1) a nurse is preparing to administer propranolol to a client. which

of the following should the ) nurse assess prior to administering this medication?
a) Temperature
b)Respiratory rate
c) Pain level
d) Heart Rate


2)A nurse is caring for a client who has heart failure and is taking hydrochlorothiazide. The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?
a) Hypokalemia
b)Hypocalcemia
c) Hypernatremia
d) Hypermagnesmia


3) A nurse is reviewing the laboratory results of a client who has rheumatoid arthritis and a prescription for cyclosporine. The nurse should report which of the following laboratory values to the provider?
a) Sodium 139mEq/l
b) Potassium 4.2 mEq/L
C)Bun 18mg/dl
d) Creatinine 2.5mg/dl


4) A nurse is preparing to administer medications to a group of clients. Which of the following prescriptions should the nurse clarify with the provider before administering?
a) Tetracycline 1g orally every 6hr
b) Penicillin G 5.000.000 units intramuscularly every 4 hr
c) Warfarin 100units subcutaneaously daily
d) Zoledronate 5 mg intravenously x 1 dose


5) A nurse is reviewing the laboratory report of a client who has bipolar disorder prior to administration of Lithium carbonate. The client's Lithium level is 2.6 mEq/L. Which of the following actions should the nurse take?
a) Request a dosage increase from the provider
b) Assist the client to a left lateral position
c)Prepare the client for hemodialysis
d) Implement fluid restrictions


6) A nurse is caring for a client who is receiving total parenteral nutrition(TPN).Which of the following actions should the nurse take?
a) Hang the TPN solution to gravity to infuse
b) Titrate TPN solution to blood pressure
c) Obtain the client's blood glucose level weekly
d) Monitor the client's weight daily


7)A nurse is initiating iv therapy for a client who had a right sided mastectomy. In which of the following locations should the nurse place a catheter?
a) Most proximal site
b) Left arm
c)Cordlike vein
d) Wrist


8) A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. which of the following findings should the nurse include as risk factors for an adverse drug reaction?( Select all that apply).
a) Multiple health problems
b) Increased rate of absorption
c) Decreased percentage of body of body fat
d) Polypharmacy
e) Decreased renal function


9) A nurse is assessing a client who has septic shock and is receiving dopamine by continous IV infusion. Which of the following findings indicates that the nurse should increase the rate of infusion.
a) Headach
b) Hypertension
c) Extravasation
d) Chest pain


10) A nurse is assessing a client who has Graves's disease and is taking methimazole. Which of the following findings indicates the client needs a lower dose of the medication?
a) Bradycardia
b) Diaphoresis
c) Exophythalmos
d) Weight loss


11) A nurse is reviewing the laboratory results of a client who received a dose of sodium polystyrene sulfate. which of the following findings should the nurse identify as an indication that the medication has been effective?
a) Sodium 150mEq/L
b) Calcium 8mg/dl
c) Magnesium 1.1mEq/L
d) Potassium 4.6mEq/L


12)A nurse in the emmergency department is admitting a client who has diabetic ketoacidosis and a blood glucose level of 800 mg/dl. Which of the following interventions should the nurse initiate first?
a) 0.9% sodium chloride 15ml/kg/hr
b) Potassium Chloride 10mEq/hr
c) Bicarbonate by iv infusion
d) Subcutaneous insulin injections


13) A nurse is reviewing agency protocol prior to administering epoetin alfa to a client who has chronic kidney disease. Which of the following actions should the nurse plan to take?
a) Discard the vial of medication if solution is cloudy
b) Thaw the medication in the vial 30 min before administration
c) Dilute the vial of medication with sterile water
d) Shake the vial of medication to disolve particulates


14) A nurse is providing discharge teaching about wafarin to a client who has deep-vein thrombosis. The nurse instruct the client to obtain which of the following laboratory tests monthly?
a) aPTT
b) Platelet count
c) INR
d) Fibrinogen


15) A nurse in a provider's office is assessing a client who has hypothyroidism and has been taking levothyroxine for 2 months. Which of the following statements by the client indicates a therapeutic response to the medication.
a) I am taking a laxative for constipation
b) I have noticed i am not as cold as i use to be
c) I am loosing weight without dieting
d) I seem to be sleeping more than usual


