1. A nurse is teaching a client with a new prescription for ciprofloxacin. Which statement by
the client indicates an understanding of the teaching?
A) “I will take this medication with a multivitamin containing iron.”
B) “I should avoid dairy products and antacids within 2 hours of taking the medication.”
C) “I will stop taking the medication once my symptoms improve.”
D) “This medication will turn my urine a harmless orange-red color.”
Correct Answer: B
Rationale: Ciprofloxacin absorption is reduced by divalent cations (calcium, magnesium,
aluminum, iron). Dairy and antacids should be avoided within 2 hours. The full course must be
completed. Urine discoloration is typical of rifampin and phenazopyridine, not ciprofloxacin.
2. A client is prescribed vancomycin IV. The nurse should monitor for which serious adverse
effects?
A) Hepatotoxicity and hyperglycemia
B) Ototoxicity and nephrotoxicity
C) Cardiotoxicity and hypokalemia
D) Pulmonary toxicity and thrombocytopenia
Correct Answer: B
Rationale: Vancomycin can cause ototoxicity and nephrotoxicity, especially with high doses or in
combination with other nephrotoxic drugs. Trough levels are monitored to minimize risk.
,3. A client with a methicillin-resistant Staphylococcus aureus (MRSA) wound infection is
prescribed linezolid. The nurse should monitor for which adverse effect?
A) Myelosuppression
B) Acute kidney injury
C) Hepatotoxicity
D) Hyperkalemia
Correct Answer: A
Rationale: Linezolid can cause reversible myelosuppression (thrombocytopenia, anemia,
leukopenia) and requires periodic CBC monitoring. It also has MAOI activity and interacts with
tyramine.
4. A nurse is teaching a client who is starting metronidazole. Which instruction is most
important?
A) “Take the medication on an empty stomach.”
B) “Avoid alcohol during and for at least 48 hours after completing the medication.”
C) “Your urine will turn reddish-brown.”
D) “You may experience weight gain.”
Correct Answer: B
Rationale: Metronidazole can cause a disulfiram-like reaction with alcohol (severe nausea,
vomiting, flushing). Alcohol must be avoided completely during therapy and for 48 hours after.
5. A client is prescribed doxycycline for a respiratory infection. The nurse should instruct the
client to:
A) Take it with milk to prevent GI upset
B) Avoid direct sunlight and use sunscreen
C) Take it at bedtime only
D) Limit fluid intake to increase concentration
Correct Answer: B
Rationale: Tetracyclines cause photosensitivity; clients should avoid prolonged sun exposure
and use sunscreen. They should not be taken with dairy products, which impair absorption.
6. A nurse is caring for a client receiving gentamicin IV. Which laboratory value is most
important to monitor?
A) Serum sodium
B) Serum creatinine
C) Liver enzymes
D) Blood glucose
,Correct Answer: B
Rationale: Aminoglycosides are nephrotoxic; renal function (BUN, creatinine) and peak/trough
levels must be monitored to prevent kidney damage and ototoxicity.
7. A client with active tuberculosis is prescribed isoniazid, rifampin, pyrazinamide, and
ethambutol. Which adverse effect is associated with ethambutol?
A) Optic neuritis
B) Peripheral neuropathy
C) Hepatotoxicity
D) Hyperuricemia
Correct Answer: A
Rationale: Ethambutol can cause optic neuritis, leading to decreased visual acuity and loss of
color discrimination (red-green). Clients should have baseline and monthly visual testing.
8. A client is prescribed acyclovir for herpes zoster. The nurse should instruct the client to:
A) Take the medication only when lesions are present
B) Start the medication as early as possible after the onset of symptoms
C) Apply the medication directly to open lesions
D) Expect complete eradication of the virus
Correct Answer: B
Rationale: Antivirals like acyclovir are most effective when started within 72 hours of symptom
onset. They reduce severity and duration but do not cure the latent virus.
