Pharmacology Proctored ATI Exam
1. A nurse is caring for a client who has schizophrenia and generalized anxiety disorder. The
client has a prescription for alprazolam 0.25 mg PO every 8 hr PRN anxiety. For which of the
following client statements should the nurse consider administering alprazolam?
A. "My heart is pounding out of my chest."
B. "I can't remember where I put my keys."
C. "I'm seeing things that aren't there."
D. "I feel really sleepy and lethargic."
Answer: A. "My heart is pounding out of my chest."
2. A nurse is preparing to administer a pre-packaged oral medication to a client and complete the
final medication check. At which of the following times or places should the nurse perform this
final check?
A. At the medication preparation area.
B. Outside the client’s room.
C. At the client’s bedside before administration.
D. At the nurse's station.
Answer: C. At the client’s bedside before administration.
3. A nurse is teaching a client about the adverse effects of cisplatin. Which of the following
adverse effects should the nurse include in the teaching?
A. Insomnia
B. Tinnitus
C. Constipation
D. Weight gain
Answer: B. Tinnitus
4. A nurse is caring for a client who was admitted with acute psychosis and is being treated with
haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia
when the client exhibits which of the following? (Select all that apply.)
A. Tongue thrusting and lip smacking,
B. Facial grimacing and eye blinking,
C. Involuntary pelvic rocking and hip thrusting movements
Answer: A. Tongue thrusting and lip smacking,
B. Facial grimacing and eye blinking,
C. Involuntary pelvic rocking and hip thrusting movements
5. A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and
requests a prescription for sildenafil. Which of the following medications currently prescribed
for the client is a contraindication to taking sildenafil?
A. Lisinopril
B. Isosorbide
C. Metformin
D. Pantoprazole
Answer: B. Isosorbide
6. A nurse is caring for four clients. After administering morning medications, she realizes that
the nifedipine prescribed for one client was inadvertently administered to another client. Which
of the following actions should the nurse take first?
A. Check the client's vital signs.
B. Notify the provider.
C. Complete an incident report.
D. Inform the charge nurse.
Answer: A. Check the client's vital signs.
7. A nurse is providing dietary teaching for a client who has a new prescription for a monoamine
oxidase inhibitor (MAOI). When the client develops a sample lunch menu, which of the
following items requires intervention by the nurse?
A. Grilled chicken sandwich
B. Bologna sandwich
C. Salad with vinegar dressing
D. Apple slices
Answer: B. Bologna sandwich
8. A nurse is caring for a client who is withdrawing from opioids. Which of the following
medications should the nurse prepare to administer?
A. Lorazepam
B. Methadone
C. Haloperidol
D. Fluoxetine
Answer: D. Fluoxetine
9. A nurse on a crisis hotline is speaking to a client who says, "I just took an entire bottle of
amitriptyline." Which of the following responses should the nurse make?
A. "Why did you take so many pills?"
B. "You should try to make yourself vomit."
C. "I'm glad you called, and I want to send an ambulance to help you."
D. "Have you tried drinking some water to dilute it?"
Answer: C. "I'm glad you called, and I want to send an ambulance to help you."
10. A nurse is caring for a newborn who has respiratory depression. Which of the following
medications should the nurse anticipate administering?
A. Naloxone
B. Epinephrine
C. Albuterol
D. Atropine
Answer: A. Naloxone
11. A nurse is caring for a client who is receiving cisplatin to treat bladder cancer. After several
treatments, the client reports fatigue. Which of the following actions should the nurse take?
A. Administer oxygen therapy.
B. Check the results of the client's most recent CBC.
C. Encourage the client to increase physical activity.
D. Assess the client's intake and output.
Answer: B. Check the results of the client's most recent CBC.
12. A nurse is providing teaching to a client who has breast cancer about the adverse effects of
chemotherapy. Which of the following client statements indicates an understanding of the
teaching?
