Questions with Rationale 2023-2024
1)Anurseiscaringforaclientwithhyperparathyroidismandnotesthattheclient'sserum calcium level
is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the
client?
1. Calciumchloride
2. Calciumgluconate
3. Calcitonin(Miacalcin)
4. Large doses of vitamin D 3.Calcitonin(Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia.
Calciumgluconateandcalciumchloridearemedicationsusedforthetreatmentoftetany,which occurs
as aresult ofacute hypocalcemia.In hypercalcemia, largedoses ofvitamin Dneed to be avoided.
Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption
and lowering the serum calcium concentration.
10.) Theclinicnurseisperforminganadmissionassessmentonaclient.Thenursenotesthatthe client
is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect
that the client is being treated for:
1. Acne
2. Eczema
3. Hairloss
4. Herpes simplex 1.Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to
workbysuppressingthegrowthofPropionibacteriumacnesanddecreasingtheproliferationof
keratinocytes. Options 2, 3, and 4 are incorrect.
100.) Saquinavir(Invirase)isprescribedfortheclientwhoishumanimmunodeficiencyvirus
seropositive. The nurse reinforces medication instructions and tells the client to:
1. Avoidsunexposure.
2. Eatlow-caloriefoods.
3. Eatfoodsthatarelowin fat.
4. Takethemedicationonanemptystomach. 1.Avoidsunexposure.
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Questions with Rationale 2023-2024
Rationale:
Saquinavir (Invirase) is an antiretroviral (protease inhibitor) used with other antiretroviral
medications to manage human immunodeficiency virus infection. Saquinavir is administered
withmealsandisbestabsorbediftheclientconsumeshigh-calorie,high-fatmeals.Saquinavir can
cause photosensitivity, and the nurse should instruct the client to avoid sun exposure.
101.) Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the
interventionsthatthenurseincludeswhenadministeringthismedication.Selectallthatapply.
1. Restrictfluidintake.
2. Instructtheclienttoavoidalcohol.
3. Monitorhepaticandliverfunctionstudies.
4. Administerthemedicationwithanantacid.
5. Instructtheclienttoavoidexposuretothe sun.
6. Administerthemedicationonanemptystomach. 2.Instructtheclienttoavoidalcohol.
3.Monitorhepaticandliverfunctionstudies.
5.Instructtheclienttoavoidexposuretothesun.
Rationale:
Ketoconazole is an antifungal medication. It is administered with food (not on an empty
stomach)andantacidsareavoidedfor2hoursaftertakingthemedicationtoensureabsorption. The
medication is hepatotoxic and the nurse monitors liver function studies. The client is instructed
toavoid exposureto thesun because themedication increasesphotosensitivity.The client is
alsoinstructed toavoid alcohol. Thereisnoreason for theclient torestrict fluid intake. In fact, this
could be harmful to the client.
102.) Aclientwithhumanimmunodeficiencyvirusistakingnevirapine(Viramune).Thenurse
should monitor for which adverse effects of the medication? Select all that apply.
1. Rash
2. Hepatotoxicity
3. Hyperglycemia
4. Peripheralneuropathy
5. Reducedbonemineraldensity 1. Rash
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Questions with Rationale 2023-2024
2. Hepatotoxicity
Rationale:
Nevirapine(Viramune)isanon-nucleosidereversetranscriptaseinhibitors(NRTI)thatisusedto treat
HIV infection. It is used in combination with other antiretroviral medications to treat HIV.
Adverseeffectsincluderash,Stevens-Johnsonsyndrome,hepatitis,andincreasedtransaminase
levels.Hyperglycemia,peripheralneuropathy,andreducedbonedensityarenotadverseeffects of
this medication.
103.) Anurseis caringfor ahospitalizedclient whohasbeentakingclozapine(Clozaril)forthe
treatmentofaschizophrenicdisorder.Whichlaboratorystudyprescribedfortheclientwillthe nurse
specifically review to monitor for an adverse effect associated with the use of this
medication?
1. Plateletcount
2. Cholesterollevel
3. Whitebloodcellcount
4. Blood urea nitrogen level 3.Whitebloodcellcount
Rationale:
Hematologicalreactionscanoccurintheclienttakingclozapineandincludeagranulocytosisand mild
leukopenia. The white blood cell count should be checked before initiating treatment and
should be monitored closely during the use of this medication. The client should also be
monitored for signs indicating agranulocytosis, which may include sore throat, malaise, and
fever. Options 1, 2, and 4 are unrelated to this medication.
104.) Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care
clinic.Thenurseiscollectingdataontheclientandisprovidinginstructionsregardingtheuseof this
medication. Which is most important for the nurse to determine before administration of this
medication?
1.Ahistoryofhyperthyroidism
2.Ahistoryofdiabetesinsipidus
3. Whenthelastfullmealwasconsumed
4. Whenthelastalcoholicdrinkwasconsumed4.Whenthelastalcoholicdrinkwasconsumed
Rationale:
Disulfiramisusedasanadjuncttreatmentforselectedclientswithchronicalcoholismwhowant
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Questions with Rationale 2023-2024
toremain in astate ofenforced sobriety.Clients must abstain from alcoholintakefor at least 12
hours before the initial dose of the medication is administered. The most important data are to
determine when the last alcoholic drink was consumed. The medication is used with caution in
clientswithdiabetesmellitus,hypothyroidism,epilepsy,cerebraldamage,nephritis,andhepatic
disease.Itisalsocontraindicatedinsevereheartdisease,psychosis,orhypersensitivityrelatedto the
medication.
105.) A nurse is collecting data from a client and the client's spouse reports that the client is
takingdonepezilhydrochloride(Aricept).Whichdisorderwouldthenursesuspectthatthisclient may
have based on the use of this medication?
1. Dementia
2. Schizophrenia
3. Seizuredisorder
4. Obsessive-compulsive disorder 1.Dementia
Rationale:
Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate
dementia of the Alzheimer type. It enhances cholinergic functions by increasing the
concentrationofacetylcholine.ItslowstheprogressionofAlzheimer'sdisease.Options2,3,and 4 are
incorrect.
106.) Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the
clientregardingtheadministrationofthemedication.Whichstatementbytheclientindicatesan
understanding about administration of the medication?
1. "Ishouldtakethemedicationwithmyeveningmeal."
2. "Ishouldtakethemedicationatnoonwithanantacid."
3. "IshouldtakethemedicationinthemorningwhenIfirstarise."
4. "I should take the medication right before bedtime with a snack." 3."Ishouldtakethe
medication in the morning when I first arise."
Rationale:
Fluoxetinehydrochlorideisadministeredintheearlymorningwithoutconsiderationtomeals.
**Eliminateoptions1,2,and4becausetheyarecomparableoralikeandindicatetakingthe medication
with an antacid or food.**
107.) Aclientreceivingatricyclicantidepressantarrivesatthementalhealthclinic.Which