1. A client taking phenytoin shows swollen, bleeding gums.
What
should the nurse recommend?
A. Discontinue the drug
B. Increase fluid intake
C. Practice good oral hygiene
D. Reduce dietary sugar
Answer: C
Rationale: Gingival hyperplasia is a known side effect.
Encourage
oral care, not discontinuation.
2. A client taking warfarin has an INR of 4.2. Which action
should
the nurse take?
A. Administer the next dose of warfarin
B. Hold the dose and notify the provider
C. Give vitamin K IV immediately
D. Prepare for platelet transfusion
Answer: B
Rationale: An INR >3.0 indicates increased bleeding risk.
The
nurse should hold the medication and notify the provider.
3. A client is prescribed loratadine for seasonal allergies.
What is
A. key difference from diphenhydramine?
A. Loratadine causes more drowsiness
B. Loratadine causes GI upset
C. Loratadine is non-sedating
D. Loratadine is only available IV
Answer: C
Rationale: Second-generation antihistamines like loratadine
are
non-sedating.
4. 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.
, 5. A nurse is caring for a client prescribed lisinopril. Which
lab
result should the nurse report to the provider?
A. Sodium 138 mEq/L
B. Potassium 5.8 mEq/L
C. Hemoglobin 14 g/dL
D. BUN 18 mg/dL
Answer: B
Rationale: Lisinopril, an ACE inhibitor, can cause
hyperkalemia. A
potassium level of 5.8 is elevated and should be reported.
6. A nurse is reviewing a client’s chart who is prescribed
gentamicin. Which finding should concern the nurse most?
A. Tinnitus
B. WBC 10,000
C. Urine output 50 mL/hr
D. Temperature 100.2°F
Answer: A
Rationale: Tinnitus is a sign of ototoxicity, a serious adverse
effect
of gentamicin.
7. 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.
8. What lab value should be monitored in a client receiving
propylthiouracil (PTU)?
A. Glucose
B. TSH and T3/T4
C. Calcium
D. Sodium
Answer: B
Rationale: PTU suppresses thyroid hormone. Monitor TSH,
T3, and
T4 to assess effectiveness.
9. A client on clozapine reports fever and sore throat. What
is the
priority action?
A. Reassure and monitor
B. Administer antipyretics
What
should the nurse recommend?
A. Discontinue the drug
B. Increase fluid intake
C. Practice good oral hygiene
D. Reduce dietary sugar
Answer: C
Rationale: Gingival hyperplasia is a known side effect.
Encourage
oral care, not discontinuation.
2. A client taking warfarin has an INR of 4.2. Which action
should
the nurse take?
A. Administer the next dose of warfarin
B. Hold the dose and notify the provider
C. Give vitamin K IV immediately
D. Prepare for platelet transfusion
Answer: B
Rationale: An INR >3.0 indicates increased bleeding risk.
The
nurse should hold the medication and notify the provider.
3. A client is prescribed loratadine for seasonal allergies.
What is
A. key difference from diphenhydramine?
A. Loratadine causes more drowsiness
B. Loratadine causes GI upset
C. Loratadine is non-sedating
D. Loratadine is only available IV
Answer: C
Rationale: Second-generation antihistamines like loratadine
are
non-sedating.
4. 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.
, 5. A nurse is caring for a client prescribed lisinopril. Which
lab
result should the nurse report to the provider?
A. Sodium 138 mEq/L
B. Potassium 5.8 mEq/L
C. Hemoglobin 14 g/dL
D. BUN 18 mg/dL
Answer: B
Rationale: Lisinopril, an ACE inhibitor, can cause
hyperkalemia. A
potassium level of 5.8 is elevated and should be reported.
6. A nurse is reviewing a client’s chart who is prescribed
gentamicin. Which finding should concern the nurse most?
A. Tinnitus
B. WBC 10,000
C. Urine output 50 mL/hr
D. Temperature 100.2°F
Answer: A
Rationale: Tinnitus is a sign of ototoxicity, a serious adverse
effect
of gentamicin.
7. 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.
8. What lab value should be monitored in a client receiving
propylthiouracil (PTU)?
A. Glucose
B. TSH and T3/T4
C. Calcium
D. Sodium
Answer: B
Rationale: PTU suppresses thyroid hormone. Monitor TSH,
T3, and
T4 to assess effectiveness.
9. A client on clozapine reports fever and sore throat. What
is the
priority action?
A. Reassure and monitor
B. Administer antipyretics
