1. 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.
2. A client receiving amphotericin B develops chills and
fever.
What should the nurse do?
A. Stop the infusion
B. Document findings
C. Pre-medicate with acetaminophen
D. Increase infusion rate
Answer: C
Rationale: Infusion reactions are common. Premedication
with
acetaminophen or diphenhydramine is standard.
3. 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.
4. 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.
, 5. What should the nurse include when teaching a client
taking
ferrous sulfate?
A. Take with milk
B. Take with food if GI upset occurs
C. Expect pale stools
D. Avoid vitamin C
Answer: B
Rationale: Iron can upset the stomach. If so, take with food
(but
not dairy). Vitamin C increases absorption.
6. A client with hypothyroidism takes levothyroxine. Which
statement indicates effective therapy?
A. “I feel cold all the time.”
B. “My heart rate is slower than usual.”
C. “I have more energy now.”
D. “I’m gaining weight quickly.”
Answer: C
Rationale: Increased energy suggests improved thyroid
function.
7. A nurse is caring for a client on glipizide. Which
statement
indicates understanding?
A. “I can skip meals if I’m not hungry.”
B. “This medication will not cause low blood sugar.”
C. “I will avoid alcohol while taking this.”
D. “I can take this with grapefruit juice.”
Answer: C
Rationale: Alcohol with glipizide increases the risk of
hypoglycemia and a disulfiram-like reaction.
8. Which lab value should be monitored regularly for a
client on
statins?
A. BUN
B. AST and ALT
C. Sodium
D. Hematocrit
Answer: B
Rationale: Statins can cause liver damage. Monitor liver
enzymes
(AST/ALT).
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."
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.
2. A client receiving amphotericin B develops chills and
fever.
What should the nurse do?
A. Stop the infusion
B. Document findings
C. Pre-medicate with acetaminophen
D. Increase infusion rate
Answer: C
Rationale: Infusion reactions are common. Premedication
with
acetaminophen or diphenhydramine is standard.
3. 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.
4. 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.
, 5. What should the nurse include when teaching a client
taking
ferrous sulfate?
A. Take with milk
B. Take with food if GI upset occurs
C. Expect pale stools
D. Avoid vitamin C
Answer: B
Rationale: Iron can upset the stomach. If so, take with food
(but
not dairy). Vitamin C increases absorption.
6. A client with hypothyroidism takes levothyroxine. Which
statement indicates effective therapy?
A. “I feel cold all the time.”
B. “My heart rate is slower than usual.”
C. “I have more energy now.”
D. “I’m gaining weight quickly.”
Answer: C
Rationale: Increased energy suggests improved thyroid
function.
7. A nurse is caring for a client on glipizide. Which
statement
indicates understanding?
A. “I can skip meals if I’m not hungry.”
B. “This medication will not cause low blood sugar.”
C. “I will avoid alcohol while taking this.”
D. “I can take this with grapefruit juice.”
Answer: C
Rationale: Alcohol with glipizide increases the risk of
hypoglycemia and a disulfiram-like reaction.
8. Which lab value should be monitored regularly for a
client on
statins?
A. BUN
B. AST and ALT
C. Sodium
D. Hematocrit
Answer: B
Rationale: Statins can cause liver damage. Monitor liver
enzymes
(AST/ALT).
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."