1. 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.
2. 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.
3. A client with COPD is on prednisone. Which instruction is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding and
ulcers. Tarry stools may indicate bleeding.
4. 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.
5. A client on lithium therapy has a sodium level of 128 mEq/L.
What is the nurse's best action?
A. Encourage low-sodium diet
B. Administer next dose
C. Hold the dose and notify the provider
D. Increase fluid restriction
Answer: C
Rationale: Hyponatremia can increase lithium toxicity risk. Hold
the dose and notify the provider.
6. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Answer: B
Rationale: Metoprolol can cause bradycardia. Always check HR
before administering.
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 client is using a scopolamine patch for motion sickness.
What side effect should the nurse monitor?
A. Diarrhea
B. Blurred vision and dry mouth
C. Rash
D. Hearing loss
Answer: B
Rationale: Scopolamine has anticholinergic effects like dry mouth,
blurred vision, and urinary retention.
9. 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.
10. A client with chronic constipation uses magnesium citrate
daily. What risk should the nurse discuss?
A. Hypertension
B. Hypernatremia
C. Electrolyte imbalance
D. Dehydration
Answer: C
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.
2. 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.
3. A client with COPD is on prednisone. Which instruction is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding and
ulcers. Tarry stools may indicate bleeding.
4. 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.
5. A client on lithium therapy has a sodium level of 128 mEq/L.
What is the nurse's best action?
A. Encourage low-sodium diet
B. Administer next dose
C. Hold the dose and notify the provider
D. Increase fluid restriction
Answer: C
Rationale: Hyponatremia can increase lithium toxicity risk. Hold
the dose and notify the provider.
6. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Answer: B
Rationale: Metoprolol can cause bradycardia. Always check HR
before administering.
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 client is using a scopolamine patch for motion sickness.
What side effect should the nurse monitor?
A. Diarrhea
B. Blurred vision and dry mouth
C. Rash
D. Hearing loss
Answer: B
Rationale: Scopolamine has anticholinergic effects like dry mouth,
blurred vision, and urinary retention.
9. 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.
10. A client with chronic constipation uses magnesium citrate
daily. What risk should the nurse discuss?
A. Hypertension
B. Hypernatremia
C. Electrolyte imbalance
D. Dehydration
Answer: C
