1. A client receiving methotrexate for cancer reports mouth
sores. What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral care
is essential to prevent infection and discomfort.
2. A nurse monitors a client taking lamotrigine. What adverse
effect should prompt discontinuation?
A. Rash
B. Constipation
C. Nausea
D. Drowsiness
Answer: A
Rationale: Lamotrigine can cause a life-threatening rash (e.g.,
Stevens-Johnson syndrome). Report immediately.
3. A client is prescribed exenatide. What is a common side
effect?
A. Hyperglycemia
B. Constipation
C. Nausea
D. Tachycardia
Answer: C
Rationale: Exenatide can cause nausea, especially when initiating
therapy. It’s an injectable incretin mimetic.
4. A client on sertraline reports increased restlessness and
,confusion. What should the nurse suspect?
A. Extrapyramidal symptoms
B. Lithium toxicity
C. Serotonin syndrome
D. Neuroleptic malignant syndrome
Answer: C
Rationale: Serotonin syndrome includes agitation, confusion,
tachycardia, and hyperreflexia.
5. A client is prescribed loperamide. Which condition is a
contraindication?
A. IBS
B. Infectious diarrhea
C. Traveler’s diarrhea
D. Post-antibiotic diarrhea
Answer: B
Rationale: Do not use antidiarrheals in infectious diarrhea, as it
may retain toxins in the bowel.
6. A client takes aluminum hydroxide for GERD. What adverse
effect should the nurse monitor?
A. Diarrhea
B. Constipation
C. Hypokalemia
D. Rash
Answer: B
Rationale: Aluminum-based antacids commonly cause
constipation.
7. A client started on fluoxetine 5 days ago reports increased
energy and planning their funeral. What should the nurse do?
A. Encourage journaling
B. Monitor sleep
, C. Notify the provider immediately
D. Provide distraction techniques
Answer: C
Rationale: Increased energy + suicidal ideation early in SSRI
therapy is dangerous and should be reported.
8. A client on lithium therapy has a sodium level of 128 mEq/L.
What is the nurse's best action?
A. Encourage low-sodium diet
B. Administer next dose
C. Hold the dose and notify the provider
D. Increase fluid restriction
Answer: C
Rationale: Hyponatremia can increase lithium toxicity risk. Hold
the dose and notify the provider.
9. A client asks about insulin glargine (Lantus). What is the
correct response?
A. “It works immediately.”
B. “It peaks in 4 hours.”
C. “It has no peak and lasts 24 hours.”
D. “It must be mixed with regular insulin.”
Answer: C
Rationale: Glargine is a long-acting insulin with no pronounced
peak, providing steady glucose control.
10. A nurse gives regular insulin subcutaneously at 0700. At what
time should the nurse monitor for signs of hypoglycemia?
A. 0715
B. 0800
C. 0930
D. 1200
Answer: C
sores. What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral care
is essential to prevent infection and discomfort.
2. A nurse monitors a client taking lamotrigine. What adverse
effect should prompt discontinuation?
A. Rash
B. Constipation
C. Nausea
D. Drowsiness
Answer: A
Rationale: Lamotrigine can cause a life-threatening rash (e.g.,
Stevens-Johnson syndrome). Report immediately.
3. A client is prescribed exenatide. What is a common side
effect?
A. Hyperglycemia
B. Constipation
C. Nausea
D. Tachycardia
Answer: C
Rationale: Exenatide can cause nausea, especially when initiating
therapy. It’s an injectable incretin mimetic.
4. A client on sertraline reports increased restlessness and
,confusion. What should the nurse suspect?
A. Extrapyramidal symptoms
B. Lithium toxicity
C. Serotonin syndrome
D. Neuroleptic malignant syndrome
Answer: C
Rationale: Serotonin syndrome includes agitation, confusion,
tachycardia, and hyperreflexia.
5. A client is prescribed loperamide. Which condition is a
contraindication?
A. IBS
B. Infectious diarrhea
C. Traveler’s diarrhea
D. Post-antibiotic diarrhea
Answer: B
Rationale: Do not use antidiarrheals in infectious diarrhea, as it
may retain toxins in the bowel.
6. A client takes aluminum hydroxide for GERD. What adverse
effect should the nurse monitor?
A. Diarrhea
B. Constipation
C. Hypokalemia
D. Rash
Answer: B
Rationale: Aluminum-based antacids commonly cause
constipation.
7. A client started on fluoxetine 5 days ago reports increased
energy and planning their funeral. What should the nurse do?
A. Encourage journaling
B. Monitor sleep
, C. Notify the provider immediately
D. Provide distraction techniques
Answer: C
Rationale: Increased energy + suicidal ideation early in SSRI
therapy is dangerous and should be reported.
8. A client on lithium therapy has a sodium level of 128 mEq/L.
What is the nurse's best action?
A. Encourage low-sodium diet
B. Administer next dose
C. Hold the dose and notify the provider
D. Increase fluid restriction
Answer: C
Rationale: Hyponatremia can increase lithium toxicity risk. Hold
the dose and notify the provider.
9. A client asks about insulin glargine (Lantus). What is the
correct response?
A. “It works immediately.”
B. “It peaks in 4 hours.”
C. “It has no peak and lasts 24 hours.”
D. “It must be mixed with regular insulin.”
Answer: C
Rationale: Glargine is a long-acting insulin with no pronounced
peak, providing steady glucose control.
10. A nurse gives regular insulin subcutaneously at 0700. At what
time should the nurse monitor for signs of hypoglycemia?
A. 0715
B. 0800
C. 0930
D. 1200
Answer: C
