Exam [Latest] Correct Answers & Rationales
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Question 1: A nurse is caring for a client who has a new prescription for atenolol. Which of the
following actions should the nurse plan to take?
A) Obtain orthostatic blood pressures
B) Hold the medication for an apical heart rate of less than 70/min
C) Assess the client for tinnitus
D) Monitor the client for the development of a cough
Correct Answer: A) Obtain orthostatic blood pressures
Explanation: Atenolol is a beta blocker that can cause orthostatic hypotension. The nurse should
check the client's blood pressure supine, sitting, and standing, and instruct the client to change
positions slowly.
Question 2: A nurse is performing a focused assessment on a client who is taking naproxen. Which of
the following findings is the nurse's priority?
A) Ringing in ears
B) Black stools
C) Nausea
D) Sweating
Correct Answer: B) Black stools
Explanation: Black stools are a manifestation of gastrointestinal bleeding, which can lead to
ulceration, perforation, and hemorrhage. This requires immediate intervention.
,Question 3: A nurse is caring for a client who is taking nitroglycerin for angina and reports feeling
faint when standing up. Which of the following actions should the nurse take?
A) Inform the client that feeling faint is caused by rapid constriction of blood vessels
B) Assist the client into bed, elevate the lower extremities, and check blood pressure
C) Request a prescription for dobutamine from the provider
D) Check the client's blood pressure while they're still standing
Correct Answer: B) Assist the client into bed, elevate the lower extremities, and check blood pressure
Explanation: Nitroglycerin causes vasodilation leading to orthostatic hypotension. The nurse should
first prevent injury from falling, then elevate legs to enhance venous return, and check blood pressure.
Question 4: A nurse is preparing to administer Rho(D) immune globulin to a female client who is 6
hours postpartum. Which of the following actions should the nurse take?
A) Confirm the client is Rh-positive prior to administration
B) Administer the medication intramuscularly into the client's deltoid
C) Observe the client for an allergic reaction for 5 minutes following administration
D) Administer the medication within 10 minutes of removing from refrigeration
Correct Answer: B) Administer the medication intramuscularly into the client's deltoid
Explanation: Rho(D) immune globulin is administered intramuscularly into either the deltoid or
anterolateral thigh. The client must be Rh-negative, and observation for allergic reactions should
continue for longer than 5 minutes.
Question 5: A nurse is caring for a client who has noted extravasation of an IV site following
infiltration of dopamine. After stopping the dopamine infusion, which of the following actions should
the nurse take next?
A) Inject phentolamine into the affected area
B) Apply a cold compress to the site
C) Aspirate dopamine from the IV cannula
D) Photograph the site
Correct Answer: C) Aspirate dopamine from the IV cannula
, Explanation: The nurse should first attempt to aspirate any remaining medication from the IV site to
minimize tissue damage, then proceed with other interventions like phentolamine administration.
Question 6: A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new
prescription for sucralfate. Which of the following information should the nurse include?
A) Decreases stomach acid secretion
B) Neutralizes acids in the stomach
C) Forms a protective barrier over ulcers
D) Treats ulcers by eradicating H. pylori
Correct Answer: C) Forms a protective barrier over ulcers
Explanation: Sucralfate is a mucosal protectant that forms a gel-like substance coating the ulcer,
creating a barrier to hydrochloric acid and pepsin, protecting the damaged tissue.
Question 7: A nurse is preparing to administer amoxicillin 250 mg PO to a school-age child. The
amount available is amoxicillin oral suspension 200mg/5 mL. How many mL should the nurse
administer?
A) 5.2 mL
B) 6.3 mL
C) 7.5 mL
D) 8.0 mL
Correct Answer: B) 6.3 mL
Explanation: Using the formula D/H × Q: 250 mg ÷ 200 mg × 5 mL = 6.25 mL, which rounds to 6.3 mL.
Question 8: A nurse is teaching a client who is starting to take diltiazem. Which of the following
statements should the nurse identify as an indication that the client understands the teaching?
A) "I will stop taking the medication if I get dizzy"
B) "I should not drink orange juice while taking this medication"
C) "I should expect to gain weight while taking this medication"
D) "I will check my heart rate before I take the medication"