,Table of Contents
Assessment 1 -------------------------------------------------------------------------------------------------- 2
Assessment 2 ---------------------------------------------------------------------------------------------------- 69
Assessment 1
1. A nurse is caring for a client who is receiving morphine. What assessment is priority?
Correct Answer: Respiratory rate
Rationale: This question tests knowledge of opioid monitoring. Morphine is an opioid agonist
that acts on mu receptors in the central nervous system to provide analgesia, but it also causes
dose-dependent respiratory depression by decreasing the responsiveness of the brainstem's
respiratory center to carbon dioxide. The nurse must assess the respiratory rate before
administering morphine and frequently thereafter, because a rate below 12 breaths per minute
indicates impending respiratory depression, which is the most life-threatening adverse effect of
opioids. While sedation, blood pressure, and pain level are also important assessments,
respiratory rate takes priority because untreated respiratory depression can progress rapidly to
apnea, hypoxia, cardiac arrest, and death. If the respiratory rate is below the prescribed
parameter, the nurse should withhold the dose, stimulate the client, and notify the provider,
with naloxone available as the antidote.
2. A nurse is assessing a client who has been using beclomethasone for 2 weeks to manage
her asthma. What is the priority to report to the provider?
Correct Answer: Bronchospasms
Rationale: This question tests knowledge of inhaled corticosteroid adverse effects.
Beclomethasone is an inhaled glucocorticoid used as a long-term controller medication for
asthma, working by suppressing airway inflammation rather than providing immediate
bronchodilation. Because it does not relieve acute bronchospasm, a client who experiences
bronchospasms while on beclomethasone is not achieving adequate control and requires
reassessment of the treatment regimen, possibly including a short-acting beta2 agonist or a
systemic corticosteroid. The nurse should report bronchospasms immediately because they
indicate the airway is constricting and the client is at risk for an acute asthma exacerbation.
,Other findings such as oral candidiasis, hoarseness, and dry mouth are common local adverse
effects that require teaching about rinsing the mouth after use, but they are not immediately
life-threatening.
3. A nurse is caring for a client who has a prescription for terazosin. The nurse should
identify that this medication is indicated for which of the following disorders? (Select all
that apply.)
Correct Answer: Hypertension and BPH (Benign Prostatic Hyperplasia)
Rationale: This question tests knowledge of alpha1-adrenergic blocker indications. Terazosin is a
selective alpha1-adrenergic antagonist that produces vasodilation by relaxing vascular smooth
muscle, which lowers blood pressure, and relaxes smooth muscle in the prostate and bladder
neck, which improves urinary flow in BPH. The nurse should recognize both indications and
understand that the same mechanism of action explains both uses. Clients should be taught to
take the first dose at bedtime to minimize the risk of first-dose syncope from orthostatic
hypotension, to rise slowly from sitting or lying positions, and to report dizziness or palpitations.
4. A nurse is providing teaching to a client who has a new prescription for a
beclomethasone inhaler to use with an albuterol inhaler for asthma maintenance. What
should the nurse instruct?
Correct Answer: You should gargle with water after each use of this inhaler.
Rationale: This question tests knowledge of inhaled corticosteroid administration.
Beclomethasone is an inhaled glucocorticoid that can deposit on the oropharyngeal mucosa and
suppress local immune defenses, leading to oral candidiasis (thrush) and hoarseness. The nurse
must teach the client to rinse and gargle with water after each use and to spit out the rinse
rather than swallow it, to remove residual medication from the mouth and throat. The nurse
should also teach the client to use the albuterol (bronchodilator) inhaler first and wait 5
minutes before using the beclomethasone inhaler, because bronchodilation opens the airways
and allows the corticosteroid to reach deeper into the lungs.
5. A nurse is preparing to administer topotecan IV. Which of the following medications
should the nurse expect to administer to control the adverse effects?
Correct Answer: Granisetron
Rationale: This question tests knowledge of chemotherapy-induced nausea and vomiting
management. Topotecan is a topoisomerase inhibitor used to treat ovarian and small cell lung
cancers, and it is classified as highly emetogenic, meaning it causes severe nausea and vomiting
by stimulating serotonin release from enterochromaffin cells in the gastrointestinal tract.
Granisetron is a 5-HT3 receptor antagonist that blocks serotonin binding at the 5-HT3 receptors
, in the chemoreceptor trigger zone and the gastrointestinal tract, making it the antiemetic of
choice for chemotherapy-induced nausea and vomiting. The nurse should anticipate
administering granisetron before, during, and after chemotherapy to prevent and control this
distressing adverse effect.
