ACTUAL Exam Questions and CORRECT
Answers
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30
mg IV q6h. Which action should the nurse implement?
a) Administer both medications according to the prescription.
b) Hold the ketorolac to prevent an antagonistic effect.
c) Hold the morphine to prevent an additive drug interaction.
d) Contact the healthcare provider to clarify the prescription. - CORRECT ANSWER -
Rationale: A
Morphine and ketorolac (Toradol) can be administered concurrently, and may produce an
additive analgesic effect, resulting in the ability to reduce the dose of morphine, as seen in this
prescription. Toradol is an anti inflammatory analgesic, and does not have an antagonistic effect
with morphine.
The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which
prescription should the nurse prepare to administer this client?
a) Dopamine.
b) Ephedrine.
c) Epinephrine.
d) Diphenhydramine. - CORRECT ANSWER -Rationale: C
Epinephrine is an adrenergic agent that stimulates beta receptors to increase cardiac automaticity
in cardiac arrest and relax bronchospasms in anaphylaxis. On the ither hand, dopamine is a
vasopressor used to treat clients with shock. Ephedrine causes peripheral vasoconstriction and is
used in the treatment of nasal congestion. Diphenhydramine is an antihistamine decongestant
used in the treatment of mild allergic reactions and motion sickness. Epinephrine is the
medication of choice in treating anaphylaxis.
,Which instruction(s) should the nurse give to a female client who just received a prescription for
oral metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
o Increase fluid intake, especially cranberry juice.
o Do not abruptly discontinue the medication, taper use.
o Check blood pressure daily to detect hypertension.
o Avoid drinking alcohol while taking this medication.
o Use condoms until treatment is completed.
o Ensure that all sexual partners are treated at the same time. - CORRECT ANSWER -
Rationale: 1,4,6
Increased fluid intake and cranberry juice are recommended for prevention and treatment of
urinary tract infections, which frequently accompany vaginal infections. It is not necessary to
taper use of this drug or to check the blood pressure daily, as this condition is not related to
hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion of
alcohol, so the client should be instructed to avoid alcohol. All sexual partners should be treated
at the same time and condoms should be used until after treatment is completed to avoid
reinfection.
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new
prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the
nurse assesses the client. Which finding requires the most immediate intervention?
a) Heartburn.
b) Headache.
c) Constipation.
d) Vomiting. - CORRECT ANSWER -Rationale: D
Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since Lipitor
increases the risk for digitalis toxicity, this finding requires the most immediate intervention by
the nurse.
, While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy
to another type of anti-infective agent should the nurse ask the client about when taking the
nursing history?
a) Aminoglycosides.
b) Cephalosporins.
c) Sulfonamides.
d) Tetracyclines. - CORRECT ANSWER -Rationale: B
If a client has a history of being allergic to penicillin (PCN); there is appears to be a cross
sensitivity between penicillins and 1st generation cephalosporins. According to research, there
appears to be no cross sensitivity between PCN and 3rd or 4th generation cephalosporins.
A category X drug is prescribed for a young adult female client. Which instruction is most
important for the nurse to teach this client?
a) Use a reliable form of birth control.
b) Avoid exposure to ultra violet light.
c) Refuse this medication if planning pregnancy.
d) Abstain from intercourse while on this drug. - CORRECT ANSWER -Rationale: A
Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk
for teratogenesis, so women in the childbearing years should be counseled to use a reliable form
of birth control during drug therapy. If the client is planning to become pregnant, she should be
encouraged to discuss plans for pregnancy with the healthcare provider, so a safer alternative
prescription can be provided if pregnancy occurs.
A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an
increase in which laboratory value as the result of this medication?
a) Serum glucose.
b) Serum calcium.