1. 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.
2. 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.
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 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.
5. 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.
6. A client is prescribed exenatide. What is a common side effect?
A. Hyperglycemia
B. Constipation
C. Nausea
, D. Tachycardia
Answer: C
Rationale: Exenatide can cause nausea, especially when initiating
therapy. It’s an injectable incretin mimetic.
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 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.
9. A client taking haloperidol develops a high fever and muscle
rigidity. What should the nurse suspect?
A. Serotonin syndrome
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.
2. 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.
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 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.
5. 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.
6. A client is prescribed exenatide. What is a common side effect?
A. Hyperglycemia
B. Constipation
C. Nausea
, D. Tachycardia
Answer: C
Rationale: Exenatide can cause nausea, especially when initiating
therapy. It’s an injectable incretin mimetic.
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 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.
9. A client taking haloperidol develops a high fever and muscle
rigidity. What should the nurse suspect?
A. Serotonin syndrome
