CMS PHARMACOLOGY COMPREHENSIVE EXAM 2025/2026
QUESTIONS AND SOLUTIONS MARKED A+
✔✔A nurse is caring for a client who is taking diphenhydramine for allergies. The client
reports, "I feel sleepy during the day." Which of the following responses should the
nurse make? - ✔✔"You should try antihistamines with non-sedative effects."
The nurse should tell the client to try second-generation antihistamines that have no
sedative effect, as these are large molecules with low lipid solubility that cannot cross
the blood-brain barrier. Diphenhydramine is a first-generation antihistamine and has a
common adverse effect of sedation.
✔✔A nurse is assessing a client who has AIDS and is taking zidovudine. Which of the
following findings is the priority for the nurse to report to the provider? - ✔✔Decreased
hemoglobin
The nurse should apply the safety and risk-reduction priority-setting framework, which
assigns priority to the factor or situation posing the greatest safety risk to the client.
When there are several risks to client safety, the one posing the greatest threat is the
highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority
setting framework, and/or nursing knowledge to identify which risk poses the greatest
threat to the client. Therefore, the priority finding for the nurse to report to the provider is
a decreased hemoglobin level. Zidovudine can cause severe anemia and neutropenia
from bone marrow suppression, resulting in hematologic toxicity.
✔✔A nurse is preparing to administer timolol eye drops to a client who has primary
open-angle glaucoma (POAG). Prior to administering the medication, the nurse should
recognize that which of the following conditions in the client's medical history is a
contraindication to receiving this medication? - ✔✔Asthma
The nurse should identify that asthma is a contraindication to receiving timolol. Timolol
is a beta-blocker that can cause blocking of the beta2-receptors, causing
bronchospasm. A client who has a history of asthma is a candidate for an alternate
medication to treat this condition such as betaxolol.
✔✔A nurse is caring for a male client who has been taking cimetidine for the treatment
of a duodenal ulcer. Which of the following manifestations related to the medication
should the nurse report to the provider? - ✔✔Emesis that looks like coffee grounds
The nurse should identify that coffee-ground emesis is a manifestation of a
gastrointestinal bleed as a result of the duodenal ulcer and can indicate that treatment
with cimetidine has been ineffective. Therefore, the nurse should report this finding to
the provider immediately.
, ✔✔A nurse is teaching a client who has osteoporosis and a new prescription for
alendronate. Which of the following client statements indicates that the teaching was
effective? - ✔✔"I will sit upright for 30 minutes after taking the medication."
The nurse should instruct the client to sit upright or stand for at least 30 minutes after
taking the medication to prevent esophagitis.
✔✔A nurse is teaching a client who has primary adrenal insufficiency (Addison's
disease) and a prescription for hydrocortisone. Which of the following statements should
the nurse include in the teaching about this medication? - ✔✔"Carry a supply of pills
and a single-use injectable preparation with you at all times."
The nurse should tell the client to carry an emergency supply of the medication to take
during times of unexpected stress. The client should carry an adequate supply at all
times, which should include an injectable preparation plus a supply equal to the regular
oral dosage. The single-use injectable preparation should be administered IM if the
client has an emergency and needs an extra dose of the glucocorticoid.
✔✔A nurse is providing discharge teaching to a client who has a bacterial infection
about adverse effects of imipenem to report to the provider. Which of the following
pieces of information should the nurse include? - ✔✔"Seizures can occur with this
medication."
The nurse should tell the client that seizures can occur when receiving imipenem. The
client should notify the provider immediately if these occur.
✔✔A nurse is providing teaching to a client who has hypothyroidism and is taking
levothyroxine. The nurse should instruct the client that which of the following findings is
an indication of thyrotoxicosis? - ✔✔Chest pain
Thyrotoxicosis can result if a client takes too much levothyroxine. Manifestations include
chest pain, tachycardia, insomnia, tremors, hyperthermia, heat intolerance, and
diaphoresis. The client should notify the provider if any of these manifestations are
present.
✔✔A nurse in a provider's office is assessing a client who reports taking a dietary
supplement to reduce hot flashes related to menopause. Which of the following
supplements should the nurse expect the client to report taking? - ✔✔Black cohosh
Black cohosh is an herb that is used for the treatment of menopausal symptoms such
as hot flashes, vaginal dryness, irritability, and sleep disturbance.
