Answers solutions with Rationales
1. A patient is prescribed a loop diuretic. Which electrolyte imbalance should the nurse
monitor most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics (e.g., furosemide) increase urinary potassium excretion, putting
patients at risk for hypokalemia.
2. Which instruction should the nurse provide to a patient starting on warfarin?
A. Avoid all leafy green vegetables
B. Take the medication only when symptoms occur
C. Have regular INR lab tests
D. Stop taking aspirin immediately
Answer: C. Have regular INR lab tests
Rationale: Warfarin requires monitoring of the INR to ensure therapeutic anticoagulation and
prevent bleeding or clotting.
3. A patient is experiencing a dry cough while taking an ACE inhibitor. What is the
appropriate nursing action?
A. Reassure the patient that it is harmless
B. Hold the medication and notify the provider
C. Encourage the patient to increase fluids
D. Switch to a beta-blocker
,Answer: B. Hold the medication and notify the provider
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors and may
require discontinuation.
4. Which statement by a patient indicates understanding of insulin therapy?
A. “I can skip a meal if I forgot my insulin dose.”
B. “I should store unopened insulin in the freezer.”
C. “I should rotate injection sites to prevent lipodystrophy.”
D. “I should take all my insulin at bedtime only.”
Answer: C. “I should rotate injection sites to prevent lipodystrophy.”
Rationale: Rotating injection sites prevents tissue changes; insulin should not be frozen and
should be given according to prescribed timing.
5. The nurse administers morphine to a patient. Which side effect requires immediate
intervention?
A. Constipation
B. Respiratory rate of 8/min
C. Mild nausea
D. Drowsiness
Answer: B. Respiratory rate of 8/min
Rationale: Morphine can cause respiratory depression; a rate <10/min is dangerous and
requires immediate action.
6. Which lab test should the nurse monitor for a patient on digoxin therapy?
A. Blood glucose
B. Serum digoxin level
C. Complete blood count
D. Serum potassium only
Answer: B. Serum digoxin level
Rationale: Therapeutic digoxin levels must be monitored to avoid toxicity; potassium is also
important to monitor.
7. A patient is prescribed an opioid for pain. Which teaching point is most important?
A. Avoid driving while taking this medication
B. Only take the drug when in severe pain
, C. Take with food to increase absorption
D. Stop abruptly if pain decreases
Answer: A. Avoid driving while taking this medication
Rationale: Opioids can impair cognition and reaction time; patients should avoid hazardous
activities.
8. Which patient is at greatest risk for adverse effects from NSAIDs?
A. 25-year-old with mild asthma
B. 50-year-old with peptic ulcer disease
C. 30-year-old with seasonal allergies
D. 45-year-old with controlled hypertension
Answer: B. 50-year-old with peptic ulcer disease
Rationale: NSAIDs increase the risk of GI bleeding, especially in patients with a history of
ulcers.
9. A patient receiving an aminoglycoside antibiotic reports tinnitus. What is the nurse’s
priority action?
A. Document the finding and continue therapy
B. Notify the provider immediately
C. Encourage increased fluid intake
D. Reduce the dose by half
Answer: B. Notify the provider immediately
Rationale: Tinnitus may indicate ototoxicity, a serious adverse effect of aminoglycosides.
10. A patient is prescribed a beta-blocker. Which condition should be reported before
administration?
A. Diabetes
B. Asthma
C. Mild headache
D. Hyperlipidemia
Answer: B. Asthma
Rationale: Nonselective beta-blockers can cause bronchoconstriction and worsen asthma
symptoms.