6. A nurse is planning a staff education session on adverse effects of medications. What
information should the nurse discuss about anticholinergic adverse effects? (Select all
that apply.)
Correct Answer: Blurred vision, Tachycardia, Constipation
Rationale: This question tests knowledge of anticholinergic adverse effects. Anticholinergic
medications block the parasympathetic nervous system by antagonizing acetylcholine at
muscarinic receptors, producing a predictable set of adverse effects captured by the mnemonic:
dry mouth, urinary retention, blurred vision (from mydriasis and cycloplegia), tachycardia (from
loss of vagal tone), constipation (from decreased gastrointestinal motility), confusion, and
hyperthermia (from decreased sweating). The nurse should teach clients to increase fluids and
fiber, use caution in hot weather, and report visual changes or palpitations to the provider.
7. A nurse is providing teaching to a client who has a new prescription for guaifenesin.
What information regarding the action of guaifenesin should the nurse include in the
teaching?
Correct Answer: Guaifenesin increases cough production.
Rationale: This question tests knowledge of expectorant action. Guaifenesin is an expectorant
that works by increasing the volume and reducing the viscosity of respiratory secretions, making
coughs more productive and helping the client clear mucus from the airways. The nurse should
teach the client to take the medication with a full glass of water to enhance its effectiveness and
to maintain adequate hydration throughout the day. The statement "guaifenesin increases
cough production" reflects this mechanism, as the medication makes coughs more productive
rather than suppressing them like an antitussive would.
8. A nurse is preparing to administer verapamil to a client who is 2 days post-myocardial
infarction. The nurse should monitor the client for which of the following outcomes as a
therapeutic response to the medication?
Correct Answer: Decreased anginal pain
Rationale: This question tests knowledge of calcium channel blocker therapy. Verapamil is a
non-dihydropyridine calcium channel blocker that decreases myocardial oxygen demand by
reducing heart rate, contractility, and afterload, while also dilating coronary arteries to increase
oxygen supply. After myocardial infarction, the goal of verapamil therapy is to prevent angina
Assessment 1 -------------------------------------------------------------------------------------------------- 2
Assessment 2 ---------------------------------------------------------------------------------------------------- 69
Assessment 1
1. A nurse is caring for a client who is receiving morphine. What assessment is priority?
Correct Answer: Respiratory rate
Rationale: This question tests knowledge of opioid monitoring. Morphine is an opioid agonist
that acts on mu receptors in the central nervous system to provide analgesia, but it also causes
dose-dependent respiratory depression by decreasing the responsiveness of the brainstem's
respiratory center to carbon dioxide. The nurse must assess the respiratory rate before
administering morphine and frequently thereafter, because a rate below 12 breaths per minute
indicates impending respiratory depression, which is the most life-threatening adverse effect of
opioids. While sedation, blood pressure, and pain level are also important assessments,
respiratory rate takes priority because untreated respiratory depression can progress rapidly to
apnea, hypoxia, cardiac arrest, and death. If the respiratory rate is below the prescribed
parameter, the nurse should withhold the dose, stimulate the client, and notify the provider,
with naloxone available as the antidote.
2. A nurse is assessing a client who has been using beclomethasone for 2 weeks to manage
her asthma. What is the priority to report to the provider?
Correct Answer: Bronchospasms
Rationale: This question tests knowledge of inhaled corticosteroid adverse effects.
Beclomethasone is an inhaled glucocorticoid used as a long-term controller medication for
asthma, working by suppressing airway inflammation rather than providing immediate
bronchodilation. Because it does not relieve acute bronchospasm, a client who experiences
bronchospasms while on beclomethasone is not achieving adequate control and requires
reassessment of the treatment regimen, possibly including a short-acting beta2 agonist or a
systemic corticosteroid. The nurse should report bronchospasms immediately because they
indicate the airway is constricting and the client is at risk for an acute asthma exacerbation.
,Other findings such as oral candidiasis, hoarseness, and dry mouth are common local adverse
effects that require teaching about rinsing the mouth after use, but they are not immediately
life-threatening.
3. A nurse is caring for a client who has a prescription for terazosin. The nurse should
identify that this medication is indicated for which of the following disorders? (Select all
that apply.)