9. A client with HIV is prescribed zidovudine. The nurse should monitor for which adverse
effect?
A) Pancreatitis
B) Bone marrow suppression
C) Peripheral neuropathy
D) Nephrolithiasis
Correct Answer: B
Rationale: Zidovudine (AZT) commonly causes bone marrow suppression (anemia,
neutropenia). CBC must be monitored regularly.
10. A client is receiving amphotericin B for a systemic fungal infection. The nurse should
monitor for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
, Correct Answer: B
Rationale: Amphotericin B can cause renal potassium wasting, leading to hypokalemia and
hypomagnesemia. Electrolyte levels and renal function are closely monitored.
11. A nurse is teaching a client about the use of oseltamivir for influenza. Which statement by
the client indicates an understanding?
A) “I will take this medication once daily for 10 days.”
B) “This medication will cure my influenza immediately.”
C) “I should start this medication within 48 hours of symptom onset for best effect.”
D) “I can skip doses if I feel better.”
Correct Answer: C
Rationale: Oseltamivir is most effective when started within 48 hours of flu symptoms. It
reduces the duration and severity, but is not a cure. The typical course is 5 days.
12. A client is prescribed nitrofurantoin for a urinary tract infection. The nurse should instruct
the client to:
A) Take the medication on an empty stomach
B) Expect a harmless brownish discoloration of urine
C) Avoid all dairy products
D) Discontinue the medication when symptoms improve
Correct Answer: B
Rationale: Nitrofurantoin can turn urine a harmless brownish color. It should be taken with food
to improve absorption. The full course must be completed.
13. A client with a severe Pseudomonas aeruginosa infection is receiving
piperacillin/tazobactam. The nurse should monitor for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: C
Rationale: Piperacillin is a sodium-containing penicillin; high doses can cause hypernatremia,
especially in clients with renal impairment or heart failure.
14. A nurse is caring for a client receiving clindamycin. The nurse should monitor for which
serious adverse effect?
A) Pseudomembranous colitis
B) Cardiac dysrhythmias
the client indicates an understanding of the teaching?
A) “I will take this medication with a multivitamin containing iron.”
B) “I should avoid dairy products and antacids within 2 hours of taking the medication.”
C) “I will stop taking the medication once my symptoms improve.”
D) “This medication will turn my urine a harmless orange-red color.”
Correct Answer: B
Rationale: Ciprofloxacin absorption is reduced by divalent cations (calcium, magnesium,
aluminum, iron). Dairy and antacids should be avoided within 2 hours. The full course must be
completed. Urine discoloration is typical of rifampin and phenazopyridine, not ciprofloxacin.
2. A client is prescribed vancomycin IV. The nurse should monitor for which serious adverse
effects?
A) Hepatotoxicity and hyperglycemia
B) Ototoxicity and nephrotoxicity
C) Cardiotoxicity and hypokalemia
D) Pulmonary toxicity and thrombocytopenia
Correct Answer: B
Rationale: Vancomycin can cause ototoxicity and nephrotoxicity, especially with high doses or in
combination with other nephrotoxic drugs. Trough levels are monitored to minimize risk.
,3. A client with a methicillin-resistant Staphylococcus aureus (MRSA) wound infection is
prescribed linezolid. The nurse should monitor for which adverse effect?
A) Myelosuppression
B) Acute kidney injury
C) Hepatotoxicity
D) Hyperkalemia
Correct Answer: A
Rationale: Linezolid can cause reversible myelosuppression (thrombocytopenia, anemia,
leukopenia) and requires periodic CBC monitoring. It also has MAOI activity and interacts with
tyramine.
4. A nurse is teaching a client who is starting metronidazole. Which instruction is most
important?
A) “Take the medication on an empty stomach.”
B) “Avoid alcohol during and for at least 48 hours after completing the medication.”
C) “Your urine will turn reddish-brown.”
D) “You may experience weight gain.”