A. "I’ll avoid foods that are high in fibre."
B. "I’ll increase my fluid intake to prevent dehydration."
C. "I’ll call my doctor if I notice any unusual menstrual bleeding."
D. "I’ll avoid taking naps during the day."
Answer: C. "I’ll call my doctor if I notice any unusual menstrual bleeding."
13. A home health nurse is making a home visit to a client who takes a daily diuretic for heart
failure. Which of the following manifestations should the nurse identify as indicating the client is
hypokalemic?
A. Fatigue
B. Hypertension
C. Weight gain
D. Diarrhoea
Answer: A. Fatigue
14. A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure.
Which of the following findings should indicate to the nurse that the medication is having a
therapeutic effect?
A. Systolic blood pressure is increased.
B. Heart rate is decreased.
C. Urine output is decreased.
D. Respiratory rate is increased.
Answer: A. Systolic blood pressure is increased.
15. A nurse is teaching a client who has a new prescription for cyclobenzaprine. Which of the
following information should the nurse include in the teaching?
A. Avoid driving until effects are known.
B. Increase fluid intake to avoid dehydration.
C. Take on an empty stomach.
D. Avoid taking the medication after 6 pm.
Answer: A. Avoid driving until effects are known.
16. A nurse is preparing to administer an intramuscular (IM) injection of meperidine to a client.
Which of the following is the priority assessment the nurse should complete?
A. Heart rate
B. Temperature
C. Respiratory rate
D. Blood pressure
Answer: C. Respiratory rate
17. A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac
dysrhythmias. For which of the following adverse effects should the nurse monitor when giving
this medication?
A. Hyperglycaemia
B. Hypotension
C. Hypertension
D. Tachycardia
Answer: B. Hypotension
18. A nurse is teaching a client who has a new prescription for clopidogrel. Which of the
following instructions should the nurse include?
A. "Take this medication on an empty stomach."
B. "You might have to stop taking this medication 5 days before any planned surgeries."
C. "Avoid dairy products while taking this medication."
D. "Monitor your blood sugar daily."
Answer: B. "You might have to stop taking this medication 5 days before any planned
surgeries."
19. A nurse is preparing to administer a medication to a client who states, "That looks different
from the pill I usually take." Which of the following responses should the nurse make?
A. "It's probably just a different brand."
B. "Describe what the pill looks like."
C. "This is what was ordered for you."
D. "Take it, and I'll double-check later."
Answer: B. "Describe what the pill looks like."
20. A nurse is admitting a client who has acute heart failure following myocardial infarction
(MI). The nurse recognizes that which of the following prescriptions by the provider requires
clarification?
A. 0.9% normal saline IV at 50 mL/hr continuous.
B. Furosemide 40 mg IV once.
C. Oxygen at 2 L/min via nasal cannula.
D. Enalapril 5 mg PO once daily.
Answer: A. 0.9% normal saline IV at 50 mL/hr continuous.
21. A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the
following findings is a priority to report?
A. Dry cough
B. Headache
C. Dizziness
D. Fatigue
Answer: A. Dry cough
22. A nurse is teaching a client who has a new prescription for alprazolam to treat insomnia.
Which of the following instructions should the nurse included?
A. "Avoid activities that require alertness such as driving."
B. "Take this medication in the morning with food."
C. "Limit fluid intake while on this medication."
D. "Take an extra dose if you wake up during the night."
Answer: A. "Avoid activities that require alertness such as driving."
23. A nurse is monitoring a client who received epinephrine for angioedema after a first dose of
losartan. Which of the following data indicates a therapeutic response to the epinephrine?
A. Respirations are unlaboured.
B. Blood pressure is elevated.
C. Heart rate is decreased.
D. Skin is cool and pale.
Answer: A. Respirations are unlaboured.
24. A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's
INR is 5.2. Which of the following medications should the nurse prepare to administer?
