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| Allopurinol (Zyloprim) is prescribed for a client and the nurse provides mediation instructions to the client. The nurse instructs the client: a. To drink 3000 mL of fluid a day b. To take the medication on an empty stomach c. That the effect of the medication will occur immediately d. That if swelling of the lips occurs, this is a normal expected response |
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| Colchicines is prescribed for a client with a diagnosis of gout. The nurse reviews the client’s record, knowing that this medication would be contraindicated in which of the following disorders? a. Myxedema b. Renal failure c. Hypothyroidism d. Diabetes mellitus |
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| Alendronate (Fosamax) is prescribed for a client with osteoporosis. The nurse instructs the client to: a. Take the medication at bedtime. b. Take the medication in the morning with breakfast. c. Lie down for 30 minutes after taking the medication. d. Take the medication with a full glass of water after rising in the morning. |
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| A nurse is providing discharge instruction s to a client receiving baclofen (Lioresal). Which of the following would be included in the teaching plan? a. Restrict fluid intake. b. Avoid the use of alcohol. c. Notify the physician if fatigue occurs. d. Stop the medication if diarrhea occurs. |
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| A nurse is analyzing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which of the following laboratory tests would identify an adverse effect associated with the administration of this medication? a. Creatinine level determination b. Platelet count determination c. Blood urea nitrogen level determination d. Liver function tests |
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| A nurse is reviewing the record of a client who has been prescribed baclofen (Lioresal). Which of the following disorders, if noted in the client’s history, would alert the nurse to contact the physician? a. Seizure disorder b. Hyperthyroidism c. Diabetes mellitus d. Coronary artery disease |
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| Cyclobenzaprine hydrochloride (Flexeril) is prescribed for a client for muscle spasms. The nurse is reviewing the client’s record. Which of the following disorders, if noted in the record, would indicate a need to contact the physician about the administration of this medication? a. Glaucoma b. Emphysema c. Hypothyroidism d. Diabetes mellitus |
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| A client is to receive a prescription for methocarbamol (Robaxin). The nurse provides instructions to the client about the medication. Which of the following client statements would indicate a need for further education? a. “My urine may turn brown or green.” b. “I might get some nasal congestion from this medication.” c. “This medication is prescribed to help relieve my muscle spasms.” d. “If my vision becomes blurred, I don’t need to be concerned about it.” |
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| A nurse is administering an intravenous dose of methocarbamol (Robaxin) to a client with multiple sclerosis. For which of the following adverse effects would the nurse monitor? a. Tachycardia b. Rapid pulse c. Bradycardia d. Hypertension |
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| Amikacin (Amikin) is prescribed for a client with a bacterial infection. The nurse instructs the client to contact the physician immediately if which of the following occurs? a. Nausea b. Lethargy c. Hearing loss d. Muscle aches |
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| The client who is human immunodeficiency virus seropositive has been taking zalcitabine (ddC, Hivid) as a component of treatment. The nurse plans to monitor which of the following most closely while the client is taking this medication? a. Platelet count b. Glucose level c. Red blood cell count d. Liver function studies |
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| The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet (Foscavir), an antiviral. The nurse checks the latest results of which of the following laboratory studies while the client is taking this medication? a. CD4 cell count b. Serum albumin level c. Serum creatinine level d. Lymphocyte count |
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| The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The client develops a temperature of 101F. the nurse does further monitoring of the client, knowing that this sign would most likely indicate: a. That the dose of the medication is too low. b. That the client is experiencing toxic effects of the medication. c. That the client has developed inadequacy of thermoregulation. d. That the result of another infection caused by leukopenic effects of the medication. |
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| Saquinavir (Invirase) is prescribed for the client who is seropositive for human immunodeficiency virus. The nurse reinforces medication instructions and tells the client to: a. Avoid sun exposure. b. Eat low-calorie foods. c. Eat foods that are low in fat. d. Take the medication on an empty stomach. |
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| The client who is immunodeficiency virus seropositive has been taking Stavudine (d4t, Zerit). The nurse monitors which of the following most closely while the client is taking this medication? a. Gait b. Appetite c. Level of consciousness d. Gastrointestinal function |
