1.      A client has been taking isoniazid (INH) for 1 ½ months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing:

a.      Hypercalcemia

b.      Peripheral neuritis

c.       Small blood vessel spasm

d.      Impaired peripheral circulation

1.      A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:

a.      Use alcohol in small amounts only.

b.      Report yellow eyes or skin immediately.

c.       Increase intake of Swiss or aged cheeses.

d.      Avoid vitamin supplements during therapy.

1.      A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication:

a.      Should always be taken with food or antacids

b.      Should be double-dosed if one dose is forgotten

c.       Causes orange discoloration of sweat, tears, urine, and feces

d.      May be discontinued independently if symptoms are gone in 3 months

1.      A nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states to report immediately:

a.      Impaired sense of hearing

b.      Gastrointestinal side effects

c.       Orange-red discoloration of body secretions

d.      Difficulty in discriminating the color red from green

1.      Cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client teaching plan regarding this medication?

a.      Take the medication before meals.

b.      Return to the clinic weekly for serum drug level determination.

c.       It is not necessary to call the physician if a skin rash occurs.

d.      It is not necessary to restrict alcohol intake with this medication.

1.      A client with tuberculosis is being started on ant tuberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed?

a.      Electrolyte levels

b.      Liver enzyme levels

c.       Serum keratinize level

d.      Coagulation times

1.      A nurse is preparing to administer albuterol (Proventil) to a client. The nurse assesses which of the following parameters before and during therapy?

a.      Nausea and vomiting

b.      Urine output and blood urea nitrogen level

c.       Headache and level of consciousness

d.      Lung sounds and presence of dyspnea

1.      A home care nurse has observed a client self-administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse interprets that this is the result of:

a.      Insufficient dosage of the medication, which needs to be increased.

b.      Paradoxical bronchospasm, which must be reported to the physician.

c.       Probable interaction of this medication with an over-the-counter cold remedy.

d.      Tolerance to the medication, indicating a need for a stronger type of bronchodilator.

1.      A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. the nurse would determine that the client is receiving the therapeutic effect based on which of the following results?

a.      Prothrombin time of 12.5 seconds

b.      Activated partial thromboplastin time of 60 seconds

c.       Activated partial thromboplastin time of 28 seconds

d.      Activated partial thromboplastin time longer than 120 seconds

1.      A client develops atrial fibrillation with a ventricular rate of 140 beats/min and signs of decreased cardiac output. Which of the following medications should the nurse first anticipate administering?

a.      Atropine sulfate

b.      Warfarin (Coumadin)

c.       Lidocaine (Xylocaine)

d.      Metoprolol (Lopressor)

1.      In reviewing the medication records of the following groups of clients, the nurse determines that which client would be at greatest risk for developing hyperkalemia?

a.      Client receiving furosemide (Lasix)

b.      Client receiving bumetanide (Bumex)

c.       Client receiving spironolactone (Aldactone)

d.      Client receiving hydrochlorothiazide (HCTZ)

1.      A nurse provides discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?

a.      “I will take my pills every day at the same time.”

b.      “I will be certain to limit my alcohol consumption.”

c.       “I have already called my family to pick up a Medic-Alert bracelet.”

d.      “I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated.”

1.      A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A physician orders a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?

a.      0.5 to 2 ng/mL

b.      1.2 to 2.8 ng/mL

c.       3 to 5 ng/mL

d.      3.5 to 5.5 ng/mL

1.      A client is being treated with procainamide (Procanbid) for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first?

a.      Administer ordered nitroglycerin tablets.

b.      Measure the heart rate on the rhythm strip.

c.       Obtain a 12-lead electrocardiogram immediately.

d.      Auscultate the client’s apical pulse and obtain a blood pressure.

1.      A nurse is monitoring a client who is taking propranolol (Inderal). Which assessment data would indicate a potential serious complication associated with propranolol?

a.      The development of complaints of insomnia

b.      The development of audible expiratory wheezes

c.       A baseline blood pressure of 15/80 mmHg after two doses of the medication

d.      A baseline resting heart rate of 88 beats/min followed by a resting hear rate of 72 beats/min after two doses of the medication

1.      A home health care nurse is visiting an older client at home. Furosemide (Lasix) is prescribed for the client and the nurse teaches the client about the medication. Which of the following statements, if made by the client, indicates the need for further teaching?

a.      “I will sit up slowly before standing each morning.”

b.      “I will take my medication every morning with breakfast.”

c.       “I need to drink lots of coffee and tea to keep myself healthy.”

d.      “I will call my doctor if my ankles swell or my rings get tight.”