A. Vitamin K
B. Protamine sulphate
C. Epinephrine
D. Aspirin
Answer: A. Vitamin K
25. A nurse is caring for a client who is postoperative following hip arthroplasty. The nurse
should anticipate which of the following prescriptions for this client?
A. Enoxaparin
B. Warfarin
C. Acetaminophen
D. Clopidogrel
Answer: A. Enoxaparin
26. A nurse is teaching an adolescent about medication therapy with oral acetylcysteine. Which
of the following information should the nurse include in the teaching?
A. "This medication may cause drowsiness."
B. "This medication can cause skin rash."
C. "This medication has a very unusual Odor."
D. "This medication may increase your appetite."
Answer: C. "This medication has a very unusual Odor."
27. A nurse is reviewing the medical record of a client who reports taking pseudoephedrine for
sinus congestion as needed. The nurse should identify that pseudoephedrine is contraindicated
for which of the following client conditions?
A. Diabetes
B. Hypertension
C. Hypothyroidism
D. GERD
Answer: C. Hypothyroidism
28. A nurse is caring for a client who has a traumatic head injury and is exhibiting signs of
increasing intracranial pressure. Which of the following medications should the nurse plan to
administer?
A. Mannitol 25%
B. Furosemide
C. Dexamethasone
D. Acetaminophen
Answer: A. Mannitol 25%
29. A nurse is preparing to administer Ringer's lactate by continuous IV infusion at 120 mL/hr.
The drop factor of the manual IV tubing is 60 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: 120
30. A nurse is providing discharge teaching to the parent of a child who is prescribed
diphenhydramine 25 mg elixir every 4 hr as needed. The amount available is diphenhydramine
elixir 12.5 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: 10
31. A nurse is assessing an older adult client who is receiving digoxin. The nurse should
recognize that which of the following findings is a manifestation of digoxin toxicity?
A. Anorexia
B. Weight gain
C. Increased appetite
D. Muscle cramps
Answer: A. Anorexia
32. A nurse is establishing health promotion goals for a female client who smokes cigarettes, has
hypertension, and has a BMI of 26. Which of the following goals should the nurse include?
A. The client will walk for 30 min 5 days a week.
B. The client will lose 10 pounds in a week.
C. The client will stop smoking immediately.
D. The client will eliminate all fat from her diet
Answer: A. The client will walk for 30 min 5 days a week.
33. A nurse is assessing a client after administering a dose of losartan. The client has a hoarse
voice, and swollen lips and tongue. In which order should the nurse take the following actions?
Move the nursing actions into the box on the right, placing them in the selected order of
performance. (All steps must be used.)
A. assess the clients airway
B. call the emergency response team
C. apply high flow oxygen
D. initiate IV access
E. administer IV epinephrine
F. administer IV antihistamines
Answer: A. assess the clients airway
B. call the emergency response team
D. initiate IV access
E. administer IV epinephrine
C. apply high flow oxygen
F. administer IV antihistamines
34. A nurse is teaching a client who has a new prescription for disulfiram. Which of the
following information should the nurse include in the teaching?
A. "Do not drink alcohol while taking this medication."
B. "You can drink small amounts of alcohol safely."
C. "This medication will help you drink alcohol in moderation."
D. "You will not experience any side effects from alcohol."
Answer: A. "Do not drink alcohol while taking this medication."
35. A nurse is reviewing the medical record of a client who has hypertension and a new
prescription for metoprolol. Which of the following findings should the nurse investigate
further?
A. A history of left-sided heart failure
B. A recent diagnosis of type 2 diabetes
C. A family history of hypertension
D. A recent increase in physical activity
Answer: A. A history of left-sided heart failure
36. A nurse is caring for a client who has chemotherapy- induced peripheral neuropathy. The
nurse should expect the client to report having experienced which of the following symptoms?
A. Tingling feeling in the extremities
B. Severe headache
C. Shortness of breath
D. Blurred vision
Answer: A. Tingling feeling in the extremities
37. A nurse is assessing a client who is receiving a unit of packed red blood cells. Which of the
following findings is a manifestation of acute haemolytic reaction?
