1. A client on lithium therapy has a sodium level of 128 mEq/L.
What is the nurse's best action?
A. Encourage low-sodium diet
B. Administer next dose
C. Hold the dose and notify the provider
D. Increase fluid restriction
Answer: C
Rationale: Hyponatremia can increase lithium toxicity risk. Hold
the dose and notify the provider.
2. A child prescribed methylphenidate for ADHD should be
monitored for which effect?
A. Drowsiness
B. Increased appetite
C. Weight loss and insomnia
D. Bradycardia
Answer: C
Rationale: Stimulants like methylphenidate commonly cause
decreased appetite, insomnia, and weight loss.
3. A client asks about insulin glargine (Lantus). What is the
correct response?
A. “It works immediately.”
B. “It peaks in 4 hours.”
C. “It has no peak and lasts 24 hours.”
D. “It must be mixed with regular insulin.”
Answer: C
Rationale: Glargine is a long-acting insulin with no pronounced
peak, providing steady glucose control.
4. 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.
5. A client taking warfarin has an INR of 4.2. Which action should
the nurse take?
A. Administer the next dose of warfarin
B. Hold the dose and notify the provider
C. Give vitamin K IV immediately
D. Prepare for platelet transfusion
Answer: B
Rationale: An INR >3.0 indicates increased bleeding risk. The
nurse should hold the medication and notify the provider.
6. 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.
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. 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.
9. A client with herpes simplex is prescribed acyclovir. What is the
most important teaching?
A. "Take on an empty stomach."
B. "Drink plenty of fluids."
C. "Discontinue when symptoms improve."
D. "Expect yellowing of the eyes."
Answer: B
Rationale: Acyclovir can cause nephrotoxicity. Hydration is
essential to reduce the risk.
10. A client taking omeprazole asks why it is prescribed. Which
response is correct?
A. "It coats the lining of the stomach."
B. "It neutralizes gastric acid."
C. "It blocks acid production."
D. "It stimulates protective mucus production."
Answer: C
What is the nurse's best action?
A. Encourage low-sodium diet
B. Administer next dose
C. Hold the dose and notify the provider
D. Increase fluid restriction
Answer: C
Rationale: Hyponatremia can increase lithium toxicity risk. Hold
the dose and notify the provider.
2. A child prescribed methylphenidate for ADHD should be
monitored for which effect?
A. Drowsiness
B. Increased appetite
C. Weight loss and insomnia
D. Bradycardia
Answer: C
Rationale: Stimulants like methylphenidate commonly cause
decreased appetite, insomnia, and weight loss.
3. A client asks about insulin glargine (Lantus). What is the
correct response?
A. “It works immediately.”
B. “It peaks in 4 hours.”
C. “It has no peak and lasts 24 hours.”
D. “It must be mixed with regular insulin.”
Answer: C
Rationale: Glargine is a long-acting insulin with no pronounced
peak, providing steady glucose control.
4. 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.
5. A client taking warfarin has an INR of 4.2. Which action should
the nurse take?
A. Administer the next dose of warfarin
B. Hold the dose and notify the provider
C. Give vitamin K IV immediately
D. Prepare for platelet transfusion
Answer: B
Rationale: An INR >3.0 indicates increased bleeding risk. The
nurse should hold the medication and notify the provider.
6. 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.
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. 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.
9. A client with herpes simplex is prescribed acyclovir. What is the
most important teaching?
A. "Take on an empty stomach."
B. "Drink plenty of fluids."
C. "Discontinue when symptoms improve."
D. "Expect yellowing of the eyes."
Answer: B
Rationale: Acyclovir can cause nephrotoxicity. Hydration is
essential to reduce the risk.
10. A client taking omeprazole asks why it is prescribed. Which
response is correct?
A. "It coats the lining of the stomach."
B. "It neutralizes gastric acid."
C. "It blocks acid production."
D. "It stimulates protective mucus production."
Answer: C
