1. A nurse is administering vancomycin to a client via IV
infusion. Which of the following should the nurse be aware
of when administering the medication?
A. The infusion should be given over 60 minutes to prevent
red man syndrome.
B. The infusion should be given as a rapid bolus for quicker
therapeutic effect.
C. The medication should be given on an empty stomach.
D. The client should be observed for signs of hyperkalemia.
Answer: a) The infusion should be given over 60 minutes to
prevent red man syndrome.
Rationale: Vancomycin should be infused slowly over at
least 60 minutes to prevent red man syndrome, which is
characterized by flushing and hypotension.
2. A nurse is administering a dose of phenytoin to a client
with seizures. The nurse should monitor the client for which
of the following adverse effects?
A. Gingival hyperplasia
B. Weight loss
C. Tremors
D. Hypoglycemia
Answer: a) Gingival hyperplasia
Rationale: Phenytoin is associated with gingival
hyperplasia, an overgrowth of the gum tissue, as a common
adverse effect.
3. A nurse is caring for a client who is prescribed metformin
for type 2 diabetes mellitus. The nurse should monitor for
which of the following adverse effects?
,A. Hypoglycemia
B. Hyperkalemia
C. Lactic acidosis
D. Constipation
Answer: c) Lactic acidosis
Rationale: Metformin can cause lactic acidosis, a serious
adverse effect. The nurse should monitor for symptoms
such as muscle pain, weakness, and respiratory distress.
4. A nurse is teaching a client who is prescribed a beta-
blocker for hypertension. Which of the following statements
indicates the need for further teaching?
A. "I should monitor my heart rate regularly."
B. "I can stop taking this medication if I feel tired."
C. "I may feel lightheaded when I stand up."
D. "I should avoid getting up too quickly."
Answer: b) "I can stop taking this medication if I feel tired."
Rationale: Beta-blockers should not be stopped abruptly, as
this can cause rebound hypertension. The client should be
instructed to follow the provider's guidance on tapering the
medication.
5. A nurse is caring for a client receiving furosemide. Which
of the following findings should the nurse monitor for as a
potential adverse effect?
A. Hyperglycemia
B. Hypokalemia
C. Hypotension
D. Hypercalcemia
Answer: b) Hypokalemia
Rationale: Furosemide is a loop diuretic that can cause
potassium loss, leading to hypokalemia. The nurse should
, monitor potassium levels and provide supplementation as
needed.
6. A nurse is caring for a client receiving enalapril. Which of
the following should be monitored regularly?
A. Blood pressure
B. Blood glucose level
C. Respiratory rate
D. Serum calcium
Answer: a) Blood pressure
Rationale: Enalapril is an ACE inhibitor, primarily used for
hypertension management. Blood pressure should be
closely monitored to ensure the medication is effective.
7. A nurse is caring for a client with tuberculosis who is
prescribed isoniazid. The nurse should instruct the client to
report which of the following symptoms immediately?
A. Nausea and vomiting
B. Yellowing of the skin or eyes
C. Dizziness
D. Muscle pain
Answer: b) Yellowing of the skin or eyes
Rationale: Yellowing of the skin or eyes (jaundice) can
indicate hepatotoxicity, a serious side effect of isoniazid.
8. A nurse is teaching a client who is prescribed a selective
serotonin reuptake inhibitor (SSRI) for depression. The
nurse should instruct the client to avoid which of the
following substances?
A. Alcohol
B. Caffeine
C. Citrus fruits
infusion. Which of the following should the nurse be aware
of when administering the medication?
A. The infusion should be given over 60 minutes to prevent
red man syndrome.
B. The infusion should be given as a rapid bolus for quicker
therapeutic effect.
C. The medication should be given on an empty stomach.
D. The client should be observed for signs of hyperkalemia.
Answer: a) The infusion should be given over 60 minutes to
prevent red man syndrome.
Rationale: Vancomycin should be infused slowly over at
least 60 minutes to prevent red man syndrome, which is
characterized by flushing and hypotension.
2. A nurse is administering a dose of phenytoin to a client
with seizures. The nurse should monitor the client for which
of the following adverse effects?
A. Gingival hyperplasia
B. Weight loss
C. Tremors
D. Hypoglycemia
Answer: a) Gingival hyperplasia
Rationale: Phenytoin is associated with gingival
hyperplasia, an overgrowth of the gum tissue, as a common
adverse effect.
3. A nurse is caring for a client who is prescribed metformin
for type 2 diabetes mellitus. The nurse should monitor for
which of the following adverse effects?
,A. Hypoglycemia
B. Hyperkalemia
C. Lactic acidosis
D. Constipation
Answer: c) Lactic acidosis
Rationale: Metformin can cause lactic acidosis, a serious
adverse effect. The nurse should monitor for symptoms
such as muscle pain, weakness, and respiratory distress.
4. A nurse is teaching a client who is prescribed a beta-
blocker for hypertension. Which of the following statements
indicates the need for further teaching?
A. "I should monitor my heart rate regularly."
B. "I can stop taking this medication if I feel tired."
C. "I may feel lightheaded when I stand up."
D. "I should avoid getting up too quickly."
Answer: b) "I can stop taking this medication if I feel tired."
Rationale: Beta-blockers should not be stopped abruptly, as
this can cause rebound hypertension. The client should be
instructed to follow the provider's guidance on tapering the
medication.
5. A nurse is caring for a client receiving furosemide. Which
of the following findings should the nurse monitor for as a
potential adverse effect?
A. Hyperglycemia
B. Hypokalemia
C. Hypotension
D. Hypercalcemia
Answer: b) Hypokalemia
Rationale: Furosemide is a loop diuretic that can cause
potassium loss, leading to hypokalemia. The nurse should
, monitor potassium levels and provide supplementation as
needed.
6. A nurse is caring for a client receiving enalapril. Which of
the following should be monitored regularly?
A. Blood pressure
B. Blood glucose level
C. Respiratory rate
D. Serum calcium
Answer: a) Blood pressure
Rationale: Enalapril is an ACE inhibitor, primarily used for
hypertension management. Blood pressure should be
closely monitored to ensure the medication is effective.
7. A nurse is caring for a client with tuberculosis who is
prescribed isoniazid. The nurse should instruct the client to
report which of the following symptoms immediately?
A. Nausea and vomiting
B. Yellowing of the skin or eyes
C. Dizziness
D. Muscle pain
Answer: b) Yellowing of the skin or eyes
Rationale: Yellowing of the skin or eyes (jaundice) can
indicate hepatotoxicity, a serious side effect of isoniazid.
8. A nurse is teaching a client who is prescribed a selective
serotonin reuptake inhibitor (SSRI) for depression. The
nurse should instruct the client to avoid which of the
following substances?
A. Alcohol
B. Caffeine
C. Citrus fruits
