1. A client receiving amphotericin B develops chills and fever.
What should the nurse do?
A. Stop the infusion
B. Document findings
C. Pre-medicate with acetaminophen
D. Increase infusion rate
Answer: C
Rationale: Infusion reactions are common. Premedication with
acetaminophen or diphenhydramine is standard.
2. Which statement indicates proper understanding of enoxaparin
(Lovenox) administration?
A. “I will inject it into my thigh muscle.”
B. “I will rub the site after injection.”
C. “I will inject it into my belly fat.”
D. “I must monitor my INR daily.”
Answer: C
Rationale: Enoxaparin is given subcutaneously, preferably in the
abdomen, and INR monitoring is not required.
3. A client on sertraline reports increased restlessness and
confusion. What should the nurse suspect?
A. Extrapyramidal symptoms
B. Lithium toxicity
C. Serotonin syndrome
D. Neuroleptic malignant syndrome
,Answer: C
Rationale: Serotonin syndrome includes agitation, confusion,
tachycardia, and hyperreflexia.
4. A client with a penicillin allergy is prescribed cephalexin. What
is the nurse’s priority?
A. Administer as ordered
B. Ask about previous reaction type
C. Hold the dose for 30 minutes
D. Give with food
Answer: B
Rationale: Cross-sensitivity may occur. Ask if the client had a true
anaphylactic reaction before administering.
5. A client taking omeprazole asks why it is prescribed. Which
response is correct?
A. "It coats the lining of the stomach."
B. "It neutralizes gastric acid."
C. "It blocks acid production."
D. "It stimulates protective mucus production."
Answer: C
Rationale: Omeprazole is a proton pump inhibitor (PPI) that
blocks gastric acid secretion.
6. A client receiving methotrexate for cancer reports mouth sores.
What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
, C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral care
is essential to prevent infection and discomfort.
7. A nurse gives regular insulin subcutaneously at 0700. At what
time should the nurse monitor for signs of hypoglycemia?
A. 0715
B. 0800
C. 0930
D. 1200
Answer: C
Rationale: Regular insulin peaks in 2–4 hours. Hypoglycemia is
most likely around 0930–1100.
8. A client with herpes simplex is prescribed acyclovir. What is the
most important teaching?
A. "Take on an empty stomach."
B. "Drink plenty of fluids."
C. "Discontinue when symptoms improve."
D. "Expect yellowing of the eyes."
Answer: B
Rationale: Acyclovir can cause nephrotoxicity. Hydration is
essential to reduce the risk.
9. A nurse teaches a client taking cyclobenzaprine. Which
statement indicates understanding?
What should the nurse do?
A. Stop the infusion
B. Document findings
C. Pre-medicate with acetaminophen
D. Increase infusion rate
Answer: C
Rationale: Infusion reactions are common. Premedication with
acetaminophen or diphenhydramine is standard.
2. Which statement indicates proper understanding of enoxaparin
(Lovenox) administration?
A. “I will inject it into my thigh muscle.”
B. “I will rub the site after injection.”
C. “I will inject it into my belly fat.”
D. “I must monitor my INR daily.”
Answer: C
Rationale: Enoxaparin is given subcutaneously, preferably in the
abdomen, and INR monitoring is not required.
3. A client on sertraline reports increased restlessness and
confusion. What should the nurse suspect?
A. Extrapyramidal symptoms
B. Lithium toxicity
C. Serotonin syndrome
D. Neuroleptic malignant syndrome
,Answer: C
Rationale: Serotonin syndrome includes agitation, confusion,
tachycardia, and hyperreflexia.
4. A client with a penicillin allergy is prescribed cephalexin. What
is the nurse’s priority?
A. Administer as ordered
B. Ask about previous reaction type
C. Hold the dose for 30 minutes
D. Give with food
Answer: B
Rationale: Cross-sensitivity may occur. Ask if the client had a true
anaphylactic reaction before administering.
5. A client taking omeprazole asks why it is prescribed. Which
response is correct?
A. "It coats the lining of the stomach."
B. "It neutralizes gastric acid."
C. "It blocks acid production."
D. "It stimulates protective mucus production."
Answer: C
Rationale: Omeprazole is a proton pump inhibitor (PPI) that
blocks gastric acid secretion.
6. A client receiving methotrexate for cancer reports mouth sores.
What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
, C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral care
is essential to prevent infection and discomfort.
7. A nurse gives regular insulin subcutaneously at 0700. At what
time should the nurse monitor for signs of hypoglycemia?
A. 0715
B. 0800
C. 0930
D. 1200
Answer: C
Rationale: Regular insulin peaks in 2–4 hours. Hypoglycemia is
most likely around 0930–1100.
8. A client with herpes simplex is prescribed acyclovir. What is the
most important teaching?
A. "Take on an empty stomach."
B. "Drink plenty of fluids."
C. "Discontinue when symptoms improve."
D. "Expect yellowing of the eyes."
Answer: B
Rationale: Acyclovir can cause nephrotoxicity. Hydration is
essential to reduce the risk.
9. A nurse teaches a client taking cyclobenzaprine. Which
statement indicates understanding?
