1. 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.
2. A nurse is teaching a client about hydroxychloroquine for
lupus. What adverse effect should be reported immediately?
A. Dizziness
B. Blurred vision
C. Dry mouth
D. Rash
Answer: B
Rationale: Retinal damage is a serious side effect. Clients need
regular eye exams.
3. A client taking isoniazid (INH) for tuberculosis develops
numbness and tingling in their hands and feet. What should the
nurse anticipate?
A. The need for increased calcium
B. Administration of pyridoxine (vitamin B6)
C. Discontinuation of therapy
D. Addition of prednisone
Answer: B
Rationale: Isoniazid can cause peripheral neuropathy, often
prevented or treated with vitamin B6.
,4. A client with asthma uses albuterol PRN. Which statement
shows proper understanding?
A. “I use this every morning and night.”
B. “I use this when I’m having shortness of breath.”
C. “I use it with my steroid inhaler at the same time.”
D. “I use this even if I’m not having symptoms.”
Answer: B
Rationale: Albuterol is a rescue inhaler used during asthma attacks
or acute symptoms.
5. A client is taking diphenhydramine. Which side effect is most
likely?
A. Hypertension
B. Drowsiness
C. Diarrhea
D. Insomnia
Answer: B
Rationale: First-generation antihistamines like diphenhydramine
cause sedation and drowsiness.
6. A client is receiving morphine IV post-op. Which finding is the
priority?
A. Nausea
B. Respiratory rate of 8/min
C. Itching
D. Sedation score of 2
Answer: B
Rationale: Respiratory depression (<12/min) is the most life
threatening side effect of opioids.
7. A child prescribed methylphenidate for ADHD should be
monitored for which effect?
A. Drowsiness
, B. Increased appetite
C. Weight loss and insomnia
D. Bradycardia
Answer: C
Rationale: Stimulants like methylphenidate commonly cause
decreased appetite, insomnia, and weight loss.
8. A client with myasthenia gravis is prescribed neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic crisis,
requiring dosage adjustment.
9. A client with herpes simplex is prescribed acyclovir. What is the
most important teaching?
A. "Take on an empty stomach."
B. "Drink plenty of fluids."
C. "Discontinue when symptoms improve."
D. "Expect yellowing of the eyes."
Answer: B
Rationale: Acyclovir can cause nephrotoxicity. Hydration is
essential to reduce the risk.
10. A post-op client is given ondansetron. Which is an expected
outcome?
A. Decreased heart rate
B. Absence of nausea
C. Increased bowel sounds
D. Sedation
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.
2. A nurse is teaching a client about hydroxychloroquine for
lupus. What adverse effect should be reported immediately?
A. Dizziness
B. Blurred vision
C. Dry mouth
D. Rash
Answer: B
Rationale: Retinal damage is a serious side effect. Clients need
regular eye exams.
3. A client taking isoniazid (INH) for tuberculosis develops
numbness and tingling in their hands and feet. What should the
nurse anticipate?
A. The need for increased calcium
B. Administration of pyridoxine (vitamin B6)
C. Discontinuation of therapy
D. Addition of prednisone
Answer: B
Rationale: Isoniazid can cause peripheral neuropathy, often
prevented or treated with vitamin B6.
,4. A client with asthma uses albuterol PRN. Which statement
shows proper understanding?
A. “I use this every morning and night.”
B. “I use this when I’m having shortness of breath.”
C. “I use it with my steroid inhaler at the same time.”
D. “I use this even if I’m not having symptoms.”
Answer: B
Rationale: Albuterol is a rescue inhaler used during asthma attacks
or acute symptoms.
5. A client is taking diphenhydramine. Which side effect is most
likely?
A. Hypertension
B. Drowsiness
C. Diarrhea
D. Insomnia
Answer: B
Rationale: First-generation antihistamines like diphenhydramine
cause sedation and drowsiness.
6. A client is receiving morphine IV post-op. Which finding is the
priority?
A. Nausea
B. Respiratory rate of 8/min
C. Itching
D. Sedation score of 2
Answer: B
Rationale: Respiratory depression (<12/min) is the most life
threatening side effect of opioids.
7. A child prescribed methylphenidate for ADHD should be
monitored for which effect?
A. Drowsiness
, B. Increased appetite
C. Weight loss and insomnia
D. Bradycardia
Answer: C
Rationale: Stimulants like methylphenidate commonly cause
decreased appetite, insomnia, and weight loss.
8. A client with myasthenia gravis is prescribed neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic crisis,
requiring dosage adjustment.
9. A client with herpes simplex is prescribed acyclovir. What is the
most important teaching?
A. "Take on an empty stomach."
B. "Drink plenty of fluids."
C. "Discontinue when symptoms improve."
D. "Expect yellowing of the eyes."
Answer: B
Rationale: Acyclovir can cause nephrotoxicity. Hydration is
essential to reduce the risk.
10. A post-op client is given ondansetron. Which is an expected
outcome?
A. Decreased heart rate
B. Absence of nausea
C. Increased bowel sounds
D. Sedation
