2022 ATI Pharmacology Proctored Exam With Answers-238 Solved Questions

ATI Pharmacology Proctored Exam Test bank 1
1. 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
Answer: A. One
2. A nurse educator is reviewing medication metabolism 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 excretion
B. Increased medication-metabolizing enzymes
C. Liver failure
D. Peripheral vascular disease
E. Concurrent use of medication the same pathway metabolizes
Answer: C. Liver failure
E. Concurrent use of medication the same pathway metabolizes
3. 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 one side.
B. Ask the client to look up at the ceiling.
C. Tell the client to blink when the drops enter the eye.
D. Drop the medication into the client's conjunctival sac.
E. Instruct the client to close the eye gently after instillation.
Answer: B. Ask the client to look up at the ceiling.
D. Drop the medication into the client's conjunctival sac.
E. Instruct the client to close the eye gently after instillation.

4. A nurse is teaching a client about transdermal patches. Which of the following statements
should the nurse identify as an indication that the client understands?
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."
Answer: C. "I will apply the patch to an area of skin with no hair."
5. 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 24hr 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.
Answer: A. Obtain a blood specimen immediately prior to administering the next dose of
medication.
6. A nurse is preparing a client's medications. Which the of following actions should the nurse
take in following legal practice guidelines? (Select all that apply.)
A. Teach the client about the medication.
B. Determine the dosage.
C. Monitor for adverse effects.
D. Lock compartments for controlled substances.
E. Determine the client's insurance status.
Answer: A. Teach the client about the medication.
C. Monitor for adverse effects.
D. Lock compartments for controlled substances.
7. A nurse is preparing to administer digoxin to a client who states, "I don't want to take that
medication. I do not want one more pill." Which of the following responses should the nurse
make?
A. "Your physician prescribed it for so you really should take it."
B. "Well, let's just get it over quickly then." you,

C. "Okay, I'll just give you your other medications."
D. "Tell me your concerns about taking this medication."
Answer: D. "Tell me your concerns about taking this medication."
8. A nurse is reviewing a client's prescribed medications. Which of the following situations
represents a contraindication to medication administration?
A. The client drank grapefruit juice, which could reduce a medication's effectiveness.
B. The medication has orthostatic hypotension as an adverse effect.
C. A medication is approved for ages 12 and older, and the client is 8 years old.
D. An antianxiety medication that has an adverse effect of drowsiness is prescribed as a
preoperative sedative.
Answer: C. A medication is approved for ages 12 and older, and the client is 8 years old.
9. A nurse is assessing a client before administering medications. Which of the following data
should the nurse obtain? (Select all that apply.)
A. Use of herbal products
B. Daily fluid intake
C. Ability to swallow
D. Previous surgical history
E. Allergies
Answer: A. Use of herbal products
C. Ability to swallow
E. Allergies
10. A nurse is working with a newly licensed nurse who is administering medications to
clients. Which of the following actions should the nurse identify as an indication that the
newly hired nurse understands medication error prevention?
A. Taking all medications out of the unit-dose wrappers before entering the client's room
B. Checking the prescription when a single dose requires administration of multiple tablets
C. Administering a medication, then looking up the usual dosage range
D. Relying on another nurse to clarify a medication prescription
Answer: B. Checking the prescription when a single dose requires administration of multiple
tablets

11. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider
about a potential contraindication to a medication for which of the following clients? (Select
all that apply.)
A. A client at 8 weeks of gestation who asks for an influenza immunization
B. A client who takes prednisone and has a possible fungal infection
C. A client who has chronic liver disease and is taking hydrocodone / acetaminophen
D. A client who has peptic ulcer disease, takes sucralfate, and has started taking OTC
aluminum hydroxide
E. A client who has a prosthetic heart valve, takes warfarin, and reports a suspected
pregnancy
Answer: B. A client who takes prednisone and has a possible fungal infection
C. A client who has chronic liver disease and is taking hydrocodone / acetaminophen
E. A client who has a prosthetic heart valve, takes warfarin, and reports a suspected
pregnancy
12. A nurse is preparing to administer an IM dose of penicillin to a client who has a new
prescription. The client states when they took penicillin 3 years ago, they developed a rash.
Which of the following actions should the nurse take?
A. Administer the prescribed dose.
B. Withhold the medication.
C. Ask the provider to change the prescription to an oral form.
D. Administer an oral antihistamine the same time.
Answer: B. Withhold the medication.
13. A nurse is providing discharge instructions for a client who has a new prescription for an
antihypertensive medication. Which of the following statements should the nurse give?
A. "Be sure to limit your potassium intake while taking the medication."
B. "You should check your blood pressure every 8 hours while taking this medication."
C. "Your medication dosage will be increased if you develop tachycardia."
D. "Change positions slowly when you move from sitting to standing."
Answer: D. "Change positions slowly when you move from sitting to standing."

14. A nurse is reviewing a client's health record and notes that the client experienced
permanent extrapyramidal effects caused by a previous medication. The nurse should
recognize that the medication affected which of the following systems in the client?
A. Cardiovascular
B. Immune
C. Central nervous
D. Gastrointestinal
Answer: C. Central nervous
15. A nurse is caring for a client who is taking oral oxycodone. The client is also taking
ibuprofen in three recommended doses daily. The nurse should identify that an interaction
between these two medications will cause which of the following findings?
A. A decrease in blood levels of ibuprofen, possibly leading to a need for increased doses of
this medication
B. A decrease in blood levels of oxycodone, possibly leading to a need for increased doses of
this medication.
C. An increase in the expected therapeutic effect of both medications
D. An increase in expected adverse effects for both medications
Answer: C. An increase in the expected therapeutic effect of both medications
16. A nurse is preparing to administer medications to a 4-month-old infant. Which of the
following pharmacokinetic principles should the nurse consider when administering
medications to this client? (Select all that apply.)
A. Infants have a more rapid gastric emptying time.
B. Infants have immature liver function.
C. Infants' blood-brain barrier is poorly developed.
D. Infants have an increased ability to absorb topical medications.
E. Infants have an increased number of protein-binding sites.
Answer: B. Infants have immature liver function.
C. Infants' blood-brain barrier is poorly developed.
D. Infants have an increased ability to absorb topical medications.

17. A nurse in a provider's office is reviewing the medical record of a client who is pregnant
and at the first prenatal visit. Which of the following immunizations can the nurse administer
safely to this client?
A. Varicella vaccine
B. Rubella vaccine
C. Inactivated influenza vaccine
D. Measles vaccine
Answer: C. Inactivated influenza vaccine
18. A nurse on a medical-surgical unit administers a hypnotic medication to an older adult
client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating
breakfast. Which of the following factors should the nurse identify as a possible reason for
the client's drowsiness?
A. Reduced cardiac function
B. First-pass effect
C. Reduced hepatic function
D. Increased gastric motility
Answer: C. Reduced hepatic function
19. A nurse is caring for a client who has increased liver enzymes and is taking herbal
supplements. Which of the following herbal supplements should the nurse report to the
provider as the potential cause?
A. Glucosamine
B. Saw palmetto
C. Kava
D. St. John's Wort
Answer: C. Kava
20. A nurse is caring for a client who requests information on the use of feverfew. Which of
the tallowing responses should the nurse make?
A. "It is used to treat skin infections."
B. "It can decrease the frequency of migraine headaches."
C. "It can lessen the nasal congestion in the common cold."
D. "It can relieve nausea of morning sickness during pregnancy."

Answer: B. "It can decrease the frequency of migraine headaches."
21. A nurse is reviewing a client's current medications. The client states, "I also take ginkgo
biloba." Which of the following medications has the potential to interact with ginkgo biloba?
A. Acetaminophen
B. Warfarin
C. Digoxin
D. Lisinopril
Answer: B. Warfarin
22. A nurse is caring for a client who asks about the potential adverse effects of smoking
cannabis. Which of the following manifestations should the nurse include in the response?
(Select all that apply.)
A. Decreased heart rate
B. Dry mouth
C. Hallucinations
D. Hypertension
E. Increased urination
Answer: B. Dry mouth
C. Hallucinations
23. A nurse is teaching about the use of medical marijuana with a group of newly licensed
nurses. Which of the following statements indicates an understanding of the teaching?
A. A health care provider must write a prescription for medical marijuana.
B. Medical marijuana is a Schedule V controlled substance in the United States.
C. Pharmacies must obtain certification prior to dispensing medical marijuana.
D. The FDA does not recognize the marijuana plant as a form of medicine.
Answer: D. The FDA does not recognize the marijuana plant as a form of medicine.
24. A nurse working in an emergency department is caring for a client who has
benzodiazepine toxicity. Which of the following actions is the nurse's priority?
A. Administer flumazenil.
B. Identify the client's level of orientation.
C. Infuse IV fluids.

D. Prepare the client for gastric lavage.
Answer: B. Identify the client's level of orientation.
25. A nurse is teaching a client who has a new prescription for escitalopram for treatment of
generalized anxiety disorder. Which of the following statements by the client indicates
understanding of the teaching?
A. "I should take the medication on an empty stomach."
B. "I will follow a low-sodium diet while taking this medication."
C. "I need to discontinue this medication slowly."
D. "I should not crush this medication before swallowing."
Answer: C. "I need to discontinue this medication slowly."
26. A nurse is providing teaching to a client who has a new prescription for buspirone to treat
anxiety. Which of the following information should the nurse include?
A. "Take this medication on an empty stomach."
B. "Expect optimal therapeutic effects within 24 hr."
C. "Take this medication when needed for anxiety."
D. "This medication has a low risk for dependency."
Answer: D. "This medication has a low risk for dependency."
27. A nurse is teaching a client who has obsessive-compulsive disorder and has a new
prescription for paroxetine. Which of the following instructions should the nurse include?
A. "It can take several weeks before you feel like the medication is helping."
B. "Take the medication just before bedtime to promote sleep."
C. "You should take the medication when needed for obsessive urges."
D. "Monitor for weight gain while taking this medication."
Answer: A. "It can take several weeks before you feel like the medication is helping."
28. A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder
and reports that they grind their teeth during the night. The nurse should identify which of the
following interventions to manage bruxism? (Select all that apply.)
A. Concurrent administration of buspirone
B. Administration of a different SSRI
C. Use of a mouth guard

D. Changing to a different class of antidepressant medication
E. Increasing the dose of paroxetine
Answer: A. Concurrent administration of buspirone
C. Use of a mouth guard
D. Changing to a different class of antidepressant medication
29. A nurse is teaching the guardians of a child who has a new prescription for desipramine.
The nurse should include that which of the following adverse effects is the priority to report
to the provider?
A. Constipation
B. Suicidal thoughts
C. Photophobia
D. Dry mouth
Answer: B. Suicidal thoughts
30. A nurse is teaching an adolescent client who has a new prescription for clomipramine for
OCD. Which of the following instructions should the nurse include to minimize an adverse
effect of his medication?
A. Wear sunglasses when outdoors.
B. Check your temperature daily.
C. Take this medication in the morning.
D. Add extra calories to your diet.
Answer: A. Wear sunglasses when outdoors.
31. A nurse is caring for a school-age child who has a new prescription for atomoxetine. The
nurse should monitor the client for which of the following manifestations as an adverse effect
of this medication?
A. Kidney toxicity
B. Liver damage
C. Seizure activity
D. Adrenal insufficiency
Answer: B. Liver damage

