1. A client with myasthenia gravis reports the occurrence of difficulty chewing. The
physician prescribes pyridostigmine bromide (Mestinon) to increase muscle strength
for this activity. The nurse instructs the client to take the medication at what time, in
relation to meals?
a. after dinner daily when most fatigued
b. before breakfast daily
c. as soon as arising in the morning
d. thirty minutes before each meal
(Rationale: the client will have more energy to eat during meals and avoid aspiration)
2. A client is advised to take senna (Senokot) for the treatment of constipation asks the
nurse how this medication works. The nurse responds knowing that it:
a. accumulates water in the stool and increases peristalsis
b. stimulates the vagus nerve
c. coats the bowel wall (Emollients/Stool softeners)
d. adds fiber and bulk to the stool (Bulk-forming laxatives)
(Rationale: Senna is a stimulant laxative which stimulates motility of large intestines)
3. A client is receiving heparin sodium by continuous intravenous infusion. The nurse
monitors the client for which adverse effect of this therapy?
a. decreased blood pressure
b. increased pulse rate
c. ecchymoses
d. tinnitus
(Rationale: Heparin is an anticoagulant where it has a risk for bleeding. S/sx of bleeding
are: melena, bleeding gums, ecchymosis, hematochezia, hematuria, hematoma, etc. )
4. A client is being treated for acute congestive heart failure (CHF) and the client’s vital
signs are as follows: BP 85/50 mm Hg; pulse, 96 bpm; respirations, 26 cpm. The
physician prescribes digoxin (Lanoxin). To evaluate a therapeutic effectiveness of this
medication, the nurse would expect which of the following changes in the client’s vital
signs? *
a. BP 85/50 mm Hg, pulse 60 bpm, respirations 26 cpm
b. BP 98/60 mm Hg, pulse 80 bpm, respirations 24 cpm
c. BP 130/70 mm Hg, pulse 104 bpm, respirations 20 cpm
d. BP 110/40 mm Hg, 110 bpm, respirations 20 cpm
(Rationale: digoxin has a positive inotrtopic effect: increases myocardial contraction; and
negative chronotropic effect: decreases heart rate.)
5. Diazepam (Valium) is prescribed for a client with anxiety. The nurse instructs the
client to expect which side effect? *
,a. incoordination
b. cough
c. tinnitus
d. hypertension
(Rationale: Diazepam depresses the CNS levels which affects the signaling impulses
throughout the body)
6. A client receives oxytocin (Pitocin) to induce labor. During the administration of the
oxytocin, it is most important for the nurse to monitor: *
a. urinary output
b. fetal heart rate
c. central venous pressure
d. maternal blood glucose
(Rationale: Oxytocin increases uterine contractions which causes decrease placental
blood flow affecting the fetal heart rate)
7. A clinic nurse is performing assessment on a client who is being seen in the clinic for
the first time. When asking about the client’s medication history, the client tells the
nurse that he takes nateglinide (Starlix). The nurse then questions the client about the
presence of which disorder that is treated with this medication? *
a. hypothyroidism
b. insomnia
c. type 2 diabetes mellitus
d. renal failure
(Rationale: Nateglinide (Starlix) is an oral hypoglycemic agent in treating type 2 DM. it
stimulates the release of beta cells in the pancreas)
8. A client who is taking rifampin (Rifadin) as part of the medication regimen for the
treatment of tuberculosis calls the clinic nurse and reports that her urine is a red-orange
color. The nurse tells the client to: *
a. come to the clinic to provide a urine sample
b. stop the medication until further instructions are given by the physician
c. take the medication dose with an antacid to prevent this adverse effect
d. expect a red-orange color in urine, feces, sweat, sputum, and tears as a harmless
side effect
(Rationale: Rifampicin S/E consists of reddish orange secretion and hepatotoxic)
9. A nurse is caring for a client with a tracheostomy that has been diagnosed with a
respiratory infection. The client is receiving vancomycin hydrochloride (Vancocin) 500
mg intravenously every 12 hours. Which of the following would indicate to the nurse that
the client is experiencing an adverse effect of the medication? *
, a. decreased hearing acuity
b. photophobia
c. hypotension
d. bradycardia
(Rationale: Vancomycin S/E are ototoxic and nephrotoxic)
10. A nurse is caring for a client with a diagnosis of metastatic breast carcinoma who is
receiving tamoxifen citrate (Nolvadex) 10 mg orally twice daily. Which of the following
would indicate to the nurse that the client is experiencing a side effect related to the
medication? *
a. hypetension
b. diarrhea
c. nose bleeds
d. vaginal bleeding
(Rationale: Breast cancer increases estrogen levels which causes early menarche and
late menopause. Tamoxifen is an anti-estrogen drug which has a side effect of
menstrual-like symptoms: hot flashes, vaginal bleeding, nausea & vomiting, pruritus)