1.      A nurse is caring for a client receiving a heparin intravenous (IV) infusion. The nurse anticipates that which laboratory study will be prescribed to monitor the therapeutic effect of heparin?

a.      Hematocrit

b.      Hemoglobin

c.       Prothrombin time

d.      Activated partial thromboplastin time

1.      A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which of the following is a priority nursing intervention?

a.      Monitor for renal failure.

b.      Monitor psychosocial status.

c.       Monitor for signs of bleeding.

d.      Have heparin sodium available.

1.      A home health nurse instructs a client about the use of a nitrate patch. The nurse tells the client that which of the following will prevent client tolerance to nitrates?

a.      “Do not remove the patches.”

b.      “Have a 12-hour ‘no nitrate’ time.”

c.       “Have a 24-hour ‘no nitrate’ time.”

d.      “Keep nitrates on 24 hours, then off 24 hours.”

1.      A client is admitted to a medical unit with nausea and bradycardia. The family hands a nurse a small white envelope labeled “heart pill.” The envelope is sent to the pharmacy and it is found to be digoxin (Lanoxin). A family member states, “That doctor doesn’t know how to take care of my family.” Which of the following statements would convey a therapeutic response by the nurse?

a.      “Don’t worry about this. I’ll take care of everything.”

b.      “You are concerned your loved one receives the best care.”

c.       “You’re right! I’ve never seen a doctor put pills in an envelope.”

d.      “I think you’re wrong. That physician has been in practice over 30 years.”

1.      A nurse is caring for a client receiving dopamine. Which of the following potential nursing diagnoses is appropriate for this client?

a.      Fluid volume, excess

b.      Cardiac output, increased

c.       Tissue perfusion, ineffective

d.      Sensory perception, disturbed

1.      A nurse is planning to administer hydrochlorathiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication?

a.      Hypouricemia, hyperkalemia

b.      Increased risk of osteoporosis

c.       Hypokalemia, hyperglycemia, sulfa allergy

d.      Hyperkalemia, hypoglycemia, penicillin allergy

1.      A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. Which of the following statements, if made by the client, indicates the need for further education?

a.      “Constipation and bloating might be a problem.”

b.      “I’ll continue to watch my diet and reduce my fats.”

c.       “Walking a mile each day will help the whole process.”

d.      “I’ll continue my nicotinic acid from the health food store.”

1.      A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions?

a.      “It is not necessary to avoid the use of alcohol.”

b.      “The medication should be taken with meals to decrease flushing.”

c.       “Clay-colored stools are a common side effect and should not be of concern.”

d.      “Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing.”

1.      A client has developed paroxysmal nocturnal dyspnea. Which of the following medications does a nurse anticipate will be prescribed by the physician?

a.      Propranolol (Inderal)

b.      Bumetanide (Bumex)

c.       Lidocaine (Xylocaine)

d.      Streptokinase (Streptase)

1.      A 66-year-old client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include atenolol (Tenormin), digoxin (Lanoxin), and chlorothiazide (Diuril). A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?

a.      Dyspnea, edema, and palpitations

b.      Chest pain, hypotension, and paresthesia

c.       Double vision, loss of appetite, and nausea

d.      Constipation, dry mouth, and sleep disorder

1.      A client is being treated for acute congestive heart failure with intravenously administered bumetanide (Bumex). The vital signs are as follows: blood pressure, 100/60 mmHg; pulse, 96 beats/min; and respirations, 24 breaths/min. after the initial dose, which of the following is the priority assessment?

a.      Monitoring weight loss

b.      Monitoring urine output

c.       Monitoring blood pressure

d.      Monitoring potassium level

1.      Intravenous heparin therapy is ordered for a client. While implementing this order, a nurse ensures that which of the following medications is available on the nursing unit?

a.      Protamine sulfate

b.      Potassium chloride

c.       Aminocaproic acid (Amicar)

d.      Vitamin K (AquaMEPHYTON)

1.      A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium (Coumadin). The client’s prothrombin time is 20 seconds, with a control of 11 seconds. How would the nurse interpret these results?

a.      Client needs to have test repeated.

b.      Client results are within the therapeutic range.

c.       Client results are higher than the therapeutic range.

d.      Client results are lower than the needed therapeutic level.

