1. A client taking carbidopa/levodopa reports facial twitching
and eye spasms. What should the nurse do?
A. Reassure the client this is expected
B. Hold the dose and notify the provider
C. Administer diphenhydramine
D. Document and continue monitoring
Answer: B
Rationale: Facial twitching and spasms are signs of toxicity. Notify
the provider to adjust dosage.
2. 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.
3. 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.
4. A client is receiving morphine IV post-op. Which finding is the
,priority?
A. Nausea
B. Respiratory rate of 8/min
C. Itching
D. Sedation score of 2
Answer: B
Rationale: Respiratory depression (<12/min) is the most life
threatening side effect of opioids.
5. 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.
6. A client prescribed clopidogrel should avoid which over-the
counter medication?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Guaifenesin
Answer: B
Rationale: NSAIDs like ibuprofen increase bleeding risk when
combined with antiplatelet agents like clopidogrel.
7. 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.
8. A client uses sublingual nitroglycerin. Which instruction is
correct?
A. Swallow the pill with water
B. Take up to 3 doses, 5 minutes apart
C. Store it in a warm area
D. Use it once weekly
Answer: B
Rationale: For chest pain, take 1 tablet every 5 minutes, up to 3
doses, and call 911 if no relief after the first.
9. 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.
10. A client with chronic constipation uses magnesium citrate
daily. What risk should the nurse discuss?
A. Hypertension
B. Hypernatremia
C. Electrolyte imbalance
D. Dehydration
Answer: C
and eye spasms. What should the nurse do?
A. Reassure the client this is expected
B. Hold the dose and notify the provider
C. Administer diphenhydramine
D. Document and continue monitoring
Answer: B
Rationale: Facial twitching and spasms are signs of toxicity. Notify
the provider to adjust dosage.
2. 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.
3. 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.
4. A client is receiving morphine IV post-op. Which finding is the
,priority?
A. Nausea
B. Respiratory rate of 8/min
C. Itching
D. Sedation score of 2
Answer: B
Rationale: Respiratory depression (<12/min) is the most life
threatening side effect of opioids.
5. 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.
6. A client prescribed clopidogrel should avoid which over-the
counter medication?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Guaifenesin
Answer: B
Rationale: NSAIDs like ibuprofen increase bleeding risk when
combined with antiplatelet agents like clopidogrel.
7. 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.
8. A client uses sublingual nitroglycerin. Which instruction is
correct?
A. Swallow the pill with water
B. Take up to 3 doses, 5 minutes apart
C. Store it in a warm area
D. Use it once weekly
Answer: B
Rationale: For chest pain, take 1 tablet every 5 minutes, up to 3
doses, and call 911 if no relief after the first.
9. 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.
10. A client with chronic constipation uses magnesium citrate
daily. What risk should the nurse discuss?
A. Hypertension
B. Hypernatremia
C. Electrolyte imbalance
D. Dehydration
Answer: C
