Multiple Choice Questions

A nurse administers a dose of metformin for a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first?
  • The client rates pain as 3 on a scale from 0 to 10 (description of pain most accurate)
  • Check the client's blood glucose (assess first for hypoglycemia)
  • Dyspnea (caused by bronchoconstriction due to increased Ach level)
  • I should tell my provider if I develop a sore throat (neutropenia)
A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understanding of the teaching?
  • I will take the patch off right after my evening meal (med free time 12-14 hr to avoid tolerance)
  • Epinephrine (to induce vasoconstriction and bronchodilation during anaphylaxis)
  • The client rates pain as 3 on a scale from 0 to 10 (description of pain most accurate)
  • Potassium level 2.8 (hypokalemia that increase risk of digoxin toxicity and cardiac dysrhythmias)
A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect?
  • The client rates pain as 3 on a scale from 0 to 10 (description of pain most accurate)
  • I should tell my provider if I develop a sore throat (neutropenia)
  • Miosis (pupillary constriction due to excessive muscarinic stimulation)
  • The client's capnography has returned to baseline (gas exchange is adequate)
A nurse receives a verbal order from the provider to administer morphine 5 mg every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)?
  • A transition in care requires the nurse to conduct medication reconciliation
  • Blood in the urine (heparin toxicity)
  • Obtain the client's blood pressure (atenolol - hypotension)
  • Morphine 5 mg subcut every 4 hr PRN severe pain
A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)?
  • The client rates pain as 3 on a scale from 0 to 10 (description of pain most accurate)
  • Temperature of 39.7 (103.5)
  • Increase in ability to focus
  • The client's capnography has returned to baseline (gas exchange is adequate)
A nurse is caring for a client who received 0.9% sodium chloride 1L over 4hr instead of over 8hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident?
  • Blood in the urine (heparin toxicity)
  • Rinse your mouth after inhaling the beclomethasone (to prevent oropharyngeal candidiasis and hoarseness)
  • 0.9 % sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified (type, amount, time, status)
  • Pregnancy test (must provide two negative pregnancy tests)
A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 Ib. How many mg should the nurse administer per dose?
  • Report yellowing of the skin
  • Administer the medication outside the 5 cm (2 in) radius of the umbilicus.
  • Document the refusal and inform the client's provider (verify understanding of refusing medication)
  • 300 mg
A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching?
  • Morphine 5 mg subcut every 4 hr PRN severe pain
  • I should sit up for 30 minutes after taking the risedronate.
  • Aspirin will increase the risk of bleeding
  • A transition in care requires the nurse to conduct medication reconciliation
A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching?
  • I should tell my provider if I develop a sore throat (neutropenia)
  • Take one tablet at onset of migraine
  • Forms a protective barrier over ulcers (mucosal protectant)
  • I should sit up for 30 minutes after taking the risedronate.
A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include?
  • 1. Blood glucose levels will be monitored during therapy ( medication increase serum glucose level & require management) 2. Avoid contact with people who has known infection (medication decreased immunity putting patient at increased risk for infection) 3. Grapefruit juice can increase the effects of the medication
  • I should tell my provider if I develop a sore throat (neutropenia)
  • Determine apical pulse prior to administering (pulse rate less than 60/min - notify provider for bradycardia)
  • Take one tablet at onset of migraine
A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching?
  • Increased neutrophil count (bone marrow stiumulated)
  • Heart rate (dec HR indicate digoxin toxicity)
  • hot flashes (due to estrogen receptor blocking action of tamoxifen)
  • Decreased respiration might occur
A nurse at an urgent care clinic is collecting a history from a female client who has a UTI. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication?
  • Obtain the client's blood pressure (atenolol - hypotension)
  • Turn the client to a side lying position (reduce risk of uteroplacental insufficiency)
  • I have tendonitis, so I haven't been able to exercise (risk of tendon rupture)
  • Naloxone (to reverse respiratory depressive effect of heroin, but not too quick)
A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately?
  • Dyspnea (caused by bronchoconstriction due to increased Ach level)
  • Monitor the client for constipation (can lead to fecal impaction)
  • Increased neutrophil count (bone marrow stiumulated)
  • Bibasilar crackles (heart failure and pulmonary edema)
A nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill until I get home today." Which of the following actions should the nurse take?
