ATI PHARMACOLOGY PROCTORED ASSESSMENT
EXAM GRADED A QUESTIONS AND ANSWERS 2023/2024
1. A patient newly diagnosed with hypothyroidism is prescribed Levothyroxine (Synthroid) 0.25
mg PO daily. After 6 weeks of treatment the nurse determines that the medication was effective if
the:
A) Thyroid stimulating hormone (TSH) level is 2 microunits/mL
B) Total t4 level is 2 mcg/dL
Answer: A) Thyroid stimulating hormone (TSH) level is 2 microunits/mL
2. A nurse providing teaching to a client who has just been prescribed prazosin (Minipress)
which of the following client statement indicates understanding of teaching:
A) I will not use a salt substitute while taking meds
B) I will move slowly from sitting to standing to prevent falls
Answer: B) I will move slowly from sitting to standing to prevent falls
3. A nurse is providing teaching to a patient who is prescribed phenytoin (Dilantin). Which
statement by the patient indicates further teaching:
A) I should expect a rash to develop
B) I may develop hair or face or chest
Answer: A) I should expect a rash to develop
4. A nurse is receiving a telephone prescription for an antibiotic from a client's provider. Which
of the following is the nurse required to do:
A) Read the prescription back to the provider after transcribing
B) Write the trade name for the prescribed medicine
Answer: A) Read the prescription back to the provider after transcribing
5. A nurse is providing teaching to an adolescent and her family regarding a new prescription of
phenytoin (Dilantin) for a newly diagnosed seizure disorder. Which of the following client
statements indicates the understanding of the teaching:
A) I will keep a seizure frequency chart
B) I will skip a dose if I am experiencing nausea
Answer: A) I will keep a seizure frequency chart
6. A nurse is caring for a client who has heart failure and is receiving furosemide (Lasix) and
digoxin (Lanoxin). Routine laboratory results reveal a potassium level of 2.6 mEq/L. Which of
the following actions should the nurse take first:
A) Apply a cardiac monitor
B) Provides foods high in potassium
Answer: A) Apply a cardiac monitor
7. A nurse administers ceftazidime (Fortaz) to a client who has a severe penicillin allergy. Which
of the following client findings requires an incident report:
A) The client is also taking linsinophrel (Prinivil)
B) The client reports shortness of breath
Answer: B) The client reports shortness of breath
8. A nurse is providing teaching to a female client who has been newly diagnosed with a seizure
disorder and has begun phenytoin (Dilantin). The nurse should tell the client that phenytoin can
decrease the effectiveness of which of the following:
A) Ethunyl estradiol/desogestrel (Cyclessa)
B) Fluroxetine (Prozac)
Answer: A) Ethunyl estradiol/desogestrel (Cyclessa)
9. A nurse providing teaching to a client who is diagnosed with migrane headaches. The client is
prescribed ergotamine (Ergostat) sublingual (SL). Which of the following should the nurse
include in her instructions:
A) Take 1SL tablet three times a day before meals
B) Take 1SL tablet at onset of migrane
Answer: B) Take 1SL tablet at onset of migrane
10. A nurse is reviewing a client's daily laboratory findings before administering 0.125 mg of
digoxin (Lanoxin). The client's serum digoxin level is 0.7 mg/mL. Which of the following
actions should the nurse take:
A) Give the medication
B) Request a dose increase
Answer: A) Give the medication
11. A nurse is planning to provide medication education for a client who will begin a course of
therapy with metronidazole (Flagyl). Which of the following should the nurse instruct the client
to avoid during the course of therapy:
A) Coffee
B) Beer
Answer: B) Beer
12. A nurse is teaching a client who has heart failure about a new prescription for captopril
(Capoten). Which of the following statements by the client indicates a need for further teaching:
A) I will take the medication 1 hr before my meals
B) I will use a salt substitute with my meals
Answer: B) I will use a salt substitute with my meals
13. A client is experiencing acute angle closure glaucoma and IV mannitol (Osmitrol) 25% is
prescribed. Which of the following client findings should the nurse recognize as being the best
indication that the medication is achieving it's therapeutic effect:
A) Decrease in intraocular pressure
B) Lung fluids clear to auscultation
Answer: A) Decrease in intraocular pressure
14. A nurse is educating a client who has a new prescription for simvastatin (Zacor). Which of
the following instructions should the nurse include in the teaching plan: (Select all that apply):
A) Report muscle pain to provider
B) Do not take the medication with grapefruit juice
C) Take the medication in the early morning
D) Minimize intake of alcoholic beverages
E) Expect therapy with this medication to be life long
Answer: A) Report muscle pain to provider
B) Do not take the medication with grapefruit juice
D) Minimize intake of alcoholic beverages
E) Expect therapy with this medication to be life long
15. A client taking IV heparin and oral warfarin (coumadin) for deep thrombosis. The client
aPTT is 4x the normal value and his INR is 2. Which of the following actions should the nurse
plan to take:
A) Decrease the heparin
B) Increase the warfarin
Answer: A) Decrease the heparin
16. The nurse is caring for a client who is in labor. The client is receiving oxytocin (pitocin) by
continuous IV infusion, piggy backed into a maintenance IV solution. The external FHR monitor
indicates late decelerations. Which of the following actions should the nurse take first:
A) Turn the client to side lying position
B) Discontinue the client's IV meds
Answer: B) Discontinue the client's IV meds
17. A nurse is providing teaching to a client taking bupropion (Zyban) as an aid to quit smoking.
For which of the following side effects should the nurse assess the client:
A) Insomnia
B) Tinnitus
Answer: A) Insomnia
18. A nurse is teaching a client about the use of risedronate (Actonel) to treat osteoporosis.
Which of the following client statements indicates a need for further teaching:
A) I need to set up or stand after taking the risedronate
B) I need to take the risedronate with food
Answer: B) I need to take the risedronate with food
19. A nurse is caring for a client who is receiving haloperidol (Haldol). For which of the
following adverse effects should the nurse be observing:
A) Vomiting
B) Akathesia
Answer: B) Akathesia
20. A nurse is caring for a client who is receiving oprelvekin (Interleukin ll). which should the
nurse document to indicate the effectiveness of the therapy:
A) Increased platelet count
B) Increased RBC count
Answer: A) Increased platelet count
21. A nurse is administering baclofen (Lioresal) for a client with a spinal cord injury. Which of
the following should the nurse document as a therapeutic outcome:
A) Increase in seizure threshold
B) Decrease flexor & extension spasticity
Answer: B) Decrease flexor & extension spasticity
22. A nurse is assessing a client who is receiving epoetin alfa (Procit) to treat anemia. For which
should the nurse monitor related to this medication:
A) Paresthesias
B) Increased BP
Answer: B) Increased BP
23. A nurse is planning teaching for a client who has depression and is to start a new prescription
for tranylcypromine (Parnate). Which should be included in teaching:
A) Avoid eating citrus fruits while taking this medication
B) Move slowly when changing to a standing position
Answer: B) Move slowly when changing to a standing position
24. Provide teaching new prescription: exenatide (Byetta) for Type 2 Diabetes. What should the
nurse monitor and report:
A) Abdominal pain
B) Increased thirst
Answer: A) Abdominal pain
25. A nurse is reviewing lab results, for a patient who has chronic asthma and is taking
prednisone (Deltasome) every other day. Which of the following lab values should the nurse
report to the doctor:
A) Blood glucose 200 mg/dL
B) BUN 14 mg/dL
Answer: A) Blood glucose 200 mg/dL
26. A nurse is caring for a client receiving zidovudine (Retrovir) for which of the following lab
results should the nurse prepare to monitor:
A) Serum creatine
B) Hemoglobin
Answer: B) Hemoglobin
27. A client informs the nurse at the primary care providers office that he received a prescription
for timolol (timoptic) to treat glaucoma. Which of the following in the client's history should
concern you:
A) The client has a history of bradycardia
B) The client reports that he is taking loratadine (Claritan)
Answer: A) The client has a history of bradycardia
28. A mom of a newborn asks the nurse when her newborn should receive his 1st diptheria,
tetanus, and pertusis vaccine (DTAP). Which of the following should the nurse say:
A) Birth
B) 2 months
Answer: B) 2 months
29. A nurse is preparing to administer warfarin (coumadin) to a client diagnosed with atrial
fibrillation. Which action should the nurse take before administering warfarin:
A) Check INR results
B) Monitor the aPTT level
Answer: A) Check INR results
30. A nurse caring for a client diagnosed with sickle cell anemia who is taking hydroxyurea
(Droxia). Which findings should the nurse report- select all that apply:
A) hemoglobin 4.2 g/dL
B) Hematocrit 42%
C) RBC 4,700,000/ mm3
D) Platelets 75,000/mm3
E) Neutrophils 1,400 /mm3
Answer: A) hemoglobin 4.2 g/dL
D) Platelets 75,000/mm3
E) Neutrophils 1,400 /mm3
31. A nurse assesses a patient with chronic back pain who is receiving 650 mg acetaminophen
(Tylenol) every 4 hours for pain. PCP has prescribed oxycodone/acetaminophen (Percocet) every
4 to 6 hours PRN for breakthrough pain. Which action should the nurse take:
A) Place the client on seizure precautions
B) Notify the PCP
Answer: B) Notify the PCP
32. A nurse is teaching a patient who has a peptic ulcer disease and is to start a new prescription
for sucralfate (Carafate). The nurse explains to the patient this medication:
A) Forms a protective barriers over ulcers
B) Treats ulcers by eradicating H. pylor
Answer: A) Forms a protective barriers over ulcers
33. Which of the following statements made by a client after a teaching session about Warfarin
(Coumadin) indicates a need for further teaching:
A) I may take aspirin as needed for pain
B) I should limit the amount of green, leafy vegetables
Answer: A) I may take aspirin as needed for pain
34. A nurse is caring for a patient who has pneumonia. The patient tells the nurse that she is
pregnant, but has not told her provider. Which of the following medication orders should the
nurse question:
A) Acetaminophen (Tylenol)
B) Doxycycline (Doxycin)
Answer: B) Doxycycline (Doxycin)
