ATI Pharmacology Proctored Test Bank
1. 1) A nurse is caring for a client with
hyperparathyroidism and notes that the
client's serum calcium level is 13 mg/dL.
Which medication should the nurse prepare
to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D
2. 2.) Oral iron supplements are prescribed for
a 6-year-old child with iron deficiency
anemia. The nurse instructs the mother to
administer the iron with which best food
item?
1. Milk
2. Water
3. Apple juice
4. Orange juice
3. 3.) Salicylic acid is prescribed for a client
with a diagnosis of psoriasis. The nurse
monitors the client, knowing that which of
the following would indicate the presence
of systemic toxicity from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations
4. 4.) The camp nurse asks the children
preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the
children that chemical sunscreens are most
effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to
the sun
5. 5.) Mafenide acetate (Sulfamylon) is
prescribed for the client with a burn injury.
When applying the medication, the client
complains of local discomfort and burning.
Which of the following is the most
appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed
to the burn site
3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing
hypercalcemia. Calcium gluconate and calcium chloride are medications used for the
treatment of tetany, which occurs as a result of acute hypocalcemia. In
hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid
hormone, decreases the plasma calcium level by inhibiting bone resorption and
lowering the serum calcium concentration.
4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be
instructed to administer the medication with a citrus fruit or a juice that is high in
vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption.
Orange juice contains a greater amount of vitamin C than apple juice.
1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism)
can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological
disturbances. Constipation and diarrhea are not associated with salicylism.
4. At least 30 minutes before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
3. Informing the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning and
that this is a normal reaction; therefore options 1, 2, and 4 are incorrect

6. 6.) The burn client is receiving treatments of
topical mafenide acetate (Sulfamylon) to the
site of injury. The nurse monitors the client,
knowing that which of the following indicates
that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site
7. 7.) Isotretinoin is prescribed for a client with
severe acne. Before the administration of this
medication, the nurse anticipates that which
laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count
8. 8.) A client with severe acne is seen in the
clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the
client's medication record and would contact
the (HCP) if the client is taking which
medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin)
9. 9.) The nurse is applying a topical
corticosteroid to a client with eczema. The
nurse would monitor for the potential for
increased systemic absorption of the
medication if the medication were being
applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands
10. 10.) The clinic nurse is performing an
admission assessment on a client. The nurse
notes that the client is taking azelaic acid
(Azelex). Because of the medication
prescription, the nurse would suspect that the
client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex
1. Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion
of acid, thereby causing acidosis. Clients receiving this treatment should be
monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the
medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local
rather than systemic effects. An elevated blood pressure may be expected from the
pain that occurs with a burn injury.
2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification
of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4
are not contraindicated with the use of isotretinoin.
2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is
higher from regions where the skin is especially permeable (scalp, axilla, face,
eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
poor (back, palms, soles).
1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and
decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.

11. 11.) The health care provider has prescribed silver
sulfadiazine (Silvadene) for the client with a partial-
thickness burn, which has cultured positive for gram-
negative bacteria. The nurse is reinforcing
information to the client about the medication. Which
statement made by the client indicates a lack of
understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the
wound."
12. 12.) A nurse is caring for a client who is receiving an
intravenous (IV) infusion of an antineoplastic
medication. During the infusion, the client complains
of pain at the insertion site. During an inspection of
the site, the nurse notes redness and swelling and
that the rate of infusion of the medication has
slowed. The nurse should take which appropriate
action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the
discomfort.
3. Apply ice and maintain the infusion rate, as
prescribed.
4. Elevate the extremity of the IV site, and slow the
infusion.
13. 13.) The client with squamous cell carcinoma of the
larynx is receiving bleomycin intravenously. The
nurse caring for the client anticipates that which
diagnostic study will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies
14. 14.) The client with acute myelocytic leukemia is
being treated with busulfan (Myleran). Which
laboratory value would the nurse specifically
monitor during treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level
3. "The medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum
of activity against gram-negative bacteria, gram-positive bacteria, and
yeast. It is applied directly to the wound to assist in healing. It does not
stain the skin.
1. Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are
administered via IV, great care must be taken to prevent the medication from
escaping into the tissues surrounding the injection site, because pain, tissue
damage, and necrosis can result. The nurse monitors for signs of
extravasation, such as redness or swelling at the insertion site and a
decreased infusion rate. If extravasation occurs, the registered nurse needs
to be notified; he or she will then contact the health care provider.
4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that
can cause interstitial pneumonitis, which can progress to pulmonary fibrosis.
Pulmonary function studies along with hematological, hepatic, and renal
function tests need to be monitored. The nurse needs to monitor lung
sounds for dyspnea and crackles, which indicate pulmonary toxicity. The
medication needs to be discontinued immediately if pulmonary toxicity
occurs. Options 1, 2, and 3 are unrelated to the specific use of this
medication.
2. Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level.
Hyperuricemia can produce uric acid nephropathy, renal stones, and acute
renal failure. Options 1, 3, and 4 are not specifically related to this
medication.