A. Client report of low back pain
B. Elevated blood pressure
C. Nausea and vomiting
D. Fever and chills
Answer: A. Client report of low back pain
38. A nurse in the emergency department is caring for a client who took 3 nitro-glycerine tablets
sublingually for chest pain. The client reports relief from the chest pain but now he is
experiencing a headache. Which of the following statements should the nurse make?
A. "A headache is an expected adverse effect of the medication."
B. "You should report this headache to your doctor."
C. "This headache may indicate that the medication isn't working."
D. "You should take an over-the-counter pain reliever for this headache."
Answer: A. "A headache is an expected adverse effect of the medication."
39. A nurse is caring for a client who has end-stage kidney disease (ESKD) and reports having
shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes the
client has crackles in his lungs and an elevated blood pressure. The nurse should suspect which
of the following based on the client's manifestations?
A. Hypervolemia
B. Hypovolemia
C. Anaemia
D. Hypokalaemia
Answer: D. Hypokalaemia
40. A nurse is teaching a client who has a new prescription for lithium to treat bipolar disorder.
The nurse should instruct the client to ensure an adequate intake of which of the following
dietary elements?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: A. Sodium
41. A nurse is caring for a client who has developed agranulocytosis as a result of taking
propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at
increased risk for which of the following conditions?
A. Infection
B. Hypertension
C. Hypothyroidism
D. Dehydration
Answer: A. Infection
42. A nurse is assessing a client prior to administering atenolol. Which of the following findings
should prompt the nurse to withhold the medication?
A. Heart rate 60/min
B. Heart rate 46/min
C. Blood pressure 120/80 mmHg
D. Blood pressure 90/60 mmHg
Answer: B. Heart rate 46/min
43. A nurse is teaching a client who takes warfarin daily. Which of the following statements by
the client indicates a need for further teaching?
A. "I have started taking ginger root to treat my joint stiffness."
B. "I will have my INR checked regularly."
C. "I should avoid eating large amounts of green leafy vegetables."
D. "I will report any signs of unusual bleeding to my doctor."
Answer: A. "I have started taking ginger root to treat my joint stiffness."
44. A nurse is caring for a client who is to receive a unit of packed RBCs. The nurse should
prime the blood administration tubing using which of the following IV solutions?
A. 0.9% sodium chloride
B. D5W (5% dextrose in water)
C. Lactated Ringer's solution
D. Normal saline with glucose
Answer: A. 0.9% sodium chloride
45. The nurse is preparing a medication for a client and observes the date of expiration on the
vial occurred 2 months ago. Which of the following actions should the nurse take?
A. Use the medication if it looks normal.
B. Return the medication to the pharmacy.
C. Document the expiration date and continue with administration.
D. Inform the client of the expired medication.
Answer: B. Return the medication to the pharmacy.
46. A nurse is caring for a client who has prostate cancer. The nurse should expect the provider
to prescribe which of the following medications for this client?
A. Tamoxifen
B. Leuprolide
C. Anastrozole
D. Letrozole
Answer: B. Leuprolide
47. A nurse is preparing to administer heparin subcutaneously to a client who has a deep vein
thrombosis. Which of the following techniques should the nurse use?
A. Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and observe for
bleeding.
B. Insert the needle at a 90-degree angle, inject the heparin, and massage the site.
C. Use a filter needle to draw up the medication and then switch to a regular needle.
D. Administer the medication in the deltoid muscle for faster absorption.
Answer: A. Cleanse the skin with an alcohol swab, insert the needle, inject the heparin, and
observe for bleeding.
48. A nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which
of the following actions should the nurse plan to take?
A. Administer a saline solution after injection.
B. Dilute the medication with dextrose.
C. Infuse the medication rapidly.
D. Administer the medication through a filter needle.
Answer: A. Administer a saline solution after injection.