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| The client with acquired immunodeficiency syndrome has begun therapy with zidovudine (Retrovir, azidothymidine, AZT, ZDV). The nurse carefully monitors which of the following laboratory results during treatment with this medication? a. Blood culture b. Blood glucose level c. Blood urea nitrogen level d. Complete blood count |
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| The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine (Videx). The nurse interprets that the client may have the medication discontinued by the physician if which of the following significantly elevated results is noted? a. Serum protein level b. Blood glucose level c. Serum amylase level d. Serum creatinine level |
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| The nurse is caring for a post-renal transplantation client taking cyclosporin (Sandimmune, Gengraf, Neoral). The nurse notes an increase in one of the client’s vital signs and the client is complaining of a headache. What is the vital sign that is most likely increased? a. Pulse b. Respirations c. Blood pressure d. Pulse oximetry |
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| The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluorine (Prozac). What information would be important for the nurse to obtain during this client visit regarding the side effects of the medication? a. Cardiovascular symptoms b. Gastrointestinal dysfunctions c. Problems with mouth dryness d. Problems with excessive sweating |
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| The client who has been taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up assessment. The nurse determines that the medication is effective if the absence of which manifestation(s) has occurred? a. Paranoid thought process b. Rapid heartbeat or anxiety c. Alcohol withdrawal symptoms d. Thought broadcasting or delusions |
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| A client taking lithium carbonate (Eskalith) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L. the nurse interprets this level as: a. Toxic b. Normal c. Slightly above normal d. Excessively below normal |
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| The home health nurse visits the client. The client gives the nurse a bottle of clomipramine (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. What behaviors observed in the client would validate noncompliance with this medication? a. Complaints of insomnia b. Complaints of hunger and fatigue c. A pulse rate less than 60 beats/min d. Frequent hand washing with hot soapy water |
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| The hospitalized client has begun taking bupropion (Wellbutrin) as an antidepressant agent. The nurse monitors this client for which adverse effect indicating that the client is taking an excessive amount of medication? a. Constipation b. Seizure activity c. Increased weight d. Dizziness when getting upright |
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| The client’s medication sheet contains an order for sertraline hydrochloride (Zoloft). To ensure safe administration of the medication, the nurse would administer the dose: a. On an empty stomach b. At the same time each evening c. Evenly spaced around the clock d. As needed when the client complains of depression |
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| The client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse assesses the results of which laboratory study to monitor for adverse effects from this medication? a. Platelet count b. Blood glucose level c. White blood cell count d. Liver function studies |
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| A client is scheduled for discharge and will be taking Phenobarbital (Luminal) for an extended period of time. The nurse would place highest priority on teaching the client which of the following points that directly relates to client safety? a. Take the medication only with meals. b. Take the medication at the same time each day. c. Use a dose container to help prevent missed doses. d. Avoid drinking alcohol while taking this medication. |
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| The 26-year-old female client with schizophrenia has been prescribed chlorpromazine hydrochloride (Thorazine). The client calls the mental health clinic and tells the nurse that her urine had become dark. The client has no other urinary symptoms. The nurse tells the client: a. That this indicates medication toxicity b. To seek treatment for urinary tract infection c. To increase intake of acid-ash foods and liquids d. That this is an expected side effect of the medication |
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| A client is receiving fluphenazine (Prolixin) daily. The nurse would teach the client to do which of the following to minimize common side effects of this medication? a. Monitor the temperature daily. b. Use hard sour candy or sugarless gum. c. Eat snacks at midmorning and at bedtime. d. Have the blood pressure checked once a week. |
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| The nurse is describing the medication side effects to a client who is taking oxazepam (Serax). The nurse incorporates in discussions with the client the need to: a. Consume a low-fiber diet. b. Increase fluids and bulk in the diet. c. Rest if the heart begins to beat rapidly. d. Take antidiarrheal agents if diarrhea occurs. |
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| The nurse is administering risperidone (Risperdal) to a client who is scheduled to be discharged. Prior to discharge, which of the following should the nurse teach the client? a. Get adequate sunlight. b. Avoid foods rich in potassium. c. Continue driving as usual. d. Get up slowly when changing positions |