32. A nurse is teaching the caregiver of a school-age child about transdermal
methylphenidate. Which of the following instructions should the nurse include?
A. Apply one patch twice per day.
B. Leave the patch on for 9 hr.
C. Apply the patch to the child's waist.
D. Use opened tray within 6 months.
Answer: B. Leave the patch on for 9 hr.
33. A nurse is teaching the guardians and their school-age child about a new prescription for
lisdexamfetamine. Which of the following information should the include in the teaching?
(Select all that apply.)
A. An adverse effect of this medication is CNS stimulation.
B. Administer the medication before bedtime.
C. Monitor blood pressure while taking this medication.
D. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop.
E. This medication raises the levels of dopamine in the brain.
Answer: A. An adverse effect of this medication is CNS stimulation.
C. Monitor blood pressure while taking this medication.
E. This medication raises the levels of dopamine in the brain.
34. A nurse is providing teaching to a group of new parents about medications. The nurse
should include that aspirin is contraindicated for children who have a viral infection due to
the risk of developing which of the following adverse effects?
A. Reye's syndrome
B. Visual disturbances
C. Diabetes mellitus
D. Wilms' tumor
Answer: A. Reye's syndrome
35. A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula
for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic
effects of epoetin alfa should the nurse include in the teaching?
A. Reduces blood pressure Inhibits
B. clotting of fistula

C. Promotes RBC production
D. Stimulates growth of neutrophils
Answer: C. Promotes RBC production
36. A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which
of the following medications should the nurse plan to administer?
A. Ibuprofen
B. Naproxen
C. Aspirin
D. Acetaminophen
Answer: D. Acetaminophen
37. A nurse is preparing to administer heparin 8,000 units subcutaneously every 8hr.
Available is heparin 10,000 units/1mL. How many mL should the nurse administer per dose?
(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing
zero.)
Answer: 0.8 mL
38. A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL
over 4 hr. The nurse should set the 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.)
Answer: 250 mL / 4 hours = 62.5 mL/hr
Rounded to the nearest whole number: 63 mL/hr
39. A nurse is preparing to administer amoxicillin 250 mg liquid supspension PO every 8 hr
to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL
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: 5 mL
40. A nurse is caring for a client who has a prescription for clopidogrel. The nurse should
monitor the client for which of the following adverse effects?
A. Insomnia
B. Hypotension

C. Bleeding
D. Constipation
Answer: C. Bleeding
41. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The
nurse should include a severe allergy to which of the following medications as a
contraindication to ceftriaxone?
A. Gentamicin
B. Clindamycin
C. Piperacillin
D. Sulfamethoxazole-trimethoprim
Answer: C. Piperacillin
42. A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse
should include in the teaching that which of the following conditions is a contraindication to
this medication?
A. Hyperthyroidism
B. Intestinal obstruction
C. Glaucoma
D. Low blood pressure
Answer: B. Intestinal obstruction
43. A nurse is assessing a client who has a new prescription for chlorpromazine to treat
schizophrenia. The client has a mask-like facial expression and is experiencing involuntary
movements and tremors. Which of the following medications should the nurse anticipate
administering?
A. Amantadine
B. Bupropion
C. Phenelzine
D. Hydroxyzine
Answer: A. Amantadine
44. A nurse is administering subcutaneous epinephrine for a client who is experiencing
anaphylaxis. The nurse should monitor the client for which of the following adverse effects?

A. Hypotension
B. Hyperthermia
C. Hypoglycemia
D. Tachycardia
Answer: D. Tachycardia
45. A nurse is providing teaching to a client who has a urinary tract infection and new
prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by
the client indicates the need for further teaching?
A. "If the phenazopyridine upsets my stomach, I can take it with meals."
B. "The phenazopyridine will relieve my discomfort, but the ciprofloxacin will get rid of the
infection."
C. "I need to drink 2 liters of fluid per day while I am taking the ciprofloxacin."
D. "I should notify my provider immediately if my urine turns an orange color."
Answer: D. "I should notify my provider immediately if my urine turns an orange color."
46. A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime
to promote sleep. The nurse should plan to monitor the client for which of the following
adverse effects?
A. Ecchymosis
B. Decreased urine output
C. Increased blood pressure
D. Dizziness
Answer: D. Dizziness
47. A nurse is reviewing laboratory values for a client who reports fatigue and cold
intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a
decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the
following medications?
A. Methimazole
B. Somatropin
C. Levothyroxine
D. Propylthiouracil
Answer: C. Levothyroxine

48. A nurse is providing teaching to a client who has a new prescription for
hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following
instructions should the nurse include in the teaching?
A. "Take hydrochlorothiazide as needed for edema."
B. "Check your weight once each week."
C. "Take the hydrochlorothiazide on an empty stomach."
D. "Take the hydrochlorothiazide in the morning."
Answer: D. "Take the hydrochlorothiazide in the morning."
49. A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm
labor. Which of the following medications should the nurse plan to administer?
A. Oxytocin
B. Nifedipine
C. Dinoprostone
D. Misoprostol
Answer: B. Nifedipine
50. A nurse is providing teaching to a client who has cirrhosis and a new prescription for
lactulose. The nurse should instruct the client that lactulose has which of the following
therapeutic effects?
A. Increases blood pressure
B. Prevents esophageal bleeding
C. Decreases heart rate
D. Reduces ammonia levels
Answer: D. Reduces ammonia levels
51. A nurse is caring for an older adult client who has a new prescription for amitriptyline to
treat depression. Which of the following diagnostic tests should the nurse plan to perform
prior to starting the client on this medication?
A. Hearing examination
B. Glucose tolerance test
C. Electrocardiogram
D. Pulmonary function tests

Answer: C. Electrocardiogram
52. A nurse is providing teaching to a client who has gout and a new prescription for
allopurinol. The nurse should instruct the client to discontinue taking the medication for
which of the following adverse effects?
A. Nausea
B. Metallic taste
C. Fever
D. Drowsiness
Answer: C. Fever
53. A nurse is assessing a client who is receiving IV gentamicin three times daily. Which of
the following findings indicates that the client is experiencing an adverse effect of this
medication?
A. Hypoglycemia
B. Proteinuria
C. Nasal congestion
D. Visual disturbances
Answer: B. Proteinuria
54. A nurse is providing teaching for a client who is withdrawing from alcohol and has a new
prescription for propranolol. Which of the following information should the nurse include in
the teaching?
A. Increases the risk for seizure activity
B. Provides a form of aversion therapy
C. Decreases cravings
D. Can increase blood pressure
Answer: C. Decreases cravings
55. A charge nurse is planning a staff education session to discuss medications used during
the care of a client experiencing alcohol withdrawal . Which of the following medications
should the charge nurse include the discus (Select all that apply.)
A. Lorazepam
B. Diazepam

C. Disulfiram
D. Naltrexone
E. Acamprosate
Answer: A. Lorazepam
B. Diazepam
56. A nurse is teaching a client who has a new prescription for clonidine to assist with
maintenance of abstinence from opioids. The nurse should instruct the client to monitor for
which of the following adverse effects?
A. Diarrhea
B. Dry mouth
C. Insomnia
D. Hypertension
Answer: B. Dry mouth
57. A nurse is teaching a client who has tobacco use disorder about nicotine replacement
therapy. Which of the following statements by the client indicates understanding of the
teaching?
A. "I should avoid eating right before I chew a piece of nicotine gum."
B. "I will need to stop using the nicotine gum after 1 year."
C. "I know that nicotine gum is a safe alternative to smoking if I become pregnant."
D. "I must chew the nicotine gum quickly for about 15 minutes."
Answer: A. "I should avoid eating right before I chew a piece of nicotine gum."
58. A nurse in an acute mental health facility is caring for a client who is experiencing
withdrawal from opioid use and has a new prescription for clonidine. Which of the following
actions should the nurse identify as the priority?
A. Administer the clonidine on the prescribed schedule.
B. Provide ice chips at the client's bedside.
C. Educate the client on the effects of clonidine.
D. Obtain baseline vital signs.
Answer: D. Obtain baseline vital signs.

59. 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
expect a prescription for which of the following medications?
A. Neostigmine
B. Naloxone
C. Dantrolene
D. Vecuronium
Answer: A. Neostigmine
60. A nurse is providing information to a client who has early Parkinson's disease and a new
prescription for pramipexole. The nurse should instruct the client to monitor for which of the
following adverse effects of this medication?
A. Hallucinations
B. Increased salivation
C. Diarrhea
D. Discoloration of urine
Answer: A. Hallucinations
61. A nurse is teaching a client who has a new prescription for levodopa / carbidopa for
Parkinson's disease. Which of the following instructions should the nurse include?
A. Increase intake of protein-rich foods.
B. Expect muscle twitching to occur.
C. Take this medication with food.
D. Anticipate relief of manifestations in 24 hr.
Answer: C. Take this medication with food.
62. A nurse is preparing to administer a medication to a client who has absence seizures. The
nurse should expect to administer which of the following medications to the client? (Select all
that apply.)
A. Phenytoin
B. Ethosuximide
C. Gabapentin
D. Carbamazepine
E. Valproic acid

F. Lamotrigine
Answer: B. Ethosuximide
E. Valproic acid
F. Lamotrigine
63. A nurse is reviewing a new prescription for oxcarbazepine with a client who has partial
seizures. Which of the following instructions should the nurse include? (Select all that apply.)
A. "Use caution if given a prescription for a diuretic medication."
B. "Consider using an alternate form of contraception if you are using oral contraceptives."
C. "Chew gum to increase saliva production."
D. "Avoid driving until you see how the medication affects you."
E. "Notify your provider if you develop a skin rash."
Answer: A. "Use caution if given a prescription for a diuretic medication."
B. "Consider using an alternate form of contraception if you are using oral contraceptives."
D. "Avoid driving until you see how the medication affects you."
E. "Notify your provider if you develop a skin rash."
64. 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 a rise in body
temperature. The nurse should expect a prescription for which of the following medications?
A. Neostigmine
B. Naloxone
C. Dantrolene
D. Vecuronium
Answer: C. Dantrolene
65. 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.