  • Document the refusal and inform the client's provider (verify understanding of refusing medication)
  • I will take the patch off right after my evening meal (med free time 12-14 hr to avoid tolerance)
  • Monitor the client for constipation (can lead to fecal impaction)
  • Rinse your mouth after inhaling the beclomethasone (to prevent oropharyngeal candidiasis and hoarseness)
A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take?
  • Monitor the client for constipation (can lead to fecal impaction)
  • I should tell my provider if I develop a sore throat (neutropenia)
  • Document the refusal and inform the client's provider (verify understanding of refusing medication)
  • Administer the medication outside the 5 cm (2 in) radius of the umbilicus.
A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective?
  • Flumazenil (antidote to reverse benzodiazepine)
  • Temperature of 39.7 (103.5)
  • Ibuprofen (NSAID increase Li level)
  • Increase in ability to focus
A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan?
  • 1. Blood glucose levels will be monitored during therapy ( medication increase serum glucose level & require management) 2. Avoid contact with people who has known infection (medication decreased immunity putting patient at increased risk for infection) 3. Grapefruit juice can increase the effects of the medication
  • Rinse your mouth after inhaling the beclomethasone (to prevent oropharyngeal candidiasis and hoarseness)
  • Potassium level 2.8 (hypokalemia that increase risk of digoxin toxicity and cardiac dysrhythmias)
  • 1. Report muscle pain to the provider.2. Avoid taking the medication with grapefruit juice.3. Expect therapy with this medication to be lifelong.
A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry - flavored lozenges on a stick. Which of the following information should the nurse include in the teaching?
  • Forms a protective barrier over ulcers (mucosal protectant)
  • Store unused medication sticks in a storage container
  • Obtain the client's blood pressure (atenolol - hypotension)
  • I should tell my provider if I develop a sore throat (neutropenia)
A nurses is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings?
  • hot flashes (due to estrogen receptor blocking action of tamoxifen)
  • The client's capnography has returned to baseline (gas exchange is adequate)
  • dry mouth & dry eyes (anticholinergic) blurred vision (increase intraocular pressure)
  • Heart rate (dec HR indicate digoxin toxicity)
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take?
  • I will take the patch off right after my evening meal (med free time 12-14 hr to avoid tolerance)
  • Obtain the client's blood pressure (atenolol - hypotension)
  • Potassium level 2.8 (hypokalemia that increase risk of digoxin toxicity and cardiac dysrhythmias)
  • Administer the medication outside the 5 cm (2 in) radius of the umbilicus.
A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first?
  • Pregnancy test (must provide two negative pregnancy tests)
  • Obtain the client's blood pressure (atenolol - hypotension)
  • Blood in the urine (heparin toxicity)
  • Turn the client to a side lying position (reduce risk of uteroplacental insufficiency)
A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication?
  • 100 gtt/min
  • Bibasilar crackles (heart failure and pulmonary edema)
  • Oral candidiasis
  • Store unused medication sticks in a storage container
A nurse is caring for a 20 year old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required?
  • Constipation (due to morphine) * sodium will promote increase water and fat in GI *
  • Pregnancy test (must provide two negative pregnancy tests)
  • Turn the client to a side lying position (reduce risk of uteroplacental insufficiency)
  • Increased neutrophil count (bone marrow stiumulated)
A nurse is providing teaching to a client who is begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching?
  • dry mouth & dry eyes (anticholinergic) blurred vision (increase intraocular pressure)
  • Monitor the client for constipation (can lead to fecal impaction)
  • I should tell my provider if I develop a sore throat (neutropenia)
  • Document the refusal and inform the client's provider (verify understanding of refusing medication)
A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make?
  • Decreased respiration might occur
  • Atropine (reverse cholinergic toxicity)
  • Aspirin will increase the risk of bleeding
  • Report yellowing of the skin
A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications?
  • Turn the client to a side lying position (reduce risk of uteroplacental insufficiency)
  • Administer the medication outside the 5 cm (2 in) radius of the umbilicus.
  • I will taper off the medication before discontinuing it (prevent abstinence syndrome or rebound insomnia)
  • Acetylcysteine (antidote that prevent injury when given orally or Iv within 8 to 10 hr)
A nurse is an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering?