35. A nurse is providing teaching to a patient who has hypertension and is to start a new
prescription for lisinopril (Zestril). For which of the following should the nurse instruct the client
to monitor and report to the PCP:
A) Facial Flushing
B) Dry cough
Answer: B) Dry cough
36. A nurse caring for the following patient with acute ST elevation myocardial infarction. The
patient is receiving nitroglycerin (Nitrobid IV) by continuous IV infusion to maintain a systolic
blood pressure between 130-150 mmHg:
A) Increase the dose when the Systolic BP is 120 mmHg
B) Increase the dose when the Systolic BP is 160 mmHg
Answer: B) Increase the dose when the Systolic BP is 160 mmHg
37. Older adult taking procainamide (Pronestyl) is admitted to ER with an acute myocardial
infarction and ventricular premature beats. Which finding should indicate to the nurse to
withhold medication and notify PCP:
A) Drowsiness
B) A QRS widening increase than 50%
Answer: B) A QRS widening increase than 50%
38. A nurse is caring for a client who is taking tamoxifen (Nolvadex) for treatment of breast
cancer. The nurse should inform the client that which of the side effects can develop:(Select all
that apply)
A) Bradycardia
B) Menstrual irregularities
C) Petechia
D) Hot flashes
E) Vaginal discharge
Answer: B) Menstrual irregularities
D) Hot flashes
E) Vaginal discharge
39. A nurse is providing teaching to a patient with chronic asthma, is prescribed beclomethsdone
(QVAR). What instructions should be included in the nursing care plan:
A) Use inhaler as soon as asthma attack begins
B) Take extra Vitamin B & C when using medication
Answer: A) Use inhaler as soon as asthma attack begins
40. A client with history of hypertension tells the nurse that he uses over-the counter oral
decongestant for nasal congestion. The nurse should advise client that decongestions?
A) Can constrict blood vessels
B) Are less effective than antihistamines
Answer: A) Can constrict blood vessels
41. A nurse is providing teaching for a patient with acute cystitis and is prescribed
phenazopyridine HCL (Pyridium). Which side effect will be normal for the patient to see:
A) Urine will turn red-orange color
B) A mild fever
Answer: A) Urine will turn redorange color
42. A patient has been prescribed trimethoprim/sulfamethoxazole (Bactrum DS). Which of the
following should the nurse report:
A) Photosensitivity
B) Vesicular, crusty rash
Answer: B) Vesicular, crusty rash
43. A client has been taking propylthiouracil (PTU) for 4 weeks- what should an outcome be:
A) Decrease heart rate
B) Increase body temp
Answer: A) Decrease heart rate
44. A nurse instructing on appropriate placement of the client's nitroglycerin transdermal patch
(Minitran) understands teaching with this statement:
A) I should apply the patch to an area of body with minimal fat tissue
B) I will take the patch off right after my evening meal
Answer: B) I will take the patch off right after my evening meal
45. A nurse is to administer a new prescription for amoxicillin/clavulanic acid (Augmentin) IV
bolus. The client tells the nurse allergy to penicillin. Which should be done first:
A) Withhold the medication
B) Inform the pharmacist of allergy to penicillin
Answer: A) Withhold the medication
46. A nurse providing discharge teaching for patient has a prescription for morphine. The nurse
should:
A) Increase fiber intake
B) Increase dosage to relieve pain
Answer: A) Increase fiber intake
47. A nurse is monitoring a patient who has been prescribed amphoterian B (Fungizone)
intermittent IV bolus for histoplasmosis. What adverse effects should you notify PCP:
A) Bradycardia
B) Fever
Answer: B) Fever
48. A patient has been receiving aspirin for treatment of arthritis. Which symptom should
indicate the client beginning to exhibit salicylism:
A) Excessive bruising
B) Tinnitus
Answer: B) Tinnitus
49. A nurse is caring for a patient who has cancer and is experiencing breakthrough pain every 6
to 8 hours. The client report pain level of 8 on a scale of 0 to 10. Which of the following
analgesics should the nurse anticipate administering:
A) Celecoxib (Celebrax)
B) Hydromorpine (Dilaudid)
Answer: B) Hydromorpine (Dilaudid)
50. A nurse is caring for a school age child prescribed methylphenidate (Ritalin) for ADHD. The
nurse has initiated interventions to minimize adverse effects. Which of the following indicates a
successful intervention:
A) Increase BP
B) Maintains age- appropriate weight
Answer: B) Maintains age- appropriate weight
51. A nurse is instructing a client who experiences migraines and is starting oral sumatriptan
(Imitrex) therapy. Which of the following should the nurse include in teaching:
A) Take the medication 1x daily to prevent migrane attacks
B) Use the medication as soon as migrane symptoms appear
Answer: B) Use the medication as soon as migrane symptoms appear
52. Nurse caring for postoperative patient with PCA of morphine sulfate. The nurse assesses a
respiratory rate of 10/ min and is unable to arouse the patient with verbal or tactile stimulation.