Answer: A. Place a cooling blanket on the client.
B. Administer oxygen at 100%.
C. Administer iced 0.9% sodium chloride.
E. Monitor core body temperature.
66. 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."
Answer: B. "I know the doctor will gradually increase my dose of this medication for a
while."
D. "I won't be able to drink alcohol while I'm taking this medication."
67. A nurse is reviewing the medical 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
Answer: D. Glaucoma
68. A nurse is assessing a client who has a prescription for bethanechol to treat urinary
retention. The nurse should identify that which of the following findings is a manifestation of
muscarinic stimulation?
A. Dry mouth
B. Hypertension
C. Excessive perspiration
D Fecal impaction
Answer: C. Excessive perspiration

69. A nurse is providing instructions to a client who has been experiencing insomnia and has
a new prescription for temazepam. The nurse should inform the client that which of the
following manifestations are adverse effects of temazepam? (Select all that apply.)
A. Incoordination
B. Hypertension
C. Pruritus
D. Sleep driving
E. Amnesia
Answer: A. Incoordination
D. Sleep driving
E. Amnesia
70. A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The
client is over sedated. Which of the following medications should the nurse expect to
administer to this client?
A. Ketamine
B. Naltrexone
C. Flumazenil
D. Fluvoxamine
Answer: C. Flumazenil
71. A nurse is teaching a client who has a new prescription for ramelteon. The nurse should
instruct the client to avoid which of the following foods at the time of medication
administration?
A. Baked potato
B. Fried chicken
C. Whole-grain bread
D. Citrus fruits
Answer: B. Fried chicken
72. A nurse is caring for a client who is to undergo a surgical procedure. Which of the
following preexisting conditions can be a contraindication for the use of ketamine as an
intravenous anesthetic?

A. Peptic ulcer disease
B. Breast cancer
C. Diabetes mellitus
D. Schizophrenia
Answer: D. Schizophrenia
73. A nurse is providing instructions to a client who has a new prescription for zolpidem.
Which of the following instructions should the nurse include?
A. "Notify the provider if you plan to become pregnant."
B. "Take the medication 1hr before you plan to go to sleep."
C. "Allow at least 6hr for sleep when taking zolpidem."
D. "To increase the effectiveness of zolpidem, take it with a bedtime snack."
Answer: A. "Notify the provider if you plan to become pregnant."
74. A nurse is reviewing the health record of a client who asks about using propranolol to
treat hypertension. The nurse should recognize which of the following conditions is a
contraindication for taking propranolol?
A. Asthma
B. Glaucoma
C. Hypertension
D. Tachycardia
Answer: A. Asthma
75. A nurse is teaching a client who has a new prescription for verapamil to control
hypertension. Which of the following instructions should the nurse include?
A. Increase the amount of fiber in the diet.
B. Drink grapefruit juice daily to increase vitamin C intake.
C. Decrease the amount of calcium in the diet.
D. Withhold food for 1hr after the medication is taken.
Answer: A. Increase the amount of fiber in the diet.
76. A nurse is caring for a client who has a new prescription for captopril for hypertension.
The nurse should monitor the client for which of the following as an adverse effect of this
medication?

A. Hypokalemia
B. Hypernatremia
C. Neutropenia
D. Bradycardia
Answer: C. Neutropenia
77. A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for
hypertensive crisis. Which of the following conditions should the nurse monitor the client for
as an adverse effect of this medication?
A. Intestinal ileus
B. Neutropenia
C. Delirium
D. Hyperthermia
Answer: C. Delirium
78. A nurse is planning to administer a first dose of captopril to a client who has
hypertension. Which of the following medications can intensify first dose hypotension?
(Select all that apply.)
A. Simvastatin
B. Hydrochlorothiazide
C. Phenytoin
D. Clonidine
E. Aliskiren
Answer: B. Hydrochlorothiazide
D. Clonidine
E. Aliskiren
79. A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of
the following findings is a manifestation of amiodarone toxicity?
A. Light yellow urine
B. Report of tinnitus
C. Productive cough
D. Blue-gray skin discoloration.
Answer: C. Productive cough

80. A nurse is caring for a client who received IV verapamil to treat supraventricular
tachycardia (SVT). The client's pulse rate is now 98 / min and the blood pressure is 74/44 mg
Hg. The nurse should expect a prescription for which of the following IV medications?
A. Calcium gluconate
B. Sodium bicarbonate
C. Potassium chloride
D. Magnesium sulfate
Answer: A. Calcium gluconate
81. A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the
following findings is a manifestation of digoxin toxicity?
A. Bruising
B. Report of metallic taste
C. Muscle pain
D. Report of anorexia
Answer: D. Report of anorexia
82. A nurse is assessing a client who has taken procainamide to treat dysrhythmias for the last
12 months. The nurse should assess the client for which of the following manifestations as an
adverse effect of this medication? (Select all that apply.)
A. Hypertension
B. Widened QRS complex
C. Narrowed QT interval
D. Easy bruising
E. Swollen joints
Answer: B. Widened QRS complex
D. Easy bruising
E. Swollen joints
83. A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which
of the following actions should the nurse plan to take?
A. Hold propranolol for an apical pulse greater than 100 / min.
B. Administer propranolol to increase the client's blood pressure.

C. Assist the client when sitting up or standing after taking this medication.
D. Check for hypokalemia frequently due to the risk for propranolol toxicity.
Answer: C. Assist the client when sitting up or standing after taking this medication.
84. A nurse is providing teaching to a client who is starting simvastatin. Which of the
following information should the nurse include in the teaching?
A. Take this medication in the evening.
B. Change position slowly when rising from a chair.
C. Maintain a steady intake of green leafy vegetables.
D. Consume no more than 1 L/day of fluid.
Answer: A. Take this medication in the evening.
85. A nurse is collecting data from a client who is taking gemfibrozil. Which of the following
assessment findings should the nurse identify as an adverse effect of this medication?
A. Mental status changes
B. Tremor
C. Jaundice
D. Pneumonia
Answer: C. Jaundice
86. A nurse is teaching a client who is taking digoxin and has a new prescription for
colesevelam. Which of the following instructions should the nurse include in the teaching?
A. "Take digoxin with your morning dose of colesevelam."
B. "Your sodium and potassium levels will be monitored periodically while taking
colesevelam."
C. "Watch for bleeding or bruising while taking colesevelam."
D. "Take colesevelam with food and at least one glass of water."
Answer: D. "Take colesevelam with food and at least one glass of water."
87. A nurse is completing a nursing history for a client who takes simvastatin. The nurse
should identify which of the following disorders as a contraindication to adding ezetimibe to
the client's medications?
A. History of severe constipation
B. History of hypertension

C. Active hepatitis C
D. Type 2 diabetes mellitus
Answer: C. Active hepatitis C
88. A nurse is caring for a client who has a new prescription for alirocumab to reduce
cholesterol. The nurse should monitor for which of the following findings as an adverse effect
of alirocumab? (Select all that apply.)
A. Muscle aches
B. Vasculitis
C. Hearing loss
D. Urticaria
E. Jaundice
Answer: B. Vasculitis
D. Urticaria
E. Jaundice
89. A nurse is planning to administer subcutaneous al enoxaparin 40 mg using a prefilled
syringe of enoxaparin 40 mg / 0.4 mL to an adult client following hip arthroplasty. Which of
the following actions should the nurse plan to take?
A. Expel the air bubble from the prefilled syringe before injecting.
B. Insert the needle completely into the client's tissue.
C. Administer the injection in the client's thigh.
D. Aspirate carefully after inserting the needle into the client's skin.
Answer: B. Insert the needle completely into the client's tissue.
90. A nurse is caring for a client who is receiving heparin by continuous IV infusion. The
client begins vomiting blood. After the heparin has been stopped, which of the following
medications should the nurse prepare to administer?
A. Vitamin K
B. Atropine
C. Protamine
D. Calcium gluconate
Answer: C. Protamine

91. A nurse is planning to administer IV alteplase to a client. Which of the following
interventions should the nurse plan to take?
A. Administer IM enoxaparin along with the alteplase dose.
B. Obtain the client's weight.
C. Administer aminocaproic acid IV prior to alteplase infusion.
D. Prepare to administer alteplase within 8hr of manifestation onset.
Answer: B. Obtain the client's weight.
92. A nurse is monitoring a client who takes aspirin daily. The nurse should identify which of
the following manifestations as adverse effects of aspirin? (Select all that apply.)
A. Hypertension
B. Coffee-ground emesis
C. Tinnitus
D. Paresthesias of the extremities
E. Nausea
Answer: B. Coffee-ground emesis
E. Nausea
93. A nurse is caring for a client who has atrial fibrillation and a new prescription for
dabigatran. Which of the following medications is prescribed concurrently to treat an adverse
effect of dabigatran?
A. Vitamin K
B. Protamine
C. Omeprazole
D. Probenecid
Answer: C. Omeprazole
94. A nurse is teaching a client who has angina pectoris and is learning how to treat acute
anginal attacks. The clients asks, "What is my next step if I take one tablet, wait 5 minutes,
but still have anginal pain?" Which of the following responses should the nurse make?
A. "Take two more sublingual tablets at the same time." % 3D
B. "Call the emergency response team."
C. "Take a sustained-release nitroglycerin capsule."
D. "Wait another 5 minutes then take a second sublingual tablet."

Answer: B. "Call the emergency response team."
95. A nurse is teaching a client who has a new prescription for nitroglycerin transdermal
patch for angina pectoris. Which of the following instructions should the nurse include?
A. Remove the patch each evening.
B. Cut each patch in half if angina attacks are under control.
C. Take off the nitroglycerin patch for 30 min if a headache occurs.
D. Apply a new patch every 48 hr.
Answer: A. Remove the patch each evening.
96. A nurse is taking a medication history from a client who has angina and is to begin taking
ranolazine. The nurse should report which of the following medications in the client's history
that can interact with ranolazine? (Select all that apply.)
A. Digoxin
B. Simvastatinod
C. Verapamil
D. Amlodipine
E. Nitroglycerin transdermal patch
Answer: A. Digoxin
B. Simvastatinod
C. Verapamil
97. A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable
angina and develops reflex tachycardia. Which of the following medications should the nurse
expect to administer?
A. Furosemide
B. Captopril
C. Ranolazine
D. Metoprolol
Answer: D. Metoprolol
98. A nurse is teaching a client who has angina how to use nitroglycerin transdermal
ointment. The nurse should include which of the following instructions?
A. "Remove the prior dose before applying a new dose."

B. "Rub the ointment directly into your skin until it is no longer visible."
C. "Cover the applied ointment with a clean gauze pad."
D. "Apply the ointment to the same skin area each time."
Answer: A. "Remove the prior dose before applying a new dose."
99. A nurse in a provider's office is monitoring blood electrolytes for four clients who take
digoxin. Which of the following electrolyte values increases a client's risk for digoxin
toxicity?
A. Calcium 9.2 mg/Dl
B. Calcium 10.3 mg/dL
C. Potassium 3.4 mEq/L
D. Potassium 4.8 mEq/L
Answer: C. Potassium 3.4 mEq/L
100. A nurse is caring for a client who has a new prescription for digoxin and takes multiple
other medications. The nurse should recognize that concurrent use of which of the following
medications places the client at risk for digoxin toxicity?
A. Phenytoin
B. Verapamil
C. Warfarin
D. Aluminum hydroxide
Answer: B. Verapamil
101. A nurse is administering a dopamine infusion at a low dose to a client who has severe
heart failure. Which of the following findings is an expected effect of this medication?
A. Lowered heart rate
B. Increased urine output
C. Decreased conduction through the AV node
D. Vasoconstriction of renal blood vessels
Answer: B. Increased urine output
102. A nurse is providing teaching to a client who has a new prescription for digoxin. The
nurse should instruct the client to monitor and report which of the following adverse effects
that is a manifestation of digoxin toxicity? (Select all that apply.)