  • Forms a protective barrier over ulcers (mucosal protectant)
  • Epinephrine (to induce vasoconstriction and bronchodilation during anaphylaxis)
  • Flumazenil (antidote to reverse benzodiazepine)
  • Atropine (reverse cholinergic toxicity)
A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages?
  • Tingling of fingers
  • 2 months (1st dose)
  • Prevent delirium tremens
  • Pregnancy test (must provide two negative pregnancy tests)
A nurse is reveiwing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalemia?
  • Presence of U waves
  • Potassium level 2.8 (hypokalemia that increase risk of digoxin toxicity and cardiac dysrhythmias)
  • Prevent delirium tremens
  • 1. Report muscle pain to the provider.2. Avoid taking the medication with grapefruit juice.3. Expect therapy with this medication to be lifelong.
A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate?
  • Blood in the urine (heparin toxicity)
  • Carbamazepine (cause accelerated inactivation of oral contraceptive by action on hepatic medication metabolizing enzymes)
  • Increase in ability to focus
  • Digoxin (increased toxicity)
A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following intervention should the nurse include in the plan of care?
  • 1. Report muscle pain to the provider.2. Avoid taking the medication with grapefruit juice.3. Expect therapy with this medication to be lifelong.
  • Determine apical pulse prior to administering (pulse rate less than 60/min - notify provider for bradycardia)
  • Monitor the client for constipation (can lead to fecal impaction)
  • Document the refusal and inform the client's provider (verify understanding of refusing medication)
A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider?
  • Tingling of fingers
  • Constipation (due to morphine) * sodium will promote increase water and fat in GI *
  • Blood in the urine (heparin toxicity)
  • Turn the client to a side lying position (reduce risk of uteroplacental insufficiency)
A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication?
  • Tinnitus (monitor high pitched ringing in ear and headache and notify)
  • Miosis (pupillary constriction due to excessive muscarinic stimulation)
  • Monitor the client for constipation (can lead to fecal impaction)
  • Rinse your mouth after inhaling the beclomethasone (to prevent oropharyngeal candidiasis and hoarseness)
A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects?
  • Forms a protective barrier over ulcers (mucosal protectant)
  • Monitor the client for constipation (can lead to fecal impaction)
  • Insomnia (by atypical antidepressant of bupropion)
  • Bibasilar crackles (heart failure and pulmonary edema)
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first?
  • Miosis (pupillary constriction due to excessive muscarinic stimulation)
  • Epinephrine (to induce vasoconstriction and bronchodilation during anaphylaxis)
  • Naloxone (to reverse respiratory depressive effect of heroin, but not too quick)
  • Increase in ability to focus
A nurse is reviewing the laboratory results for a client who is receiving heparin via continuous IV infusion for deep - vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings?
  • Rinse your mouth after inhaling the beclomethasone (to prevent oropharyngeal candidiasis and hoarseness)
  • Platelets 96,000/mm^3 (expected range 150,000 - 400,000) indicate heparin induced thrombocytopenia
  • Pregnancy test (must provide two negative pregnancy tests)
  • Turn the client to a side lying position (reduce risk of uteroplacental insufficiency)
A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy?
  • Decreased respiration might occur
  • Blood in the urine (heparin toxicity)
  • Pregnancy test (must provide two negative pregnancy tests)
  • Increased neutrophil count (bone marrow stiumulated)
A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor?
  • Report yellowing of the skin
  • Sedation
  • Oral candidiasis
  • 100 gtt/min
A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include?
  • Report yellowing of the skin
  • Insomnia (by atypical antidepressant of bupropion)
  • Forms a protective barrier over ulcers (mucosal protectant)
  • I should tell my provider if I develop a sore throat (neutropenia)
A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication?
  • Forms a protective barrier over ulcers (mucosal protectant)
  • Monitor the client for constipation (can lead to fecal impaction)
  • Rinse your mouth after inhaling the beclomethasone (to prevent oropharyngeal candidiasis and hoarseness)
  • Insomnia (by atypical antidepressant of bupropion)
A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions?
  • I should tell my provider if I develop a sore throat (neutropenia)
  • Take one tablet at onset of migraine
  • Report yellowing of the skin
  • Store unused medication sticks in a storage container
A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching?
  • Aspirin will increase the risk of bleeding
  • Decreased respiration might occur
  • Insomnia (by atypical antidepressant of bupropion)
  • I should sit up for 30 minutes after taking the risedronate.
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Multiple Choice Questions
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