Recognize That Which Of The
Following Findings Is A Manifestation Of Muscarinic Stimulation?
,A. Dry Mouth
B. Hypertension
C. Excessive Perspiration
D. Fecal Impaction
ANS: C. Excessive Perspiration
Rationale: Bethanechol Is A Muscarinic Agonist, And Muscarinic Stimulation Leads To
Increased Secretions, Including Sweating (Excessive Perspiration).
• A: Dry Mouth Is A Sign Of Anticholinergic Effects, Not Muscarinic Stimulation.
• B: Muscarinic Stimulation Typically Does Not Cause Hypertension; It Can Lead To
Hypotension Due To Vasodilation.
• D: Fecal Impaction Is Not A Direct Result Of Muscarinic Stimulation; It Is More
Related To Decreased Bowel Motility, Which Is Not The Effect Of Muscarinic
Agonists.
7. A Nurse In The Post-Anesthesia Recovery Unit Is Caring For A Client Who
Received A Nondepolarizing Neuromuscular Blocking Agent And Has Muscle
Weakness. The Nurse Should Anticipate A Prescription For Which Of The
Following Medications?
A. Neostigmine
B. Naloxone
C. Dantrolene
D. Vecuronium
ANS: A. Neostigmine
Rationale: Neostigmine Is A Cholinesterase Inhibitor That Is Used To Reverse The Effects
Of Nondepolarizing Neuromuscular Blockers, Restoring Muscle Function.
• B: Naloxone Is An Opioid Antagonist And Not Relevant Here.
• C: Dantrolene Is Used For Malignant Hyperthermia, Not For Reversing
Nondepolarizing Agents.
• D: Vecuronium Is Another Neuromuscular Blocker And Would Not Be Used To
Treat Muscle Weakness Caused By Its Own Effects.
8. A Provider Prescribes Phenobarbital For A Client Who Has A Seizure Disorder.
The Medication Has A Long Half-Life Of 4 Days. How Many Times Per Day
Should The Nurse Expect To Administer This Medication?
A. One
B. Two
C. Three
D. Four
,ANS: A. One
Rationale: Medications With Long Half-Lives, Like Phenobarbital, Are Typically
Administered Once Daily To Maintain Therapeutic Levels Without Fluctuations.
• B, C, D: Multiple Doses Are Not Necessary Due To The Long Duration Of Action.
9. A Staff Educator Is Reviewing Medication Dosages And Factors That Influence
Medication Metabolism With A Group Of Nurses At An In-Service Presentation.
Which Of The Following Factors Should The Educator Include As A Reason To
Administer Lower Medication Dosages? (Select All That Apply.)
A. Increased Renal Secretion
B. Increased Medication-Metabolizing Enzymes
C. Liver Failure
D. Peripheral Vascular Disease
E. Concurrent Use Of Medication The Same Pathway Metabolizes
ANS: C, E
Rationale:
• C: Liver Failure Reduces The Metabolism Of Drugs, Necessitating Lower Dosages
To Avoid Toxicity.
• E: When Two Drugs Use The Same Metabolic Pathway, They Can Compete, Leading
To Increased Concentrations Of One Or Both, Requiring Dosage Adjustments.
• A: Increased Renal Secretion Generally Doesn't Necessitate Lower Doses; It Often
Relates To Increased Elimination.
• B: Increased Enzyme Activity May Require Higher Doses, Not Lower.
• D: Peripheral Vascular Disease May Affect Drug Distribution But Does Not Directly
Impact The Need For Dosage Adjustments.
10. A Nurse Is Preparing To Administer Eye Drops To A Client. Which Of The
Following Actions Should The Nurse Take? (Select All That Apply.)
A. Have The Client Lie On Her Side.
B. Ask The Client To Look Up At The Ceiling.
C. Tell The Client To Blink When The Drops Enter Her Eye.
D. Drop The Medication Into The Center Of The Client's Conjunctival Sac.
E. Instruct The Client To Close Her Eye Gently After Instillation.
ANS: B, D, E
Rationale:
• B: Looking Up Helps Direct The Drops Into The Eye Rather Than Allowing Them To
Run Down The Cheek.
• D: Placing Drops In The Conjunctival Sac Allows For Better Absorption.
, • E: Closing The Eye Gently Helps Distribute The Medication Evenly Across The
Surface.
• A: Lying On Her Side Is Not Necessary And Can Make The Procedure More
Difficult.
• C: Blinking Right After Administration Can Expel The Drops Rather Than Allowing
Them To Be Absorbed.
11. A Nurse Is Completing Discharge Teaching For A Client Who Has A New
Prescription For Transdermal Patches. Which Of The Following Statements
Should The Nurse Identify As An Indication That The Client Understands The
Instructions?
A. "I Will Clean The Site With An Alcohol Swab Before I Apply The Patch."
B. "I Will Rotate The Application Sites Weekly."
C. "I Will Apply The Patch To An Area Of Skin With No Hair."
D. "I Will Place The New Patch On The Site Of The Old Patch."
ANS: C. "I Will Apply The Patch To An Area Of Skin With No Hair."
Rationale: Applying The Patch To Hairless Skin Ensures Better Adhesion And Absorption
Of The Medication.
• A: While Cleaning The Site Is Important, Alcohol May Irritate The Skin Or Affect
Adhesion; Soap And Water Are Usually Preferred.
• B: Patches Should Typically Be Rotated Regularly (Often Daily Or Weekly,
Depending On The Product) Rather Than Just Weekly.
• D: New Patches Should Not Be Placed Directly Over Old Patches To Avoid
Overdosing; The Old Patch Should Be Removed First.
12. A Nurse Reviewing A Client's Medical Record Notes A New Prescription For
Verifying The Trough Level Of The Client's Medication. Which Of The Following
Actions Should The Nurse Take?
A. Obtain A Blood Specimen Immediately Prior To Administering The Next Dose Of
Medication.
B. Verify That The Client Has Been Taking The Medication For 24 Hr Before Obtaining A
Blood Specimen.
C. Ask The Client To Provide A Urine Specimen After The Next Dose Of Medication.
D. Administer The Medication And Obtain A Blood Specimen 30 Min Later.
ANS: A. Obtain A Blood Specimen Immediately Prior To Administering The Next Dose Of
Medication.
Rationale: Trough Levels Are Determined Just Before The Next Dose To Ensure That The
Drug Levels Are Within The Therapeutic Range.