A. Fatigue
B. Constipation
C. Anorexia
D. Rash
E. Blurred vision
Answer: A. Fatigue
C. Anorexia
E. Blurred vision
103. A nurse is teaching a client who has a new prescription for digoxin to treat heart failure.
Which of the following instructions should the nurse include in the teaching?
A. Contact provider if heart rate is less than 60 / min.
B. Check pulse rate for 30 seconds and multiply result by 2.
C. Increase intake of sodium.
D. Take with food if nausea occurs.
Answer: A. Contact provider if heart rate is less than 60 / min.
104. A nurse is caring for a client who has a new prescription for phenelzine for the treatment
of depression. Which of the following indicates that the client has developed an adverse
effect of this medication?
A. Orthostatic hypotension
B. Hearing loss
C. Gastrointestinal bleeding
D. Weight loss
Answer: A. Orthostatic hypotension
105. A nurse is providing teaching to a client who has a new prescription for amitriptyline for
treatment of depression. Which of the following should the nurse include in the teaching?
(Select all that apply.)
A. Expect therapeutic effects in 24 to 48 hr.
B. Discontinue the medication after a week of improved mood.
C. Change positions slowly to minimize dizziness.
D. Decrease dietary fiber intake to control diarrhea.
E. Chew sugarless gum to prevent dry mouth.

Answer: C. Change positions slowly to minimize dizziness.
E. Chew sugarless gum to prevent dry mouth.
106. A nurse is providing discharge teaching to a client who has a new prescription for
fluoxetine for posttraumatic stress disorder. Which of the following statements should the
nurse include in the teaching?
A. "You can have a decreased desire for intimacy while taking this medication."
B. "You should take this medication at bedtime to help promote sleep."
C. "You will have fewer urinary adverse effects if you urinate just before taking this
medication."
D. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this
medication."
Answer: A. "You can have a decreased desire for intimacy while taking this medication."
107. A nurse is caring for a client who has depression and a new prescription for venlafaxine.
The nurse should monitor the client for which of the following manifestations as an adverse
effect of this medication? (Select all that apply.)
A. Mydriasis
B. Dizziness
C. Decreased libido
D. Alopecia
E. Hypotension
Answer: A. Mydriasis
B. Dizziness
C. Decreased libido
108. A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of
the following assessment findings should alert the nurse to the possibility that the client is
developing serotonin syndrome?
A. Bruising
B. Fever
C. Tinnitus
D. Rash
Answer: B. Fever

109. A nurse is reviewing laboratory findings and notes that a client's lithium level is 2.1
mEg/L. Which of the following is an appropriate action by the nurse?
A. Perform immediate gastric lavage.
B. Prepare the client for hemodialysis.
C. Administer an additional oral dose of lithium.
D. Request a stat repeat of the laboratory test.
Answer: A. Perform immediate gastric lavage.
110. A nurse is caring for a client who has a new prescription for lithium carbonate. When
teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to
do which of the following?
A. Avoid the use of acetaminophen for headaches.
B. Restrict intake of foods rich in sodium.
C. Decrease fluid intake to less than 1,500 mL daily.
D. Limit aerobic activity in hot weather.
Answer: D. Limit aerobic activity in hot weather.
111. A nurse is assessing a client who takes lithium carbonate for the treatment of bipolar
disorder. The nurse should identify which of the following findings is a possible indication of
toxicity to this medication?
A. Severe hypertension
B. Coarse tremors
C. Constipation
D. Muscle spasms
Answer: B. Coarse tremors
112. A nurse is caring for a client who has a new prescription for valproic acid. The nurse
should instruct the client to have which of the following blood laboratory tests completed
periodically? (Select all that apply.)
A. Thrombocyte count
B. Glucose
C. Amylase
D. Liver function tests

E. Potassium
Answer: A. Thrombocyte count
C. Amylase
D. Liver function tests
113. A nurse is preparing a teaching plan for a client who has bipolar disorder and a new
prescription for carbamazepine. Which of the following instructions should the nurse include
in the teaching?
A. "This medication can safely be taken during pregnancy."
B. "Eliminate grapefruit juice from your diet."
C. "You will need to have a complete blood count and carbamazepine levels drawn
periodically."
D. "Notify your provider if you develop a rash."
E. "Avoid driving for the first few days after starting this medication."
Answer: B. "Eliminate grapefruit juice from your diet."
C. "You will need to have a complete blood count and carbamazepine levels drawn
periodically."
D. "Notify your provider if you develop a rash."
E. "Avoid driving for the first few days after starting this medication."
114. A nurse is teaching a client, who has schizophrenia, strategies to cope with
anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to
the client to minimize anticholinergic effects?
A. Take the medication in the morning to prevent insomnia.
B. Chew sugarless gum to moisten the mouth
C. Use cooling measures to decrease fever
D. Take an antacid to relieve nausea
Answer: B. Chew sugarless gum to moisten the mouth
115. A nurse is assessing a client who recently began taking haloperidol. Which of the
following findings is the priority to report to the provider?
A. Shuffling gait
B. Neck spasms
C. Drowsiness

D. Sexual dysfunction
Answer: B. Neck spasms
116. A nurse is providing discharge teaching to a client who has a new prescription for
clozapine. Which of the following statements should the nurse include in the teaching?
A. "You should have a high-carbohydrate snack between meals and at bedtime."
B. "You are likely to develop hand tremors if you take this medication for a long period of
time."
C. "You may experience temporary numbness of your mouth after each dose."
D. "You should have your white blood cell count monitored every week."
Answer: D. "You should have your white blood cell count monitored every week."
117. A nurse is providing teaching for a client who Is to begin taking risperidone. Which of
the following instructions should the nurse include?
A. "Add extra snacks to your diet to prevent weight loss."
B. "Notify the provider if you have trouble sleeping."
C. "You may begin to have mild seizures while taking this medication."
D. "This medication is likely to increase your libido."
Answer: B. "Notify the provider if you have trouble sleeping."
118. A nurse is following up with a client who takes chlorpromazine for the treatment of
schizophrenia. The nurse should expect to find the greatest improvement in which of the
following manifestations? (Select all that apply.)
A. Disorganized speech
B. Bizarre behavior
C. Impaired social interactions
D. Hallucinations
E. Decreased motivation
Answer: A. Disorganized speech
B. Bizarre behavior
D. Hallucinations

119. A nursing is planning care for a client who is receiving furosemide IV for peripheral
edema. Which of the following interventions should the nurse include in the plan of care?
(Select all that apply.)
A. Assess for tinnitus.
B. Report urine output 50 mL/hr.
C. Monitor blood potassium levels.
D. Elevate the head of bed slowly before ambulation
E. Recommend eating a banana daily.
Answer: A. Assess for tinnitus.
C. Monitor blood potassium levels.
D. Elevate the head of bed slowly before ambulation
E. Recommend eating a banana daily.
120. A nurse is providing information to a client who has a new prescription for
hydrochlorothiazide. Which of the following information should the nurse include?
A. Take the medication with food.
B. Plan to take the medication at bedtime.
C. Expect increased swelling of the ankles.
D. Fluid intake should be limited in the morning.
Answer: A. Take the medication with food.
121. A nurse is monitoring a client who is receiving spironolactone. Which of the following
findings should the nurse report to the provider?
A. Blood sodium 144 mEq /L
B. Urine output 120 mL in 4hr
C. Blood potassium 5.2 mEq /L
D. Blood pressure 140/90 mm Hg
Answer: C. Blood potassium 5.2 mEq /L
122. A nurse is caring for a client who has increased intracranial pressure and is receiving
mannitol. Which of the following findings should the nurse report to the provider?
A. Blood glucose 150 mg/dL
B. Urine output 40 mL/hr
C. Dyspnea

D. Bilateral equal pupil size
Answer: C. Dyspnea
123. A nurse is planning care for a client who is has a new prescription for torsemide. The
nurse should plan to monitor for which of the following conditions as potential adverse
reactions of this medication? (Select all that apply.)
A. Respiratory acidosis
B. Hypokalemia
C. Hypotension
D. Ototoxicity
E. Ventricular dysrhythmias
Answer: B. Hypokalemia
C. Hypotension
D. Ototoxicity
E. Ventricular dysrhythmias
124. A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For
which of the following types of insulin should the nurse tell the clients to expect a peak effect
1 to 5hr after administration?
A. Insulin glargine
B. NPH insulin
C. Regular insulin
D. Insulin lispro
Answer: C. Regular insulin
125. A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus.
Which of the following laboratory tests should the nurse plan to monitor?
A. WBC
B. Amylase
C. Platelet count
D. Liver function tests ed son
Answer: D. Liver function tests ed son

126. A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting
repaglinide. Which of the following statements by the client indicates understanding of the
administration of this medication?
A. "I'll take this medication after I eat."
B. "I'll take this medicine 30 minutes before I eat."
C. "I'll take this medicine just before I go to bed."
D. "I'll take this medication at least 1 hour before I eat."
Answer: B. "I'll take this medicine 30 minutes before I eat."
127. A nurse is providing teaching for a client who has a new prescription for metformin.
Which of the following findings should the nurse instruct the client to report as an adverse
effect of metformin?
A. Somnolence
B. Constipation
C. Fluid retention
D. Weight gain
Answer: A. Somnolence
128. A nurse is providing teaching to a client who has a prescription for pramlintide for type 1
diabetes mellitus. Which of the following should the nurse include in the teaching? (Select all
that apply.)
A. "Take oral medications 30 min before injection."
B. "Use upper arms as preferred injection sites."
C. "Mix pramlintide with the breakfast dose of insulin."
D. "Inject pramlintide just before a meal."
E. "Discard open vials after 28 days."
Answer: D. "Inject pramlintide just before a meal."
E. "Discard open vials after 28 days."
129. A nurse is caring for a client who is taking propylthiouracil. Which of the following
findings should the nurse monitor for as an adverse effect of this medication?
A. Bradycardia
B. Insomnia
C. Heat intolerance

