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1.
A nurse is administering furosemide to a client with heart failure. Which laboratory
value requires the most immediate follow-up?
A. Sodium 136 mEq/L
B. Potassium 3.1 mEq/L
C. BUN 18 mg/dL
D. Creatinine 1.0 mg/dL
Correct Answer: B
Rationale: Furosemide causes potassium loss. A potassium level of 3.1 mEq/L
places the client at risk for dysrhythmias and requires prompt intervention.
2.
A client receiving warfarin therapy develops excessive bruising and an INR of 6.5.
Which medication should the nurse anticipate administering?
A. Protamine sulfate
B. Fresh frozen plasma
C. Vitamin K
D. Heparin
Correct Answer: C
Rationale: Vitamin K is the specific reversal agent for warfarin-induced bleeding.
,3.
A client taking digoxin reports nausea and blurred vision with yellow halos. What
is the nurse’s priority action?
A. Administer the next scheduled dose
B. Assess serum digoxin level
C. Give an antiemetic
D. Encourage oral fluids
Correct Answer: B
Rationale: These are classic signs of digoxin toxicity. Serum levels must be
assessed immediately.
4.
Which insulin provides basal glucose control when administered once daily?
A. Insulin lispro
B. Insulin NPH
C. Insulin regular
D. Insulin glargine
Correct Answer: D
Rationale: Insulin glargine is long-acting and provides steady basal insulin
coverage.
5.
A client taking atorvastatin reports muscle pain and weakness. Which laboratory
test is most important to review?
A. Potassium
B. Creatine kinase
C. Hemoglobin
D. Sodium
,Correct Answer: B
Rationale: Elevated creatine kinase may indicate statin-induced myopathy or
rhabdomyolysis.
6.
A client is prescribed sertraline and sumatriptan. Which symptom indicates a
potential life-threatening interaction?
A. Dry mouth
B. Increased appetite
C. Hyperreflexia and agitation
D. Bradycardia
Correct Answer: C
Rationale: Combining SSRIs with triptans increases the risk of serotonin
syndrome, marked by neuromuscular hyperactivity and altered mental status.
7.
Which finding best indicates therapeutic effectiveness of enalapril?
A. Decreased heart rate
B. Reduced blood pressure
C. Increased urine output
D. Lower potassium levels
Correct Answer: B
Rationale: ACE inhibitors primarily reduce blood pressure by inhibiting
angiotensin-converting enzyme.
, 8.
A client receiving IV morphine develops a respiratory rate of 8/min. What
medication should the nurse prepare?
A. Flumazenil
B. Naloxone
C. Protamine
D. Epinephrine
Correct Answer: B
Rationale: Naloxone reverses opioid-induced respiratory depression.
9.
Which instruction is most important for a client prescribed metronidazole?
A. Take with grapefruit juice
B. Avoid alcohol consumption
C. Increase calcium intake
D. Take at bedtime only
Correct Answer: B
Rationale: Alcohol combined with metronidazole can cause a severe disulfiram-
like reaction.
10.
A client taking prednisone long-term is at greatest risk for which complication?
A. Hypoglycemia
B. Osteoporosis
C. Bradycardia
D. Hyperkalemia
Correct Answer: B
Rationale: Long-term corticosteroid use causes bone loss and increases fracture
risk.