1. A nurse is reviewing a client’s chart who is prescribed
gentamicin. Which finding should concern the nurse most?
A. Tinnitus
B. WBC 10,000
C. Urine output 50 mL/hr
D. Temperature 100.2°F
Answer: A
Rationale: Tinnitus is a sign of ototoxicity, a serious adverse effect
of gentamicin.
2. A client with hypothyroidism takes levothyroxine. Which
statement indicates effective therapy?
A. “I feel cold all the time.”
B. “My heart rate is slower than usual.”
C. “I have more energy now.”
D. “I’m gaining weight quickly.”
Answer: C
Rationale: Increased energy suggests improved thyroid function.
3. A client taking phenytoin shows swollen, bleeding gums. What
should the nurse recommend?
A. Discontinue the drug
B. Increase fluid intake
C. Practice good oral hygiene
D. Reduce dietary sugar
Answer: C
,Rationale: Gingival hyperplasia is a known side effect. Encourage
oral care, not discontinuation.
4. A client on sildenafil experiences chest pain during intercourse.
What is the nurse’s next action?
A. Administer nitroglycerin
B. Encourage rest and fluids
C. Call emergency services
D. Administer aspirin
Answer: C
Rationale: Sildenafil + nitrates can cause life-threatening
hypotension. Do not give nitro—call 911.
5. A client taking warfarin has an INR of 4.2. Which action should
the nurse take?
A. Administer the next dose of warfarin
B. Hold the dose and notify the provider
C. Give vitamin K IV immediately
D. Prepare for platelet transfusion
Answer: B
Rationale: An INR >3.0 indicates increased bleeding risk. The
nurse should hold the medication and notify the provider.
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 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.
8. A client taking omeprazole asks why it is prescribed. Which
response is correct?
A. "It coats the lining of the stomach."
B. "It neutralizes gastric acid."
C. "It blocks acid production."
D. "It stimulates protective mucus production."
Answer: C
Rationale: Omeprazole is a proton pump inhibitor (PPI) that
blocks gastric acid secretion.
9. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
gentamicin. Which finding should concern the nurse most?
A. Tinnitus
B. WBC 10,000
C. Urine output 50 mL/hr
D. Temperature 100.2°F
Answer: A
Rationale: Tinnitus is a sign of ototoxicity, a serious adverse effect
of gentamicin.
2. A client with hypothyroidism takes levothyroxine. Which
statement indicates effective therapy?
A. “I feel cold all the time.”
B. “My heart rate is slower than usual.”
C. “I have more energy now.”
D. “I’m gaining weight quickly.”
Answer: C
Rationale: Increased energy suggests improved thyroid function.
3. A client taking phenytoin shows swollen, bleeding gums. What
should the nurse recommend?
A. Discontinue the drug
B. Increase fluid intake
C. Practice good oral hygiene
D. Reduce dietary sugar
Answer: C
,Rationale: Gingival hyperplasia is a known side effect. Encourage
oral care, not discontinuation.
4. A client on sildenafil experiences chest pain during intercourse.
What is the nurse’s next action?
A. Administer nitroglycerin
B. Encourage rest and fluids
C. Call emergency services
D. Administer aspirin
Answer: C
Rationale: Sildenafil + nitrates can cause life-threatening
hypotension. Do not give nitro—call 911.
5. A client taking warfarin has an INR of 4.2. Which action should
the nurse take?
A. Administer the next dose of warfarin
B. Hold the dose and notify the provider
C. Give vitamin K IV immediately
D. Prepare for platelet transfusion
Answer: B
Rationale: An INR >3.0 indicates increased bleeding risk. The
nurse should hold the medication and notify the provider.
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 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.
8. A client taking omeprazole asks why it is prescribed. Which
response is correct?
A. "It coats the lining of the stomach."
B. "It neutralizes gastric acid."
C. "It blocks acid production."
D. "It stimulates protective mucus production."
Answer: C
Rationale: Omeprazole is a proton pump inhibitor (PPI) that
blocks gastric acid secretion.
9. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