49. A nurse is caring for a client who receives furosemide to treat heart failure. Which of the
following laboratory values should the nurse monitor for this client due to this medication?
A. Calcium
B. Sodium
C. Potassium
D. Magnesium
Answer: C. Potassium
50. A nurse is providing teaching for a client who has schizophrenia and a new prescription for
fluphenazine. Which of the following information should the nurse provide?
A. "Sleepiness should subside within a week."
B. "You may notice weight gain with this medication."
C. "This medication can cause increased energy levels."
D. "You should avoid taking this medication with food."
Answer: A. "Sleepiness should subside within a week."
51. A nurse is monitoring a client who is receiving a unit of packed RBCs following surgery.
Which of the following assessments is an indication that the client might be experiencing
circulatory overload?
A. Dyspnea
B. Hypotension
C. Fever
D. Tachycardia
Answer: A. Dyspnea
52. A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started
on intravenous rifampin therapy. The nurse should instruct the client that this medication can
cause which of the following adverse effects?
A. Nausea
B. Body secretions turning a red-orange colour
C. Hepatotoxicity
D. Allergic reaction
Answer: B. Body secretions turning a red-orange colour
53. A home health nurse is assessing an older adult client who reports falling a couple of times
over the past week. Which of the following findings should the nurse suspect is contributing to
the client's falls?
A. The client has decreased vision.
B. The client takes alprazolam.
C. The client has a history of strokes.
D. The client uses a walker.
Answer: B. The client takes alprazolam.
54. A nurse is caring for a client who has acute respiratory distress syndrome (ARDS), and
requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse
recognizes that this medication is for which of the following purposes?
A. Reduce anxiety and agitation.
B. Facilitate intubation.
C. Provide analgesia
D. Suppress respiratory effort
Answer: D. Suppress respiratory effort
55. A nurse on a telemetry unit is caring for a client who has unstable angina and is reporting
chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers 1 sublingual nitroglycerine tablet. After 5 min, the client states that his chest pain is now a severity of 2. Which of
the following actions should the nurse take?
A. Administer another nitro-glycerine tablet.
B. Continue to monitor the client’s vital signs and reassess the chest pain.
C. Notify the healthcare provider immediately.
D. Document the client’s response to the medication.
Answer: B. Continue to monitor the client’s vital signs and reassess the chest pain.
56. A nurse is providing teaching for a client who is on diuretic therapy and has a new
prescription for potassium chloride (KCL) 20 mEq extended release PO daily. Which of the
following instructions should the nurse provide about the new prescription?
A. Take the extended release tablets whole.
B. Take the tablets with a full glass of water.
C. Report any muscle weakness or irregular heartbeat immediately.
D. Avoid high-potassium foods while on this medication.
Answer: A. Take the extended release tablets whole.
57. A nurse is preparing to administer a transfusion of RBCs to a client who has heart failure. For
which of the following manifestations should the nurse monitor to prevent fluid volume
overload? (Select all that apply.)
A. dyspnea,
B. jugular vein distention,
C. confusion
Answer: A. dyspnea,
B. jugular vein distention,
C. confusion
58. A nurse is educating a group of clients about the contraindications of warfarin therapy.
Which of the following statements should the nurse include in the teaching?
A. "Clients who are pregnant should not take warfarin."
B. "Clients with a history of liver disease should avoid warfarin."
C. "Clients with a history of peptic ulcer disease should not take warfarin."
D. "Clients taking aspirin should avoid warfarin."
Answer: A. "Clients who are pregnant should not take warfarin."
59. A nurse is caring for a client who has chronic renal disease and is receiving therapy with
epoetin alfa. Which of the following laboratory results should the nurse review for an indication
of a therapeutic effect of the medication?
A. The haematocrit (Hct)
B. Blood urea nitrogen (BUN)
C. Serum creatinine
D. Platelet count
Answer: A. The haematocrit (Hct)
60. A nurse is providing teaching a client who has rheumatoid arthritis and a new prescription for
methotrexate. Which of the following instructions should the nurse include? (Select all that
apply.)