Which of the following actions should the nurse first take:
A) Administer naloxone (Narcan) IV to the client
B) Notify the primary of the findings
Answer: A) Administer naloxone (Narcan) IV to the client
53. A patient diagnosed with acute bronchitis is beginning a short course of prednisone
(Deltasone) therapy. The patient asks the nurse to give him the required vaccinations because he
is joining the peace corp. The nurse appropriately responds by stating, "You should":
A) Wait until you have completed your medication therapy before receiving the vaccinations
B) Wait until after you have taken this medication for a few days
Answer: A) Wait until you have completed your medication therapy before receiving the
vaccinations
54. A nurse is providing teaching to a client regarding the administration of ferrous sulfate
(Feosol). Which of the following instructions should the nurse include in her teaching:
A) Take the tablet on an empty stomach
B) Call your provider if you begin to bruise easily
Answer: A) Take the tablet on an empty stomach
55. A nurse is providing teaching to a client who has a new prescription for phenytoin (Dilantin).
Which of the following statements by the client indicates an understanding of the teaching:
A) I should let my dentist know that I'm taking this medication
B) I should expect to experience some unusual type movement when taking Dilantin
Answer: A) I should let my dentist know that I'm taking this medication
56. A nurse is caring for an older adult patient who is taking ranitidine (Zantac) for GERD. For
which of the following findings should the client be instructed to monitor and report to provider:
A) Clay colored stools
B) Green sputum
Answer: B) Green sputum
57. A nurse is assessing a patient who is taking oral contraceptives. Which of the following
medications will interfere with the effectiveness of the oral contraceptives:
A) Warfarin (Coumadin)
B) carbamazepine (Tegretol)
Answer: B) carbamazepine (Tegretol)
58. A nurse is teaching a patient with tuberculosis about the adverse effects of isoniazid (INH).
The nurse restricts the client to notify the PCP immediately if which of the following occurs:
A) Yellowish skin tones
B) Headache
Answer: A) Yellowish skin tones
59. A nurse is reinforcing teaching to a 17 year old female patient who has severe acne regarding
the use of isotretinoin (Accutane). Which of the following side effects is the priority side effect
to report to the PCP:
A) Back pain
B) Feelings of isolation
Answer: B) Feelings of isolation
60. A nurse caring for a client who was admitted to the hospital with congestive heart failure
(CHF) and is taking digoxin (Lanoxin) 0.25 mg daily .he patient refused breakfast and is
complaining of nausea and generalized weakness. Which of the following actions should the
nurse perform 1st:
A) Check the patient's vital signs
B) Request a dietitian consult
Answer: A) Check the patient's vital signs
61. A nurse is caring for a patient who is hospitalized with active pulmonary tuberculosis and is
to be started on ethambutol (myambutol) therapy. The nurse should understand that which of the
following should be monitored:
A) Visual Activity
B) Skin color
Answer: A) Visual Activity
62. A clinic nurse is giving instructions to a mother on the proper technique of applying ointment
to her pre-school-age child. Who has conjunctivitis. Which should the nurse include in the
instructions:
A) Discard the first bead of ointment before each application
B) Instruct your client to squeeze his eyes shut following application
Answer: A) Discard the first bead of ointment before each application
63. A nurse enters an older adult patient's room to insert a saline lock. The client ask the nurse,
'Why do need that, I am drinking plenty of fluids?" Which of the following responses by the
nurse is appropriate?"
