1. 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.
2. 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.
3. A client on clozapine reports fever and sore throat. What
is the
priority action?
A. Reassure and monitor
B. Administer antipyretics
C. Check WBC count
D. Suggest lozenges
Answer: C
Rationale: Clozapine can cause agranulocytosis. A fever +
sore
throat may signal low WBC—check labs.
4. A client with COPD is on prednisone. Which instruction
is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding
and
ulcers. Tarry stools may indicate bleeding.
, 5. A client is prescribed bupropion for smoking cessation.
Which
side effect is most serious?
A. Dry mouth
B. Insomnia
C. Seizures
D. Weight loss
Answer: C
Rationale: Bupropion lowers seizure threshold. Clients at
risk (e.g.,
with eating disorders) need close monitoring.
6. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Answer: B
Rationale: Metoprolol can cause bradycardia. Always check
HR
before administering.
7. A client with chronic constipation uses magnesium
citrate
daily. What risk should the nurse discuss?
A. Hypertension
B. Hypernatremia
C. Electrolyte imbalance
D. Dehydration
Answer: C
Rationale: Chronic laxative use, especially osmotic types
like
magnesium citrate, causes fluid and electrolyte imbalances.
8. A nurse is teaching a client how to apply clotrimazole
vaginal
cream. What instruction is correct?
A. Use during menstruation
B. Stop once symptoms go away
C. Use applicator at bedtime
D. Use with a tampon
Answer: C
Rationale: For maximum effect, apply at bedtime using the
applicator. Avoid tampons during treatment.
9. A child prescribed methylphenidate for ADHD should be
monitored for which effect?
A. Drowsiness
B. Increased appetite
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.
2. 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.
3. A client on clozapine reports fever and sore throat. What
is the
priority action?
A. Reassure and monitor
B. Administer antipyretics
C. Check WBC count
D. Suggest lozenges
Answer: C
Rationale: Clozapine can cause agranulocytosis. A fever +
sore
throat may signal low WBC—check labs.
4. A client with COPD is on prednisone. Which instruction
is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding
and
ulcers. Tarry stools may indicate bleeding.
, 5. A client is prescribed bupropion for smoking cessation.
Which
side effect is most serious?
A. Dry mouth
B. Insomnia
C. Seizures
D. Weight loss
Answer: C
Rationale: Bupropion lowers seizure threshold. Clients at
risk (e.g.,
with eating disorders) need close monitoring.
6. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Answer: B
Rationale: Metoprolol can cause bradycardia. Always check
HR
before administering.
7. A client with chronic constipation uses magnesium
citrate
daily. What risk should the nurse discuss?
A. Hypertension
B. Hypernatremia
C. Electrolyte imbalance
D. Dehydration
Answer: C
Rationale: Chronic laxative use, especially osmotic types
like
magnesium citrate, causes fluid and electrolyte imbalances.
8. A nurse is teaching a client how to apply clotrimazole
vaginal
cream. What instruction is correct?
A. Use during menstruation
B. Stop once symptoms go away
C. Use applicator at bedtime
D. Use with a tampon
Answer: C
Rationale: For maximum effect, apply at bedtime using the
applicator. Avoid tampons during treatment.
9. A child prescribed methylphenidate for ADHD should be
monitored for which effect?
A. Drowsiness
B. Increased appetite