1.      A client is receiving thrombolytic therapy with a continuous infusion of streptokinase (Strepase). The client suddenly becomes extremely anxious and complains of itching. A nurse hears stridor and on examination of the client notes generalized urticaria and hypotension. Which of the following should be the priority action of the nurse?

a.      Administer oxygen and protamine sulfate.

b.      Stop the infusion and call the physician.

c.       Cut the infusion rate in half and sit the client up in bed.

d.      Administer diphenhydramine (Benadryl) and continue the infusion.

1.      A client is on enalapril (Vasotec) for the treatment of hypertension. The nurse teaches the client that he should seek emergent care if he experiences which adverse effect?

a.      Nausea

b.      Insomnia

c.       Dry cough

d.      Swelling of the tongue

1.      Which of the following would be an expected outcome of nesiritide (Natrecor) administration?

a.      Client will have an increase in urine output.

b.      Client will have an absence of dysrhythmias.

c.       Client will have an increase in blood pressure.

d.      Client will have an increase in pulmonary capillary wedge pressure.

1.      A client is admitted to a hospital with acute myocardial infarction and is started on tissue plasminogen activator (tPA, Activase) by infusion. Of the following parameters, which one would a nurse determine requires the least frequent assessment to detect complications of therapy with tissue plasminogen activator?

a.      Neurological signs

b.      Presence of bowel sounds

c.       Blood pressure and pulse

d.      Complaints of abdominal and back pain

1.      A client is admitted with pulmonary embolis and is to be treated with streptokinase (Streptase). A nurse would report which of the following assessments to the physician before initiating this therapy?

a.      Adventitious breath sounds

b.      Temperature of 99.4F orally

c.       Blood pressure of 198/110 mmHg

d.      Respiratory rate of 28 breaths/min

1.      The client who has a cold is seen in the emergency room with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which of the following medications?

a.      Diuretics

b.      Antibiotics

c.       Antitussives

d.      Decongestants

1.      Trimethoprim-sulfamethoxazole (TMP-SMA; Bactrim) is prescribed to be administered by intravenous infusion to a client with a recurrent urinary tract infection. A nurse would administer this medication:

a.      Over 30 minutes

b.      Over 60 to 90 minutes

c.       Piggybacked into the peripheral line containing parenteral nutrition

d.      Piggybacked into the existing infusion of normal saline and potassium chloride

1.      Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client’s record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client?

a.      Discontinuation of warfarin sodium (Coumadin)

b.      A decrease in the warfarin sodium (Coumadin) dosage

c.       An increase in the warfarin sodium (Coumadin) dosage

d.      A decrease in the usual dose of nalidixic acid (NegGram)

1.      A nurse is providing discharge instructions to a client receiving sulfisoxazole. Which of the following would be included in the list of instructions?

a.      Restrict fluid intake.

b.      Maintain a high fluid intake.

c.       If the urine turns dark brown, call the physician immediately.

d.      Decrease the dosage when symptoms are improving to prevent an allergic response.

1.      Trimethoprim-sulfamethoxazole (TMP-SMZ; Bactrim) is prescribed for a client. A nurse would instruct the client to report which symptom if it developed during the course of this medication therapy?

a.      Nausea

b.      Diarrhea

c.       Headache

d.      Sore throat

1.      Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse teaches the client:

a.      To take the medication at bedtime

b.      To take the medication before meals

c.       To discontinue the medication if a headache occurs

d.      That a reddish orange discoloration of the urine may occur

1.      Bethanechol chloride (Urecholine) is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?

a.      Gastric atony

b.      Urinary strictures

c.       Neurogenic atony

d.      Gastroesophageal reflux

1.      A nurse who is administering bethanechol chloride (Urecholine) is monitoring for acute toxicity associated with the medication. The nurse checks the client for which sign of toxicity?

a.      Dry skin

b.      Dry mouth

c.       Bradycardia

d.      Signs of dehydration

1.      Oxybutynin chloride (Ditropan) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?

a.      Pallor

b.      Drowsiness

c.       Bradycardia

d.      Restlessness

1.      Propantheline bromide (Pro-Banthine) is prescribed for a client with bladder spasms. Which of the following disorders, if noted in the client’s record, would alert a nurse to question the prescription for this medication?

