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Question 1:
A nurse is teaching a client who has a new prescription for warfarin. Which of the following client
statements indicates an understanding of the teaching?
A) "I will increase my intake of green leafy vegetables."
B) "I will use a soft-bristled toothbrush."
C) "I can take aspirin if I have a headache."
D) "I do not need to have my blood tested while on this medication."
Correct Answer: B
Rationale: Clients taking anticoagulants like warfarin should use a soft toothbrush to reduce the
risk of bleeding from gingival trauma. Increasing leafy greens (high in vitamin K) decreases
warfarin effectiveness by antagonizing its action, aspirin increases bleeding risk due to
antiplatelet effects, and regular INR blood testing is required to monitor therapeutic levels.
Question 2:
A nurse is preparing to administer atenolol to a client with hypertension. Which of the following
assessment findings should prompt the nurse to withhold the medication?
A) Heart rate of 72 bpm
B) Blood pressure of 148/90 mm Hg
C) Respiratory rate of 20 breaths/min
D) Heart rate of 52 bpm
Correct Answer: D
Rationale: Atenolol, a beta-blocker, can cause bradycardia, so a heart rate below 60 bpm is a
contraindication requiring provider notification. A heart rate of 72 bpm is normal, blood pressure
of 148/90 mm Hg indicates hypertension needing treatment, and a respiratory rate of 20
breaths/min is within normal limits.
Question 3:
A nurse is caring for a client receiving digoxin for heart failure. Which of the following symptoms
should the nurse recognize as an indication of toxicity?
A) Bradycardia and nausea
B) Dry cough
C) Weight gain
D) Hypertension
,Correct Answer: A
Rationale: Digoxin toxicity commonly presents with bradycardia due to increased vagal tone and
nausea from GI irritation. A dry cough is associated with ACE inhibitors, weight gain may
indicate worsening heart failure, and hypertension is not a typical sign of digoxin toxicity.
Question 4:
A nurse is teaching a client about lisinopril for hypertension. Which of the following adverse
effects should the client report immediately?
A) Dizziness when standing up
B) Swelling of the face and tongue
C) Dry cough
D) Fatigue
Correct Answer: B
Rationale: Facial and tongue swelling indicates angioedema, a life-threatening allergic reaction
to ACE inhibitors like lisinopril requiring immediate medical attention. Dizziness is orthostatic
hypotension and should be reported but is less urgent, dry cough is common but not emergent,
and fatigue is mild.
Question 5:
A nurse is administering furosemide IV to a client with pulmonary edema. Which of the following
laboratory values should the nurse monitor closely?
A) Potassium level
B) Blood glucose
C) Hemoglobin
D) Platelet count
Correct Answer: A
Rationale: Furosemide, a loop diuretic, promotes potassium excretion, leading to hypokalemia
that can cause arrhythmias; monitoring is essential. Blood glucose is affected by thiazides,
hemoglobin and platelets are unrelated to diuretic therapy.
Question 6:
A nurse is preparing to administer nitroglycerin sublingual to a client with angina. Which of the
following client instructions should the nurse provide?
A) "Sit or lie down before taking the medication."
B) "Swallow the tablet with water."
C) "Take with food if it causes stomach upset."
D) "Store the tablets in a warm place."
,Correct Answer: A
Rationale: Nitroglycerin causes vasodilation and orthostatic hypotension, so sitting or lying down
prevents falls. Swallowing reduces efficacy, food is not required, and heat degrades the drug.
Question 7:
A nurse is caring for a client receiving amiodarone for atrial fibrillation. Which of the following
findings should the nurse report to the provider?
A) Prolonged QT interval on ECG
B) Blood pressure 120/80 mm Hg
C) Heart rate 80 bpm
D) Weight stable
Correct Answer: A
Rationale: Amiodarone prolongs the QT interval, increasing the risk of torsades de pointes;
ECG monitoring is required. The other findings are normal or expected.
Question 8:
A nurse is teaching a client about clopidogrel following cardiac stent placement. Which of the
following instructions should the nurse include?
A) "Avoid NSAIDs while taking this medication."
B) "Take with antacids to reduce stomach upset."
C) "Stop the medication if bruising occurs."
D) "Expect immediate relief from chest pain."
Correct Answer: A
Rationale: Clopidogrel, an antiplatelet, increases bleeding risk with NSAIDs, which inhibit
platelets; avoidance is essential. Antacids are unnecessary, bruising requires monitoring not
stopping, and it prevents clotting not relieves pain.
Question 9:
A nurse is preparing to administer verapamil to a client with hypertension. Which of the following
medications should the nurse question if ordered concurrently?
A) Digoxin
B) Metformin
C) Atorvastatin
D) Levothyroxine
Correct Answer: A
, Rationale: Verapamil, a calcium channel blocker, increases digoxin levels by inhibiting renal
clearance, risking toxicity. The other medications have no significant interaction with verapamil.
Question 10:
A nurse is caring for a client receiving simvastatin for hyperlipidemia. Which of the following
client education points is important?
A) "Take the medication in the evening."
B) "Consume grapefruit juice daily."
C) "Expect muscle pain as a normal effect."
D) "Take with a high-fat meal."
Correct Answer: A
Rationale: Simvastatin is most effective at night when cholesterol synthesis peaks. Grapefruit
inhibits metabolism increasing toxicity, muscle pain (myopathy) requires reporting, and high-fat
meals are not recommended.
Question 11:
A nurse is administering regular insulin IV to a client with diabetic ketoacidosis. Which of the
following actions should the nurse take?
A) Monitor blood glucose every hour.
B) Administer a bolus of 100 units.
C) Mix with NPH insulin.
D) Infuse at a rate of 1 unit/min.
Correct Answer: A
Rationale: Hourly glucose monitoring guides the insulin infusion rate in DKA to avoid
hypoglycemia. A 100-unit bolus is excessive, mixing with NPH is contraindicated in DKA, and 1
unit/min is too rapid.
Question 12:
A nurse is teaching a client with type 2 diabetes about metformin. Which of the following
adverse effects should the client report immediately?
A) Symptoms of lactic acidosis
B) Mild gastrointestinal upset
C) Weight loss
D) Decreased appetite
Correct Answer: A