A) We give all our medications IV in this unit
B) The provider has prescribed antibiotics therapy to be administered IV every 6 hours
Answer: B) The provider has prescribed antibiotics therapy to be administered IV every 6 hours
64. A nurse is caring for a patient who has erectile dysfunction and is interested in taking
sildenafel (Viagra). The nurse informs the patient that sildenfil is contraindicated due to the fact
that the client also takes which one of the following medications:
A) Isosorbide (Isordel)
B) Phenytoin (Dilatin)
Answer: A) Isosorbide (Isordel)
65. A nurse reported to the nurse manager that another staff member was observed signing out
meperidine hydrochloride (Demerol), which was not administered to the patient. The nurse
manager should know that potential opiate abuse by the employees may be manifested by which
of the following symptoms:
A) Tremors
B) Rhinorrhea
Answer: A) Tremors
66. A nurse is caring for a patient who is taking clarithyromycin (Biaxin). The nurse includes a
diagnosis of "risk for altered sensory perception" in the client's plan of care. This is appropriate
because many client's on clarithromycin have an altered sense of which of the following:
A) Smell
B) Taste
Answer: B) Taste
67. A nurse is caring for a client who has asthma and is prescribed chewable mortelukast
(Singular). The nurse should instruct the child's parent to administer the medication:
A) Daily at bedtime
B) Before any activity
Answer: A) Daily at bedtime
68. A nurse is assessing a client who comes to the clinic for a seasonal influenza vaccine. The
client says he read about an influenza vaccine that is given as a nasal spray and wants to receive
it. Which of the following is a contradiction for the patient to receiving the live attenuated
influenza vaccine (LAIV)?
A) Just turned 62
B) Smokes one pack of cigarettes a day
Answer: A) Just turned 62
69. A nurse is caring for a client who is receiving chlorpromazine (Thorazine) and is given a pass
to attend a family outing on a sunny day. Which of the following is the most important for the
nurse to include in the client's teaching about the side effects of chlorpromazine?
A) Wear a hat and long sleeved shirt
B) Suck on hard candies
Answer: A) Wear a hat and long sleeved shirt
70. A nurse is reviewing a client's admission record. The nurse notes that there are prescriptions
for several medications. Which of the following factors should the nurse recognizes is of primary
consideration when determining the schedule of administration:
A) Institutional policies regarding routine medication administration times
B) Specific characteristics of the medications
Answer: B) Specific characteristics of the medications
71. A client has a history of myocardial infarction (MI) is prescribed aspirin (Ecotrin) 325 mg.
The nurse correctly understands that the aspirin is ordered due to its action as a:
A) Antiplatelet aggregate
B) Antipyretic
Answer: A) Antiplatelet aggregate
72. A home health nurse is reviewing the medication list of an older adult patient who reports
falling a couple of times over the past week. Which of the following meds should the nurse
suspect is contributing to the client's falls:
A) Alprazolam (Xanax)
B) Acetaminophen (Tylenol)
Answer: A) Alprazolam (Xanax)
73. A nurse is caring for an older adult client who is hospitalized. Which of the following
medication is likely to put the client at risk for orthostatic hypotension. (Select all that apply):
A) Furosemide (Lasix)
B) Telmisartan (Micardis)
C) Phenelzine sulfate (Nardil)
D) Clopidogrel (Plavix)
E) Atorvastatin (Lipitor)
Answer: A) Furosemide (Lasix)
B) Telmisartan (Micardis)
C) Phenelzine sulfate (Nardil)
74. A nurse is caring for a client who is receiving nifedipine (Procardia). The nurse checks the
client's blood pressure before administering medication and reports 98/58. Which of the
following actions should the nurse first take:
A) Document the patient's blood pressure
B) Recheck the client's blood pressure
Answer: B) Recheck the client's blood pressure
75. A nurse is caring for an older adult client who has rheumatoid arthritis and is taking aspirin
(Bufferin) 650 mg every 4 hours. Which of the following diagnostic tests should the nurse
monitor to evaluate the effectiveness of this medication:
A) Antinuclear antibody (ANA)
B) Erthrocyte sedimentation rate (ESR)
Answer: B) Erthrocyte sedimentation rate (ESR)
76. A nurse is caring for several patients who have bipolar disorder. The nurse should recognize
that which of the following medications are appropriate for treating this condition (Select all that
apply):
A) paraoxetine (Paxil)
B) lithium (Lethane)
C) tranylcypromine (Parnate)
D) valproic acid (Depakota)
E) phenytoin (Dilantin)
F) carbamazepine (Tegretol)
Answer: A) paraoxetine (Paxil)
B) lithium (Lethane)
D) valproic acid (Depakota)
F) carbamazepine (Tegretol)
77. A nurse is assessing a client who has numerous bruises on his upper extremities. The patient
reports that he has taken warfarin (coumadin) daily for the past 3 months. Which of the following
statements by the client indicates the client needs further teaching:
A) I have started taking ginger root to treat my joint stiffness
B) I take Tylenol whenever I have a headache
Answer: A) I have started taking ginger root to treat my joint stiffness
78. A nurse is caring for a client with nausea. The client is prescribed intravenous
metaclopramide (Reglan) as needed. The nurse knows that Reglan is an effective antimetic
