A nurse is reinforcing teaching with a client about the adverse effects of sim vastin. For
which of the following adverse effects should the nurse instruct the client to notify the
provider
a. Muscle pain
b. Fine hand tremors
c. Urinary retention
d. Double vision
Answer: A
A nurse is planning to administer metoprolol to a client who has heart failure and a hear rate
of 48/min. which of the following actions should the nurse take?
a. Encourage the client to ambulate
b. Request a different beta blocker medication to administer
c. Administer one-half of the clients prescribed dose
d. Withhold the client’s medication
Answer: D
A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription
for lithium which of the following instructions should the nurse include in the teaching?
a. Take the medication on an empty stomach
b. Monitor for signs of hyperthyroidism
c. Watch for signs of urinary retention
d. Maintain a consistent sodium intake
Answer: D
A nurse is reinforcing teaching with a client who has a new prescription for colchicine to
manage gouty arthritis. Which of the following manifestations should the nurse include as an
adverse effect of this medication?
a. Abdominal pain
b. Wheezing
c. Excessive urination
d. Tinnitus
Answer: A
A nurse is preparing to administer a PRN medication to a group of clients. Which of the
following clients should the nurse administer medication to first?
a. A client who has GERD and request an antiacid
b. A client who reports constipation for 3 days and request a stool softener
c. A client who has mild generalized anxiety disorder and request an antianxiety medication
d. A client who is attending postoperative physical therapy and requests pain medication
Answer: D
A nurse Is caring for a client who has multiple sclerosis and a new prescription for baclofen.
Which of the following findings indicated to the nurse that the medication is having a
therapeutic effect?
a. Decreased muscle spasticity
b. Increased urinary output
c. Increased mental alertness
d. Decreased heart rate
Answer: A
A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three
times daily and reports rebound congestion. Which of the following instructions should the
nurse include to reduce the effects of rebound congestion?
a. “decrease the frequency to twice daily.”
b. “continue use for one more week.”
c. “discontinue use in the left nostril, then in the right nostril.”
d. “add oxymetazoline nasal spray to relieve symptoms.”
Answer: C
A nurse is reinforcing teaching with a client who has hypertension and a new prescription for
spironolactone. Which of the following instructions should the nurse include in the teaching?
a. Increase foods high in zinc
b. Restrict foods high in potassium
c. Restrict foods high in vitamin K
d. Increase foods high in magnesium
Answer: B
A nurse is caring for a client who has a new prescription for eplerenone to treat hypertension.
The nurse should monitor for which of the following adverse effects of his medication?
a. Hematuria
b. Hypernatremia
c. Hyperkalemia
d. Constipation
Answer: C
A nurse is monitoring who is receiving a transfusion of packed RBCs. The client’s
temperature increase to 39.1 degrees C (102.4 degrees F). which of the following actions
should the nurse take first?
a. Obtain a urine specimen
b. Administer diphenhydramine
c. Stop the transfusion
d. Notify the charge nurse
Answer: C
A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine.
Which of the following actions should the nurse take to counteract the adverse effects of this
medication?
a. Suggest that the client apply antiperspirant deodorant more frequently
b. Inform the client to apply sunblock before going outside
c. Give the clients a list of over-the-counter antidiarrheal medication
d. Recommend that the client take the medication on an empty stomach
Answer: B
A nurse is collecting data from a client who is asking about taking celecoxib for treatment of
joint pain. The nurse should identify that which of the following findings is a contraindication
to receiving celecoxib
a. Hyperglycemia
b. Allergy to penicillin
c. History of myocardial infarction
d. Peptic ulcer disease
Answer: C
A nurse is monitoring a client who has type 2 diabetes mellitus and is receiving repaglinide.
Which of the following laboratory tests should the nurse plan to review to obtain information
about the long-term therapeutic effect of this medication?
a. Fasting blood glucose level
b. 1-hr oral glucose tolerance test
c. Urinary ketones
d. Glycosylated HbA1 c
Answer: D
At 0800 a nurse assist with initiating a 1,000 mL IV infusion for a client, which is running at
125 mL/hr. how much fluid is left in the IV bag at 1300? (round the answer to the nearest
whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Answer: 375
Step 1: What is the unit of measurement the nurse should calculate? mL
Step 2: What is the total volume to be infused? Total volume = 1,000 mL
Step 3: What is the rate of infusion? Rate = 125 mL/hr.