15. 15.) The client with small cell lung cancer is
being treated with etoposide (VePesid). The
nurse who is assisting in caring for the client
during its administration understands that which
side effect is specifically associated with this
medication?
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension
16. 16.) The clinic nurse is reviewing a teaching plan
for the client receiving an antineoplastic
medication. When implementing the plan, the
nurse tells the client:
1. To take aspirin (acetylsalicylic acid) as
needed for headache
2. Drink beverages containing alcohol in
moderate amounts each evening
3. Consult with health care providers (HCPs)
before receiving immunizations
4. That it is not necessary to consult HCPs
before receiving a flu vaccine at the local
health fair
17. 17.) The client with ovarian cancer is being
treated with vincristine (Oncovin). The nurse
monitors the client, knowing that which of the
following indicates a side effect specific to this
medication?
1. Diarrhea
2. Hair loss
3. Chest pain
4. Numbness and tingling in the fingers and
toes
18. 18.) The nurse is reviewing the history and
physical examination of a client who will be
receiving asparaginase (Elspar), an
antineoplastic agent. The nurse consults with
the registered nurse regarding the
administration of the medication if which of the
following is documented in the client's history?
1. Pancreatitis
2. Diabetes mellitus
3. Myocardial infarction
4. Chronic obstructive pulmonary disease
4. Orthostatic hypotension
Rationale:
A side effect specific to etoposide is orthostatic hypotension. The client's blood
pressure is monitored during the infusion. Hair loss occurs with nearly all the
antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to
this medication.
3. Consult with health care providers (HCPs) before receiving immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must
be informed not to receive immunizations without a HCP's approval. Clients also
need to avoid contact with individuals who have recently received a live virus
vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize
the risk of bleeding, and they need to avoid alcohol to minimize the risk of
toxicity and side effects.
4. Numbness and tingling in the fingers and toes
Rationale:
A side effect specific to vincristine is peripheral neuropathy, which occurs in
almost every client. Peripheral neuropathy can be manifested as numbness and
tingling in the fingers and toes. Depression of the Achilles tendon reflex may be
the first clinical sign indicating peripheral neuropathy. Constipation rather than
diarrhea is most likely to occur with this medication, although diarrhea may occur
occasionally. Hair loss occurs with nearly all the antineoplastic medications.
Chest pain is unrelated to this medication.
1. Pancreatitis
Rationale:
Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or
if the client has a history of pancreatitis. The medication impairs pancreatic
function and pancreatic function tests should be performed before therapy begins
and when a week or more has elapsed between administration of the doses. The
client needs to be monitored for signs of pancreatitis, which include nausea,
vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not
contraindicated with this medication.

19. 19.) Tamoxifen is prescribed for the
client with metastatic breast
carcinoma. The nurse understands
that the primary action of this
medication is to:
1. Increase DNA and RNA
synthesis.
2. Promote the biosynthesis of
nucleic acids.
3. Increase estrogen
concentration and estrogen
response.
4. Compete with estradiol for
binding to estrogen in tissues
containing high concentrations of
receptors.
20. 20.) The client with metastatic
breast cancer is receiving
tamoxifen. The nurse specifically
monitors which laboratory value
while the client is taking this
medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time
21. 21.) A nurse is assisting with caring
for a client with cancer who is
receiving cisplatin. Select the
adverse effects that the nurse
monitors for that are associated
with this medication. Select all
that apply.
1. Tinnitus
2. Ototoxicity
3. Hyperkalemia
4. Hypercalcemia
5. Nephrotoxicity
6. Hypomagnesemia
22. 22.) A nurse is caring for a client
after thyroidectomy and notes
that calcium gluconate is
prescribed for the client. The
nurse determines that this
medication has been prescribed
to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of
parathyroid hormone.
4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of
receptors.
Rationale:
Tamoxifen is an antineoplastic medication that competes with estradiol for binding to estrogen
in tissues containing high concentrations of receptors.

