1. A nurse is reviewing a client’s chart who is prescribed
gentamicin. Which finding should concern the nurse most?
A. Tinnitus
B. WBC 10,000
C. Urine output 50 mL/hr
D. Temperature 100.2°F
Answer: A
Rationale: Tinnitus is a sign of ototoxicity, a serious adverse effect
of gentamicin.
2. A client is taking diphenhydramine. Which side effect is most
likely?
A. Hypertension
B. Drowsiness
C. Diarrhea
D. Insomnia
Answer: B
Rationale: First-generation antihistamines like diphenhydramine
cause sedation and drowsiness.
3. A client taking haloperidol develops a high fever and muscle
rigidity. What should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome (NMS)
C. Tardive dyskinesia
D. Extrapyramidal symptoms (EPS)
,Answer: B
Rationale: NMS is a rare but fatal reaction to antipsychotics.
Requires immediate intervention.
4. 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.
5. A client is prescribed loratadine for seasonal allergies. What is a
key difference from diphenhydramine?
A. Loratadine causes more drowsiness
B. Loratadine causes GI upset
C. Loratadine is non-sedating
D. Loratadine is only available IV
Answer: C
Rationale: Second-generation antihistamines like loratadine are
non-sedating.
6. A nurse monitors a client taking lamotrigine. What adverse
effect should prompt discontinuation?
A. Rash
B. Constipation
C. Nausea
, D. Drowsiness
Answer: A
Rationale: Lamotrigine can cause a life-threatening rash (e.g.,
Stevens-Johnson syndrome). Report immediately.
7. A client taking furosemide reports muscle cramps. Which lab
value correlates with this symptom?
A. Sodium 142
B. Potassium 2.9
C. Chloride 101
D. Magnesium 2.0
Answer: B
Rationale: Furosemide can cause hypokalemia, which leads to
muscle cramps. Normal potassium: 3.5–5.0.
8. 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.
9. A client taking omeprazole asks why it is prescribed. Which
response is correct?
A. "It coats the lining of the stomach."
gentamicin. Which finding should concern the nurse most?
A. Tinnitus
B. WBC 10,000
C. Urine output 50 mL/hr
D. Temperature 100.2°F
Answer: A
Rationale: Tinnitus is a sign of ototoxicity, a serious adverse effect
of gentamicin.
2. A client is taking diphenhydramine. Which side effect is most
likely?
A. Hypertension
B. Drowsiness
C. Diarrhea
D. Insomnia
Answer: B
Rationale: First-generation antihistamines like diphenhydramine
cause sedation and drowsiness.
3. A client taking haloperidol develops a high fever and muscle
rigidity. What should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome (NMS)
C. Tardive dyskinesia
D. Extrapyramidal symptoms (EPS)
,Answer: B
Rationale: NMS is a rare but fatal reaction to antipsychotics.
Requires immediate intervention.
4. 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.
5. A client is prescribed loratadine for seasonal allergies. What is a
key difference from diphenhydramine?
A. Loratadine causes more drowsiness
B. Loratadine causes GI upset
C. Loratadine is non-sedating
D. Loratadine is only available IV
Answer: C
Rationale: Second-generation antihistamines like loratadine are
non-sedating.
6. A nurse monitors a client taking lamotrigine. What adverse
effect should prompt discontinuation?
A. Rash
B. Constipation
C. Nausea
, D. Drowsiness
Answer: A
Rationale: Lamotrigine can cause a life-threatening rash (e.g.,
Stevens-Johnson syndrome). Report immediately.
7. A client taking furosemide reports muscle cramps. Which lab
value correlates with this symptom?
A. Sodium 142
B. Potassium 2.9
C. Chloride 101
D. Magnesium 2.0
Answer: B
Rationale: Furosemide can cause hypokalemia, which leads to
muscle cramps. Normal potassium: 3.5–5.0.
8. 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.
9. A client taking omeprazole asks why it is prescribed. Which
response is correct?
A. "It coats the lining of the stomach."
