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1. An 85-year-old patient has a creatinine level of 25. When the patient is administered a medication, he/she is at risk for which of the following medication-related effects?
A) Toxicity
B) Increased absorption
C) Delayed gastric emptying
D) Therapeutic effect |
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2. A graduate of a nursing program is scheduled to take the NCLEX today. He wakes up and is noticing his heart is racing and his pupils are dilated. What can he attribute to this reaction?
A) Autonomic nervous system
B) Cardiovascular irregularity
C) Sympathetic nervous system
D) The release of dopamine |
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3. A home care nurse is visiting a patient to assess blood pressure and heart rate. The patient's grandson has a large amount of pseudoephedrine (Sudafed) in the kitchen. For what might the nurse suspect the patient's grandson is using the pseudoephedrine?
A) Methamphetamine production
B) Treatment of bronchial asthma
C) Treatment of sinusitis
D) To increase appetite |
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4. A pediatric patient is administered epinephrine to treat bronchospasm as a result of acute asthma. What effect should the patient be monitored for?
A) Edema
B) Syncope
C) Bradycardia
D) Tremors |
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5. What assessment should the nurse make before administering beta-adrenergic blocking agents?
A) Pulse and blood pressure
B) Weight and caloric intake
C) Serum albumin level
D) Serum sodium level |
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6. A patient has been diagnosed with hyperthyroidism. She asks the nurse why she is taking a medication that decreases her blood pressure like her grandmother takes. What is the nurse's best response when teaching her about the action and use of propranolol (Inderal) in the treatment of hyperthyroidism?
A) “The administration of propranolol will decrease your heart rate.”
B) “The administration of propranolol will promote bronchodilation.”
C) “The administration of propranolol will prevent respiratory depression.”
D) “The administration of propranolol will decrease the systolic blood pressure.” |
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7. A patient with myasthenia gravis is administered neostigmine (Prostigmin). How does this cholinergic drug produce its effect?
A) It stimulates the sympathetic nervous system.
B) It stimulates the parasympathetic nervous system.
C) It stimulates the cardiac system.
D) It stimulates the respiratory system. |
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8. When administering anticholinesterase drugs, what assessment finding would indicate the patient is experiencing a toxic effect of the medication?
A) Paralytic ileus
B) Abdominal distention
C) Hypertension
D) Muscle weakness |
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9. A patient is scheduled for an exploratory laparoscopy. She has been prescribed an anticholinergic agent. Why is it important to administer the anticholinergic agent in the preoperative phase?
A) It will prevent tachycardia.
B) It will decrease respiratory secretions.
C) It will decrease gastric motility.
D) It relaxes the detrusor muscle. |
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10. A patient has been administered chlorpromazine (Thorazine) for many years to treat his psychotic disorder. He has recently developed extrapyramidal symptoms related to long-term administration of chlorpromazine (Thorazine). Which of the following medications can be administered to assist in relieving these symptoms?
A) Benztropine (Cogentin)
B) Darifenacin (Enablex)
C) Trihexyphenidyl (Trihexy)
D) Trospium chloride (Sanctura) |
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11. A patient states that he is seeing halos around lights. The patient takes digoxin (Lanoxin) by mouth every day. The physician orders the patient to have serum digoxin level drawn. Which of the digoxin levels indicate the patient is experiencing toxicity?
A) 0.5 nanograms per milliliter
B) 1.0 nanograms per milliliter
C) 2.0 nanograms per milliliter
D) 4.0 nanograms per milliliter |
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12. A patient with a history of congestive heart failure is being treated with digoxin (Lanoxin). This medication increases the force of contractions of the heart. What effect improves the contractility of the heart?
A) Positive chronotropic effect
B) Positive inotropic effect
C) Negative inotropic effect
D) Negative dromotropic effect |
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13. A patient has an elevated BUN. The patient has been prescribed digoxin (Lanoxin) for heart failure. What factor is important regarding this patient?
A) The patient should be taught to increase sodium in her diet.
B) The dose should be increased with heart rate below 60.
C) The dose should be decreased in this patient.
D) The dosage should be 1.0 mg per mouth daily. |
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14. A patient is administered medications for the treatment of rapid dysrhythmias. What is the mechanism of action for these medications?
A) Reduce automaticity
B) Increase conduction
C) Repolarize myocardial cells
D) Slow refractory period |
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15. A patient is diagnosed with acute supraventricular tachycardia. Which of the following class IV calcium channel blockers are administered intravenously to treat acute supraventricular tachycardia?
A) Bethanechol chloride (Urecholine)
B) Chlorambucil (Leukeran)
C) Diltiazem (Cardizem)
D) Midazolam hydrochloride |
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16. A patient is experiencing chest pain and administers her nitroglycerine sublingually. When will the patient expect to notice relief of her chest pain?