a.      Glaucoma

b.      Myxedema

c.       Hypothyroidism

d.      Coronary artery disease

1.      Following kidney transplantation, cyclosporine (Sandimmune) is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?

a.      Decreased creatinine level

b.      Decreased hemoglobin level

c.       Elevated blood urea nitrogen level

d.      Decreased white blood cell count

1.      A nurse is providing dietary instructions to a client who has been prescribed cyclosporine (Sandimmune). Which food item would the nurse instruct the client to avoid?

a.      Red meats

b.      Orange juice

c.       Grapefruit juice

d.      Green leafy vegetables

1.      A nurse provides instructions to a client who will be taking cyclosporine (Sandimmune) oral solution. The nurse tells the client to:

a.      Mix the concentrate with chocolate milk.

b.      Mix the concentrate with grapefruit juice.

c.       Avoid diluting the concentrate for administration.

d.      Dilute the concentrate in a Styrofoam cup before administration.

1.      A nurse is monitoring a client receiving cyclosporine (Sandimmune). Which sign or symptom would indicate to the nurse that the client is experiencing an adverse effect from this medication?

a.      Nausea

b.      Tremors

c.       Alopecia

d.      Hypotension

1.      Tacrolimus (Prograf) is prescribed for a client. Which disorder, if noted in the client’s record, would indicate that the medication needs to be administered with caution?

a.      Pancreatitis

b.      Ulcerative colitis

c.       Diabetes insipidus

d.      Coronary artery disease

1.      A nurse is reviewing the laboratory results for a client receiving tacrolimus (Prograf). Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?

a.      Blood glucose of 200 mg/dL

b.      Potassium level of 3.8 mEq/L

c.       Platelet count of 300,000 cells/mm3

d.      White blood cell count of 6,000 cells/mm3

1.      Mycophenolate mofetil (CellCept) is prescribed for a client for prophylaxis of organ rejection following allogeneic renal transplantation. Which instruction would a nurse provide to the client regarding administration of this medication?

a.      Administer following meal.

b.      Contact the physician if a sore throat occurs.

c.       Take the medication with a magnesium-type antacid.

d.      Open the capsule and mix with food for administration.

1.      The nurse receives a call from a client concerned about eliminating brown-colored urine after taking nitrofurantoin (Furadantin) for a urinary tract infection. Which of the following is the appropriate response from the nurse?

a.      “Discontinue taking the medication and make an appointment for a urine culture.”

b.      “Continue taking the mediation because the urine is discolored from the medication.”

c.       “Decrease your medication to half the dose because your urine is too concentrated.”

d.      “Take magnesium hydroxide (Maalox) with your medication to lighten the urine color.”

1.      A client with chronic renal failure is receiving epoetin alfa (Epogen, Procrit). Which laboratory result would indicate a therapeutic effect of the mediation?

a.      Hematocrit of 32%

b.      Platelet count of 400,000 cells/mm3

c.       Blood urea nitrogen level of 15 mg/dL

d.      White blood cell count of 6,000 cells/mm3

1.      A nurse is instructing a client to administer epoetin alfa (Epogen, Procrit) b the subcutaneous route. The nurse tells the client to:

a.      Shake the vial before use.

b.      Refrigerate the medication.

c.       Freeze the medication before use.

d.      Obtain syringes with 1 ½ inch needles from the pharmacy.

1.      The client is receiving an eye drop and an eye ointment to the right eye. The nurse should:

a.      Administer the eye drop first, followed by the eye ointment.

b.      Administer the eye ointment first, followed by the eye drop.

c.       Administer the eye drop, wait 10 minutes, and administer the eye ointment.

d.      Administer the eye ointment, wait 10 minutes, and administer the eye drop.

1.      The nurse is caring for a client with glaucoma. Which of the following medications, if prescribed for the client, would the nurse question?

a.      Carbachol (Carboptic)

b.      Atropine sulfate (Isopto Atropine)

c.       Pilocarpine (Ocusert Pilo-20, Ocusert Pilo-40)

d.      Pilocarpine hydrochloride (Isopto Carpine)

1.      A miotic medication has been prescribed for the client with glaucoma. The client asks the nurse about the purpose of the medication. The nurse tells the client:

a.      “The medication will help dilate the eye to prevent pressure from occurring.”

b.      “The medication will relax the muscles of the eyes and prevent blurred vision.”

c.       “The medication causes the pupil to constrict and will lower the pressure of the eye.”

d.      “The medication will help block the responses that are sent to the muscles in the eye.”

