VATI GREENLIGHT MEDICAL-SURGICAL &
PHARMACOLOGY EXAM (RN) QUESTIONS WITH
VERIFIED ANSWERS
1. A nurse is preparing to administer a blood transfusion to a client. Which of
the following actions should the nurse take first?
Prime the blood tubing with dextrose 5% in water
Verify the client's identity using two identifiers
Warm the blood unit in a microwave oven
Administer the blood rapidly over 15 minutes
Correct Answer: Verify the client's identity using two identifiers
Rationale: Client identification is the first and most critical step to prevent
transfusion reactions from incompatible blood.
2. A nurse is caring for a client with heart failure who has a new prescription for
carvedilol. Which of the following findings should indicate to the nurse that the
medication is having a therapeutic effect?
Patient reports increased shortness of breath
Heart rate increases from 70 to 100 beats per minute
Weight increases by 2 kg in 24 hours
Blood pressure decreases from 160/90 to 130/80 mm Hg
Correct Answer: Blood pressure decreases from 160/90 to 130/80 mm Hg
,Rationale: Carvedilol is a beta-blocker used for heart failure and hypertension. A
decrease in blood pressure indicates therapeutic effect.
3. A nurse is reinforcing teaching with a client who has a new prescription for
alendronate for osteoporosis. Which of the following instructions should the
nurse include?
Lie down for 30 minutes after taking the medication
Take the medication at bedtime with a snack
Take the medication with a full glass of water after waking up
Take the medication with orange juice or coffee
Correct Answer: Take the medication with a full glass of water after waking up
Rationale: Alendronate must be taken on an empty stomach with plain water to
prevent esophageal irritation. The client must remain upright for 30 minutes.
4. A nurse is collecting data from a client who has chronic kidney disease. Which
of the following laboratory findings should the nurse expect?
Decreased blood urea nitrogen
Elevated serum creatinine
Elevated serum calcium
Decreased serum potassium
Correct Answer: Elevated serum creatinine
Rationale: Creatinine is a waste product excreted by the kidneys. In chronic kidney
disease, creatinine accumulates in the blood.
5. A nurse is caring for a client who is receiving continuous enteral feedings via a
nasogastric tube. Which of the following actions should the nurse take to
prevent aspiration?
Flush the tube with 100 mL of water every hour
Elevate the head of the bed to 30 to 45 degrees
,Check gastric residual every 12 hours
Administer feedings at room temperature only
Correct Answer: Elevate the head of the bed to 30 to 45 degrees
Rationale: Elevating the head of the bed reduces the risk of aspiration by
preventing reflux of enteral formula into the esophagus and pharynx.
6. A nurse is reinforcing teaching with a client who has a new prescription for
furosemide. Which of the following statements by the client indicates a need for
further teaching?
I will monitor my weight daily
I will take my medication in the morning
I will eat bananas and oranges daily
I will stand up slowly from a sitting position
Correct Answer: I will eat bananas and oranges daily
Rationale: This statement indicates understanding, not a need for further
teaching. Bananas and oranges are high in potassium, which helps replace
potassium lost by furosemide.
7. A nurse is caring for a client who has a prescription for enoxaparin 30 mg
subcutaneously every 12 hours. Which of the following actions should the nurse
take?
Massage the injection site after administering the medication
Expel the air bubble from the prefilled syringe before injection
Administer the medication in the lateral abdominal wall
Aspirate for blood return before injecting the medication
Correct Answer: Administer the medication in the lateral abdominal wall
Rationale: Enoxaparin is administered subcutaneously in the abdomen. The air
bubble should not be expelled as it ensures full dose delivery.
, 8. A nurse is collecting data from a client who is taking digoxin. Which of the
following findings should indicate to the nurse that the client may be
experiencing digoxin toxicity?
Serum digoxin level of 1.0 ng/mL
Blood pressure of 120/80 mm Hg
Heart rate of 72 beats per minute
Nausea and vomiting
Correct Answer: Nausea and vomiting
Rationale: Nausea, vomiting, anorexia, and visual disturbances (yellow halos) are
early signs of digoxin toxicity. Therapeutic digoxin level is 0.5 to 2.0 ng/mL.
9. A nurse is reinforcing teaching with a client who has a new prescription for
warfarin. Which of the following over-the-counter medications should the client
avoid?
Acetaminophen
Ibuprofen
Diphenhydramine
Loratadine
Correct Answer: Ibuprofen
Rationale: Ibuprofen and other NSAIDs increase bleeding risk when taken with
warfarin. Acetaminophen is safer but should still be used with caution.
10. A nurse is caring for a client who has pneumonia and a new prescription for
ceftriaxone. Which of the following findings should the nurse report to the
provider immediately?
