,Q1. A nurse is preparing to administer the influenza vaccine to a client. Which of the following allergies
should the nurse identify as a contraindication to the client receiving this vaccine?
A. Gelatin
B. Chicken eggs
C. Neomycin
D. Prednisone
Answer: B. Chicken eggs
Rationale: The nurse should identify that an allergy to chicken eggs is a contraindication to receiving the
influenza vaccine. Clients with this allergy can develop angioedema and severe respiratory distress if
vaccinated.
Q2. A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-
acting beta₂-agonist combination dry-powder inhaler (DPI) for maintenance therapy. The nurse should
identify that which of the following is a disadvantage of this medication?
A. Restricted dosage flexibility
B. Complicated delivery device
C. Serious systemic effects
D. Limited efficacy over time
Answer: A. Restricted dosage flexibility
Rationale: A disadvantage of combination inhalers is that the dosages are fixed. This restricts dosage
flexibility since the glucocorticoid and long-acting beta₂-agonist cannot be adjusted separately.
Q3. A nurse is reviewing the medication administration record of a client who is receiving an opioid
medication for pain. Which of the following prescriptions should the nurse clarify with the provider?
A. Metoprolol
B. Ondansetron
C. Lorazepam
D. Naloxone
Answer: C. Lorazepam
Rationale: Lorazepam can cause central nervous system depression. When given with opioids, it
increases the risk of excessive sedation and respiratory depression. The nurse should clarify this order
with the provider.
,Q4. A nurse is teaching a client who has osteoporosis about a new prescription for risedronate. Which of
the following client statements indicates an understanding of the teaching?
A. "I will take this medication with a full cup of water."
B. "I will lie down after I take this medication."
C. "I will take this medication with food."
D. "I will take this medication at bedtime."
Answer: A. "I will take this medication with a full cup of water."
Rationale: Risedronate should be taken with a full glass of water and the client should remain upright for
at least 30 minutes to prevent esophageal irritation. It should not be taken with food, at bedtime, or while
lying down.
Q1. A nurse is preparing a discharge teaching plan for a 6-year-old client with asthma who has several
prescription medications using metered-dose inhalers (MDIs). Which of the following interventions
should the nurse include in the plan?
A. Add a spacer to each MDI
B. Instruct the child to inhale more rapidly than usual when using an MDI
C. Ask the provider to change the child's medications from inhaled to oral formulations
D. Administer oxygen by facemask along with the MDI
Answer: A. Add a spacer to each MDI
Rationale: MDIs can be difficult to coordinate, and even with proper use, much of the dose is lost.
Attaching a spacer improves delivery to the lungs and reduces oropharyngeal deposition of medication.
Q2. A nurse is admitting a client who has unstable angina. Which of the following medications should the
nurse anticipate administering to the client?
A. Epinephrine
B. Nitroglycerin
C. Lidocaine
D. Atropine
Answer: B. Nitroglycerin
Rationale: Nitroglycerin relaxes coronary artery smooth muscle, reduces myocardial oxygen demand,
and improves perfusion. It is the treatment of choice for unstable angina.
Q3. A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which
of the following findings should indicate to the nurse that the client is experiencing an adverse effect of
this medication?
A. Thirst
B. Nocturia
C. Headache
D. Heart palpitations
, Answer: C. Headache
Rationale: Headache is an early manifestation of water intoxication from desmopressin-induced fluid
retention. This can progress to hyponatremia and seizures if untreated.
Q4. A nurse has administered a medication to a client. Which of the following circumstances should the
nurse identify as a medication error that resulted from a performance deficit by the nurse?
A. A medication safety coordinator was not present
B. A verbal prescription was transcribed incorrectly
C. A medication with a similar name was dispensed instead of the correct medication
D. An intramuscular injection was given instead of a subcutaneous injection
Answer: D. An intramuscular injection was given instead of a subcutaneous injection
Rationale: This represents a performance deficit (a skill execution error by the nurse), rather than a
system or communication error.
Q5. A nurse is providing teaching to a client with hypertension and type 1 diabetes mellitus who has a
new prescription for metoprolol. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I might have difficulty recognizing when my blood sugar is low."
B. "I will have a lower risk of developing an infection while I take this medication."
C. "I should be concerned about losing excess weight while I take this medication."
D. "I could have more problems with high blood sugar while taking this medication."
Answer: A. "I might have difficulty recognizing when my blood sugar is low."
Rationale: Metoprolol, a beta-blocker, masks tachycardia and palpitations — key warning signs of
hypoglycemia. This makes low blood glucose episodes harder to detect.
Q1. A nurse is assessing a client who is taking varenicline for smoking cessation. Which of the following
findings is the nurse's priority?
A. Mood changes
B. Nausea
C. Altered sense of taste
D. Skin rash
Answer: A. Mood changes
Rationale: Varenicline can cause neuropsychiatric effects, including mood changes, agitation, depression,
and suicidal ideation. This is the priority finding because it poses the greatest risk to the client’s safety.
Q2. A nurse is reviewing laboratory reports for a client who has Clostridium difficile infection and is
receiving vancomycin. Which of the following results should the nurse report to the provider before
administering the next dose?