A) 1–3 minutes
B) 5–10 minutes
C) 15–20 minutes
D) 30–60 minutes |
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17. A patient with a diagnosis of asthma is prescribed a beta blocker. What should the patient be assessed for?
A) Bronchospasm
B) Hyperglycemia
C) Pleural effusion
D) Pneumonia |
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18. A patient with diabetes is prescribed propranolol (Inderal). For what should the patient be assessed?
A) Hypercholesterolemia
B) Hypermagnesemia
C) Hypocalcemia
D) Hypoglycemia |
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19. A child who is allergic to bee stings is stung by a bee at school. The school nurse administers a EpiPen (epinephrine). Why is epinephrine the drug of choice for this patient?
A) It has a long half-life.
B) It has an effect on the adrenal gland.
C) It has an antihistamine effect.
D) It is inexpensive and affordable. |
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20. A patient with diabetes mellitus is prescribed captopril (Capoten) to treat hypertension. What electrolyte imbalance might the patient be prone to develop?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia |
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21. A patient is administered furosemide (Lasix) 20 mg every morning. What effect will a diet high in sodium have on the patient?
A) Increased diuresis
B) Decreased diuresis
C) Hyperkalemia
D) Hyperglycemia |
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22. A patient is taking warfarin (Coumadin) to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin (Coumadin) monitored?
A) RBC
B) aPTT
C) PT and INR
D) Platelet count |
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23. A patient is taking warfarin (Coumadin) after open heart surgery. The patient tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the complaint of pain, what does the nurse suspect is the cause of the pain?
A) Arthritis
B) Torn medial meniscus
C) Degenerative joint disease
D) Bleeding |
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| 24. A patient is experiencing a cough. _________________ ______________________ suppress cough by depressing the cough center in the medulla oblongata or the cough receptors in the throat, trachea, or lungs. |
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25. A patient has hypertension and wants to take a nasal decongestant for cold symptoms. Which of the following statements by the nurse indicates the effect of hypertensive medications on hypertension?
A) “The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels.”
B) “The administration of a nasal decongestant will cause bradycardia and increase peripheral blood pressure.”
C) “The administration of a nasal decongestant will decrease the thyroid production and increase blood pressure.”
D) “The administration of nasal decongestant will act on the central nervous system to cause vasodilation of blood vessels.” |
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26. A patient is started on levothyroxine (Synthroid). What should the patient be instructed on regarding medication administration?
A) Take medication with milk or food
B) Do not exercise with the medication
C) Take the medication on an empty stomach
D) Levothyroxine has a short half-life |
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27. A patient has been involved in a motor vehicle accident. Which hormone will be released in response to his blood loss?
A) Luteinizing hormone (LH)
B) Antidiuretic hormone (ADH)
C) Oxytocin
D) Melanocyte-stimulating hormone |
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28. A patient has had surgery. After the surgical procedure, the patient starts to shiver and chill. What hormone will be released in response to the reaction to cold?
A) Thyroid-stimulating hormone
B) Leuteinizing hormone
C) Corticotropin
D) Somatostatin |
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29. A patient is receiving hydrocortisone 40 mg by mouth daily for treatment of severe autoimmune inflammation. Which of the following nursing interventions is most important to implement?
A) Increase dietary sodium
B) Limit dietary protein
C) Limit fluid intake
D) Assess daily blood glucose |
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30. A 50-year-old male is admitted to the emergency room after a motorcycle crash. He was not wearing a helmet and has a head injury. He is unconscious with one eye dilated and one constricted. He has a widened pulse pressure. What corticosteroid will be administered parenterally?
A) Cortisone
B) Prednisone
C) Dexamethasone (Decadron)
D) Fluticasone (Flonase) |
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31. A 55-year-old woman is diagnosed with decreased bone density and strength. What disorder is noted with decreased bone density?
A) Chondromalacia
B) Chondritis
C) Osteomalacia
D) Osteopenia |
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32. A patient has developed an infection and is taking metformin. How will the infection change his diabetic regimen?
A) Metformin is contraindicated in the presence of an infection.
B) Metformin will be given more frequently to decrease blood sugar.
C) Metformin will result in better regulation of blood sugar.
D) Metformin will allow the patient to decrease the absorption of glucose. |
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33. A patient has suffered from hypoglycemia twice in the past week. She states she eats one time per day and snacks the rest of the day. What patient education will you provide for this patient?
A) She should limit her alcohol with meals.
B) She should increase her caloric intake frequently.
C) She should limit her aerobic exercise.
D) She should not eat at sporadic times. |
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34. A patient taking hormonal contraceptives turns 35 years of age and has smoked for 15 years. Which of the following is most important?
A) Begin an exercise regime
B) Begin smoking cessation
C) Begin daily aspirin therapy
D) Begin taking NicoDerm |
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35. A woman is prescribed hormonal contraceptives. What places her at risk for the development of blood clots?
A) Hormonal contraceptives increase serum triglyceride and cholesterol.