16) A nurse is teaching a client who is to start clopidogrel. The nurse should instruct the client to monitor and report which of the following adverse effects of the medication.
a) weight loss
b) blurred vision
c) brusing
d) constipation


17) A nurse is reviewing the laboratory results of a client who has diabetes mellitus and is taking glipizide. which of the following values indicates that the client is adhering to the treatment plan?
a) HBA1c 6.8%
b) Creatinine 1.0 mg/dl
c) Total cholesterol 225mg/dl
d) positive urinary ketones


18) A nurse is caring for a client who has diabetes mellitus and is teaching pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?
a) Orthostatic hypotension
b) Tinnitus
c) Insomnia
d) Fluid retention


19) A nurse is caring for a client who reports taking propranol for several years but has recently stopped for financial reasons. the nurse should assess the client for which of the following findings?
a) Rhinitis
b) Tachycardia
c) Hyperkalemia
d) Bradypnea


20) A nurse is providing teaching to a client who has new prescription for paroxetine.The nurse should instruct the client to monitor for which of the following adverse effects?
a)Drowsiness
b) Peripheral edema
c) Alopecia
d) Tinitus


21) A client who has Graves's disease is prescribed methimazole. Which of the following effects should the nurse expects to see the client has taken the medication for 2 months.
a) Increased in pulse rate
b) increased sleeping
c) Warmer skin
d) Weight loss


22) A nurse is administering ferrous sulfate elixir to a client who has iron deficiency anemia. which of the following actions should the nurse take?
a) Give the medication with a caffeinated beverage
b) Administer the medication through a straw
c) dilute the medication with milk
d) provide an antacid with the medication


23). A nurse is teaching a client about self- administration of enoxaparine. which of the following instructions should the nurse include?( select all that apply).
a) Expel the air bubble from the prefilled syringe
b) massage the insertion site after injecting the medication
c) alternate injection sites between the sides of the abdomen
d) Grasp the skin between the thumb and forefingers while injecting the medication.


24). A nurse is administering naloxone to a client who has developed an adverse reaction to morphine. the nurse should identify which of the following findings as a therapeutic effect of naloxone?
a) Decreased blood pressure
b) Increased pain relief
c) Decreased nausea
d) Increased respiratory rate


25) A nurse is completing medication reconciliation for a client prior to their transfer to a rehabilitation facility. Which of the following actions should the nurse take?
a) Include the medications the client received during surgery on the client's medication list.
b) Send a list of prescribed medications to the client's pharmacy
c) compare the current and newly prescribed medications and note any discrepancies
d) Review the adverse effects of the medication with the client


26) A nurse is caring for a client who has cancer and reports moderate pain. which of the following medications should the nurse expect to administer?
a) Acetaminophen
b) Asprin
c) Morphine
d) ibuprofen


27) A nurse is caring for a client who has major depression and a new prescription for citalopram. which of the following adverse effects is the priority for the nurse to report to the provider?
a) confusion
b) weight loss
c) bruxism
d) insomnia


28) A nurseon a medical surgical unit is preparing to administer an influenza vaccine to a client. the client tells the nurse, " i no longer want to receive this vaccine'. which of the following responses should the nurse make?
a) The inflenza vaccine is mandatory for all clients before discharge. so you will need to sign and against medical advice
b) Inflenza can be very serious to anyone who does not receive the vaccine
c) The inflenza vaccine is strongly encourged, but i understand you would like to decline now
d) If i were you i would get the vaccine to keep my family safe


29) A nurse is caring for a client who is receiving ceftriaxone intravenously. which of the following manifestations should the nurse identify an an allergic reaction
a) hypotension
b) plyuria
c) nausea
d) bradycardia


30) A nurse is assessing a client who is receiving heparin therapy for deep vein thrombosis.which of the following findings should indicate to the nurse that the therapy is effective.
a) reduced calf circumference
b) decreased INR
c) Decreased with the expected reference range
d) Presence of pedal bilaterally
a) R


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