D. Weight loss
Answer: A. Bradycardia
130. A nurse is teaching a client who has Grave's disease and a new prescription for
propranolol. Which of the following client statements indicates effective teaching?
A. "Propranolol helps increase blood flow to my thyroid gland."
B. "Propranolol is used to prevent excess glucose in my blood."
C. "Propranolol will decrease my tremors and fast heart beat."
D. "Propranolol promotes a decrease of thyroid hormone in my body."
Answer: C. "Propranolol will decrease my tremors and fast heart beat."
131. A nurse is caring for an older adult client who has hypothyroidism and a new
prescription for levothyroxine. Which of the following dosage schedules should the nurse
expect for this client?
A. The client will start at a high dosage, and the amount will be tapered as needed.
B. The client will remain on the initial dosage during the course of treatment.
C. The client's dosage will be adjusted daily based on blood levels.
D. The client will start on a low dosage, which can be gradually increased.
Answer: D. The client will start on a low dosage, which can be gradually increased.
132. A nurse is caring for a client who is taking for somatropin to stimulate growth. The nurse
should plan to monitor the client's urine for which of the following?
A. Bilirubin
B. Protein
C. Potassium
D. Calcium
Answer: D. Calcium
133. A nurse is reviewing the medical record of a client who takes desmopressin for diabetes
insipidus. Which of the following findings is an adverse effect of desmopressin?
A. Hypovolemia
B. Hypercalcemia
C. Agitation
D. Headache

Answer: D. Headache
134. A nurse is admitting a client for a total hip arthroplasty. The client takes hydrocortisone
for Addison's disease. Which of the following actions the nurse's priority?
A. Administering a supplemental dose of hydrocortisone
B. Instructing the client about coughing and deep breathing
C. Collecting additional information about the client's history of Addison's disease
D. Inserting an indwelling urinary catheter
Answer: A. Administering a supplemental dose of hydrocortisone
135. A nurse is teaching a client about terbutaline. Which of the following statements by the
client indicates understanding of the teaching?
A. "This medication will stop my contractions."
B. "This medication will prevent vaginal bleeding."
C. "This medication will promote blood flow to my baby."
D. "This medication will increase my prostaglandin production."
Answer: A. "This medication will stop my contractions."
136. A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate
IV continuous infusion. Which of the following findings 2 should the nurse report to the
provider?
A. 2+ deep tendon reflexes
B. 2+ pedal edema
C. 24 mL/hr urinary output
D. Respirations 12/min
Answer: C. 24 mL/hr urinary output
137. A nurse is caring for a client who has a new prescription for oxytocin to stimulate uterine
contractions. Which of the following actions should the nurse take? (Select all that apply.)
A. Use an infusion pump for medication administration.
B. Obtain vital signs frequently and with every dosage change.
C. Stop infusion if uterine contractions occur every 4 min and last 45 seconds.
D. Increase medication infusion rate rapidly.
E. Fetal heart rate continuously monitor.

Answer: A. Use an infusion pump for medication administration.
B. Obtain vital signs frequently and with every dosage change.
E. Fetal heart rate continuously monitor.
138. A nurse is caring for a client who and is receiving oxytocin. The nurse should monitor
the client for which of the following as complications of oxytocin? (Select all that apply.)
A. Uterine rupture
B. Uterine tachysystole
C. Placental abruption
D. Hyponatremia
E. Placenta previa
Answer: A. Uterine rupture
B. Uterine tachysystole
E. Placenta previa
139. A nurse is reviewing a new prescription for terbutaline with a client who has a history of
preterm labor. Which of the following client statements indicates understanding of the
teaching?
A. "I can increase my activity now that I've started on this medication."
B. "I will increase my daily fluid intake to 3 quarts."
C. "I will report increasing intensity of contractions to my doctor."
D. "I am glad this will prevent preterm labor."
Answer: C. "I will report increasing intensity of contractions to my doctor."
140. A nurse is reviewing the health care record of a client who is asking about conjugated
equine estrogens. The nurse should inform the client this medication is contraindicated in
which of the following conditions?
A. Atrophic vaginitis
B. Dysfunctional uterine bleeding
C. Osteoporosis
D. Thrombophlebitis
Answer: D. Thrombophlebitis

141. A nurse is providing teaching to a female client who is taking testosterone to treat
advanced breast cancer. The nurse should tell the client that which of the following are
adverse effects of this medication? (Select all that apply.)
A. Deepening voice
B. Weight gain
C. Low blood pressure
D. Dry mouth
E. Facial hair
Answer: A. Deepening voice
B. Weight gain
E. Facial hair
142. A nurse is explaining the mechanism of action of combination oral contraceptives to a
group of clients. The nurse should tell the clients that which of the following actions occur
with the use of combination oral contraceptives? (Select all that apply.)
A. Thickening the cervical mucus
B. Inducing maturation of ovarian follicle
C. Increasing development of the
D. Altering the endometrial lining
E. Inhibiting ovulation
Answer: A. Thickening the cervical mucus
D. Altering the endometrial lining
E. Inhibiting ovulation
143. A nurse is providing teaching to a client who will start alfuzosin for treatment of benign
prostatic hyperplasia. The nurse should instruct the client that which of the following is an
adverse effect of this medication?
A. Bradycardia
B. Edema
C. Hypotension
D. Tremor
Answer: C. Hypotension

144. A nurse is caring for a client who has angina and asks about obtaining a prescription for
sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated
with sildenafil?
A. Aspirin
B. Isosorbide
C. Clopidogrel
D. Atorvastatin
Answer: B. Isosorbide
145. A nurse is providing teaching to a newly licensed nurse about caring for a client who has
a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor
which of the following laboratory tests?
A. Platelet count
B. Electrolyte levels
C. Thyroid function
D. Liver function
Answer: D. Liver function
146. A nurse is caring for a client who has a new prescription for ergotamine. The nurse
should recognize that ergotamine is administered to treat which of the following conditions?
A. Raynaud's phenomenon
B. Migraine headaches
C. Ulcerative colitis
D. Anemia
Answer: B. Migraine headaches
147. A nurse is reviewing the laboratory values for a client who is receiving a continuous IV
heparin infusion and has an aPTT of 90 seconds. Which of the following actions should the
nurse prepare to take?
A. Administer vitamin K
B. Reduce the infusion rate
C. Give the client a low-dose
D. aspirin Request an INR
Answer: B. Reduce the infusion rate

148. A nurse is providing teaching to a client who has rhematoid arthritis and a prescription
for long-term prednisone therapy. The nurse should instruct the client to monitor for which of
the following adverse effects?
A. Stress fractures
B. Orthostatic hypotension
C. Gingival ulcerations
D. Weight loss
Answer: A. Stress fractures
149. A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should
recognize that tamoxifen has which of the following therapeutic effects?
A. Antiestrogenic
B. Antimicrobial
C. Androgenic
D. Anti-inflammatory
Answer: A. Antiestrogenic
150. A nurse is caring for a client who has a new prescription for amphotericin
B. The nurse should plan to monitor the client for which of the following adverse effects?
A. Hyperkalemia
B. Hypertension
C. Constipation
D. Nephrotoxicity
Answer: D. Nephrotoxicity
151. A nurse is administering subcutaneous heparin to a client who is at risk for deep vein
thrombosis. Which of the following actions should the nurse take?
A. Administer the medication into the client's abdomen.
B. Inject the medication into a muscle.
C. Massage the site after administering the medication.
D. Use a 22-gauge needle to administer the medication.
Answer: A. Administer the medication into the client's abdomen.

152. A nurse is reviewing the laboratory results for a client who has a prescription for
filgrastim. The nurse should recognize that an increase in which of the following values
indicates a therapeutic effect of this medication?
A. Erythrocyte count
B. Neutrophil count
C. Lymphocyte count
D. Thrombocyte count
Answer: B. Neutrophil count
153. A nurse is providing teaching to a client who has ulcerative colitis and a new
prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the
following adverse effects of this medication?
A. Jaundice
B. Constipation
C. Oral candidiasis
D. Sedation
Answer: A. Jaundice
154. A nurse is planning care for a client who has a seizure disorder and a new prescription
for valproic acid. Which of the following laboratory values should the nurse plan to monitor?
(Select all that apply.)
A. Blood Urea Nitrogen (BUN)
B. Potassium (K)
C. Prothrombin Time (PT)
D. Sodium (Na)
E. Aspartate aminotransferase (AST)
F. Alanine aminotransferase (ALT)
Answer: A. Blood Urea Nitrogen (BUN)
C. Prothrombin Time (PT)
E. Aspartate aminotransferase (AST)
F. Alanine aminotransferase (ALT)

155. A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking
tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of
which of the following adverse effects?
A. Allergic response
B. Superinfection
C. Renal toxicity
D. Hepatotoxicity
Answer: B. Superinfection
156. A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal
doses daily to a toddler who 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: 40mg
STEP 1: What is the unit of measurement the nurse should calculate? Kg
STEP 2: Set up an equation and solve for X.
2.2 lb/1 kg = client's weight in lb/X kg
2.2 lb/1 kg = 22 lb/X kg X = 10 kg
STEP 3: Round if necessary.
STEP 4: Reassess to determine whether the conversion to kg makes sense.
If 1 kg = 2.2 lb, it makes sense that 22 lb = 10 kg.
STEP 5: What is the unit of measurement the nurse should calculate? mg
STEP 6: Set up an equation and solve for X.
mg x kg / day = X
4 mg x 10 kg = 40 mg/day
STEP 7: Round if necessary.
157. A nurse is caring for a client who has a prescription for chlorothiazide to treat
hypertension. The nurse should plan to monitor the client for which of the following adverse
effects?
A. Thrombophlebitis
B. Hyperactive reflexes
C. Muscle weakness
D. Hypoglycemia

Answer: C. Muscle weakness
158. A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older
adult client who has Paget's disease of the bone. Which of the following actions should be the
nurse's priority?
A. Administer the medication to the client before breakfast in the morning.
B. Ambulate the client to a chair prior to administering the medication.
C. Give the medication to the client with water rather than milk.
D. Teach the client how to take the medication at home.
Answer: B. Ambulate the client to a chair prior to administering the medication.
159. A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for
the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange
color. Which of the following statements should the nurse make?
A. "Stop taking the isoniazid for 3 days and the discoloration should go away."
B. "Rifampin can turn body fluids orange."
C. "I'll make an appointment for you to see the provider this afternoon."
D. "Isoniazid can cause bladder irritation."
Answer: B. "Rifampin can turn body fluids orange."
160. A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8
hr. The drop factor of the manual IV tubing is 10 gtt/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: 21 gtt/min
Ratio and Proportion and Desired Over Have
STEP 1: What is the unit of measurement the nurse should calculate? gtt/min
STEP 2: What is the volume the nurse should infuse? 1,000 mL
STEP 3: What is the total infusion time? 8 hr
STEP 4: Should the nurse convert the units of measurement?
Yes (hr does not equal min) 1 hr/60 min = 8 hr/X min X = 480 min
STEP 5: Set up an equation and solve for X.
Volume (mL)/Time(min) X Drop Factor (gtt/mL) = X 1,000 mL/480 min x
10gtt/mL = X gtt/min

X = 20.833
STEP 6: Round if necessary. 20.833 = 21
161. A nurse is caring for a client who has a new prescription for enalapril. The nurse should
monitor the client for which of the following adverse effects of this medication?
A. Ecchymosis
B. Jaundice
C. Hypotension
D. Hypokalemia
Answer: C. Hypotension
162. A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is
prochlorperazine injection 5 mg/mL. How many mL should the nurse administer? (Round the
answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Answer: 0.5 mL
Ratio and Proportion
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What is the dose the nurse should administer?
Dose to administer = Desired 2.5 mg
STEP 3: What is the dose available? Dose available = Have 5 mg
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 1 mL
STEP 6: Set up an equation and solve for X.
Have/Quantity = Desired/X
5 mg/1 mL = 2.5 mg/X mL X = 0.5
163. A nurse is providing teaching to a newly licensed nurse about administering morphine
via IV bolus to a client. Which of the following information should the nurse include in the
teaching?
A. Respiratory depression can occur 7 min after the morphine is administered.
B. The morphine will peak in 10 min.
C. Withhold the morphine if the client has a respiratory rate less than 16/min.
D. Administer the morphine over 2 min.
Answer: A. Respiratory depression can occur 7 min after the morphine is administered.