A. do not drink alcoholic beverages while taking this medication
B. report unexplained bruising to provider
C. avoid people who have infections
Answer: A. do not drink alcoholic beverages while taking this medication
B. report unexplained bruising to provider
C. avoid people who have infections
61. A nurse is caring for a client who has a fungal infection and has a new prescription for
amphotericin B. Which of the following laboratory values should the nurse report to the provider
before initiating the medication?
A. BUN 55 mg/Dl
B. Haemoglobin 14 g/Dl
C. Potassium 4.5 mEq/L
D. Platelet count 150,000/mm³
Answer: A. BUN 55 mg/Dl
62. A nurse is teaching a client about taking diphenhydramine. The nurse should explain to the
client that which of the following is an adverse effect of this medication?
A. sedation
B. Diarrhoea
C. Insomnia
D. Increased appetite
Answer: A. sedation
63. A nurse is reviewing the health history for a client who has angina pectoris and a prescription
for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the
history should the nurse report to the provider?
A. Diabetes mellitus
B. Hyperlipidaemia
C. The client has a history of bronchial asthma.
D. Migraine headaches
Answer: C. The client has a history of bronchial asthma.
64. A nurse in a provider's clinic is caring for a client who reports erectile dysfunction and
requests a prescription for sildenafil. Which of the following medications currently prescribed
for the client is a contraindication to taking sildenafil?
A. Hydrochlorothiazide
B. Isosorbide
C. Metformin
D. Levothyroxine
Answer: B. Isosorbide
65. A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's
INR is 5.2. Which of the following medications should the nurse prepare to administer?
A. Protamine sulphate
B. Vitamin K
C. Epinephrine
D. Atropine
Answer: B. Vitamin K
66. A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve.
Which of the following laboratory values should the nurse monitor for a therapeutic effect of
warfarin?
A. Prothrombin time (PT)
B. Haemoglobin (Hgb)
C. White blood cell (WBC) count
D. Serum creatinine
Answer: A. Prothrombin time (PT)
67. A nurse is providing dietary teaching for a client who takes furosemide. The nurse should
recommend which of the following foods as the best source of potassium?
A. bananas
B. Apples
C. Rice
D. Bread
Answer: A. bananas
68. A nurse is assessing a client who has acute cocaine toxicity. Which of the following findings
should the nurse expect? (Select all that apply.)
A. fever
B. tremor
C. agitation
D. Hypothermia
E. Bradycardia
Answer: A. fever
B. tremor
C. agitation
69. A nurse is caring for a client who has a new prescription for propranolol. The nurse should
monitor the client for which of the following adverse reactions to this medication?
A. Postural hypotension
B. Hyperglycaemia
C. Dry mouth
D. Constipation
Answer: A. Postural hypotension
70. A nurse is caring for a 2-year-old child who has seizures and is receiving phenytoin in
suspension form. Which of the following actions should the nurse take before administering each
dose?
A. Shake the container vigorously.
B. Crush the tablets and mix with applesauce.
C. Dilute the suspension with milk.
D. Administer on an empty stomach.
Answer: A. Shake the container vigorously.
71. A charge nurse is supervising a newly licensed nurse care for a client who is receiving a
transfusion of packed RBC. The nurse suspects a possible haemolytic reaction. After stopping
the blood transfusion, which of the following actions by the new nurse requires intervention by
the charge nurse?
A. The nurse monitors the client's vital signs.
B. The nurse maintains the IV line with normal saline.
C. The nurse starts the transfusion of another unit of blood product.
D. The nurse notifies the provider about the reaction.
Answer: C. The nurse starts the transfusion of another unit of blood product.
72. A nurse is caring for a client who is to receive a unit of packed RBCs. The nurse should
prime the blood administration tubing using which of the following IV solutions?