✔✔A nurse is caring for a female adult client who is experiencing menopause and has a
prescription for estrogen along with progestin. The nurse should identify that the
QUESTIONS AND SOLUTIONS MARKED A+
✔✔A nurse is caring for a client who is taking diphenhydramine for allergies. The client
reports, "I feel sleepy during the day." Which of the following responses should the
nurse make? - ✔✔"You should try antihistamines with non-sedative effects."
The nurse should tell the client to try second-generation antihistamines that have no
sedative effect, as these are large molecules with low lipid solubility that cannot cross
the blood-brain barrier. Diphenhydramine is a first-generation antihistamine and has a
common adverse effect of sedation.
✔✔A nurse is assessing a client who has AIDS and is taking zidovudine. Which of the
following findings is the priority for the nurse to report to the provider? - ✔✔Decreased
hemoglobin
The nurse should apply the safety and risk-reduction priority-setting framework, which
assigns priority to the factor or situation posing the greatest safety risk to the client.
When there are several risks to client safety, the one posing the greatest threat is the
highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority
setting framework, and/or nursing knowledge to identify which risk poses the greatest
threat to the client. Therefore, the priority finding for the nurse to report to the provider is
a decreased hemoglobin level. Zidovudine can cause severe anemia and neutropenia
from bone marrow suppression, resulting in hematologic toxicity.
✔✔A nurse is preparing to administer timolol eye drops to a client who has primary
open-angle glaucoma (POAG). Prior to administering the medication, the nurse should
recognize that which of the following conditions in the client's medical history is a
contraindication to receiving this medication? - ✔✔Asthma
The nurse should identify that asthma is a contraindication to receiving timolol. Timolol
is a beta-blocker that can cause blocking of the beta2-receptors, causing
bronchospasm. A client who has a history of asthma is a candidate for an alternate
medication to treat this condition such as betaxolol.
✔✔A nurse is caring for a male client who has been taking cimetidine for the treatment
of a duodenal ulcer. Which of the following manifestations related to the medication
should the nurse report to the provider? - ✔✔Emesis that looks like coffee grounds
The nurse should identify that coffee-ground emesis is a manifestation of a
gastrointestinal bleed as a result of the duodenal ulcer and can indicate that treatment
with cimetidine has been ineffective. Therefore, the nurse should report this finding to
the provider immediately.
, ✔✔A nurse is teaching a client who has osteoporosis and a new prescription for
alendronate. Which of the following client statements indicates that the teaching was
effective? - ✔✔"I will sit upright for 30 minutes after taking the medication."
The nurse should instruct the client to sit upright or stand for at least 30 minutes after
taking the medication to prevent esophagitis.
✔✔A nurse is teaching a client who has primary adrenal insufficiency (Addison's
disease) and a prescription for hydrocortisone. Which of the following statements should
the nurse include in the teaching about this medication? - ✔✔"Carry a supply of pills
and a single-use injectable preparation with you at all times."
The nurse should tell the client to carry an emergency supply of the medication to take
during times of unexpected stress. The client should carry an adequate supply at all
times, which should include an injectable preparation plus a supply equal to the regular
oral dosage. The single-use injectable preparation should be administered IM if the
client has an emergency and needs an extra dose of the glucocorticoid.
✔✔A nurse is providing discharge teaching to a client who has a bacterial infection
about adverse effects of imipenem to report to the provider. Which of the following
pieces of information should the nurse include? - ✔✔"Seizures can occur with this
medication."
The nurse should tell the client that seizures can occur when receiving imipenem. The
client should notify the provider immediately if these occur.
✔✔A nurse is providing teaching to a client who has hypothyroidism and is taking
levothyroxine. The nurse should instruct the client that which of the following findings is
an indication of thyrotoxicosis? - ✔✔Chest pain
Thyrotoxicosis can result if a client takes too much levothyroxine. Manifestations include
chest pain, tachycardia, insomnia, tremors, hyperthermia, heat intolerance, and
diaphoresis. The client should notify the provider if any of these manifestations are
present.
✔✔A nurse in a provider's office is assessing a client who reports taking a dietary
supplement to reduce hot flashes related to menopause. Which of the following
supplements should the nurse expect the client to report taking? - ✔✔Black cohosh
Black cohosh is an herb that is used for the treatment of menopausal symptoms such
as hot flashes, vaginal dryness, irritability, and sleep disturbance.
✔✔A nurse is caring for a female adult client who is experiencing menopause and has a
prescription for estrogen along with progestin. The nurse should identify that the
