1. A client with a new prescription for lisinopril asks how the medication works. The nurse’s
best response is that lisinopril:
A) Blocks angiotensin II receptors
B) Inhibits the conversion of angiotensin I to angiotensin II
C) Increases heart rate and cardiac output
D) Promotes sodium and water reabsorption
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that blocks the enzyme converting angiotensin I to
angiotensin II, leading to vasodilation, reduced aldosterone secretion, and lower blood
pressure.
2. A nurse is teaching a client about the use of sublingual nitroglycerin. Which statement by
the client indicates an understanding of the teaching?
A) “I will swallow the tablet with a full glass of water.”
B) “I should sit down before taking the tablet.”
C) “If the pain is not relieved after 5 minutes, I will take a second dose and call 911.”
D) “I can take up to five doses, one every 5 minutes.”
,Correct Answer: B
Rationale: The client should sit or lie down before taking sublingual nitroglycerin to prevent falls
from orthostatic hypotension. The tablet should dissolve under the tongue, not be swallowed. If
pain persists after one dose, call 911; up to three doses may be taken total while awaiting EMS.
3. A client is prescribed furosemide 40 mg PO daily. The nurse should instruct the client to
take the medication:
A) At bedtime
B) In the morning
C) With a high-fat meal
D) On an empty stomach only
Correct Answer: B
Rationale: Furosemide is a diuretic that should be taken in the morning to prevent nocturia and
sleep disruption.
4. A nurse is monitoring a client receiving IV heparin. The aPTT is 70 seconds (control 30
seconds). What is the appropriate nursing action?
A) Stop the heparin infusion and administer protamine sulfate
B) Continue the heparin infusion at the current rate
C) Increase the heparin rate
D) Notify the prescriber and prepare to administer vitamin K
Correct Answer: B
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times control (45–75 seconds). At 70
seconds, the level is therapeutic, so the infusion should continue at the current rate.
5. A client is prescribed alendronate for osteoporosis. Which client statement indicates a need
for further teaching?
A) “I will take the medication with a full glass of water first thing in the morning.”
B) “I will remain sitting upright for at least 30 minutes after taking the medication.”
C) “I can take my calcium supplement at the same time as alendronate.”
D) “I should not eat or drink anything else for 30 minutes.”
Correct Answer: C
Rationale: Calcium supplements and other minerals interfere with alendronate absorption.
They should be taken at a different time of day.
6. A client is prescribed digoxin 0.125 mg PO daily. The nurse should hold the medication and
notify the prescriber if the client’s apical pulse is:
A) 72 bpm
B) 64 bpm
,C) 58 bpm
D) 80 bpm
Correct Answer: C
Rationale: Digoxin should be held if the pulse is below 60 bpm (or per facility protocol) because
it can cause bradycardia and heart block.
7. A client with asthma is prescribed an albuterol inhaler and a fluticasone inhaler. The nurse
should instruct the client to:
A) Use the fluticasone first, then the albuterol
B) Use the albuterol first, wait 1–5 minutes, then use the fluticasone
C) Use both inhalers simultaneously
D) Use fluticasone only during acute attacks
Correct Answer: B
Rationale: The bronchodilator (albuterol) is used first to open airways, allowing better
penetration of the corticosteroid (fluticasone).
8. A nurse is teaching a client about warfarin therapy. Which statement by the client indicates
a need for further teaching?
A) “I will use an electric razor instead of a blade.”
B) “I can continue to take my daily aspirin for heart health.”
C) “I will have my INR checked regularly.”
D) “I should report any unusual bruising or bleeding.”
Correct Answer: B
Rationale: Aspirin increases the risk of bleeding when taken with warfarin. The client should not
take aspirin without prescriber approval.
9. A client with type 2 diabetes is prescribed metformin. Which laboratory value is most
important to monitor before and during therapy?
A) Liver enzymes
B) Serum potassium
C) Serum creatinine
D) Serum amylase
Correct Answer: C
Rationale: Metformin is renally excreted; impaired renal function increases the risk of lactic
acidosis. eGFR should be monitored.
10. A client is prescribed levothyroxine. Which finding indicates the dose may be too high?
A) Bradycardia
, B) Weight gain
C) Palpitations and tremors
D) Cold intolerance
Correct Answer: C
Rationale: Symptoms of hyperthyroidism (palpitations, tremors, heat intolerance, weight loss)
indicate excessive thyroid replacement.
11. A client is starting omeprazole for GERD. The nurse should instruct the client to take the
medication:
A) With a full meal
B) 30–60 minutes before the first meal of the day
C) At bedtime only
D) When symptoms occur
Correct Answer: B
Rationale: PPIs are most effective when taken before meals because they block proton pumps
activated by food intake.
12. A client is prescribed spironolactone for heart failure. The nurse should instruct the client
to avoid which food?
A) Apples
B) Bananas
C) White bread
D) Chicken breast
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic; high-potassium foods like bananas
increase the risk of hyperkalemia.
13. A client is receiving an IV infusion of vancomycin. The nurse notes the client’s face and
neck are flushed. The nurse should:
A) Stop the infusion and administer epinephrine
B) Slow the infusion rate and monitor vital signs
C) Increase the rate to complete the dose quickly
D) Administer diphenhydramine IV push
Correct Answer: B
Rationale: Red Man Syndrome is a histamine-mediated reaction from rapid vancomycin
infusion. Slowing the rate usually resolves symptoms.
best response is that lisinopril:
A) Blocks angiotensin II receptors
B) Inhibits the conversion of angiotensin I to angiotensin II
C) Increases heart rate and cardiac output
D) Promotes sodium and water reabsorption
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that blocks the enzyme converting angiotensin I to
angiotensin II, leading to vasodilation, reduced aldosterone secretion, and lower blood
pressure.