11. A client has just been given a prescription for diphenoxylate with atropine (Lomotil).
The nurse teaches the client which of the following about the use of this medication? *
a. drooling may occur while taking this medication (Lomotil causes dry mouth)
b. irritability may occur while taking this medication (Lomotil causes drowsiness)
c. this medication contains a habit-forming ingredient
d. take the medication with a laxative of choice
(Rationale: Lomotil is an anti-diarrheal medication. Also, it has the risk of becoming
habit-forming.)
12. A nurse is gathering data from client about the client’s medication history and notes
that the client is taking tolterodine tartrate (Detrol LA). The nurse determines that the
client is taking the medication to treat which disorder? *
a. glaucoma (Contraindicated to Detrol LA)
b. renal insufficiency
c. pyloric stenosis
d. urinary frequency and urgency
(Rationale: In urinary frequency and urgency, the overactive urinary bladder is contracting
continuously or in spasms. Tolterodine tartrate (Detrol LA) is an antispasmodic.
13. A client has an order to receive psyllium (Metamucil) daily. The nurse administers
this medication with: *
physician prescribes pyridostigmine bromide (Mestinon) to increase muscle strength
for this activity. The nurse instructs the client to take the medication at what time, in
relation to meals?
a. after dinner daily when most fatigued
b. before breakfast daily
c. as soon as arising in the morning
d. thirty minutes before each meal
(Rationale: the client will have more energy to eat during meals and avoid aspiration)
2. A client is advised to take senna (Senokot) for the treatment of constipation asks the
nurse how this medication works. The nurse responds knowing that it:
a. accumulates water in the stool and increases peristalsis
b. stimulates the vagus nerve
c. coats the bowel wall (Emollients/Stool softeners)
d. adds fiber and bulk to the stool (Bulk-forming laxatives)
(Rationale: Senna is a stimulant laxative which stimulates motility of large intestines)
3. A client is receiving heparin sodium by continuous intravenous infusion. The nurse
monitors the client for which adverse effect of this therapy?
a. decreased blood pressure
b. increased pulse rate
c. ecchymoses
d. tinnitus
(Rationale: Heparin is an anticoagulant where it has a risk for bleeding. S/sx of bleeding
are: melena, bleeding gums, ecchymosis, hematochezia, hematuria, hematoma, etc. )
4. A client is being treated for acute congestive heart failure (CHF) and the client’s vital
signs are as follows: BP 85/50 mm Hg; pulse, 96 bpm; respirations, 26 cpm. The
physician prescribes digoxin (Lanoxin). To evaluate a therapeutic effectiveness of this
medication, the nurse would expect which of the following changes in the client’s vital
signs? *
a. BP 85/50 mm Hg, pulse 60 bpm, respirations 26 cpm
b. BP 98/60 mm Hg, pulse 80 bpm, respirations 24 cpm
c. BP 130/70 mm Hg, pulse 104 bpm, respirations 20 cpm
d. BP 110/40 mm Hg, 110 bpm, respirations 20 cpm
(Rationale: digoxin has a positive inotrtopic effect: increases myocardial contraction; and
negative chronotropic effect: decreases heart rate.)