1.      A client was just admitted to the hospital to rule out a gastrointestinal (GI) bleed. The client has brought several bottles of medications prescribed by different specialists. During the admission assessment, the client states, “Lately, I have been hearing some roaring sounds in my ears, especially when I am alone.” Which medication would the nurse determine could be the cause of the client’s complaint?

a.      Doxycycline (Vibramycin)

b.      Acetazolamide (Diamox)

c.       Acetylsalicylic acid (aspirin)

d.      Diltiazem hydrochloride (Cardizem)

1.      Pilocarpine hydrochloride (Isopto Carpine) is prescribed for the client with glaucoma. Which of the following medications does the nurse plan to have available in case of systemic toxicity?

a.      Atropine sulfate

b.      Pindolol (Visken)

c.       Protamine sulfate

d.      Naloxone hydrochloride (Narcan)

1.      Betaxolol hydrochloride (Betoptic) eye drops have been prescribed for the client with glaucoma. Which of the following nursing actions is most appropriate related to monitoring for the side effects of this medication?

a.      Monitoring temperature

b.      Monitoring blood pressure

c.       Assessing peripheral pulses

d.      Assessing blood glucose level

1.      The nurse prepares the client for an ear irrigation as prescribed by the physician. In performing the procedure, the nurse

a.      Warms the irrigating solution to 98F

b.      Positions the client with the affected side up following the irrigation

c.       Directs a slow steady stream of irrigation solution toward the eardrum

d.      Assists the client to run his or her head so that the ear to be irrigated is facing upward

1.      In preparation for cataract surgery, the nurse is to administer cyclopentolate (Cyclogyl) eye drops. The nurse administers the eye drops, knowing that the purpose of this medication is to:

a.      Produce miosis of the operative eye.

b.      Dilate the pupil of the operative eye.

c.       Provide lubrication to the operative eye.

d.      Constrict the pupil of the operative eye.

1.      Ear drops are prescribed for an infant with otitis media. The most appropriate method to administer the ear drops to the infant is to:

a.      Pull up and back on the pinna and direct the solution onto the eardrum.

b.      Pull down and back on the pinna and direct the solution onto the eardrum.

c.       Pull down and back on the pinna and direct the solution toward the wall of the canal.

d.      Pull up and back on the ear lobe and direct the solution toward the wall of the canal.

1.      The nurse is providing instructions to a client who will be self-administering eye drops. To minimize the systemic effects that eye drops can produce, the nurse instructs the client to:

a.      Eat before instilling the drops.

b.      Swallow several times after instilling the drops.

c.       Blink vigorously to encourage tearing after instilling the drops.

d.      Occlude the nasolacrimal duct with a finger over the inner canthus for 30 to 60 seconds after instilling the drops.

1.      The nurse has given medication instructions to the client receiving phenytoin (Dilantin). The nurse determines that the client has an adequate understanding if the client states that:

a.      “Alcohol is not contraindicated while taking this medication.”

b.      “Good oral hygiene is needed, including brushing and flossing.”

c.       “The medication dose may be self-adjusted, depending on side effects.

d.      “The morning dose of the medication should be taken before serum drug level is drawn.”

1.      The client with myasthenia gravis has become increasingly weaker. The physician prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis).  An injection of edrophonium (Tensilon) is administered. Which of the following would indicate that the client is in cholinergic crisis?

a.      No change in the condition

b.      Complaints of muscle spasms

c.       An improvement of the weakness

d.      A temporary worsening of the condition

1.      Carbidopa-levodopa (Sinemet) is prescribed for the client with Parkinson’s disease. The nurse monitors the client for adverse reactions to the medication. Which of the following would indicate that the client is experiencing an adverse reaction?

a.      Pruritus

b.      Tachycardia

c.       Hypertension

d.      Impaired voluntary movements

1.      The client is taking phenytoin (Dilantin) for seizure control. A sample is drawn to determine the serum drug level, and the nurse reviews the results. Which of the following would indicate a therapeutic serum drug range?

