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Question 1
A patient with bacterial pneumonia is prescribed amoxicillin 500 mg PO every 8
hours. The patient reports a history of penicillin allergy causing hives. What is the
best nursing action?
A. Administer the medication as prescribed.
B. Hold the medication and notify the prescriber.
C. Administer with an antihistamine to prevent reaction.
D. Document the allergy but give a test dose.
Answer: B. Hold the medication and notify the prescriber.
Rationale:
Amoxicillin is a penicillin-class antibiotic. A patient with a history of penicillin
allergy is at risk for anaphylaxis. The correct action is to hold the medication and
contact the prescriber for an alternative antibiotic. Administering a test dose or co-
administering an antihistamine is unsafe.
,Question 2
A patient with hypertension is prescribed lisinopril 10 mg daily. Which
laboratory value should the nurse monitor closely?
A. Serum potassium
B. Blood glucose
C. Hemoglobin
D. Serum calcium
Answer: A. Serum potassium
Rationale:
Lisinopril is an ACE inhibitor. It can increase potassium levels, causing
hyperkalemia. Monitoring serum potassium is essential to prevent cardiac
arrhythmias.
Question 3
A patient is receiving morphine IV for postoperative pain. Which assessment
finding requires immediate intervention?
A. Pain rated 8/10
B. Respiratory rate of 8/min
C. Mild nausea
D. Blood pressure 130/80 mmHg
Answer: B. Respiratory rate of 8/min
Rationale:
Morphine is an opioid that can cause respiratory depression. A respiratory rate
below 10/min is a critical sign requiring intervention (e.g., opioid reversal with
naloxone and respiratory support).
,Question 4
A patient taking metformin for type 2 diabetes reports fatigue and muscle
cramps. Which lab test is most important to evaluate?
A. Serum creatinine
B. Hemoglobin A1c
C. Blood glucose
D. Serum potassium
Answer: A. Serum creatinine
Rationale:
Metformin is contraindicated in renal impairment due to the risk of lactic acidosis.
Fatigue and muscle cramps may indicate decreased kidney function. Monitoring
serum creatinine ensures safe use.
Question 5
Which drug is commonly prescribed for major depressive disorder and works by
selectively inhibiting serotonin reuptake?
A. Fluoxetine
B. Diazepam
C. Lithium
D. Haloperidol
Answer: A. Fluoxetine
Rationale:
Fluoxetine is an SSRI, increasing serotonin availability in the CNS. Diazepam is
an anxiolytic, lithium is a mood stabilizer, and haloperidol is an antipsychotic.
, Question 6
A patient is prescribed furosemide 40 mg PO daily. The nurse should monitor for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B. Hypokalemia
Rationale:
Furosemide is a loop diuretic that increases potassium excretion. Hypokalemia can
lead to cardiac arrhythmias; potassium levels should be monitored.
Question 7
A patient receives nitroglycerin sublingual for chest pain. Which instruction is
important?
A. Take at the onset of chest pain, and call EMS if pain persists after 3 doses.
B. Take on an empty stomach only.
C. Avoid use of any antihypertensive medications.
D. Swallow the tablet whole with water.
Answer: A. Take at the onset of chest pain, and call EMS if pain persists after 3
doses.
Rationale:
Nitroglycerin sublingual relieves angina by vasodilation. If chest pain persists after
3 doses (5 minutes apart), emergency medical attention is necessary. Tablets
should be dissolved under the tongue, not swallowed.