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23. 23.) A client who has been newly
diagnosed with diabetes mellitus
has been stabilized with daily insulin
injections. Which information should
the nurse teach when carrying out
plans for discharge?
1. Keep insulin vials refrigerated at
all times.
2. Rotate the insulin injection sites
systematically.
3. Increase the amount of insulin
before unusual exercise.
4. Monitor the urine acetone level
to determine the insulin dosage.
24. 24.) A nurse is reinforcing teaching
for a client regarding how to mix
regular insulin and NPH insulin in
the same syringe. Which of the
following actions, if performed by
the client, indicates the need for
further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial
first
4. Injects an amount of air equal to
the desired dose of insulin into the
vial
25. 25.) A home care nurse visits a
client recently diagnosed with
diabetes mellitus who is taking
Humulin NPH insulin daily. The
client asks the nurse how to store
the unopened vials of insulin. The
nurse tells the client to:
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry
place.
4. Keep the insulin at room
temperature.
26. 26.)

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27. 27.) Sildenafil (Viagra) is prescribed to treat a client
with erectile dysfunction. A nurse reviews the
client's medical record and would question the
prescription if which of the following is noted in the
client's history?
1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
4. Use of multivitamins
28. 28.) The health care provider (HCP) prescribes
exenatide (Byetta) for a client with type 1 diabetes
mellitus who takes insulin. The nurse knows that
which of the following is the appropriate
intervention?
1. The medication is administered within 60 minutes
before the morning and evening meal.
2. The medication is withheld and the HCP is called
to question the prescription for the client.
3. The client is monitored for gastrointestinal side
effects after administration of the medication.
4. The insulin is withdrawn from the Penlet into an
insulin syringe to prepare for administration.
29. 29.) A client is taking Humulin NPH insulin daily
every morning. The nurse reinforces instructions for
the client and tells the client that the most likely
time for a hypoglycemic reaction to occur is:
1. 2 to 4 hours after administration
2. 4 to 12 hours after administration
3. 16 to 18 hours after administration
4. 18 to

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34. 34.) A client with Crohn's disease is
scheduled to receive an infusion of
infliximab (Remicade). The nurse assisting in
caring for the client should take which action
to monitor the effectiveness of treatment?
1. Monitoring the leukocyte count for 2 days
after the infusion
2. Checking the frequency and consistency
of bowel movements
3. Checking serum liver enzyme levels
before and after the infusion
4. Carrying out a Hematest on gastric fluids
after the infusion is completed
35. 35.) The client has a PRN prescription for
loperamide hydrochloride (Imodium). The
nurse understands that this medication is
used for which condition?
1. Constipation
2. Abdominal pain
3. An episode of diarrhea
4. Hematest-positive nasogastric tube
drainage
36. 36.) The client has a PRN prescription for
ondansetron (Zofran). For which condition
should this medication be administered to
the postoperative client?
1. Paralytic ileus
2. Incisional pain
3. Urinary retention
4. Nausea and vomiting
37. 37.) The client has begun medication therapy
with pancrelipase (Pancrease MT). The nurse
evaluates that the medication is having the

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39. 39.) The client with a gastric ulcer has a prescription for
sucralfate (Carafate), 1 g by mouth four times daily. The nurse
schedules the medication for which times?
1. With meals and at bedtime
2. Every 6 hours around the clock
3. One hour after meals and at bedtime
4. One hour before meals and at bedtime
40. 40.) The client who chronically uses nonsteroidal anti-
inflammatory drugs has been taking misoprostol (Cytotec).
The nurse determines that the medication is having the
intended therapeutic effect if which of the following is
noted?
1.