A. Lactated Ringer's
B. Dextrose 5% in water (D5W)
C. 0.9% sodium chloride
D. Sterile water
Answer: C. 0.9% sodium chloride
73. A nurse is preparing to transfuse one unit of packed RBC to a client who experienced a mild
allergic reaction during a previous transfusion. The nurse should administer diphenhydramine
prior to the transfusion for which of the following allergic responses?
A. Urticaria
B. Anaphylaxis
C. Febrile reaction
D. Haemolytic reaction
Answer: A. Urticaria
74. A nurse is caring for a client whose serum potassium level is 5.3 mEq/L. Which of the
following scheduled medications should the nurse plan to administer?
A. Furosemide
B. Spironolactone
C. Amiodarone
D. Lisinopril
Answer: A. Furosemide
75. A nurse is caring for a client who has deep vein thrombosis and has been on heparin
continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the
heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following
statements should the nurse make?
A. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches
a therapeutic level."
B. "Heparin is more effective than warfarin for immediate anticoagulation."
C. "You will need both medications to prevent blood clots from forming."
D. "The combination will reduce the risk of bleeding during treatment."
Answer: A. "Warfarin takes several days to work, so the IV heparin will be used until the
warfarin reaches a therapeutic level."
76. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the
following actions is appropriate?
A. Administer the medication without assessing the heart rate.
B. Evaluate the client for nausea, vomiting, and anorexia.
C. Check the client's blood pressure before administration.
D. Administer the medication with a high-fat meal.
Answer: B. Evaluate the client for nausea, vomiting, and anorexia.
77. A nurse is providing discharge teaching to a client who has a new prescription for lithium.
Which of the following information should the nurse include in the teaching?
A. Obtain a daily weight.
B. Avoid drinking fluids.
C. Limit sodium intake.
D. Take the medication at bedtime.
Answer: A. Obtain a daily weight.
78. A nurse is providing teaching for a client who has anaemia and a new prescription for ferrous
sulphate liquid. Which of the following instructions should the nurse provide?
A. Take the medication with milk to decrease stomach upset.
B. Take the medication with orange juice to enhance absorption.
C. Limit intake of vitamin C while taking this medication.
D. Take the medication immediately before bedtime.
Answer: B. Take the medication with orange juice to enhance absorption.
79. A nurse is caring for a client who received an injection of penicillin G procaine. The client
begins to experience dyspnea and tongue swelling. Which of the following actions should the
nurse perform first?
A. Call the healthcare provider.
B. Administer epinephrine subcutaneously.
C. Monitor vital signs.
D. Place the client in a supine position.
Answer: B. Administer epinephrine subcutaneously.
80. A nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerine tablets. The nurse should include which of the following instructions regarding how to
take the medication?
A. Take one tablet at the first indication of chest pain.
B. Take one tablet at the first indication of chest pain.
C. Take one tablet after a meal.
D. Take one tablet before engaging in physical activity.
Answer: A. Take one tablet at the first indication of chest pain.
81. A nurse is providing discharge teaching to a client who has a new prescription for verapamil
for angina. Which of the following instructions should the nurse include?
A. Avoid consuming grapefruit juice.
B. Increase your daily intake of dietary fibre.
C. Take the medication on an empty stomach.
D. Limit fluid intake to prevent enema.
Answer: B. Increase your daily intake of dietary fibre.
82. A nurse is assessing an older adult client who is receiving IV therapy. The nurse should
recognize that which of the following findings indicates fluid volume excess? (Select all that
apply.)
A. bounding pulse
B. pitting edema
C. crackles upon auscultation
D. Decreased blood pressure
E. Increased urine output
Answer: A. bounding pulse
B. pitting edema
C. crackles upon auscultation
83. A nurse is caring for a child who is experiencing status asthmaticus. Which of the following
interventions is the priority for the nurse to take?
A. Administer a systemic corticosteroid.
B. Monitor the child's oxygen saturation.
C. Administer a short-acting β2-agonist (SABA).
D. Prepare for intubation.
Answer: C. Administer a short-acting β2-agonist (SABA).