a.      5 to 10 mcg/mL

b.      10 to 20 mcg/mL

c.       20 to 30 mcg/mL

d.      30 to 40 mcg/mL

1.      The nurse is preparing an intravenous infusion of phenytoin (Dilantin) as prescribed by the physician for the client with seizures. Which of the following solutions will the nurse plan to use to dilute this medication?

a.      Dextrose 5%

b.      Normal saline solution

c.       Lactated Ringer’s solution

d.      Dextrose 5% and half-normal saline (0.45%)

1.      The home health nurse visits a client who is taking phenytoin (Dilantin) for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse include in the teaching plan?

a.      Pregnancy should be avoided while taking phenytoin.

b.      The client may stop the medication if it is causing severe gastrointestinal effects.

c.       There is the potential of decreased effectiveness of birth control pills while taking phenytoin.

d.      There is the increased risk of thrombophlebitis while taking phenytoin and birth control pills together.

1.      The nurse is caring for a client in the emergency room diagnosed with Bell’s palsy. The client has been taking acetaminophen (Tylenol), and acetaminophen overdose is suspected. The nurse anticipates that the antidote to be prescribed is:

a.      Pentostatin (Nipent)

b.      Auranofin (Ridaura)

c.       Fludarabine (Fludara)

d.      Acetylcysteine (Mucomyst)

1.      The client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken daily for the relief of generalized discomfort. Which laboratory value would indicate toxicity associated with the medication?

a.      Sodium level of 140 mEq/L

b.      Prothrombin time of 12 seconds

c.       Direct bilirubin level of 2 mg/dL

d.      Platelet count of 400,000/mm3

1.      The client is suspected of having myasthenia gravis. Edrophonium (Tensilon) 2 mg is administered intravenously to determine the diagnosis. Which of the following indicates that the client has myasthenia gravis?

a.      Joint pain following administration of the medication

b.      Feelings of faintness, dizziness, hypotension, and signs of flushing in the client

c.       A decrease in muscle strength within 30 to 60 seconds following administration of the medication

d.      An increase in muscle strength within 30 to 60 seconds following administration of the medication

1.      The client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. which of the following symptoms would be expected as a result of this laboratory result?

a.      Nystagmus

b.      Tachycardia

c.       Slurred speech

d.      No symptoms, because this is a normal therapeutic level

1.      The client arrives at the emergency department complaining of back spasms. The client states, “I have been taking two to three aspirin every 4 hours for the last week, and it hasn’t helped my back.” Aspirin intoxication is suspected, and the nurse assesses the client for which of the following?

a.      Tinnitus

b.      Diarrhea

c.       Constipation

d.      Photosensitivity

1.      A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol), 400 mg PO daily. Which of the following indicates that the client is experiencing an adverse reaction to the medication?

a.      Uric acid level, 5 mcg/dL

b.      Sodium level, 140 mEq/L

c.       Blood urea nitrogen level, 15 mg/dL

d.      White blood cell count, 3000/mm3

1.      The nurse is caring for a client receiving morphine sulfate 1- mg subcutaneously every 4 hours for pain. Because this medication has been prescribed for this client, which nursing action would be included in the plan of care?

a.      Encourage fluids.

b.      Monitor the client’s temperature.

c.       Maintain the client in a supine position.

d.      Encourage the client to cough and deep-breathe.

1.      Meperidine hydrochloride (Demerol) is prescribed for the client with pain. For which of the following would the nurse monitor as a side effect of this medication?

a.      Diarrhea

b.      Bradycardia

c.       Hypertension

d.      Urinary retention

1.      The nurse is caring for a client with severe back pain. Codeine sulfate has been prescribed for the client. Which of the following does the nurse specifically include in the plan of care while the client is taking this medication?

a.      Monitor fluid balance.

b.      Monitor bowel activity

c.       Monitor peripheral pulses.

d.      Monitor for hypertension.

1.      The client has been on treatment for rheumatoid arthritis for 3 weeks. Prior to the administration of etanercept (Enbrel), it is most important for the nurse to assess:

a.      The injection site for itching and edema

b.      The white blood cell counts and platelet counts

c.       Whether the client is experiencing fatigue and joint pain

d.      A metallic taste in the mouth, with a loss of appetite