because it
A) Promotes gastric emptying
B) Decrease gastric acid secretions
Answer: A) Promotes gastric emptying
79. A nurse is caring for a patient with chronic renal failure and states she has heartburn.
Prescribes aluminum hydroxide (Amphojel). The patient asks the nurse why can’t i just take the
antacide magadrate (Reopan) my husband has at home. The nurse explains to the client that
aluminum hydroxide is the preferred antacid because it lowers which of the following:
A) Serum phosphorus levels
B) Serum potassium levels
Answer: A) Serum phosphorus levels
80. A nurse is planning teaching for a child who has been prescribed fluticasone propionate
(Flovent) for treatment of chronic asthma. The nurse plans to teach the child to use a spacer to
minimize the risk for which of the following:
A) Adrenal Suppression
B) Candidiasis of the mouth
Answer: B) Candidiasis of the mouth
81. A nurse is caring for a client who has hypovolemic shock. The client is being administered
mannitol (Osmitrol) by IV bolus. Which of the following findings is the best indicator of the
medication's effectiveness:
A) Urine output 50 mL/hr
B) BUN 18 mg/dL
Answer: A) Urine output 50 mL/hr
82. A nurse is caring for a client taking atorvastatin (Lipitor). Which of the following should the
nurse recognize should be monitored for this client:
A) CK
B) ESR
Answer: A) CK
83. A client is being treated for heart failure and is receiving digoxin (Lanoxin) and furosemide
(Lasix). Based on the chart findings, which of the following actions should the nurse take first:
A) Obtain an order for serum digoxin level
B) Review the client's blood pressure over the past 24 hours
Answer: A) Obtain an order for serum digoxin level
84. A nurse is teaching a client about the use of risedronate (Actonel) for the treatment of
osteoporosis. Which of the following client statements indicates an understanding of the
teaching:
A) I should take an antacid with the risedronate to avoid nausea
B) I should sit up for 30 minutes after taking the risedronate
Answer: B) I should sit up for 30 minutes after taking the risedronate
85. A nurse is teaching a client who has a prescription for pilocarpine (Pilocar) eye drops. Which
of the following client statements should indicate to the nurse a need for additional teaching:
A) I will stop using the drops as soon as my vision improves
B) I know this medication can cause side effects in other areas of my body
Answer: A) I will stop using the drops as soon as my vision improves
86. A nurse is precepting a newly licensed nurse who us caring for four clients. Which of the
following actions should be noted in an incident report? The nurse administers:
A) Regular insulin (Humulin R) to a client who has a blood glucose of 250 mg/dL
B) Isosorbide mononitrate (Imdur) to a client who has blood pressure 82/60 mmHg
Answer: B) Isosorbide mononitrate (Imdur) to a client who has blood pressure 82/60 mmHg
87. A nurse is caring for a client who has been receiving parenteral morphine sulfate following a
thoracic procedure. Which of the following findings should the nurse recognize is the most
reliable indicator that the client's pain is being adequately managed:
A) The client is speaking with a family member
B) The client is able to breathe deeply and cough
Answer: B) The client is able to breathe deeply and cough
88. A nurse is caring for a 20 year old female who has been prescribed isotretinoin (Accutane)
for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should
advise the client that which of the following tests will be required:
A) Hgb level
B) Pregnancy test
Answer: B) Pregnancy test
89. A nurse is caring for a client receiving heparin IV at 1,000 units/hr. Which of the following
should the nurse recognize as an adverse reaction to this medication:
A) Paresthesias
B) Pink tinged urine
Answer: B) Pink tinged urine
90. A nurse is assessing a 5 year old child's need for pain medication. Which of the following
actions by the nurse will best determine whether the child needs for pain medication:
A) Ask the parents if they think the child is in pain
B) Have the child rate the pain using the FACES pain rating scale
Answer: B) Have the child rate the pain using the FACES pain rating scale
91. A nurse is providing teaching to a client who is prescribed an MAOI. Which of the following
should the nurse instruct the client to avoid while taking this medication:
A) Red wine
B) Cottage cheese
Answer: A) Red wine
92. A nurse is obtaining a medication history from a client who is prescribed tobramycin sulfate.
Which of the following medications should the nurse notify the provider concerning concurrent
use:
A) Paroxetine (Paxil)
B) Ibuprofen (Motrin)
Answer: B) Ibuprofen (Motrin)
93. A nurse is caring for a client in the PACU. The client is 1 hour postoperative, is difficult to
arouse, and is hypotensice. The nurse should administer which of the following:
A) Lorazepam (Ativan)
B) Naloxone (Narcan)
Answer: B) Naloxone (Narcan)
94. A nurse is providing discharge instructions for a client who has a prescription for
colesevelam (WelChol). Which of the following indicates the client needs additional teaching:
A) I will mix the medication with 30 mL of water
B) I will increase my fiber intake while taking this medication
Answer: A) I will mix the medication with 30 mL of water
95. A nurse is providing teaching about insulin glargine (Lantus) to a client who has Type 1
diabetes mellitus. Which of the following should the nurse include in the instructions:
A) Do not mix this medication in a syringe with other insulins
B) Rotate the bottle gently prior to drawing up the insulin
Answer: A) Do not mix this medication in a syringe with other insulins
96. A client is being started on ferrous sulfate. To enhance absorption, the nurse should advise the
client to take the medication with which of the following?