Diarrhea
Headache
Rash
PHARMACOLOGY EXAM (RN) QUESTIONS WITH
VERIFIED ANSWERS
1. A nurse is preparing to administer a blood transfusion to a client. Which of
the following actions should the nurse take first?
Prime the blood tubing with dextrose 5% in water
Verify the client's identity using two identifiers
Warm the blood unit in a microwave oven
Administer the blood rapidly over 15 minutes
Correct Answer: Verify the client's identity using two identifiers
Rationale: Client identification is the first and most critical step to prevent
transfusion reactions from incompatible blood.
2. A nurse is caring for a client with heart failure who has a new prescription for
carvedilol. Which of the following findings should indicate to the nurse that the
medication is having a therapeutic effect?
Patient reports increased shortness of breath
Heart rate increases from 70 to 100 beats per minute
Weight increases by 2 kg in 24 hours
Blood pressure decreases from 160/90 to 130/80 mm Hg
Correct Answer: Blood pressure decreases from 160/90 to 130/80 mm Hg
,Rationale: Carvedilol is a beta-blocker used for heart failure and hypertension. A
decrease in blood pressure indicates therapeutic effect.
3. A nurse is reinforcing teaching with a client who has a new prescription for
alendronate for osteoporosis. Which of the following instructions should the
nurse include?
Lie down for 30 minutes after taking the medication
Take the medication at bedtime with a snack
Take the medication with a full glass of water after waking up
Take the medication with orange juice or coffee
Correct Answer: Take the medication with a full glass of water after waking up
Rationale: Alendronate must be taken on an empty stomach with plain water to
prevent esophageal irritation. The client must remain upright for 30 minutes.
4. A nurse is collecting data from a client who has chronic kidney disease. Which
of the following laboratory findings should the nurse expect?
Decreased blood urea nitrogen
Elevated serum creatinine
Elevated serum calcium
Decreased serum potassium
Correct Answer: Elevated serum creatinine
Rationale: Creatinine is a waste product excreted by the kidneys. In chronic kidney
disease, creatinine accumulates in the blood.
5. A nurse is caring for a client who is receiving continuous enteral feedings via a
nasogastric tube. Which of the following actions should the nurse take to
prevent aspiration?
Flush the tube with 100 mL of water every hour
Elevate the head of the bed to 30 to 45 degrees
,Check gastric residual every 12 hours
Administer feedings at room temperature only
Correct Answer: Elevate the head of the bed to 30 to 45 degrees
Rationale: Elevating the head of the bed reduces the risk of aspiration by
preventing reflux of enteral formula into the esophagus and pharynx.
6. A nurse is reinforcing teaching with a client who has a new prescription for
furosemide. Which of the following statements by the client indicates a need for
further teaching?
I will monitor my weight daily
I will take my medication in the morning
I will eat bananas and oranges daily
I will stand up slowly from a sitting position
Correct Answer: I will eat bananas and oranges daily
Rationale: This statement indicates understanding, not a need for further
teaching. Bananas and oranges are high in potassium, which helps replace
potassium lost by furosemide.
7. A nurse is caring for a client who has a prescription for enoxaparin 30 mg
subcutaneously every 12 hours. Which of the following actions should the nurse
take?
Massage the injection site after administering the medication
Expel the air bubble from the prefilled syringe before injection
Administer the medication in the lateral abdominal wall
Aspirate for blood return before injecting the medication
Correct Answer: Administer the medication in the lateral abdominal wall
Rationale: Enoxaparin is administered subcutaneously in the abdomen. The air
bubble should not be expelled as it ensures full dose delivery.
, 8. A nurse is collecting data from a client who is taking digoxin. Which of the
following findings should indicate to the nurse that the client may be
experiencing digoxin toxicity?
Serum digoxin level of 1.0 ng/mL
Blood pressure of 120/80 mm Hg
Heart rate of 72 beats per minute
Nausea and vomiting
Correct Answer: Nausea and vomiting
Rationale: Nausea, vomiting, anorexia, and visual disturbances (yellow halos) are
early signs of digoxin toxicity. Therapeutic digoxin level is 0.5 to 2.0 ng/mL.
9. A nurse is reinforcing teaching with a client who has a new prescription for
warfarin. Which of the following over-the-counter medications should the client
avoid?
Acetaminophen
Ibuprofen
Diphenhydramine
Loratadine
Correct Answer: Ibuprofen
Rationale: Ibuprofen and other NSAIDs increase bleeding risk when taken with
warfarin. Acetaminophen is safer but should still be used with caution.
10. A nurse is caring for a client who has pneumonia and a new prescription for
ceftriaxone. Which of the following findings should the nurse report to the
provider immediately?
Diarrhea
Headache
Rash
