1. A client takes aluminum hydroxide for GERD. What adverse
effect should the nurse monitor?
A. Diarrhea
B. Constipation
C. Hypokalemia
D. Rash
Answer: B
Rationale: Aluminum-based antacids commonly cause
constipation.
2. 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.
3. 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.
4. 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.
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 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. A client with COPD is on prednisone. Which instruction is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
, C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding and
ulcers. Tarry stools may indicate bleeding.
8. 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.
9. 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.
10. 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
effect should the nurse monitor?
A. Diarrhea
B. Constipation
C. Hypokalemia
D. Rash
Answer: B
Rationale: Aluminum-based antacids commonly cause
constipation.
2. 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.
3. 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.
4. 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.
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 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. A client with COPD is on prednisone. Which instruction is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
, C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding and
ulcers. Tarry stools may indicate bleeding.
8. 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.
9. 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.
10. 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