A) Calcium carbonate
B) Ascorbic acid
Answer: B) Ascorbic acid
97. A nurse in the PACU is caring for a client who has received midazolam (Versed) IV bolus
prior to an endoscopy. Which of the following findings indicate to the nurse to administer
flumazenil (Romazicon) IV?
A) Elevated temperature
B) Respiratory depression
Answer: B) Respiratory depression
98. A nurse is caring for an older adult client. The client received 0.9% sodium chloride 1 L over
4 hr instead of over 8 hour as prescribed. Which of the following entries is the appropriate
documentation of this occurrence in the client's medical record:
A) IV fluid infused over 4 hours instead of the prescribed 8 hours. Client tolerated fluids well
B) 0.9% sodium chloride 1 L IV infused over 4 hours. Vital signs stable
Answer: B) 0.9% sodium chloride 1 L IV infused over 4 hours. Vital signs stable
99. A nurse is obtaining the medication history of a client who is starting a new prescription for
allopurinol (Zyloprim). Which of the following medications should the nurse contact the
provider regarding a potential interaction:
A) Nifesipine (Adalat)
B) Warfarin (Coumadin)
Answer: B) Warfarin (Coumadin)
100. A nurse is caring for a client receiving filgrastim (Neupogen) for neutropenia. Which of the
following laboratory values indicates that the treatment has been effective:
A) Hgb 15 g/dL
B) WBC 8,000/mm3
Answer: B) WBC 8,000/mm3
101. A client who has hypothyroidism and is breastfeeding tells the nurse that she is taking
levothyroxine (Synthroid) and is concerned that it will be excreted in her breast milk. Which of
the following responses by the nurse is appropriate?
A) You will need to take the medication after breastfeeding the infant each morning
B) You will need to decrease your medication while breastfeeding
Answer: A) You will need to take the medication after breastfeeding the infant each morning
102. At 0900 a nurse is preparing a client's medications. Based on the chart findings, which of
the following medications should the nurse give first:
A) Sodium polystyrene sulfate (Kayexalate)
B) Atenolol (Tenormin)
Answer: A) Sodium polystyrene sulfate (Kayexalate)
103. A nurse administers naloxone (Narcan) as prescribed for a client who is 8 hr. postoperative
adverse effects after administration of opioid analgesia. Which of the following interventions
should the nurse plan to take following naloxone administration? (Select all that apply)
A) Observes the client for bleeding
B) Assess the client for nausea and vomiting
C) Check the client's pain level frequency
D) Monitor the client for bradycardia
E) Repeat the dose every 15 min until the client responds
Answer: A) Observes the client for bleeding
B) Assess the client for nausea and vomiting
104. A nurse is planning teaching for a client who has a new diagnosis of exercise-induces
asthma. Which of the following medications should the nurse instruct the client to use prior to
physical activity:
A) Cromolyn sodium (Intal)
B) Predisone (Deltasone)
Answer: A) Cromolyn sodium (Intal)
105. A nurse is providing teaching to a client who has just been prescribed prazosin (Minipress).
Which of the following client statements indicates an understanding of the teaching:
A) I will not use salt substitute while taking this medication
B) I will move slowly from sitting to standing to prevent falls
Answer: B) I will move slowly from sitting to standing to prevent falls
106. A nurse is providing teaching to a client who is prescribed thrimethoprim/ sulfamethoxazole
(Bactrim DS). Which of the following instructions should the nurse include in her teaching:
A) Drink 8 to 10 glasses of water daily
B) Rise slowly from bed in the morning
Answer: A) Drink 8 to 10 glasses of water daily
107. A client is receiving a heparin infusion for deep vein thrombosis. The nurse should
discontinue the medication infusion for which client findings:
A) Hemoglobin 15 g/dL
B) Platelets 96,000/mm3
Answer: B) Platelets 96,000/mm3
108. A client newly diagnosed with hyperthyroidism is prescribed (Synthyroid) 0.25 mg PO
daily. After 6 weeks of treatment, the nurse determines that the medication was effective if the:
A) Thyroid-stimulating hormone (TSH) level is 2 microunits/mL
B) Total t4 level is 3 mcg/dL
Answer: A) Thyroidstimulating hormone (TSH) level is 2 microunits/mL
109. A nurse is caring for a client who has just been transferred from the PACU to the medical
surgical unit following a colon resection. The client reports pain of an 8 on a scale from 0 to 10
and has a prescription for morphine sulfate 4 mg IV bolus PRN pain every 2 hr. Which of the
following actions should the nurse take first:
A) Administer the morphine sulfate
B) Check the client's PACU medication record
Answer: B) Check the client's PACU medication record
110. A client who has diabetes mellitus insulin lispro and is prescribed metoprolol (Lopressor)
for hypertension. Which of the following should the nurse observe for in this client as an early
indicator of hypoglycemia:
A) Sweating
B) Tachycardia
Answer: A) Sweating
111. A nurse is caring for a client who has cancer and is taking oral morphine sulfate and
docusate sodium (Colace). Which of the following side effects will be minimized by taking the
docusate sodium on a daily basis?