164. A nurse is providing teaching to a parent of a child who has asthma and a new
prescription for a cromolyn sodium metered dose inhaler. Which of the following statements
by the parent indicates the need for further teaching?
A. "I will give my child a dose as soon as wheezing starts."
B. "My child should rinse out his mouth after using the inhaler."
C. "My child should exhale completely before placing the inhaler in his mouth."
D. "If my child has difficulty breathing in the dose, a spacer can be used."
Answer: A. "I will give my child a dose as soon as wheezing starts."
165. A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma
and several prescription medications using metered dose inhalers (MDIs). Which of the
following interventions should the nurse include in the plan?
A. Add a spacer to each MDI.
B. Instruct the child to inhale more rapidly than usual when using an MDI.
C. Request that the provider change the child's medications from inhaled to oral formulations.
D. Administer oxygen by facemask along with the MDI.
Answer: A. Add a spacer to each MDI.
166. A nurse is administering oral hydroxyzine to a client. Which of the following adverse
effects should the nurse instruct the client to expect?
A. Diarrhea
B. Anxiety
C. Nausea and vomiting
D. Dry mouth
Answer: D. Dry mouth
167. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg
daily, but the client reports that she has been taking extra doses to promote weight loss.
Which of the following findings should indicate to the nurse that the client is dehydrated?
A. Urine specific gravity 1.035
B. Distended neck veins
C. BUN 18 mg/Dl
D. Bounding radial pulses

Answer: A. Urine specific gravity 1.035
168. A nurse is preparing a discharge teaching plan for a client who is to begin long-term oral
prednisone for asthma. Which of the following instructions should the nurse include in the
plan?
A. Stop taking the medication if a rash occurs.
B. Take the medication on an empty stomach to enhance absorption.
C. Schedule the medication on alternate days to decrease adverse effects.
D. Treat shortness of breath with an extra dose of the medication.
Answer: C. Schedule the medication on alternate days to decrease adverse effects.
169. A nurse is providing teaching to a client who has hypertension and type 1 diabetes
mellitus and a new prescription for metoprolol. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I might have difficulty recognizing when my blood sugar is low."
B. "I will have less risk for developing an infection while I take this medication."
C. "I should be concerned about losing excess weight while I take this medication."
D. "I could have more problems with high blood sugars while taking this medication."
Answer: A. "I might have difficulty recognizing when my blood sugar is low."
170. A nurse is preparing to administer ampicillin 500 mg in 50 mL of dextrose 5% in water
(D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/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: 33 gtt/min
STEP 1: What is the unit of measurement the nurse should calculate? gtt/min
STEP 2: What is the quantity of the drop factor that is available? 10 gtt/min
STEP 3: What is the total infusion time? 15 min
STEP 4: What is the volume the nurse should infuse? 50 Ml
STEP 5: Should the nurse convert the units of measurement? No
STEP 6: Set up an equation and solve for X.
Quantity/1 mL x Conversion (hr)/ Conversion(min) x Volume (mL)/Time (min) =
X gtt/min 10 gtt/1 mL x 50 mL/15 min = X gtt/min
X = 33.3333

STEP 7: Round if necessary. 33.3333 = 33 gtt/min
171. A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure.
Which of the following data should the nurse plan to review prior to administration of this
medication?
A. Blood pressure
B. Temperature
C. Blood glucose levels
D. Total protein level
Answer: A. Blood pressure
172. A nurse is planning care for a female client who has severe irritable bowel syndrome
with diarrhea (IBS-D) and a new prescription for alosetron. Which of the following
interventions should the nurse include in the plan of care?
A. The client must sign an agreement with the provider before beginning alosetron.
B. The client must stop taking alosetron if diarrhea continues 1 week after beginning the
medication.
C. The client should expect to have a slower heart rate while taking alosetron.
D. The client should use a barrier birth control method because alosetron interacts with oral
contraceptives.
Answer: A. The client must sign an agreement with the provider before beginning alosetron.
173. A nurse is caring for a client and realizes after administering the 0900 medications that
she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg
PO. Which of the following actions should the nurse take first?
A. Notify the provider.
B. Contact the nursing supervisor.
C. Assess the client's apical pulse.
D. Complete an incident report.
Answer: C. Assess the client's apical pulse.
174. A nurse is providing discharge teaching to a client who has angina pectoris and a new
prescription for verapamil. The client tells the nurse, "My brother takes verapamil for high

blood pressure. Do you think the provider made a mistake?" Which of the following
responses should the nurse make?
A. "Verapamil is used to treat both high blood pressure and angina."
B. "You should talk to your provider to make sure the prescription is correct for you."
C. "Are you concerned that you might have high blood pressure?"
D. "Your provider has prescribed verapamil so that you will not develop high blood
pressure."
Answer: A. "Verapamil is used to treat both high blood pressure and angina."
175. A nurse is providing discharge teaching to a client who had a kidney transplant and has a
prescription for oral cyclosporine. Which of the following statements by the client indicates
an understanding of the teaching?
A. "I will be able to stop taking this medication 6 months after my surgery."
B. "I am likely to develop higher blood pressure while taking this medication."
C. "I am likely to lose my hair while taking this medication."
D. "I am taking this medication to boost my immune system."
Answer: B. "I am likely to develop higher blood pressure while taking this medication."
176. A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2
hr to a client who is dehydrated. 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.)
Answer: 500 mL/hr
STEP 1: What is the unit of measurement the nurse should calculate? mL/hr
STEP 2: What is the volume the nurse should infuse? 1 L
STEP 3: What is the total infusion time? 2 hr
STEP 4: Should the nurse convert the units of measurement?
Yes (L does not equal mL) 1 L/1 L = 1,000 mL/X mL X = 1,000 mL
STEP 5: Set up an equation and solve for X.
Volume (mL)/Time (hr) = X mL/hr 1,000 mL/2 hr = X mL/hr X = 500
177. A nurse is providing discharge teaching to a client who has venous thrombosis and a
prescription for warfarin. Which of the following instructions should the nurse include in the
teaching?

A. Take ibuprofen as needed for headache or other minor pains.
B. Carry a medic alert ID card.
C. Report to the laboratory weekly to have blood drawn for aPTT.
D. Increase intake of dark green vegetables.
Answer: B. Carry a medic alert ID card.
178. A nurse is preparing to administer ampicillin 50 mg/kg/day PO divided into 4 equal
doses for a toddler who weighs 33 lb. Available is ampicillin 125 mg/5 mL oral solution. How
many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a
leading zero if it applies. Do not use a trailing zero.)
Answer: 7.5 mL
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What is the dose the nurse should administer?
Dose to administer = Desired 187.5 mg
STEP 3: What is the dose available? Dose available = Have 125 mg
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 5 mL
STEP 6: Set up an equation and solve for X.
Desired x Quantity/Have = X
187.5 mg x 5 mL/125 mg = X mL
7.5 mL = X
179. A nurse is preparing to administer iron dextran IV to a client. Which of the following
actions should the nurse plan to take?
A. Administer a small test dose before giving the full dose.
B. Infuse the medication over 30 seconds.
C. Monitor the client closely for hypertension after the infusion.
D. Administer cyanocobalamin as an antidote if iron dextran toxicity occurs.
Answer: A. Administer a small test dose before giving the full dose.
180. A nurse is caring for a client who has congestive heart failure and is taking digoxin. The
client reports nausea and refuses to eat breakfast. Which of the following actions should the
nurse take first?
A. Encourage the client to eat the toast on the breakfast tray.

B. Administer an antiemetic.
C. Inform the client's provider.
D. Check the client's apical pulse.
Answer: D. Check the client's apical pulse.
181. A nurse is administering ciprofloxacin and phenazopyridine to a client who has a severe
urinary tract infection (UTI). The client asks why both medications are needed. Which of the
following responses should the nurse make?
A. "Phenazopyridine decreases adverse effects of ciprofloxacin hydrochloride."
B. "Combining phenazopyridine with ciprofloxacin hydrochloride shortens the course of
therapy."
C. "The use of phenazopyridine allows for a lower dosage of ciprofloxacin hydrochloride."
D. "Ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain."
Answer: D. "Ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats
pain."
182. A nurse is providing teaching to a client who has postmenopausal osteoporosis and a
new prescription for intranasal calcitonin-salmon. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I will administer a spray into each nostril daily."
B. "I should expect nasal bleeding for the first week."
C. "I will need to depress the side arms to activate the pump."
D. "I should expect to take this medication for a short-term course of treatment."
Answer: C. "I will need to depress the side arms to activate the pump."
183. A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg
daily. For which of the following adverse effects should the client be taught to monitor and
notify the provider if it occurs?
A. Nasal congestion
B. Tremors
C. Tinnitus
D. Frontal headache
Answer: C. Tinnitus

184. A nurse is teaching a client who has chronic stable angina pectoris and a prescription for
sublingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell
the client to use if he experiences chest pain. (Move the steps into the box on the right,
placing them in the selected order of performance. Use all the steps.)
3. Wait 5 min.
1. Stop activity.
4. Call 911 if the pain is not relieved.
2. Place a tablet under the tongue.
Answer: 1. Stop activity.
2. Place a tablet under the tongue.
3. Wait 5 min.
4. Call 911 if the pain is not relieved.
185. A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg
three times daily PO and gabapentin 1,800 mg three times daily PO to manage pain. The
client tells the nurse, "I'm having pain that keeps me from doing what I'd like most of the
time." Which of the following additions should the nurse anticipate to the client's medication
regimen?
A. Oral meperidine
B. Parenteral naloxone
C. Parenteral diazepam
D. Oral oxycodone
Answer: D. Oral oxycodone
186. A nurse is planning to administer diphenhydramine 50 mg via IV bolus to a client who is
having an allergic reaction. The client has an IV infusion containing a medication that is
incompatible with diphenhydramine in solution. Which of the following actions should the
nurse take?
A. Choose an IV port for IV bolus injection of the diphenhydramine as near as possible to the
client's hanging IV bag.
B. Flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering
diphenhydramine.
C. Allow the IV infusion to keep running while administering the diphenhydramine via IV
bolus.