Step 4: What is the total infusion time so far? Time = 5 hr.
Step 5: Should the nurse convert the units of measurement? No
Step 6: Set up an equation and solve for X.
Rate (mL/hr.) x Time (hr.) = Volume infused (X mL)
125 mL/hr. x 5 hr. = X mL
Volume infused = 625 mL
Total volume (mL) – Volume infused (mL) = Volume remaining (mL)
1,000 mL – 625 mL = 375 mL
Volume remaining = 375 mL
Step 7: Round if necessary.
Step 8: Determine whether the amount remaining makes sense. If the rate of the IV infusion
is 125 mL/hr., with a total volume of 1,000 mL, it makes sense that after 5 hr. there are 375
mL of IV fluid remaining to infuse.
A nurse is caring for a client who has a prescription for an IM injection of penicillin G
benzathine. The client asks why the injection must be given Im instead of through the IV line.
Which of the following should the nurse make?
a. “the medication is more rapidly absorbed when given IM.”
b. “your medication can’t be given IV because it is not water-soluble.”
c. “you will experience less discomfort with an IM injection.”
d. “an IM injection allows more precise control of the medication level in your blood.”
Answer: B
A nurse is reinforcing teaching with a client who has a new prescription for etanercept to treat
rheumatoid arthritis. Which of the following instructions about self-administering this
medication should the nurse include?
a. Discard any solutions that are cloudy
b. Attach a 21-gauge needle to the syringe for injection
c. Self-administer the medication on alternate days
d. Shake the reconstituted solution well before self-administration
Answer: A
A nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of
the following actions should the nurse take?
a. Determine the client’s daily alcohol intake
b. Tell the client to expect red-orange colored urine
c. Reinforce teaching about a low-calorie diet
d. Instruct the client to have a yearly tuberculin skin test
Answer: A
A nurse is reinforcing teaching with the parent of a preschooler who has Otis media. The
child has had a low-grade fever and irritability for 2 days. Which of the following instructions
should the nurse include in the teaching?
a. “administer amoxicillin twice a day for 3 days.”
b. “apply cold packs every 4 hours for relief of pain.”
c. “give acetaminophen as needed for discomfort and fever.”
d. “return to the office in 72 hours for a follow-up appointment.”
Answer: C
A nurse is reinforcing teaching with a client who has a new prescription for ethinyl
estradiol/norethindrone, an oral contraceptive. Which of the following client statements
should indicate to the nurse an understanding of the teaching?
a. “I should expect my menstrual flow to increase.”
b. “I should monitor my blood pressure for hypotension while on this medication.”
c. “I will take the medication at the same time each day.”
d. “this type of medication is the most effective because it only contains estrogen.”
Answer: C
A nurse is reinforcing teaching with a client following placement of a cast for a fractured
ankle. The client is to take oxycodone for pain management. The nurse should instruct the
client that which of the following over-the-counter medications is contraindicated while
oxycodone?
a. Docusate sodium
b. Ranitidine
c. Diphenhydramine
d. Ibuprofen
Answer: C
A nurse is reviewing medication prescriptions for a group of clients. The nurse should
recognize that which of the following prescription can result in a medication administration
error?
a. Penicillin G benzathine 1.2 million units IM daily
b. Furosemide 10.0 mg PO daily
c. Albuterol 2.5 mg 2 inhalation every 6 hrs. as needed for shortness of breath
d. Insulin glargine 15 units subcutaneous daily at bedtime
Answer: B
A nurse is reinforcing teaching with a female client who has a new prescription for
isotretinoin. Which of the following information should the nurse include in the teaching?
(select all that apply)
a. “you will need to have your liver enzymes monitored after 1 month.”
b. “you can have nosebleeds while taking this medication.”
c. “you should report any thoughts of harming yourself.”
d. “you will need to have two negative pregnancy tests prior to starting the medication
e. “you will need to take a vitamin A supplement twice daily.”
Answer: A, b, c, d
A nurse is reinforcing teaching with a client who has HIV and a new prescription for
zidovudine. Which of the following client statements should indicate to the nurse an
understanding of the teaching?
a. “ I can have unprotected sex after 6 months of taking this medication.”
b. “I can expect to have constipation while taking this medication.”
c. “I will be sure to have my blood tested for anemia.”
d. “my fingers might feel numb after I start therapy.”
