1. A client started on fluoxetine 5 days ago reports increased
energy and planning their funeral. What should the nurse do?
A. Encourage journaling
B. Monitor sleep
C. Notify the provider immediately
D. Provide distraction techniques
Answer: C
Rationale: Increased energy + suicidal ideation early in SSRI
therapy is dangerous and should be reported.
2. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Answer: B
Rationale: Metoprolol can cause bradycardia. Always check HR
before administering.
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 is prescribed exenatide. What is a common side effect?
A. Hyperglycemia
B. Constipation
C. Nausea
D. Tachycardia
Answer: C
Rationale: Exenatide can cause nausea, especially when initiating
therapy. It’s an injectable incretin mimetic.
5. A nurse is teaching a client about hydroxychloroquine for lupus.
What adverse effect should be reported immediately?
A. Dizziness
B. Blurred vision
C. Dry mouth
D. Rash
Answer: B
Rationale: Retinal damage is a serious side effect. Clients need
regular eye exams.
6. A client is started on lorazepam for anxiety. Which teaching
point is essential?
A. “Avoid grapefruit juice.”
B. “Take with NSAIDs.”
C. “Do not stop abruptly.”
, D. “It may take weeks to work.”
Answer: C
Rationale: Benzodiazepines must be tapered to prevent
withdrawal symptoms and seizures.
7. A client with hypothyroidism takes levothyroxine. Which
statement indicates effective therapy?
A. “I feel cold all the time.”
B. “My heart rate is slower than usual.”
C. “I have more energy now.”
D. “I’m gaining weight quickly.”
Answer: C
Rationale: Increased energy suggests improved thyroid function.
8. A client is prescribed loperamide. Which condition is a
contraindication?
A. IBS
B. Infectious diarrhea
C. Traveler’s diarrhea
D. Post-antibiotic diarrhea
Answer: B
Rationale: Do not use antidiarrheals in infectious diarrhea, as it
may retain toxins in the bowel.
9. A nurse is teaching a client how to apply clotrimazole vaginal
cream. What instruction is correct?
A. Use during menstruation
B. Stop once symptoms go away
energy and planning their funeral. What should the nurse do?
A. Encourage journaling
B. Monitor sleep
C. Notify the provider immediately
D. Provide distraction techniques
Answer: C
Rationale: Increased energy + suicidal ideation early in SSRI
therapy is dangerous and should be reported.
2. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Answer: B
Rationale: Metoprolol can cause bradycardia. Always check HR
before administering.
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 is prescribed exenatide. What is a common side effect?
A. Hyperglycemia
B. Constipation
C. Nausea
D. Tachycardia
Answer: C
Rationale: Exenatide can cause nausea, especially when initiating
therapy. It’s an injectable incretin mimetic.
5. A nurse is teaching a client about hydroxychloroquine for lupus.
What adverse effect should be reported immediately?
A. Dizziness
B. Blurred vision
C. Dry mouth
D. Rash
Answer: B
Rationale: Retinal damage is a serious side effect. Clients need
regular eye exams.
6. A client is started on lorazepam for anxiety. Which teaching
point is essential?
A. “Avoid grapefruit juice.”
B. “Take with NSAIDs.”
C. “Do not stop abruptly.”
, D. “It may take weeks to work.”
Answer: C
Rationale: Benzodiazepines must be tapered to prevent
withdrawal symptoms and seizures.
7. A client with hypothyroidism takes levothyroxine. Which
statement indicates effective therapy?
A. “I feel cold all the time.”
B. “My heart rate is slower than usual.”
C. “I have more energy now.”
D. “I’m gaining weight quickly.”
Answer: C
Rationale: Increased energy suggests improved thyroid function.
8. A client is prescribed loperamide. Which condition is a
contraindication?
A. IBS
B. Infectious diarrhea
C. Traveler’s diarrhea
D. Post-antibiotic diarrhea
Answer: B
Rationale: Do not use antidiarrheals in infectious diarrhea, as it
may retain toxins in the bowel.
9. A nurse is teaching a client how to apply clotrimazole vaginal
cream. What instruction is correct?
A. Use during menstruation
B. Stop once symptoms go away