A. Hematocrit 46%
B. Serum glucose 110 mg/dL
should the nurse identify as a contraindication to the client receiving this vaccine?
A. Gelatin
B. Chicken eggs
C. Neomycin
D. Prednisone
Answer: B. Chicken eggs
Rationale: The nurse should identify that an allergy to chicken eggs is a contraindication to receiving the
influenza vaccine. Clients with this allergy can develop angioedema and severe respiratory distress if
vaccinated.
Q2. A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-
acting beta₂-agonist combination dry-powder inhaler (DPI) for maintenance therapy. The nurse should
identify that which of the following is a disadvantage of this medication?
A. Restricted dosage flexibility
B. Complicated delivery device
C. Serious systemic effects
D. Limited efficacy over time
Answer: A. Restricted dosage flexibility
Rationale: A disadvantage of combination inhalers is that the dosages are fixed. This restricts dosage
flexibility since the glucocorticoid and long-acting beta₂-agonist cannot be adjusted separately.
Q3. A nurse is reviewing the medication administration record of a client who is receiving an opioid
medication for pain. Which of the following prescriptions should the nurse clarify with the provider?
A. Metoprolol
B. Ondansetron
C. Lorazepam
D. Naloxone
Answer: C. Lorazepam
Rationale: Lorazepam can cause central nervous system depression. When given with opioids, it
increases the risk of excessive sedation and respiratory depression. The nurse should clarify this order
with the provider.
,Q4. A nurse is teaching a client who has osteoporosis about a new prescription for risedronate. Which of
the following client statements indicates an understanding of the teaching?
A. "I will take this medication with a full cup of water."
B. "I will lie down after I take this medication."
C. "I will take this medication with food."
D. "I will take this medication at bedtime."
Answer: A. "I will take this medication with a full cup of water."
Rationale: Risedronate should be taken with a full glass of water and the client should remain upright for
at least 30 minutes to prevent esophageal irritation. It should not be taken with food, at bedtime, or while
lying down.
Q1. A nurse is preparing a discharge teaching plan for a 6-year-old client with asthma who has several
prescription medications using metered-dose inhalers (MDIs). Which of the following interventions
should the nurse include in the plan?
A. Add a spacer to each MDI
B. Instruct the child to inhale more rapidly than usual when using an MDI
C. Ask the provider to change the child's medications from inhaled to oral formulations
D. Administer oxygen by facemask along with the MDI
Answer: A. Add a spacer to each MDI
Rationale: MDIs can be difficult to coordinate, and even with proper use, much of the dose is lost.
Attaching a spacer improves delivery to the lungs and reduces oropharyngeal deposition of medication.
Q2. A nurse is admitting a client who has unstable angina. Which of the following medications should the
nurse anticipate administering to the client?
A. Epinephrine
B. Nitroglycerin
C. Lidocaine
D. Atropine
Answer: B. Nitroglycerin
Rationale: Nitroglycerin relaxes coronary artery smooth muscle, reduces myocardial oxygen demand,
and improves perfusion. It is the treatment of choice for unstable angina.
Q3. A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which
of the following findings should indicate to the nurse that the client is experiencing an adverse effect of
this medication?
A. Thirst
B. Nocturia
C. Headache
D. Heart palpitations
, Answer: C. Headache
Rationale: Headache is an early manifestation of water intoxication from desmopressin-induced fluid
retention. This can progress to hyponatremia and seizures if untreated.
Q4. A nurse has administered a medication to a client. Which of the following circumstances should the
nurse identify as a medication error that resulted from a performance deficit by the nurse?
A. A medication safety coordinator was not present
B. A verbal prescription was transcribed incorrectly
C. A medication with a similar name was dispensed instead of the correct medication
D. An intramuscular injection was given instead of a subcutaneous injection
Answer: D. An intramuscular injection was given instead of a subcutaneous injection
Rationale: This represents a performance deficit (a skill execution error by the nurse), rather than a
system or communication error.
Q5. A nurse is providing teaching to a client with hypertension and type 1 diabetes mellitus who has a
new prescription for metoprolol. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I might have difficulty recognizing when my blood sugar is low."
B. "I will have a lower risk of developing an infection while I take this medication."
C. "I should be concerned about losing excess weight while I take this medication."
D. "I could have more problems with high blood sugar while taking this medication."
Answer: A. "I might have difficulty recognizing when my blood sugar is low."
Rationale: Metoprolol, a beta-blocker, masks tachycardia and palpitations — key warning signs of
hypoglycemia. This makes low blood glucose episodes harder to detect.
Q1. A nurse is assessing a client who is taking varenicline for smoking cessation. Which of the following
findings is the nurse's priority?
A. Mood changes
B. Nausea
C. Altered sense of taste
D. Skin rash
Answer: A. Mood changes
Rationale: Varenicline can cause neuropsychiatric effects, including mood changes, agitation, depression,
and suicidal ideation. This is the priority finding because it poses the greatest risk to the client’s safety.
Q2. A nurse is reviewing laboratory reports for a client who has Clostridium difficile infection and is
receiving vancomycin. Which of the following results should the nurse report to the provider before
administering the next dose?
A. Hematocrit 46%
B. Serum glucose 110 mg/dL