A) Constipation
B) Drowsiness
Answer: A) Constipation
112. A nurse caring for a client that has undergone a liver transplant and is taking cyclosporine
(Sandimmune). Which of the following laboratory findings indicates an adverse effect of the
medication:
A) WBC count 8,000/mm3
B) Serum creatine 2.5 mg/dL
Answer: B) Serum creatine 2.5 mg/dL
113. A nurse is providing teaching to a client who has a new pancrelipase (Pancrease). Which of
the following should the nurse include in the teaching:
A) Take the medication with each meal and snack
B) Monitor blood glucose levels daily
Answer: A) Take the medication with each meal and snack
114. A client who is postoperative has received 2 mg of hydromorphine (Dilaudid) IV bolus
every 2 hours. The client continue to rate his pain at a 7 on a scale from 0 to 10. which of the
following client findings should the nurse attend to first:
A) Constipation
B) Hypotension
Answer: B) Hypotension
115. A nurse is instructing a client who has asthma. The client is currently taking albuterol
(Proventil) every 4 hours PRM for bronchial spasms. He is to start a new prescription for
montelukast (Singulair). Which of the following instructions should the nurse include: (Select all
that apply)
A) Use montelukast to relieve an asthma attack
B) Do not take montelukast with food
C) Administer montelukast 30 min before sports activities
D) Report any increased need to use albuterol
E) Take montelukast once a day in the the evening
Answer: D) Report any increased need to use albuterol
E) Take montelukast once a day in the the evening
116. A nurse is caring for a client who is experiencing acute alcohol withdraw. For which of the
following is the client prescribed chlordiazpoxide (Librium)
A) Lessen craving
B) Prevent delirium tremens
Answer: B) Prevent delirium tremens
117. A child is prescribed amoxicillin-clavulanic acid (Augmentin) for the treatment of an ear
infection. The child's mother asks the nurse why her child is receiving this combination of two
medications. The nurse appropriately responds by stating that this medication is:
A) More effective
B) Known to decrease allergic reaction
Answer: A) More effective
118. A nurse is providing teaching to a client who has rheumatoid arthritis and is prescribed
methotrexate (Rheumatrex). Which of the following statements by the client indicates an
understanding of the teaching:
A) I should call my doctor if I develop sores in my mouth
B) I will have difficulty sleeping when I take this medication
Answer: A) I should call my doctor if I develop sores in my mouth
119. A nurse is caring for a client who is starting a new prescription for warfarin (Coumadin).
Which of the following medications should the nurse plan to administer if the client experiences
bleeding:
A) Vitamin K
B) Protamine sufate
Answer: A) Vitamin K
120. A nurse is evaluating a client who has been prescribed oral metformin (Glucophage) and
glipizide (Glucotrol) 3 months ago to control diabetes mellitus. The nurse should identify which
of the following laboratory findings as indicative of client compliance over time:
A) HbA1c 8.0%
B) HbA1c 6.5%
Answer: B) HbA1c 6.5%
121. An older adult client who has an infection is prescribed gentamicin (Garamycin). Which of
the following client statements indicates a side effect of this medication and should be reported
to the provider immediately:
A) I'm having difficulty reading the newspaper
B) I have to turn the volume up on the TV to hear it
Answer: B) I have to turn the volume up on the TV to hear it
122. A client is prescribed amitriptyline (Elavil). Which of the following adverse effects should
the nurse instruct the client to report:
A) Urinary retention
B) Decreased libido
Answer: A) Urinary retention
123. A nurse is caring for a client who has heart failure and is prescribed enalapril (Vasotec) and
spironolactone (Aldactone). For which of the following potential side effects should the nurse
plan to monitor:
A) Hypokalemia
B) Hyperkalemia
Answer: B) Hyperkalemia
124. A nurse is monitoring a client receiving an IV infusion of magnesium sulfate for preterm
labor. Which of the following indicates to the nurse that the client is experiencing magnesium
toxicity:
A) Decreased level of consciousness
B) Agitation
Answer: A) Decreased level of consciousness
125. A nurse is administering donepezil (Aricept) to a client who has Alzheimer's disease. Which
of the following documented findings should the nurse report to the provider immediately:
A) Dizziness
B) Dyspnea
Answer: B) Dyspnea