B) Hormonal contraceptives stimulate skeletal growth and RBC production.
C) Hormonal contraceptives increase blood levels of clotting factors.
D) Hormonal contraceptives will cause peripheral vasoconstriction. |
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36. A patient with anorexia nervosa has taken a saline cathartic to lose weight. What is the patient at risk for?
A) Constipation
B) Diarrhea
C) Bowel obstruction
D) Hyponatremia |
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37. The nurse is preparing to administer gentamicin (Garamycin) to a patient when he suddenly complains of diminished hearing. What action should the nurse take based on this statement?
A) Administer the dosage and notify the physician of the alteration in hearing
B) Hold the dosage and notify the physician of the alteration in hearing
C) Administer the dosage and report the alteration in hearing to the audiologist
D) Hold the dosage and document the finding in the nurses' notes |
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38. A patient is administered telithromycin (Ketek) to treat a community-acquired pneumonia. What blood levels should be monitored closely with this medication?
A) Creatinine
B) AST and ALT
C) CPK
D) Differential |
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39. A patient receiving isoniazid (INH) and rifampin (Rifadin) has a decreased urinary output and peripheral neuropathy. Which laboratory values should be assessed?
A) Hematocrit and hemoglobin
B) ALT/AST and creatinine
C) Urine culture and sensitivity
D) Erythrocyte count and differential |
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40. A patient is being treated with amphotericin B. Which of the following statements indicates that the patient has understood the patient teaching?
A) “The medication may cause diabetes.”
B) “The medication will cause liver necrosis.”
C) “The medication may cause kidney damage.”
D) “The medication will cause pancreatitis.” |
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41. A patient is receiving nystatin for a fungal infection of the mouth. Which of the following adverse effects are most likely to be experienced with this form of nystatin?
A) Local irritation
B) Burning
C) Nausea
D) Urinary urgency |
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42. A nurse is administering a mumps vaccine to an adolescent. Which of the following medications should be available when administering an immunization?
A) Diphenhydramine (Benadryl)
B) Hydroxyzine (Vistaril)
C) Physostigmine
D) Epinephrine |
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43. A patient develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this noted as?
A) Infectious process
B) Anaphylaxis
C) Serum sickness
D) Distress syndrome |
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44. A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies are imperative with epoetin alfa?
A) Potassium supplements
B) Sodium restriction
C) Iron supplement
D) Renal dialysis |
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45. A patient is being treated for anemia with epoetin alfa (Epogen). Which of the following laboratory values should be assessed before and during treatment?
A) AST
B) BUN
C) CBC
D) ALT |
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46. A patient has been receiving morphine sulfate 5 mg IV every 4 hours for the past 2 weeks. She states that the pain is not being relieved as well as it was in the past. What is the reason for this development?
A) She has developed a dependency on the morphine.
B) She has metastatic cancer and is dying.
C) She has greater pain with inactivity.
D) She has developed tolerance to morphine. |
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47. A patient is administered the opioid antagonist naloxone (Narcan) for respiratory depression and a state of unresponsiveness. How does naloxone work?
A) Synergism
B) Breakthrough
C) Tolerance
D) Displacement |
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48. A patient has developed excessive sedation and respiratory depression. The patient has been taking a benzodiazepine and has diminished liver function. Which of the following medications will reduce the effects of sedation and respiratory depression in this patient?
A) Olmesartan medoxomil (Benicar)
B) Pancrelipase (Pancrease)
C) Pamidronate disodium (Aredia)
D) Flumazenil (Romazicon) |
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49. A patient has been administered flumazenil (Romazicon) because of the toxic effects of benzodiazepines. The patient should be observed for acute benzodiazepine withdrawal symptoms. Which of the following symptoms is indicative of acute benzodiazepine withdrawal?
A) Tachycardia
B) Seizures
C) Lethargy
D) Coma |
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50. A patient who was diagnosed with schizophrenia in 1962 was prescribed chlorpromazine (Thorazine). The patient has been taking the medication for more than 40 years. What adverse effect will the patient most likely experience?
A) Hypertension
B) Tardive dyskinesia
C) Central nervous system agitation
D) Urinary frequency |
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51. An 80-year-old patient has been prescribed an anticholinergic agent for treatment of Parkinson-related symptoms. What patient education should be provided?
A) Avoid high environmental temperatures.
B) Anticholinergics increase mental alertness.
C) It is safe to take Sudafed for a cold.
D) You may experience urinary incontinence. |
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52. A patient is being prescribed a central nervous system stimulant. Which of the following will have the lowest risk of abuse and dependence?
A) Amphetamine
B) Atomoxetine (Strattera)
C) Dexmethylphenidate (Focalin)
D) Adderall |
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53. A child is prescribed an amphetamine for attention deficit hyperactivity disorder. Which of the following effects provide evidence that the medications are working?
A) Improved grades
B) Increased sleep
C) Impulsivity
D) Polyphagia |
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