Correct Answer: Hypertension and BPH (Benign Prostatic Hyperplasia)
Rationale: This question tests knowledge of alpha1-adrenergic blocker indications. Terazosin is a
selective alpha1-adrenergic antagonist that produces vasodilation by relaxing vascular smooth
muscle, which lowers blood pressure, and relaxes smooth muscle in the prostate and bladder
neck, which improves urinary flow in BPH. The nurse should recognize both indications and
understand that the same mechanism of action explains both uses. Clients should be taught to
take the first dose at bedtime to minimize the risk of first-dose syncope from orthostatic
hypotension, to rise slowly from sitting or lying positions, and to report dizziness or palpitations.
4. A nurse is providing teaching to a client who has a new prescription for a
beclomethasone inhaler to use with an albuterol inhaler for asthma maintenance. What
should the nurse instruct?
Correct Answer: You should gargle with water after each use of this inhaler.
Rationale: This question tests knowledge of inhaled corticosteroid administration.
Beclomethasone is an inhaled glucocorticoid that can deposit on the oropharyngeal mucosa and
suppress local immune defenses, leading to oral candidiasis (thrush) and hoarseness. The nurse
must teach the client to rinse and gargle with water after each use and to spit out the rinse
rather than swallow it, to remove residual medication from the mouth and throat. The nurse
should also teach the client to use the albuterol (bronchodilator) inhaler first and wait 5
minutes before using the beclomethasone inhaler, because bronchodilation opens the airways
and allows the corticosteroid to reach deeper into the lungs.
5. A nurse is preparing to administer topotecan IV. Which of the following medications
should the nurse expect to administer to control the adverse effects?
Correct Answer: Granisetron
Rationale: This question tests knowledge of chemotherapy-induced nausea and vomiting
management. Topotecan is a topoisomerase inhibitor used to treat ovarian and small cell lung
cancers, and it is classified as highly emetogenic, meaning it causes severe nausea and vomiting
by stimulating serotonin release from enterochromaffin cells in the gastrointestinal tract.
Granisetron is a 5-HT3 receptor antagonist that blocks serotonin binding at the 5-HT3 receptors
, in the chemoreceptor trigger zone and the gastrointestinal tract, making it the antiemetic of
choice for chemotherapy-induced nausea and vomiting. The nurse should anticipate
administering granisetron before, during, and after chemotherapy to prevent and control this
distressing adverse effect.
6. A nurse is planning a staff education session on adverse effects of medications. What
information should the nurse discuss about anticholinergic adverse effects? (Select all
that apply.)
Correct Answer: Blurred vision, Tachycardia, Constipation
Rationale: This question tests knowledge of anticholinergic adverse effects. Anticholinergic
medications block the parasympathetic nervous system by antagonizing acetylcholine at
muscarinic receptors, producing a predictable set of adverse effects captured by the mnemonic:
dry mouth, urinary retention, blurred vision (from mydriasis and cycloplegia), tachycardia (from
loss of vagal tone), constipation (from decreased gastrointestinal motility), confusion, and
hyperthermia (from decreased sweating). The nurse should teach clients to increase fluids and
fiber, use caution in hot weather, and report visual changes or palpitations to the provider.
7. A nurse is providing teaching to a client who has a new prescription for guaifenesin.
What information regarding the action of guaifenesin should the nurse include in the
teaching?
Correct Answer: Guaifenesin increases cough production.
Rationale: This question tests knowledge of expectorant action. Guaifenesin is an expectorant
that works by increasing the volume and reducing the viscosity of respiratory secretions, making
coughs more productive and helping the client clear mucus from the airways. The nurse should
teach the client to take the medication with a full glass of water to enhance its effectiveness and
to maintain adequate hydration throughout the day. The statement "guaifenesin increases
cough production" reflects this mechanism, as the medication makes coughs more productive
rather than suppressing them like an antitussive would.
8. A nurse is preparing to administer verapamil to a client who is 2 days post-myocardial
infarction. The nurse should monitor the client for which of the following outcomes as a
therapeutic response to the medication?
Correct Answer: Decreased anginal pain
Rationale: This question tests knowledge of calcium channel blocker therapy. Verapamil is a
non-dihydropyridine calcium channel blocker that decreases myocardial oxygen demand by
reducing heart rate, contractility, and afterload, while also dilating coronary arteries to increase
oxygen supply. After myocardial infarction, the goal of verapamil therapy is to prevent angina
