1. A nurse is preparing to administer warfarin to a client who has a new onset of
atrial fibrillation. The client asks the nurse, “What does this medication do?”
Which of the following responses should the nurse make?
a. “It helps your heart return to a normal rhythm.”
b. “It dissolves blood clots.”
c. “It can reduce your risk of having a stroke.”
d. “It helps to prevent bleeding in atrial fibrillation.”
Rationale: C. The nurse should identify that atrial fibrillation increases the
client’s risk of having a stroke due to clot formation in the atrium. Warfarin
can prevent clot formation when used long term, which will reduce the
client’s risk of having a stroke.
2. A nurse is caring for a client who has diabetes insipidus. Which of the following
laboratory values should the nurse identify as reflecting a contraindication to
receiving vasopressin to treat this disorder?
e. Sodium 152 mEq/L
f. Potassium 6.0 mEq/L
g. Creatinine clearance 50 mL/min
h. Aspartate aminotransferase (AST) 52 units/L
Rationale: C. Creatinine clearance should be above 87 mL/min for female
clients and above 107 mL/min for male clients. A creatinine clearance of 50
mL/min indicates renal impairment and is a contraindication to receiving
vasopressin. Renal impairment increases the likelihood of the life-
threatening adverse effect of water intoxication
3. A nurse is reviewing the medication history of a client who has mild
intermittent asthma. The nurse should anticipate a prescription for which of the
following inhalers for the client?
i. Ipratropium
j. Albuterol sulfate
k. Tiotropium
l. Budesonide
Rationale: B. The nurse should anticipate a client who has mild intermittent
asthma to be prescribed albuterol sulfate. Albuterol sulfate is a short acting
, beta2-agonist that activates beta2-receptors in the smooth muscle of the
lung, allowing the client’s airway and lungs to dilate, thereby relieving
bronchospasm and allowing the client to breathe.
4. A nurse is caring for a client who has a dry nonproductive cough. Which of the
following types of medication should the nurse recommend?
m. Expectorant
n. Mucolytic
o. Bronchodilator
p. Antitussive
Rationale: D. Antitussives suppress the cough reflex. Expectorants help
mobilize secretions. Mucolytics help liquefy secretions.
5. A nurse is caring for a client who has heart failure and is taking oral furosemide
40 mg daily. For which of the following adverse effects should the client be
taught to monitor and notify the provider if it occurs?
q. Nasal congestion
r. Tremors
s. Tinnitus
t. Frontal headache
Rationale: C. Loop diuretics such as furosemide can cause ototoxicity. The
client should be taught to notify the provider if tinnitus, a full feeling in the
ears, or hearing loss occurs.
6. A nurse is monitoring a client who is receiving terbutaline to suppress preterm
labor. Which of the following findings should indicate to the nurse that the
client is experiencing an adverse effect of the medication?
u. BP 132/84 mmHg
v. Blood glucose 106 mg/dL
w. Decreased deep tendon reflexes
x. Maternal heart rate >120/min
Rationale: D. A client who is receiving terbutaline can experience
tachycardia, which poses a significant risk to the mother. Therefore, when
the maternal heart rate exceeds 120/min, the medication should be stopped.
, Adverse effects result from activating beta 1 receptors as well as beta2
receptors.
7. A nurse is teaching about levodopa with a family member of a client who has
Parkinson’s disease. Which of the following pieces of information should the
nurse include?
y. “A full therapeutic response may take several months to happen.”
z. “This medication should be taken with high-protein foods.”
aa. “A full therapeutic response might cause vivid dreams.”
bb.“The medication is given at the onset of mild symptoms.”
Rationale: A. The nurse should inform the family member that although
levodopa is the most effective medication for Parkinson’s disease, a full
therapeutic response might not occur for several months. Amino acids
compete with levodopa for intestinal absorption. Therefore, high-protein
foods decrease the therapeutic effects of levodopa. Vivid dreams may occur
with levodopa as an adverse effect.
8. A nurse is preparing to administer a hydromorphone IV infusion to a client for
pain. Which of the following actions should the nurse take?
cc. Administer the medication over 4 to 5 minutes
dd.Place the client in a high-Fowler’s position
ee. Assess the client’s pain level after administering the medication
ff. Review the client’s last set of vital signs
Rationale: A. The nurse should administer the IV injection of this opioid
medication over 4 to 5 minutes to prevent the adverse effects of the
medication such as respiratory depression and cardiac arrest. The nurse
should place the client supine during administration to prevent hypotension.
9. A nurse is caring for a client who has a new prescription for ergotamine. The
nurse should recognize that ergotamine is administered to treat which of the
following conditions?
gg.Raynaud’s phenomenon
hh.Migraine headaches
ii. Ulcerative colitis
jj. Anemia
atrial fibrillation. The client asks the nurse, “What does this medication do?”