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| A client receiving lithium carbonate (Eskalith) complains of loose watery stools and difficulty walking. The nurse would expect the serum lithium level to be which of the following? a. 0.7 mEq/L b. 1 mEq/L c. 1.3 mEq/L d. 1.8 mEq/L |
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| The nurse is teaching a client who is being started on imipramine hydrochloride (Tofranil) about the medication. The nurse informs the client that the maximum desired effects may: a. Start during the first week of administration b. Not occur for 2 to 3 weeks of administration c. Start during the second week of administration d. Not occur until after 2 months of administration |
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| The client receiving tricyclic antidepressants arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly? a. Client reports not going to work for this past week. b. Client arrives at the clinic neat and appropriate in appearance. c. Client complains of not being able to “do anything” anymore. d. Client reports sleeping 12 hours per night and 3 to 4 hours during the day. |
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| A client begins to experience extrapyramidal side effects from an antipsychotic medication. The nurse anticipates that the physician will prescribe which of the following to treat this condition? a. Haloperidol (Haldol) b. Benztropine (Cogentin) c. Prochlorperazine (Compazine) d. Chlorpromazine (Thorazine) |
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| The nurse notes that a client diagnosed with schizophrenia is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing: a. Torticollis b. Tardive dyskinesia c. Hypertensive crisis d. Neuroleptic malignant syndrome |
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| A client has a continuously running peripheral infusion. The physician orders an antibiotic as a piggyback infusion 4 times a day. In order to administer the antibiotic, the nurse should do which of the following? a. Start a new IV access to administer the antibiotic so that there will not be compatibility issues. b. Start a new IV access to eliminate the problem of too much volume for one site. c. Increase the flow rate of the continuous infusion to facilitate the administration of the antibiotic. d. Check to see if the antibiotic is compatible with the continuous infusion. |
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| The family of a home infusion client calls the home health nurse one night to report that the electronic infusion pump is alarming. The nurse anticipates that the infusion pump alarm could be caused by which of the following? a. The client’s pulse and blood pressure falling. b. The client experiencing a reaction to the medication c. The infusion is complete or there is an occlusion d. An incompatibility with the medications. |
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| The home health nurse is monitoring a client who performs self-care of a central line. The nurse observes the client doing all of the following activities. Which activity indicates the need for further education? a. Flushing the central line with a 3 mL syringe. b. Cleaning the needleless injection cap with alcohol before accessing. c. Using sterile gloves to change the central line dressing. d. Wearing a mask while changing the central line dressing. |
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| The client has a tunneled Groshong catheter for intermittent medication administration. After administering the medication, the nurse prepares to do which of the following? a. Clamp the catheter. b. Flush the catheter with saline, then heparin. c. Flush the catheter with saline. d. Ask the client to perform the Valsalva maneuver when the medication IV tubing is disconnected. |
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| The client has a percutaneous jugular central venous line that is capped and used for intermittent infusions. After administering the medication, the best method to maintain patency is to do which of the following? a. Flush the line first with 3-5 mL of normal saline, then with 1-3 mL of heparinized normal saline. b. Flush the line with 3-5 mL of normal saline. c. Flush the line with 3-5 mL of heparinized normal saline. d. Flush the line first with 3-5 mL of heparin, then with 1-3 mL of normal saline. |
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| The nurse is caring for a client with a Hickman central line. While changing the central line dressing, the nurse notes that the injection cap (heplock adapter) is of the slip lock variety instead of a luer lock device. The nurse recognizes that this adapter puts the client at risk for which of the following complications? a. Sepsis b. Occlusion c. Phlebitis d. Air embolism |
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| The client is to receive vancomycin, an intravenous medication. To prevent adverse reactions from rapid infusion, the nurse would plan to administer this drug using which of the following methods? a. By gravity b. With a regulator c. By electronic infusion pump d. In an elastomeric pump |
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| The physician is going to order a hypotonic intravenous solution for a client with cellular dehydration. The nurse would expect which of the following fluids to be administered? a. 0.9% normal saline b. 5% dextrose in normal saline c. Lactated Ringer’s solution d. 0.45% sodium chloride |
