1. A client taking phenytoin shows swollen, bleeding gums. What
should the nurse recommend?
A. Discontinue the drug
B. Increase fluid intake
C. Practice good oral hygiene
D. Reduce dietary sugar
Answer: C
Rationale: Gingival hyperplasia is a known side effect. Encourage
oral care, not discontinuation.
2. A client is prescribed bupropion for smoking cessation. Which
side effect is most serious?
A. Dry mouth
B. Insomnia
C. Seizures
D. Weight loss
Answer: C
Rationale: Bupropion lowers seizure threshold. Clients at risk (e.g.,
with eating disorders) need close monitoring.
3. A client with myasthenia gravis is prescribed neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic crisis,
requiring dosage adjustment.
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 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.
6. 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.
7. A nurse teaches a client taking cyclobenzaprine. Which
statement indicates understanding?
A. “I will take this long-term.”
B. “I can drink alcohol in moderation.”
C. “I should avoid driving until I know how it affects me.”
, D. “It will help my heart condition.”
Answer: C
Rationale: Cyclobenzaprine causes drowsiness. Clients should
avoid driving or alcohol initially.
8. What lab value should be monitored in a client receiving
propylthiouracil (PTU)?
A. Glucose
B. TSH and T3/T4
C. Calcium
D. Sodium
Answer: B
Rationale: PTU suppresses thyroid hormone. Monitor TSH, T3, and
T4 to assess effectiveness.
9. 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.
10. 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
should the nurse recommend?
A. Discontinue the drug
B. Increase fluid intake
C. Practice good oral hygiene
D. Reduce dietary sugar
Answer: C
Rationale: Gingival hyperplasia is a known side effect. Encourage
oral care, not discontinuation.
2. A client is prescribed bupropion for smoking cessation. Which
side effect is most serious?
A. Dry mouth
B. Insomnia
C. Seizures
D. Weight loss
Answer: C
Rationale: Bupropion lowers seizure threshold. Clients at risk (e.g.,
with eating disorders) need close monitoring.
3. A client with myasthenia gravis is prescribed neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic crisis,
requiring dosage adjustment.
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 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.
6. 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.
7. A nurse teaches a client taking cyclobenzaprine. Which
statement indicates understanding?
A. “I will take this long-term.”
B. “I can drink alcohol in moderation.”
C. “I should avoid driving until I know how it affects me.”
, D. “It will help my heart condition.”
Answer: C
Rationale: Cyclobenzaprine causes drowsiness. Clients should
avoid driving or alcohol initially.
8. What lab value should be monitored in a client receiving
propylthiouracil (PTU)?
A. Glucose
B. TSH and T3/T4
C. Calcium
D. Sodium
Answer: B
Rationale: PTU suppresses thyroid hormone. Monitor TSH, T3, and
T4 to assess effectiveness.
9. 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.
10. 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
