ANSWERS// 2025/2026 UPDATE
Which prescription should the practical nurse (PN) administer for a client who is experiencing an
anaphylactic reaction to an antibiotic?
A) Ephedra (ma-huang).
B) Epinephrine (Adrenalin).
C) Phenylephrin (Neo-Synephrine).
D) Fexofenadine with pseudoephedrine (Allegra D). - ANSWER-B) Epinephrine (Adrenalin).
Feedback:
Epinephrine (Adrenalin), a potent sympathomimetic, is the drug of choice for the treatment of
anaphylaxis (B). (A, C, and D) are not used for an acute immunololgical dysfunction that causes
cardiovascular effects.
An older adult client receives a prescription for hydrochlorothiazide (HydroDIURIL), a thiazide
diuretic for the treatment of heart failure. Which side effect(s) should the practical nurse
reinforce with the client? (Select all that apply.)
A) Constipation.
B) Fatigue.
C) Edema.
D) Nausea.
E) Dehydration.
F) Blurred vision. - ANSWER-B) Fatigue.
E) Dehydration.
Feedback:
Hydrochlorothiazide (HydroDIURIL), a thiazide diuretic, reduces blood pressure by reducing
blood volume and reducing arterial resistance. Adverse effects of thiazides include hypokalemia,
,fatigue (B), dehydration (E), hyperglycemia, and hyperuricemia. Although (A, C, D and F) may be
associated with aging or other pathology, they are not side effects commonly associated with
HydroDIURIL.
A client who returns from surgery for bowel resection complains of severe pain around the
incision. Which assessment is most important for the practical nurse (PN) to obtain prior to the
administration of morphine sulfate?
A) Rate of respirations.
B) Core temperature.
C) Appearance of the incision.
D) Presence of bowel sounds. - ANSWER-A) Rate of respirations.
Feedback:
Opioids cause respiratory depression, so the respiratory rate (A) should be assessed prior to
administration of morphine sulfate. (B, C, and D) do not address the concept of medication
safety.
A client is receiving the third course of 5-fluorouracil (5FU) therapy for a tumor of the liver.
Which action should the practical nurse implement to reduce the client's risk for stomatitis?
A) Use commercial oral products to reduce the risk of oral infections.
B) Observe for black, tarry stools or bleeding ulcerations.
C) Increase intake of foods containing fiber and citric acid.
D) Examine mouth daily for bleeding, white spots, and ulcerations. - ANSWER-D) Examine
mouth daily for bleeding, white spots, and ulcerations.
Feedback:
5-fluorouracil (5FU) is an antimetabolite, antineoplastic agent that causes sloughing of the rapid
proliferating epithelial cells of the oral mucosa causing ulceration, bleeding, and oral candidiasis
(thrush). Daily examination of the oral mucosa (D) should be implemented to identify signs of
stomatitis, such as white spots, ulcerations, and bleeding of the mouth, so early intervention
can be implemented. Oral commercial products usually contain alcohol, which contributes to
inflammation of the oral mucosa, and should be avoided (A). Although monitoring the stool for
, bleeding (B) should be implemented, stomatitis occurs in 75% of clients who receive 5FU. Foods
high in fiber and citric acid should also be avoided (C) to reduce pain and trauma to the mouth.
Which instruction should the practical nurse (PN) reinforce with a client who is taking disulfiram
(Antabuse)?
A) Cigarette smoking cessation program should be started.
B) Avoid using any over-the-counter substances containing alcohol.
C) This drug is similar to alcohol but without euphoric effects.
D) Small amounts of mouthwash or cough medicine can be used. - ANSWER-B) Avoid using any
over-the-counter substances containing alcohol.
Feedback:
The use of disulfiram (Antabuse) with over-the-counter (OTC) products that contain alcohol
causes severe adverse reactions, such as severe nausea, vomiting, chest pain, hyperventilation,
tachycardia, seizures, and cardiovascular collapse, and should be avoided (B). Although a
smoking cessation program is always a good health recommendation (A), it is not a priority with
Antabuse. (C) is inaccurate. Small amounts, as little as 7 ml, of mouthwash or cough syrup that
contains alcohol can precipitate a disulfiram reaction and should not be used (D).
Which prescription should the practical nurse administer for a client who is experiencing an
acute episode of bronchial asthma?
A) Nedocromil (Tilade).
B) Albuterol (Proventil).
C) Zafirlukast (Accolate).
D) Triamcinolone (Azmacort). - ANSWER-B) Albuterol (Proventil).
Feedback:
Albuterol (Proventil) (B), an adrenergic agonist, is the first line of treatment for acute episodes
of bronchial asthma. (A, C, and D) are maintenance medications used in the prevention of
asthmatic episodes and are routinely taken every day, not during an acute episode.