ATI RN Pharmacology Proctored Assessment

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Sample questions from ATI RN Pharmacology Proctored Assessment

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A newborn receiving an oral medication has a lower-than-expected serum drug concentration after the prescribed dose. Which developmental factor can contribute to slower drug metabolism in a newborn?

   • A.More rapid gastric emptying
   • B.Increased glomerular filtration rate
   • C.Increased plasma albumin concentration
   • D.Immature hepatic enzyme activity

   Rationale: Immature hepatic enzyme systems can slow metabolism of many medications in newborns, affecting drug concentrations and duration of action. Newborn glomerular filtration is also immature rather than increased, so it does not explain faster elimination. Plasma albumin is not increased in a way that accounts for this finding, and gastric emptying is generally slower and variable, not more rapid. The exam takeaway is to account for developmental differences in absorption, metabolism, and elimination when dosing infants.

2. 2.At a community clinic, a 6-month-old is prescribed an oral liquid medication. Which action best ensures an accurate dose?

   • A.Measure the dose with an oral syringe marked in milliliters
   • B.Pour the medication into a cup and use the cup's markings
   • C.Use a household teaspoon and estimate the prescribed volume
   • D.Mix the medication into a full bottle of formula

   Rationale: An oral syringe provides a precise volume for a small infant dose and reduces measurement error. Household spoons vary in size, and estimating a dose is unsafe. Mixing medication into a full bottle can result in an incomplete dose if the infant does not finish it. A cup is less accurate for small volumes and may be difficult for an infant to use. Use a calibrated device and follow medication-specific instructions.

3. 3.A parent of a 4-year-old asks how to give a newly prescribed oral medication at home. Which instructions should the nurse provide? Select all that apply.

   • A.Use the oral syringe supplied with the medication to measure each dose
   • B.Check the concentration on the bottle each time the medication is dispensed
   • C.Keep the medication in its original, child-resistant container and out of the child's reach
   • D.If a dose is missed, give two doses together at the next scheduled time
   • E.Follow the label or pharmacist's instructions about whether to give the medication with food

   Rationale: An oral syringe is more accurate than a household spoon, and checking the concentration helps prevent errors when products or formulations differ. Food instructions depend on the specific medication, so the caregiver should follow the label or pharmacist's guidance. A missed dose should not routinely be doubled; the caregiver should follow medication-specific instructions or contact the prescriber or pharmacist. Child-resistant packaging and storage out of reach reduce accidental ingestion risk.

4. 4.In the emergency department, an adolescent with a severe infection is prescribed an intravenous medication. The nurse notes the dose was calculated using the client's weight from 18 months ago. What should the nurse do first?

   • A.Ask the client to confirm the old weight
   • B.Administer the dose because the client is older than 12 years
   • C.Obtain a current weight and verify the weight-based dose before administration
   • D.Reduce the dose by half to account for possible weight gain

   Answer and rationale are in the full material.

5. 5.A primigravida at 32 weeks asks why the prescriber is reviewing her medication doses during pregnancy. Which response is most accurate?

   • A.The placenta prevents medications from reaching the fetus
   • B.Pregnancy-related changes in renal blood flow and volume of distribution can alter medication concentrations
   • C.All medications are metabolized more slowly during pregnancy
   • D.Medication doses never need adjustment during pregnancy

   Answer and rationale are in the full material.