D. Aspirate to check for IV patency before administering the diphenhydramine.
Answer: D. Aspirate to check for IV patency before administering the diphenhydramine.
187. A nurse is providing teaching to a client who has heart failure and is taking
spironolactone. Which of the following statements by the client indicates an understanding of
the teaching?
A. "I will increase my intake of citrus fruits, bananas, and potatoes."
B. "I will use salt substitutes on my food."
C. "I will drink as much water as I can while taking this medication."
D. "I will watch for increased breast tissue growth while taking this medication."
Answer: D. "I will watch for increased breast tissue growth while taking this medication."
188. A nurse is providing teaching to a client who has type 2 diabetes mellitus and a new
prescription for metformin. Which of the following adverse effects of metformin should the
nurse instruct the client to watch for and report to the provider?
A. Weight gain
B. Myalgia
C. Hypoglycemia
D. Severe constipation
Answer: B. Myalgia
189. A nurse is assessing a client who reports using several herbal and vitamin supplements
daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement
used by clients to elicit which of the following therapeutic effects?
A. Urinary health promotion
B. Immune system stimulation
C. Decreased leg pain from arterial disease
D. Prevention of nausea caused by motion sickness
Answer: A. Urinary health promotion
190. A nurse is caring for a client who is in preterm labor and has a new prescription for
nifedipine. The client states she is concerned because her father takes nifedipine for his
angina pectoris. The nurse should explain to the client that nifedipine works for clients who
are pregnant by which of the following mechanisms?

A. It decreases the incidence of bacterial vaginosis, thus preventing uterine contractions.
B. It inhibits uterine contractions by blocking entry of calcium into uterine cells.
C. It decreases the activity within the CNS, which regulates all smooth muscle.
D. It stimulates beta2 receptors in the uterus, which results in decreased frequency of
contractions.
Answer: B. It inhibits uterine contractions by blocking entry of calcium into uterine cells.
191. A nurse is assessing a client who takes oral theophylline for relief of chronic bronchitis.
The nurse should recognize that which of the following findings indicates toxicity to
theophylline?
A. Constipation
B. Tremors
C. Fatigue
D. Bradycardia
Answer: B. Tremors
192. A nurse is caring for a client who was brought to the emergency department by friends
who report the client has overdosed on heroin. Which of the following findings should the
nurse expect to assess?
A. Temperature 39.2° C (102.6° F)
B. Respiratory rate 30/min
C. Pinpoint pupils
D. Severe abdominal cramping
Answer: C. Pinpoint pupils
193. A nurse is providing discharge teaching to a client who has been hospitalized for major
depressive disorder and has a prescription for amitriptyline. Which of the following
statements by the client indicates an understanding of the teaching?
A. "I will take amitriptyline in the morning because I'm likely to have trouble falling asleep if
I take it in the evening."
B. "I will move slowly when I stand up because amitriptyline can cause my blood pressure to
decrease."
C. "I can drink a glass of beer or wine with my evening meal because amitriptyline doesn't
interact with alcohol."

D. "I will avoid foods high in fiber because amitriptyline can cause diarrhea."
Answer: B. "I will move slowly when I stand up because amitriptyline can cause my blood
pressure to decrease."
194. A nurse is providing teaching to a client who is to start taking hydrochlorothiazide for
hypertension. The nurse instructs the client to eat foods rich in potassium. Which of the
following statements by the client indicates an understanding of the teaching?
A. "This medication will not work unless I have enough potassium."
B. "Potassium will increase the therapeutic effect of my blood pressure medication."
C. "Potassium will lower my blood pressure."
D. "This medication can cause a loss of potassium."
Answer: D. "This medication can cause a loss of potassium."
195. A nurse is administering adenosine via IV bolus for a client who has developed
paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the
client during administration of adenosine?
A. Seizures
B. Cinchonism
C. Dyspnea
D. Transient pallor of the face
Answer: C. Dyspnea
196. A nurse is planning discharge teaching for a client who has major depressive disorder
and a new prescription for phenelzine. Which of the following foods should the nurse include
in the plan as safe for the client to consume while taking phenelzine?
A. Broiled beef steak
B. Macaroni and cheese
C. Pepperoni pizza
D. Smoked salmon
Answer: A. Broiled beef steak
197. A nurse is caring for a client who has alcohol use disorder and is admitted with lower
extremity fractures following a motor-vehicle crash. A few hours after admission, the client

develops restlessness and tremors. Which of the following medications should the nurse
anticipate administering to the client first?
A. Acamprosate
B. Naltrexone
C. Chlordiazepoxide
D. Disulfiram
Answer: C. Chlordiazepoxide
198. A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an
adolescent client who has type 1 diabetes mellitus. The nurse should anticipate onset of
action of the insulin at which of the following times?
A. 0800
B. 0745
C. 0900
D. 1030
Answer: B. 0745
199. A nurse is providing teaching to the parents of a school-age child who has asthma about
medications for bronchospasm. Which of the following inhaled medications should the nurse
instruct the parents to use to relieve an acute asthma attack?
A. Salmeterol
B. Cromolyn
C. Fluticasone
D. Albuterol
Answer: D. Albuterol
200. A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation
and is experiencing ineffective labor. Which of the following actions should the nurse plan to
take?
A. Place the oxytocin from a pre-filled syringe into the posterior fornix of the vagina every
10 min until effective labor occurs.
B. Check the client's blood pressure and pulse every 15 min while induction of labor is
occurring.
C. Stop the oxytocin for contractions that continue longer than 30 seconds.

D. Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min.
Answer: D. Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to
3 min.
201. A nurse is providing discharge teaching to a client who has heart failure and a
prescription for digoxin 0.125 mg PO daily and furosemide 20 mg PO daily. Which of the
following statements by the client indicates an understanding of the teaching?
A. "I know that blurred vision is something I will expect to happen while taking digoxin."
B. "I will measure my urine output each day and document it in my diary."
C. "I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute."
D. "I will eat fruits and vegetables that have high potassium content every day."
Answer: D. "I will eat fruits and vegetables that have high potassium content every day."
202. A nurse is caring for a client who has a positive tuberculin skin test and is beginning a
prescription for isoniazid. The nurse should teach the client that which of the following
laboratory values should be monitored while taking isoniazid?
A. Thyroid Stimulating Hormone level (TSH)
B. Aspartate aminotransferase (AST)
C. Potassium Sodium
Answer: B. Aspartate aminotransferase (AST)
203. A nurse is planning to administer diltiazem via IV bolus to a client who has atrial
fibrillation. When assessing the client, the nurse should recognize that which of the following
findings is a contraindication to administration of diltiazem?
A. Hypotension
B. Tachycardia
C. Decreased level of consciousness
D. History of diuretic use
Answer: A. Hypotension
204. A nurse is preparing to administer chlorothiazide 20 mg/kg/day PO divided equally and
administered twice daily for a toddler who weighs 28.6 lb. The amount available is
chlorothiazide oral suspension 250 mg/5 mL. How many mL should the nurse administer per

dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a
trailing zero.)
Answer: 2.6 mL
STEP 1: What is the unit of measurement the nurse should calculate? Kg
STEP 2: Set up an equation and solve for X.
2.2 lb/1 kg = Client's weight in lb/X kg
2.2 lb/1 kg = 28.6 lb/X kg X = 13 kg
STEP 3: Round if necessary.
STEP 4: Reassess to determine whether the conversion to kg makes sense.
If 1 kg = 2.2 lb, it makes sense that 28.6 lb = 13 kg.
STEP 5: What is the unit of measurement the nurse should calculate? Mg
STEP 6: Set up an equation and solve for X. mg x kg/day = X 20 mg x 13 kg = 260 mg/day
STEP 7: Round if necessary.
205. A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride 400 mL IV to
an older adult client over 8 hr. 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.)
Answer: 50 mL/hr
STEP 1: What is the unit of measurement the nurse should calculate? mL/hr
STEP 2: What is the volume the nurse should infuse? 400 mL
STEP 3: What is the total infusion time? 8 hr
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: Set up an equation and solve for X.
Volume (mL)/Time (hr) = X mL/hr 400 mL/8 hr = XmL/hr X = 50 mL/hr
206. A nurse is assessing a client who has hypothyroidism and takes levothyroxine. Which of
the following findings should alert the nurse that the client is experiencing acute
levothyroxine overdose?
A. Bradycardia
B. Cold intolerance
C. Tremor
D. Hypothermia
Answer: C. Tremor

207. A nurse is providing discharge teaching about lithium toxicity to a client who has a new
prescription for lithium. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I should take naproxen if I have a headache because aspirin can cause lithium toxicity."
B. "I can develop lithium toxicity if I eat foods with lots of sodium."
C. "I can develop lithium toxicity if I experience vomiting or diarrhea."
D. "I might need to take a daily diuretic along with my lithium to prevent lithium toxicity."
Answer: C. "I can develop lithium toxicity if I experience vomiting or diarrhea."
208. A nurse is preparing to administer heparin 900 units/hr via IV infusion. The amount
available is heparin 25,000 units in 500 mL 5% dextrose in water. 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.)
Answer: 18 mL/hr
STEP 1: What is the unit of measurement the nurse should calculate? mL/hr
STEP 2: What is the dose the nurse should administer?
Dose to administer = Desired 900 units/hr
STEP 3: What is the dose available? Dose available = Have 25,000 units
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 500 mL
STEP 6: Set up an equation and solve for X.
Desired x Quantity/Have = X 900 units/hr x 500 mL/25,000 units = X mL/hr 18
mL/hr = X
209. A nurse is monitoring laboratory values for a male client who has leukemia and is
receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following
laboratory values should the nurse report to the provider?
A. BUN 18 mg/dL
B. Platelets 78,000/mm3
C. Hemoglobin 14.2g/dL
D. Aspartate aminotransferase (AST) 35 units/L
Answer: B. Platelets 78,000/mm3

210. A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer
and is prescribed omeprazole. Which of the following statements should the nurse include in
the teaching?
A. "You will need to take this medication for the next 6 months."
B. "Taking this medication will decrease your risk for acquiring pneumonia."
C. "You should take this medication before breakfast every day."
D. "Watch for the serious adverse effects of tachycardia and heart palpitations while taking
this medication."
Answer: C. "You should take this medication before breakfast every day."
211. A nurse is preparing to administer digoxin 0.2 mg via IV bolus to a client. The amount
available is digoxin 0.25 mg/1 mL. How many mL should the nurse administer? (Round the
answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
Answer: 0.8 mL
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What is the dose the nurse should administer?
Dose to administer = Desired. 0.2 mg
STEP 3: What is the dose available? Dose available = Have. 0.25 mg
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 1 mL
STEP 6: Set up an equation and solve for X.
Desired x Quantity/Have = X
0.2 mg x 1 mL/0.25 mg = X mL
0.8 mL = X
212. A nurse is providing teaching to a client who has hypertension and a new prescription
for oral clonidine. Which of the following instructions should the nurse include in the
teaching?
A. Discontinue the medication if a rash develops.
B. Expect increased salivation during the first few weeks of therapy.
C. Minimize fiber intake to prevent diarrhea.
D. Avoid driving until the client's reaction to the medication is known.
Answer: D. Avoid driving until the client's reaction to the medication is known.