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| The nurse is caring for several clients with central venous catheters. While changing the tubing on the central lines, the nurse would not need to instruct the client to perform a Valsalva maneuver when the client has which of the following catheters? a. Groshong catheter b. Single-lumen catheter c. Percutaneous catheter d. Accessed subcutaneous venous port |
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| The client is receiving 5% dextrose in 0.45% normal saline. The physician has ordered the client received one unit of packed cells. Prior to hanging the blood, the nurse will prime the blood tubing with which of the following solutions? a. 5% dextrose b. Lactated Ringer’s The client is receiving 5% dextrose in 0.45% normal saline. The physician has ordered the client received one unit of packed cells. Prior to hanging the blood, the nurse will prime the blood tubing with which of the following solutions? a. 5% dextrose b. Lactated Ringer’s c. 0.9% normal saline d. 5% dextrose in 0.45% sodium chloride d. 5% dextrose in 0.45% sodium chloride |
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| While assessing a client’s intravenous line, the nurse notes that the area is swollen, cool, pale, and causes the client discomfort. The nurse documents which of the following complications of IV therapy? a. Infiltration b. Phlebitis c. Infection d. Air embolism |
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| The client is receiving 5% dextrose and 0.45% sodium chloride intravenously and is complaining of pain at the IV site. The nurse assesses the site and notes erythema and edema. Which of the following would be the appropriate nursing action? a. Slow the infusion rate. b. Discontinue the IV and apply a warm compress to the IV site. c. Apply antibiotic ointment to the IV site. d. Gently pull back the IV access device to reposition within the vein. |
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| The nurse is starting a new peripheral intravenous line in a client. The client reports a latex allergy. The nurse has a typical IV start kit. Because of the latex allergy, the nurse should take which of the following actions? a. Utilize a new tourniquet for this client. b. Utilized a blood pressure cuff to distend the vein. c. Avoid putting providone iodine on the skin. d. Suggest an alternative therapy to a peripheral IV. |
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| The nurse is inserting a peripheral intravenous line into a client. After piercing the skin and entering the vein, the nurse would refrain from advancing the catheter if which of the following were noted? a. Blood backflow into the IV catheter b. Mild resistance with advancement c. No reports of client discomfort d. The IV catheter was inserted bevel side up |
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| A nurse has obtained a unit of packed red blood cells (PRBCs) from the blood bank. She and another nurse have confirmed that it is the correct blood for the patient. Immediately prior to starting the blood transfusion, the nurse should assess which of the following? a. Vital signs b. Skin color c. Hemoglobin level d. Creatinine clearance |
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| A nurse is preparing to administer a unit of PRBCs. When obtaining the necessary supplies, the nurse would obtain which of the following IV solutions to hang with the unit of blood? a. Ringer’s lactate b. 5% dextrose in 0.9% sodium chloride c. 5% dextrose in 0.45% sodium chloride d. 0.9% sodium chloride |
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| A nurse returns to evaluate a client who has been receiving a blood transfusion for the past 30 minutes. The client is observed to be dyspnic. Upon assessment, the nurse auscultates the presence of crackles in the lung bases and an apical heart rate of 110 beats per minute. The nurse suspects that the client is experiencing which of the following complications associated with blood transfusions? a. Immune response to transfusion b. Hypovolemia c. Fluid overload d. Polycythemia vera |
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| A nurse determines that a client receiving a unit of PRBCs is experiencing a transfusion reaction. The nurse promptly stops the blood transfusion and does which of the following next? a. Contact the physician b. Obtain a white blood cell count c. Run normal saline at keep vein open (KVO) rate d. Infuse a normal saline bolus |
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| A client arrives at the emergency department following a gunshot wound. The client is actively bleeding and has been taking warfarin (Coumadin) therapy. His prothrombin time is twice the desired amount. You expect that the physician will order a transfusion with which of the following blood products: a. Fresh frozen plasma b. Random donor platelets c. Red blood cells d. Crystalloids |
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| An adult female client has a hemoglobin level of 9.2 grams/dL. A nurse interprets that this is most likely related to which of the following conditions? a. Leukemia b. Amenorrhea c. Vitamin B12 deficiency anemia d. Iron deficiency anemia |
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| A nurse has received an order to transfuse a client with one unite of PRBCs. In preparation for the infusion, the nurse selects the appropriate tubing for blood administration. The nurse is aware that the tubing is manufactured with which of the following? a. A macrodrip chamber b. An air vent c. An in-line filter d. Tinting that protects blood from exposure to light |
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