Correct Answer: B
Rationale: Metronidazole can cause a disulfiram-like reaction with alcohol (severe nausea,
vomiting, flushing). Alcohol must be avoided completely during therapy and for 48 hours after.
5. A client is prescribed doxycycline for a respiratory infection. The nurse should instruct the
client to:
A) Take it with milk to prevent GI upset
B) Avoid direct sunlight and use sunscreen
C) Take it at bedtime only
D) Limit fluid intake to increase concentration
Correct Answer: B
Rationale: Tetracyclines cause photosensitivity; clients should avoid prolonged sun exposure
and use sunscreen. They should not be taken with dairy products, which impair absorption.
6. A nurse is caring for a client receiving gentamicin IV. Which laboratory value is most
important to monitor?
A) Serum sodium
B) Serum creatinine
C) Liver enzymes
D) Blood glucose
,Correct Answer: B
Rationale: Aminoglycosides are nephrotoxic; renal function (BUN, creatinine) and peak/trough
levels must be monitored to prevent kidney damage and ototoxicity.
7. A client with active tuberculosis is prescribed isoniazid, rifampin, pyrazinamide, and
ethambutol. Which adverse effect is associated with ethambutol?
A) Optic neuritis
B) Peripheral neuropathy
C) Hepatotoxicity
D) Hyperuricemia
Correct Answer: A
Rationale: Ethambutol can cause optic neuritis, leading to decreased visual acuity and loss of
color discrimination (red-green). Clients should have baseline and monthly visual testing.
8. A client is prescribed acyclovir for herpes zoster. The nurse should instruct the client to:
A) Take the medication only when lesions are present
B) Start the medication as early as possible after the onset of symptoms
C) Apply the medication directly to open lesions
D) Expect complete eradication of the virus
Correct Answer: B
Rationale: Antivirals like acyclovir are most effective when started within 72 hours of symptom
onset. They reduce severity and duration but do not cure the latent virus.
9. A client with HIV is prescribed zidovudine. The nurse should monitor for which adverse
effect?
A) Pancreatitis
B) Bone marrow suppression
C) Peripheral neuropathy
D) Nephrolithiasis
Correct Answer: B
Rationale: Zidovudine (AZT) commonly causes bone marrow suppression (anemia,
neutropenia). CBC must be monitored regularly.
10. A client is receiving amphotericin B for a systemic fungal infection. The nurse should
monitor for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
, Correct Answer: B
Rationale: Amphotericin B can cause renal potassium wasting, leading to hypokalemia and
hypomagnesemia. Electrolyte levels and renal function are closely monitored.
11. A nurse is teaching a client about the use of oseltamivir for influenza. Which statement by
the client indicates an understanding?
A) “I will take this medication once daily for 10 days.”
B) “This medication will cure my influenza immediately.”
C) “I should start this medication within 48 hours of symptom onset for best effect.”
D) “I can skip doses if I feel better.”
Correct Answer: C
Rationale: Oseltamivir is most effective when started within 48 hours of flu symptoms. It
reduces the duration and severity, but is not a cure. The typical course is 5 days.
12. A client is prescribed nitrofurantoin for a urinary tract infection. The nurse should instruct
the client to:
A) Take the medication on an empty stomach
B) Expect a harmless brownish discoloration of urine
C) Avoid all dairy products
D) Discontinue the medication when symptoms improve
Correct Answer: B
Rationale: Nitrofurantoin can turn urine a harmless brownish color. It should be taken with food
to improve absorption. The full course must be completed.
13. A client with a severe Pseudomonas aeruginosa infection is receiving
piperacillin/tazobactam. The nurse should monitor for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Correct Answer: C
Rationale: Piperacillin is a sodium-containing penicillin; high doses can cause hypernatremia,
especially in clients with renal impairment or heart failure.
14. A nurse is caring for a client receiving clindamycin. The nurse should monitor for which
serious adverse effect?
A) Pseudomembranous colitis
B) Cardiac dysrhythmias