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44. 44.) A client is receiving acetylcysteine
(Mucomyst), 20% solution diluted in 0.9%
normal saline by nebulizer. The nurse should
have which item available for possible use
after giving this medication?
1. Ambu bag
2. Intubation tray
3. Nasogastric tube
4. Suction equipment
45. 45.) A client has a prescription to take
guaifenesin (Humibid) every 4 hours, as
needed. The nurse determines that the client
understands the most effective use of this
medication if the client states that he or she
will:
1. Watch for irritability as a side effect.
2. Take the tablet with a full glass of water.
3. Take an extra dose if the cough is
accompanied by fever.
4. Crush the sustained-release tablet if
immediate relief is needed.
46. 46.) A postoperative client has received a
dose of naloxone hydrochloride for
respiratory depression shortly after transfer
to the nursing unit from the postanesthesia
care unit. After administration of the
medication, the nurse checks the client for:
1. Pupillary changes
2. Scattered lung wheezes
3. Sudden increase in pain
4. Sudden episodes of diarrhea
47. 47.) A client has been taking isoniazid (INH) for
2 months. The client complains to a nurse
about numbness, paresthesias, and tingling in
the extremities. The nurse interprets that the
client is experiencing:
1. Hypercalcemia
2. Peripheral neuritis
3. Small blood vessel spasm
4. Impaired peripheral circulation
4. Suction equipment
Rationale:
Acetylcysteine can be given orally or by nasogastric tube to treat acetaminophen
overdose, or it may be given by inhalation for use as a mucolytic. The nurse
administering this medication as a mucolytic should have suction equipment
available in case the client cannot manage to clear the increased volume of
liquefied secretions.
2. Take

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52. 52.) A client with tuberculosis is being
started on antituberculosis therapy with
isoniazid (INH). Before giving the client the
first dose, a nurse ensures that which of the
following baseline studies has been
completed?
1. Electrolyte levels
2. Coagulation times
3. Liver enzyme levels
4. Serum creatinine level
53. 53.) Rifabutin (Mycobutin) is prescribed for a
client with active Mycobacterium avium
complex (MAC) disease and tuberculosis. The
nurse monitors for which side effects of the
medication? Select all that apply.
1. Signs of hepatitis
2. Flu-like syndrome
3. Low neutrophil count
4. Vitamin B6 deficiency
5. Ocular pain or blurred vision
6. Tingling and numbness of the fingers
54. 54.) A nurse reinforces discharge instructions
to a postoperative client who is taking
warfarin sodium (Coumadin). Which
statement, if made by the client, reflects the
need for further teaching?

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56. 56.) Heparin sodium is prescribed for the
client. The nurse expects that the health
care provider will prescribe which of the
following to monitor for a therapeutic
effect of the medication?
1. Hematocrit level
2. Hemoglobin level
3. Prothrombin time (PT)
4. Activated partial thromboplastin time
(aPTT)
57. 57.) A nurse is monitoring a client who is
taking propranolol (Inderal LA). Which
data collection finding would indicate a
potential serious complication associated
with propranolol?
1. The development of complaints of
insomnia
2. The development of audible expiratory
wheezes
3. A baseline blood pressure of 150/80
mm Hg followed by a blood pressure of
138/72 mm Hg after two doses of the
medication
4. A baseline resting heart rate of 88
beats/min followed by a resting heart
rate of 72 beats/min after two doses of
the medication
58. 58.) Isosorbide mononitrate (Imdur) is
prescribed for a client with angina
pectoris. The client tells the nurse that
the medication is causing a chronic
headache. The nurse appropriately
suggests that the client:
1. Cut the dose in half.
2. Discontinue the medication.
3. Take the medication with food.
4. Contact the health care provider
(HCP).
59. 59.) A client is diagnosed with an acute
myocardial infarction and is receiving
tissue plasminogen activator, alteplase
(Activase, tPA). Which action is a priority
nursing intervention?
1.

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60. 60.) A nurse is planning to administer
hydrochlorothiazide (HydroDIURIL) to a
client. The nurse understands that which of
the following are concerns related to the
administration of this medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa
allergy
4. Hyperkalemia, hypoglycemia, penicillin
allergy
61. 61.) A home health care nurse is visiting a
client with elevated triglyceride levels and
a serum cholesterol level of 398 mg/dL. The
client is taking cholestyramine (Questran).
Which of the following statements, if made
by the client, indicates the need for further
education?
1. "Constipation and bloating might be a
problem."
2. "I'll continue to watch my diet and reduce
my fats."
3. "Walking a mile each day will help the
whole process."
4. "I'll continue my nicotinic acid from the
health food store."
62. 62.) A client is on nicotinic acid (niacin) for
hyperlipidemia and the nurse provides
instructions to the client about the
medication. Which statement by the client
would indicate an understanding of the
instructions?
1. "It is not necessary to avoid the use of
alcohol."
2. "The medication should be taken with
meals to decrease flushing."
3. "Clay-colored stools are a common

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ATI Pharmacology Proctored Test Bank with Answers (313 Solved Questions)

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