Answer: C
A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral
capsules. Which of the following instructions should the nurse include?
a. Take the medication at bedtime.
b. Swallow the medication whole
c. Take the medication with food
d. Avoid antacids when taking this medication
Answer: B
A nurse is planning to reinforce teaching about newborn immunizations with a client who is
24 hr. postpartum. Which of the following information should the nurse plan to include?
a. “your baby will receive the first hepatitis B vaccine before discharge.”
b. “your baby will receive the rotavirus vaccine if your blood titer is low.”
c. “your baby will receive their first influenza vaccine at the 4-weeks checkup.”
d. “your baby will receive the varicella vaccine if you have a history of chickenpox.”
Answer: A
A nurse is reinforcing teaching with a client who is to start therapy using a nitroglycerin
transdermal patch. Which of the following instructions should the nurse include?
a. Cover the patch with a dry dressing
b. Apply another patch if experiencing chest pain
c. Leave each patch in place for 24 hrs.
d. Place the patch on a different site for each application
Answer: D
A nurse is reviewing the history of a client who is to start taking cefotetan to treat a bacterial
infection. Which of the following information from the client’s medical record should the
nurse report to the provider before the client begins receiving this medication?
a. Hearing impairment
b. Milk-protein allergy
c. Tendon pain
d. Penicillin allergy
Answer: D
A nurse is reinforcing teaching with a client who has a new prescription for propranolol.
Which of the following information should the nurse include in the teaching?
a. “if you miss a dose, double the next scheduled dose.”
b. “discontinue this medication if light headedness occurs.”
c. “if your pulse rate is less than 50 BPM, notify your provider.”
d. “this medication can cause heat intolerance.”
Answer: C
A nurse is reinforcing teaching with a newly license nurse about using metoprolol to treat
hypertension. Which of the following conditions should the nurse include as a
contraindication for the medication?
a. Peripheral vascular disease
b. Diabetes mellitus
c. Bradycardia
d. Chronic kidney disease
Answer: C
A nurse is caring for a client who has chronic kidney disease and has been receiving epoetin
for 2 weeks. Which of the following findings should indicate to the nurse that the client’s
medication is having desired therapeutic effect?
a. Albumin is within the expected reference range
b. Urine output increases to 60 mL/hr.
c. Hemoglobin rises 0.5 g/dl
d. Blood urea nitrogen level is within the expected reference range
Answer: C
A nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following
actions should the nurse take after instilling the eyedrops?
a. Press the nasolacrimal duct
b. Apply pressure to the upper eyelid
c. Ask the client to blink their eyes several times
d. Tell the client to keep their eyes open for at least 15 seconds
Answer: A
A nurse is caring for a client who is receiving 0.9% sodium chloride 1,000 mL infuse over 8
hr. the drop factor on the manual IV tubing is 15 gtt/mL. the nurse should ensure that the
manual IV infusion is set 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: 31
A nurse is preparing to administer diphenhydramine 50 mg PO at 2200 to a client who has
difficulty swallowing pills and capsules. Available is diphenhydramine syrup 12.5 mg/5 mL
PO. Which of the following nursing actions requires the completion of an incident report?
a. Giving the medication at 2140
b. Administering the medication with grapefruit juice
c. Giving the medication when the clients apical pulse is 58/min
d. Administering 25 mL of the syrup
Answer: D
A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the
following findings reported by the client should indicate to the nurse that the medication is
having therapeutic effect?
a. Passing of a soft, formed stool daily
b. Decreased number of viral illnesses
c. Improved ability to fall asleep
d. Increased tolerance to exercise
Answer: D
A nurse is reinforcing teaching about comfort measures with the parent of a 10-year-old child
who has viral infection. The nurse should plan to tell the parent that aspirin is contraindicated
because of the risk of the following conditions.
a. Juvenile idiopathic arthritis
b. Reye syndrome
c. Glomerulonephritis
d. Iron-deficiency anemia
Answer: B
A nurse is caring for a client who has hyperthyroidism and has been taking methimazole.
Which of the following findings should indicate to the nurse that the medication has had a
therapeutic effect?
a. Decreased blood glucose level
b. Increased Hgb
c. Increased platelets
d. Decreased T4
Answer: D
A nurse is collecting data from a client who is receiving digoxin for treatment of hear failure.
