1. A client prescribed clopidogrel should avoid which over-the
counter medication?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Guaifenesin
Answer: B
Rationale: NSAIDs like ibuprofen increase bleeding risk when
combined with antiplatelet agents like clopidogrel.
2. A client receiving methotrexate for cancer reports mouth
sores. What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral care
is essential to prevent infection and discomfort.
3. A client with myasthenia gravis is prescribed neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic crisis,
requiring dosage adjustment.
4. A client started on fluoxetine 5 days ago reports increased
,energy and planning their funeral. What should the nurse do?
A. Encourage journaling
B. Monitor sleep
C. Notify the provider immediately
D. Provide distraction techniques
Answer: C
Rationale: Increased energy + suicidal ideation early in SSRI
therapy is dangerous and should be reported.
5. A client with a penicillin allergy is prescribed cephalexin. What
is the nurse’s priority?
A. Administer as ordered
B. Ask about previous reaction type
C. Hold the dose for 30 minutes
D. Give with food
Answer: B
Rationale: Cross-sensitivity may occur. Ask if the client had a true
anaphylactic reaction before administering.
6. 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.
7. 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.
8. A nurse is caring for a client on glipizide. Which statement
indicates understanding?
A. “I can skip meals if I’m not hungry.”
B. “This medication will not cause low blood sugar.”
C. “I will avoid alcohol while taking this.”
D. “I can take this with grapefruit juice.”
Answer: C
Rationale: Alcohol with glipizide increases the risk of
hypoglycemia and a disulfiram-like reaction.
9. A client uses sublingual nitroglycerin. Which instruction is
correct?
A. Swallow the pill with water
B. Take up to 3 doses, 5 minutes apart
C. Store it in a warm area
D. Use it once weekly
Answer: B
Rationale: For chest pain, take 1 tablet every 5 minutes, up to 3
doses, and call 911 if no relief after the first.
10. A client taking haloperidol develops a high fever and muscle
rigidity. What should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome (NMS)
C. Tardive dyskinesia
D. Extrapyramidal symptoms (EPS)
Answer: B
counter medication?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Guaifenesin
Answer: B
Rationale: NSAIDs like ibuprofen increase bleeding risk when
combined with antiplatelet agents like clopidogrel.
2. A client receiving methotrexate for cancer reports mouth
sores. What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral care
is essential to prevent infection and discomfort.
3. A client with myasthenia gravis is prescribed neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic crisis,
requiring dosage adjustment.
4. A client started on fluoxetine 5 days ago reports increased
,energy and planning their funeral. What should the nurse do?
A. Encourage journaling
B. Monitor sleep
C. Notify the provider immediately
D. Provide distraction techniques
Answer: C
Rationale: Increased energy + suicidal ideation early in SSRI
therapy is dangerous and should be reported.
5. A client with a penicillin allergy is prescribed cephalexin. What
is the nurse’s priority?
A. Administer as ordered
B. Ask about previous reaction type
C. Hold the dose for 30 minutes
D. Give with food
Answer: B
Rationale: Cross-sensitivity may occur. Ask if the client had a true
anaphylactic reaction before administering.
6. 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.
7. 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.
8. A nurse is caring for a client on glipizide. Which statement
indicates understanding?
A. “I can skip meals if I’m not hungry.”
B. “This medication will not cause low blood sugar.”
C. “I will avoid alcohol while taking this.”
D. “I can take this with grapefruit juice.”
Answer: C
Rationale: Alcohol with glipizide increases the risk of
hypoglycemia and a disulfiram-like reaction.
9. A client uses sublingual nitroglycerin. Which instruction is
correct?
A. Swallow the pill with water
B. Take up to 3 doses, 5 minutes apart
C. Store it in a warm area
D. Use it once weekly
Answer: B
Rationale: For chest pain, take 1 tablet every 5 minutes, up to 3
doses, and call 911 if no relief after the first.
10. A client taking haloperidol develops a high fever and muscle
rigidity. What should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome (NMS)
C. Tardive dyskinesia
D. Extrapyramidal symptoms (EPS)
Answer: B