5. Diazepam (Valium) is prescribed for a client with anxiety. The nurse instructs the
client to expect which side effect? *
,a. incoordination
b. cough
c. tinnitus
d. hypertension
(Rationale: Diazepam depresses the CNS levels which affects the signaling impulses
throughout the body)
6. A client receives oxytocin (Pitocin) to induce labor. During the administration of the
oxytocin, it is most important for the nurse to monitor: *
a. urinary output
b. fetal heart rate
c. central venous pressure
d. maternal blood glucose
(Rationale: Oxytocin increases uterine contractions which causes decrease placental
blood flow affecting the fetal heart rate)
7. A clinic nurse is performing assessment on a client who is being seen in the clinic for
the first time. When asking about the client’s medication history, the client tells the
nurse that he takes nateglinide (Starlix). The nurse then questions the client about the
presence of which disorder that is treated with this medication? *
a. hypothyroidism
b. insomnia
c. type 2 diabetes mellitus
d. renal failure
(Rationale: Nateglinide (Starlix) is an oral hypoglycemic agent in treating type 2 DM. it
stimulates the release of beta cells in the pancreas)
8. A client who is taking rifampin (Rifadin) as part of the medication regimen for the
treatment of tuberculosis calls the clinic nurse and reports that her urine is a red-orange
color. The nurse tells the client to: *
a. come to the clinic to provide a urine sample
b. stop the medication until further instructions are given by the physician
c. take the medication dose with an antacid to prevent this adverse effect
d. expect a red-orange color in urine, feces, sweat, sputum, and tears as a harmless
side effect
(Rationale: Rifampicin S/E consists of reddish orange secretion and hepatotoxic)
9. A nurse is caring for a client with a tracheostomy that has been diagnosed with a
respiratory infection. The client is receiving vancomycin hydrochloride (Vancocin) 500
mg intravenously every 12 hours. Which of the following would indicate to the nurse that
the client is experiencing an adverse effect of the medication? *
, a. decreased hearing acuity
b. photophobia
c. hypotension
d. bradycardia
(Rationale: Vancomycin S/E are ototoxic and nephrotoxic)
10. A nurse is caring for a client with a diagnosis of metastatic breast carcinoma who is
receiving tamoxifen citrate (Nolvadex) 10 mg orally twice daily. Which of the following
would indicate to the nurse that the client is experiencing a side effect related to the
medication? *
a. hypetension
b. diarrhea
c. nose bleeds
d. vaginal bleeding
(Rationale: Breast cancer increases estrogen levels which causes early menarche and
late menopause. Tamoxifen is an anti-estrogen drug which has a side effect of
menstrual-like symptoms: hot flashes, vaginal bleeding, nausea & vomiting, pruritus)
11. A client has just been given a prescription for diphenoxylate with atropine (Lomotil).
The nurse teaches the client which of the following about the use of this medication? *
a. drooling may occur while taking this medication (Lomotil causes dry mouth)
b. irritability may occur while taking this medication (Lomotil causes drowsiness)
c. this medication contains a habit-forming ingredient
d. take the medication with a laxative of choice
(Rationale: Lomotil is an anti-diarrheal medication. Also, it has the risk of becoming
habit-forming.)
12. A nurse is gathering data from client about the client’s medication history and notes
that the client is taking tolterodine tartrate (Detrol LA). The nurse determines that the
client is taking the medication to treat which disorder? *
a. glaucoma (Contraindicated to Detrol LA)
b. renal insufficiency
c. pyloric stenosis
d. urinary frequency and urgency
(Rationale: In urinary frequency and urgency, the overactive urinary bladder is contracting
continuously or in spasms. Tolterodine tartrate (Detrol LA) is an antispasmodic.
13. A client has an order to receive psyllium (Metamucil) daily. The nurse administers
this medication with: *