Which of the following responses should the nurse make?
a. “It helps your heart return to a normal rhythm.”
b. “It dissolves blood clots.”
c. “It can reduce your risk of having a stroke.”
d. “It helps to prevent bleeding in atrial fibrillation.”
Rationale: C. The nurse should identify that atrial fibrillation increases the
client’s risk of having a stroke due to clot formation in the atrium. Warfarin
can prevent clot formation when used long term, which will reduce the
client’s risk of having a stroke.
2. A nurse is caring for a client who has diabetes insipidus. Which of the following
laboratory values should the nurse identify as reflecting a contraindication to
receiving vasopressin to treat this disorder?
e. Sodium 152 mEq/L
f. Potassium 6.0 mEq/L
g. Creatinine clearance 50 mL/min
h. Aspartate aminotransferase (AST) 52 units/L
Rationale: C. Creatinine clearance should be above 87 mL/min for female
clients and above 107 mL/min for male clients. A creatinine clearance of 50
mL/min indicates renal impairment and is a contraindication to receiving
vasopressin. Renal impairment increases the likelihood of the life-
threatening adverse effect of water intoxication
3. A nurse is reviewing the medication history of a client who has mild
intermittent asthma. The nurse should anticipate a prescription for which of the
following inhalers for the client?
i. Ipratropium
j. Albuterol sulfate
k. Tiotropium
l. Budesonide
Rationale: B. The nurse should anticipate a client who has mild intermittent
asthma to be prescribed albuterol sulfate. Albuterol sulfate is a short acting
, beta2-agonist that activates beta2-receptors in the smooth muscle of the
lung, allowing the client’s airway and lungs to dilate, thereby relieving
bronchospasm and allowing the client to breathe.
4. A nurse is caring for a client who has a dry nonproductive cough. Which of the
following types of medication should the nurse recommend?
m. Expectorant
n. Mucolytic
o. Bronchodilator
p. Antitussive
Rationale: D. Antitussives suppress the cough reflex. Expectorants help
mobilize secretions. Mucolytics help liquefy secretions.
5. A nurse is caring for a client who has heart failure and is taking oral furosemide
40 mg daily. For which of the following adverse effects should the client be
taught to monitor and notify the provider if it occurs?
q. Nasal congestion
r. Tremors
s. Tinnitus
t. Frontal headache
Rationale: C. Loop diuretics such as furosemide can cause ototoxicity. The
client should be taught to notify the provider if tinnitus, a full feeling in the
ears, or hearing loss occurs.
6. A nurse is monitoring a client who is receiving terbutaline to suppress preterm
labor. Which of the following findings should indicate to the nurse that the
client is experiencing an adverse effect of the medication?
u. BP 132/84 mmHg
v. Blood glucose 106 mg/dL
w. Decreased deep tendon reflexes
x. Maternal heart rate >120/min
Rationale: D. A client who is receiving terbutaline can experience
tachycardia, which poses a significant risk to the mother. Therefore, when
the maternal heart rate exceeds 120/min, the medication should be stopped.
, Adverse effects result from activating beta 1 receptors as well as beta2
receptors.
7. A nurse is teaching about levodopa with a family member of a client who has
Parkinson’s disease. Which of the following pieces of information should the
nurse include?
y. “A full therapeutic response may take several months to happen.”
z. “This medication should be taken with high-protein foods.”
aa. “A full therapeutic response might cause vivid dreams.”
bb.“The medication is given at the onset of mild symptoms.”
Rationale: A. The nurse should inform the family member that although
levodopa is the most effective medication for Parkinson’s disease, a full
therapeutic response might not occur for several months. Amino acids
compete with levodopa for intestinal absorption. Therefore, high-protein
foods decrease the therapeutic effects of levodopa. Vivid dreams may occur
with levodopa as an adverse effect.
8. A nurse is preparing to administer a hydromorphone IV infusion to a client for
pain. Which of the following actions should the nurse take?
cc. Administer the medication over 4 to 5 minutes
dd.Place the client in a high-Fowler’s position
ee. Assess the client’s pain level after administering the medication
ff. Review the client’s last set of vital signs
Rationale: A. The nurse should administer the IV injection of this opioid
medication over 4 to 5 minutes to prevent the adverse effects of the
medication such as respiratory depression and cardiac arrest. The nurse
should place the client supine during administration to prevent hypotension.
9. A nurse is caring for a client who has a new prescription for ergotamine. The
nurse should recognize that ergotamine is administered to treat which of the
following conditions?
gg.Raynaud’s phenomenon
hh.Migraine headaches
ii. Ulcerative colitis
jj. Anemia