2. A nurse is teaching a client about the use of sublingual nitroglycerin. Which statement by
the client indicates an understanding of the teaching?
A) “I will swallow the tablet with a full glass of water.”
B) “I should sit down before taking the tablet.”
C) “If the pain is not relieved after 5 minutes, I will take a second dose and call 911.”
D) “I can take up to five doses, one every 5 minutes.”
,Correct Answer: B
Rationale: The client should sit or lie down before taking sublingual nitroglycerin to prevent falls
from orthostatic hypotension. The tablet should dissolve under the tongue, not be swallowed. If
pain persists after one dose, call 911; up to three doses may be taken total while awaiting EMS.
3. A client is prescribed furosemide 40 mg PO daily. The nurse should instruct the client to
take the medication:
A) At bedtime
B) In the morning
C) With a high-fat meal
D) On an empty stomach only
Correct Answer: B
Rationale: Furosemide is a diuretic that should be taken in the morning to prevent nocturia and
sleep disruption.
4. A nurse is monitoring a client receiving IV heparin. The aPTT is 70 seconds (control 30
seconds). What is the appropriate nursing action?
A) Stop the heparin infusion and administer protamine sulfate
B) Continue the heparin infusion at the current rate
C) Increase the heparin rate
D) Notify the prescriber and prepare to administer vitamin K
Correct Answer: B
Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times control (45–75 seconds). At 70
seconds, the level is therapeutic, so the infusion should continue at the current rate.
5. A client is prescribed alendronate for osteoporosis. Which client statement indicates a need
for further teaching?
A) “I will take the medication with a full glass of water first thing in the morning.”
B) “I will remain sitting upright for at least 30 minutes after taking the medication.”
C) “I can take my calcium supplement at the same time as alendronate.”
D) “I should not eat or drink anything else for 30 minutes.”
Correct Answer: C
Rationale: Calcium supplements and other minerals interfere with alendronate absorption.
They should be taken at a different time of day.
6. A client is prescribed digoxin 0.125 mg PO daily. The nurse should hold the medication and
notify the prescriber if the client’s apical pulse is:
A) 72 bpm
B) 64 bpm
,C) 58 bpm
D) 80 bpm
Correct Answer: C
Rationale: Digoxin should be held if the pulse is below 60 bpm (or per facility protocol) because
it can cause bradycardia and heart block.
7. A client with asthma is prescribed an albuterol inhaler and a fluticasone inhaler. The nurse
should instruct the client to:
A) Use the fluticasone first, then the albuterol
B) Use the albuterol first, wait 1–5 minutes, then use the fluticasone
C) Use both inhalers simultaneously
D) Use fluticasone only during acute attacks
Correct Answer: B
Rationale: The bronchodilator (albuterol) is used first to open airways, allowing better
penetration of the corticosteroid (fluticasone).
8. A nurse is teaching a client about warfarin therapy. Which statement by the client indicates
a need for further teaching?
A) “I will use an electric razor instead of a blade.”
B) “I can continue to take my daily aspirin for heart health.”
C) “I will have my INR checked regularly.”
D) “I should report any unusual bruising or bleeding.”
Correct Answer: B
Rationale: Aspirin increases the risk of bleeding when taken with warfarin. The client should not
take aspirin without prescriber approval.
9. A client with type 2 diabetes is prescribed metformin. Which laboratory value is most
important to monitor before and during therapy?
A) Liver enzymes
B) Serum potassium
C) Serum creatinine
D) Serum amylase
Correct Answer: C
Rationale: Metformin is renally excreted; impaired renal function increases the risk of lactic
acidosis. eGFR should be monitored.
10. A client is prescribed levothyroxine. Which finding indicates the dose may be too high?
A) Bradycardia
, B) Weight gain
C) Palpitations and tremors
D) Cold intolerance
Correct Answer: C
Rationale: Symptoms of hyperthyroidism (palpitations, tremors, heat intolerance, weight loss)
indicate excessive thyroid replacement.
11. A client is starting omeprazole for GERD. The nurse should instruct the client to take the
medication:
A) With a full meal
B) 30–60 minutes before the first meal of the day
C) At bedtime only
D) When symptoms occur
Correct Answer: B
Rationale: PPIs are most effective when taken before meals because they block proton pumps
activated by food intake.
12. A client is prescribed spironolactone for heart failure. The nurse should instruct the client
to avoid which food?
A) Apples
B) Bananas
C) White bread
D) Chicken breast
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic; high-potassium foods like bananas
increase the risk of hyperkalemia.
13. A client is receiving an IV infusion of vancomycin. The nurse notes the client’s face and
neck are flushed. The nurse should:
A) Stop the infusion and administer epinephrine
B) Slow the infusion rate and monitor vital signs
C) Increase the rate to complete the dose quickly
D) Administer diphenhydramine IV push
Correct Answer: B
Rationale: Red Man Syndrome is a histamine-mediated reaction from rapid vancomycin
infusion. Slowing the rate usually resolves symptoms.