84. A nurse is caring for a client who has an infection and a prescription for gentamicin
intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the
following actions should the nurse take to obtain an accurate gentamicin serum level?
A. Draw a trough level immediately prior to administering the medication and a peak level 30
min after the dose.
B. Draw a peak level immediately prior to administering the medication and a trough level 1
hour after the dose.
C. Draw a peak level 1 hour after administering the medication and a trough level 30 min after
the dose.
D. Draw both peak and trough levels immediately after administering the medication.
Answer: A. Draw a trough level immediately prior to administering the medication and a peak
level 30 min after the dose.
85. A nurse is providing teaching to a client who has angina pectoris and a new prescription for
nitro-glycerine sublingual tablets. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I will take the nitro-glycerine tablet only if the pain lasts longer than 15 minutes."
B. "I can take 3 nitro-glycerine tablets at one time if the pain is severe."
C. "I'll dial 911 if 1 nitro-glycerine tablet does not relieve my pain, and then take up to 2 more
tablets 5 minutes apart while waiting."
D. "I should not chew the tablet; I can swallow it with water."
Answer: C. "I'll dial 911 if 1 nitro-glycerine tablet does not relieve my pain, and then take up to
2 more tablets 5 minutes apart while waiting."
86. A nurse is caring for a client who is at 6 weeks of gestation and has pneumonia. While the
nurse is obtaining the client's history, the client tells the nurse that she takes the herb feverfew
for migraine headaches. Which of the following actions should the nurse take?
A. Advise the client to continue taking the herb as it is safe during pregnancy.
B. Explain to the client that she should not take this herb while she is pregnant.
C. Suggest the client consult her healthcare provider about alternative treatments.
D. Inform the client that feverfew can help with her pneumonia.
Answer: B. Explain to the client that she should not take this herb while she is pregnant.
87. A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before
administering this medication, which of the following actions should the nurse take?
A. Measure the client's blood pressure.
B. Measure the client's apical pulse.
C. Assess the client's respiratory rate.
D. Check the client's weight.
Answer: B. Measure the client's apical pulse.
88. 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 recognize is of primary
consideration when determining the schedule of administration?
A. Specific characteristics of the medications
B. The time of day the client prefers to take medications
C. The client's previous experience with medications
D. The availability of nursing staff for administration
Answer: A. Specific characteristics of the medications
89. A nurse is caring for a client is who has a deep vein thrombosis and is prescribed heparin by
continuous IV infusion at 1,200 units/hr. Available is heparin 25,000 units in 500 mL D5W. The
nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest
tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Answer: 24
90. A nurse in a provider's clinic is assessing a client who has cancer and a prescription for
methotrexate PO. Which of the following actions should the nurse take when the client reports
bleeding gums?
A. Administer the next dose of methotrexate.
B. Check the value of the client's current platelet count.
C. Encourage the client to use a soft-bristle toothbrush.
D. Schedule the client for a follow-up appointment.
Answer: B. Check the value of the client's current platelet count.
91. A nurse is caring for a client who has a fractured ulna and a new prescription for
cyclobenzaprine. Before administering, which of the following explanations should the nurse
provide to explain the purpose of the medication?
A. "This medication will reduce pain associated with your fracture."
B. "This medication will help prevent infections that may occur with your injury."
C. "The medication will relieve muscle spasms that might occur with a fracture."
D. "This medication will promote healing of the fractured bone."
Answer: C. "The medication will relieve muscle spasms that might occur with a fracture."
92. A nurse is providing teaching to a client who has oral candidiasis and a new prescription for
nystatin suspension. Which of the following statements by the client indicates an understanding
of the teaching?
A. "I will rinse my mouth with water after taking the medication."
B. "I should swallow the medication quickly."
C. "I will store the medication at room temperature."
D. "I need to take this medication on an empty stomach."
Answer: C. "I will store the medication at room temperature."