213. A nurse is preparing to administer codeine 30 mg PO every 4 hr PRN to a client for pain.
The amount available is codeine oral solution 15 mg/5 mL. How many mL should the nurse
plan to 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: 10 mL
STEP 1: What is the unit of measurement the nurse should calculate? mL
STEP 2: What is the dose the nurse should administer?
Dose to administer = Desired 30 mg
STEP 3: What is the dose available? Dose available = Have 15 mg
STEP 4: Should the nurse convert the units of measurement? No
STEP 5: What is the quantity of the dose available? 5 mL
STEP 6: Set up an equation and solve for X.
Desired x Quantity/Have = X
30 mg x 5 mL/15 mg = X mL 10 mL = X
214. A home health nurse is visiting an older adult client who has Alzheimer's disease. His
caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg three times
per day, to the client for restlessness and anxiety during the past few days. For which of the
following adverse effects should the nurse assess the client?
A. Low-grade fever
B. Sedation
C. Diuresis
D. Tonic-clonic seizures
Answer: B. Sedation
215. A nurse is teaching a client who has a new prescription for beclomethasone. Which of
the following instructions should the nurse include?
A. "Rinse your mouth out after each use of this medication."
B. "Expect immediate relief from your symptoms."
C. "Use a spacer device with the inhaler for best results."
D. "Stop taking the medication if you start to feel better."
Answer: A. "Rinse your mouth out after each use of this medication"

216. A nurse is providing instructions to a client who has a new prescription for albuteroll and
beclomethasone inhalers for the control of asthma. Which of the following instructions
should the nurse include in the teaching?
A. Take the albuterol at the same time each day.
B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
C. Use beclomethasone if experiencing an acute episode.
D. Avoid shaking the beclomethasone before use
Answer: B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
217. A nurse is providing instructions to a client who has a new prescription for albuterol,
PO. Which of the following instructions should the nurse include?
A. "You can take this medication to abort an acute asthma attack."
B. "Tremors are an adverse effect of this medication."
C. "Prolonged use of this medication can cause hyperglycemia."
D. "This medication can slow skeletal growth rate."
Answer: B. "Tremors are an adverse effect of this medication."
218. A nurse is teaching a client who has a prescription for long-term use of oral prednisone
for treatment of chronic asthma. The nurse should instruct the client to monitor for which of
the following manifestations as an adverse effect of this medication?
A. Weight gain
B. Nervousness
C. Bradycardia
D. Constipation
Answer: A. Weight gain
219. A nurse is caring for a client who has been taking phenylephrine nasal drops for the past
10 days for sinusitis. The nurse should assess the client for which of the following
manifestations as an adverse effect of this medication?
A. Sedation
B. Nasal congestion.
C. Productive cough
D. Constipation
Answer: B. Nasal congestion.

220. A nurse is teaching a client who has a new prescription for dextromethorphan to
suppress a cough. The nurse should instruct the client to monitor for which of the following
manifestations as an adverse effect of this medication?
A. Diarrhea
B. Anxiety
C. Sedation
D. Palpitations
Answer: C. Sedation
221. A nurse is teaching the family of a child who has cystic fibrosis and a new prescription
for acetylcysteine. Which of the following information should the nurse include in the
instructions?
A. "Expect this medication to suppress your child's cough."
B. "Expect this medication to smell like rotten eggs."
C. "Expect this medication to cause euphoria."
D. "Expect this medication to turn your child's urine orange."
Answer: B. "Expect this medication to smell like rotten eggs."
222. A nurse is teaching a client who has a new prescription for diphenhydramine for allergic
rhinitis. The nurse should instruct the client to monitor for which of the following
manifestations as an adverse effect of this medication? (Select all that apply.)
A. Dry mouth
B. Nonproductive cough
C. Skin rash
D. Drowsiness
E. Urinary hesitation
Answer: A. Dry mouth
223. A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which
of the following statements by the client indicates an understanding of the teaching?
A. "I should use the spray every 4 hours while I am awake."
B. "It can take as long as 3 weeks before the medication takes a maximum effect."
C. "This medication can also be used to treat motion sickness."

D. "I can use this medication when my nasal passages are blocked."
Answer: B. "It can take as long as 3 weeks before the medication takes a maximum effect."
224. A nurse is implementing a plan of care for a client who has a wound infection. Which of
the following actions is the nurse's priority?
A. Administer antibiotic medication.
B. Obtain a wound specimen for culture.
C. Monitor the client for a superinfection.
D. Teach the client about wound care.
Answer: B. Obtain a wound specimen for culture.
225. A nurse is teaching a client who has manifestations of a urinary tract infection. The nurse
should instruct the client that which of the following tests is needed to determine which
microorganism is causing the infection?
A. Blood WBC
B. Blood creatinine
C. Urine culture
D. Urine specific gravity
Answer: C. Urine culture
226. A nurse is teaching a group of nurses about antimicrobial therapy. The nurse should that
effective penetration of antibiotics can be impeded by which of the following conditions?
struct
A. Meningitis dh
B. An infected abscess
C. Endocarditis
D. Pneumonia
E. Pyelonephritis
Answer: A. Meningitis dh
B. An infected abscess
C. Endocarditis
227. A nurse is caring for a group of clients who are receiving antimicrobial therapy. The
nurse should identify that which of the following clients is at risk for medication toxicity?

A. A young adult client who has a sinus infection
B. An older adult client who has prostatitis
C. A client who is postpartum and has mastitis
D. A middle adult client who has a urinary tract infection
Answer: B. An older adult client who has prostatitis
228. A nurse is teaching a group of nurses about the importance of prophylactic antimicrobial
therapy. Which of the following information should the nurse include in the teaching? (Select
all that apply.)
A. Administer prophylactic antimicrobial therapy to clients who report exposure to a sexually
transmitted infection.
B. Administer prophylactic antimicrobial therapy to clients who are having orthopedic
surgery.
C. Instruct clients who have a prosthetic heart valve about the need for prophylactic
antimicrobial therapy before dental work.
D. Consult the provider for prophylactic antimicrobial therapy for clients who have recurrent
urinary tract infections.
E. Instruct clients to request prophylactic antimicrobial therapy immediately when they have
an upper respiratory infection.
Answer: A. Administer prophylactic antimicrobial therapy to clients who report exposure to
a sexually transmitted infection.
B. Administer prophylactic antimicrobial therapy to clients who are having orthopedic
surgery.
C. Instruct clients who have a prosthetic heart valve about the need for prophylactic
antimicrobial therapy before dental work.
D. Consult the provider for prophylactic antimicrobial therapy for clients who have recurrent
urinary tract infections.
229. A nurse is preparing to administer nafcillin IM to an adult client who has an infection.
Which of the following actions should the nurse plan to take? (Select all that apply.)
A. Select a 25-gauge, ½-inch needle for the injection.
B. Administer the medication deeply into the ventrogluteal muscle.
C. Ask the client about an allergy to penicillin before administering the medication.
D. Monitor the client for 30 min following the injection.

E. Tell the client to expect a temporary rash to develop following the injection.
Answer: B. Administer the medication deeply into the ventrogluteal muscle.
C. Ask the client about an allergy to penicillin before administering the medication.
D. Monitor the client for 30 min following the injection.
230. A nurse is assessing a client who has a severe infection and has been receiving
cefotaxime for the past week. Which of the following findings indicates potentially serious
adverse reaction to this medication that the nurse should report to the provider?
A. Diaphoresis
B. Epistaxis
C. Diarrhea
D. Alopecia
Answer: C. Diarrhea
231. A nurse is obtaining a medication history from a client who is to receive imipenemcilastatin IV to treat an infection. Which of the following medications the client also receives
increases the risk for a medication interaction?
A. Regular insulin
B. Furosemide
C. Valproic acid
D. Ferrous sulfate
Answer: C. Valproic acid
232. A nurse is caring for a client who has a cerebrospinal fluid infection with gram-negative
bacteria. Which of the following cephalosporin antibiotics should the nurse expect to
administer IV to treat this infection?
A. Cefaclor
B. Cefazolin
C. Cefepime
D. Cephalexin
Answer: C. Cefepime
233. A nurse is preparing to administer penicillin V to a client who has a streptococcal
infection. The client reports difficulty swallowing tablets and doesn't "do well" with liquid or

chewable medications because of the taste, even when the nurse mixes the medication with
food. The nurse should request a prescription for which of the following medications?
A. Fosfomycin
B. Amoxicillin
C. Nafcillin
D. Cefaclor
Answer: C. Nafcillin
234. A nurse is teaching a client about taking tetracycline to treat a Gl infection due to
Helicobacter pylori. Which of the following statements should the nurse identify as an
indication that the client understands the instructions?
A. "I will take this medication with 8 ounces of milk."
B. "I will let my doctor know if I start having diarrhea."
C. "I can stop taking this medication when I feel completely well."
D. "I can take this medication just before bedtime."
Answer: B. "I will let my doctor know if I start having diarrhea."
235. A nurse is administering gentamicin by IV infusion at 0900. The medication will take 1
hr to infuse. When should the nurse plan to obtain a blood sample for a peak blood level of
gentamicin?
A. 1000
B. 1030
C. 1100
D. 1130
Answer: B. 1030
236. A nurse is caring for a client who is starting a course of gentamicin IV for a serious
respiratory infection. For which of the following manifestations should the nurse monitor as
an adverse effect of this medication? (Select all that apply.)
A. Pruritus
B. Hematuria
C. Muscle weakness
D. Difficulty swallowing
E. Vertigo

Answer: A. Pruritus
B. Hematuria
C. Muscle weakness
E. Vertigo
237. A nurse is caring for a client who has subacute bacterial endocarditis and is receiving
several antibiotics, including streptomycin IM. For which of the following manifestations
should the nurse monitor as an adverse effect of this medication?
A. Ataxia
B. Urinary retention
C. Constipation
D. Complex partial seizures
Answer: A. Ataxia
238. A nurse is caring for a client who is undergoing preparation for extensive colorectal
surgery. Which of the following oral antibiotics should the nurse expect to administer
specifically to suppress normal flora in the Gl tract?
A. Kanamycin
B. Gentamic in
C. Neomycin
D. Tobramycin
Answer: C. Neomycin