The nurse should identify which of the following findings as adverse effects of this
medication? (select all that apply)
a. Blurred vision
b. Nausea
c. Hyperactivity
d. Increased appetite
e. Dysrhythmia
Answer: a, b, e
A nurse is caring for a client who has a new prescription for sumatriptan. The nurse notes that
the client take fluoxetine. The nurse should notify the provider that the combination of these
medications will place the client at risk for which of the following adverse effects?
a. Tremors
b. Renal calculi
c. Dysphagia
d. Hearing loss
Answer: A
A nurse is contributing to the plan of care for a client who has schizophrenia and a new
prescription for clozapine. The nurse should include in the plan to monitor the client for
which of the following adverse effects of this medication?
a. Hypoglycemia
b. Iron-deficiency anemia
c. Serotonin syndrome
d. Agranulocytosis
Answer: D
A nurse is assisting with the care of a client who has methicillin-resistant staphylococcus
aureus (MRSA) infection and is receiving vancomycin via IV infusion. Which of the
following changes in the client’s condition should the nurse identify as the priority finding to
report to the provider?
a. Nausea
b. Back pain
c. Hypotension
d. Chills
Answer: C
A nurse is collecting data from a client who has Parkinson’s disease and is taking
levodopa/carbidopa. The nurse should identify which of the following findings as an adverse
effect of this medication?
a. Dark urine
b. Hypertension
c. Increased salivation
d. Bradycardia
Answer: A
A client comes to an urgent care clinic and announces with great enthusiasm, “I am an expert
at all things medical as they apply to me, and I require zolpidem.” The client’s pupil are
dilated, along with an elevated heart rate and blood pressure level. The nurse should suspect
intoxication with which of the following substances?
a. Alcohol
b. Cocaine
c. Barbiturates
d. Heroin
Answer: B
A nurse is reinforcing teaching with a client who has a new prescription for regular insulin.
Which of the following statements by the client indicated an understanding of the teaching?
a. “I should ear right before I give myself an insulin injection.”
b. “I should shake the vial gently prior to drawing up the insulin.”
c. “I should ensure that the insulin is clear prior to drawing it up.”
d. “I should inject the insulin deep into a muscle.”
Answer: C
A nurse is collecting data from the parent of a toddler who is about to receive the varicella
immunization. The nurse should identify that an anaphylactic reaction to which of the
following substances is contraindication for receiving this immunization?
a. Gelatin
b. Penicillin
c. Sulfa
d. Egg
Answer: A
A nurse is reinforcing teaching with a client who has a new prescription for theophylline. The
nurse should instruct the client that which of the following is an expected outcome of this
medication?
a. Dilated bronchioles
b. Reduces inflammation
c. Loosens secretions
d. Blocks leukotrienes
Answer: A
A nurse is caring for a client who is taking phenylephrine. The nurse should plan to monitor
the client for which of the following manifestations as an adverse effect of this medication?
a. Increased drowsiness
b. Increased heart rate
c. Decreased blood pressure
d. Decreased WBC count
Answer: B
A nurse is collecting data from a client who is postoperative and takin morphine for pain.
Which of the following findings is the priority for the nurse to report to the provider/
a. Constipation
b. Oxygen saturation 87%
c. Vomiting
d. Urinary output 25 mL over 1 hour
Answer: B
A nurse is reinforcing teaching with a client who has prescription for alendronate. Which of
the following client responses indicates to the nurse an understanding of the teaching?
a. “I will take the medication with my breakfast.”
b. “I will take the medication with 1 tablespoon of an antacid
c. “I will lie down for 30 minutes before taking the medication
d. “I will take the medication with 8 ounces of water.”
Answer: D
A nurse is reinforcing teaching with a client who has seizures and a new prescription for
valproic acid. The nurse should instruct the client to report which of the following adverse
effects of valproic acid to the provider immediately?
a. Abdominal pain
b. Hair loss
c. Weight gain
d. Ataxia
Answer: A
A nurse is collecting data from a female client who has been taking propylthiouracil (PTU)
for 2 months to treat graves’ disease. Which of the following findings should the nurse
recognize as an indication that the medication is effective?
a. Weight loss
b. Pulse 82/min
c. Respiratory rate 22/min
d. Decreased menstrual flow
Answer: B
