1) A nurse is caring for a client with injury. The nurse monitors the client, knowing that
hyperparathyroidism and notes that the client's which of the following indicates that a systemic
serum calcium level is 13 mg/dL. Which medication effect has occurred?
should the nurse prepare to administer as prescribed 1.Hyperventilation
to the client? 2.Elevated blood pressure
1. Calcium chloride 3.Local pain at the burn site
2. Calcium gluconate 4.Local rash at the burn site
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D 7.) Isotretinoin is prescribed for a client with severe
acne. Before the administration of this medication,
2.) Oral iron supplements are prescribed for a 6- the nurse anticipates that which laboratory test will
year-old child with iron deficiency anemia. The be prescribed?
nurse instructs the mother to administer the iron 1. Platelet count
with which best food item? 2. Triglyceride level
1. Milk 3. Complete blood count
2. Water 4. White blood cell count
3. Apple juice
4. Orange juice 8.) A client with severe acne is seen in the clinic
and the health care provider (HCP) prescribes
3.) Salicylic acid is prescribed for a client with a isotretinoin. The nurse reviews the client's
diagnosis of psoriasis. The nurse monitors the medication record and would contact the (HCP) if
client, knowing that which of the following would the client is taking which medication?
indicate the presence of systemic toxicity from this 1. Vitamin A
medication? 2. Digoxin (Lanoxin)
1. Tinnitus 3. Furosemide (Lasix)
2. Diarrhea 4. Phenytoin (Dilantin)
3. Constipation
4. Decreased respirations 9.) The nurse is applying a topical corticosteroid to
a client with eczema. The nurse would monitor for
4.) The camp nurse asks the children preparing to the potential for increased systemic absorption of
swim in the lake if they have applied sunscreen. The the medication if the medication were being applied
nurse reminds the children that chemical sunscreens to which of the following body areas?
are most effective when applied: 1. Back
1. Immediately before swimming 2. Axilla
2. 15 minutes before exposure to the sun 3. Soles of the feet
3. Immediately before exposure to the sun 4. Palms of the hands
4. At least 30 minutes before exposure to the sun
10.) The clinic nurse is performing an admission
5.) Mafenide acetate (Sulfamylon) is prescribed for assessment on a client. The nurse notes that the
the client with a burn injury. When applying the client is taking azelaic acid (Azelex). Because of the
medication, the client complains of local discomfort medication prescription, the nurse would suspect
and burning. Which of the following is the most that the client is being treated for:
appropriate nursing action? 1. Acne
1. Notifying the registered nurse 2. Eczema
2. Discontinuing the medication 3. Hair loss
3. Informing the client that this is normal 4. Herpes simplex
4. Applying a thinner film than prescribed to the
burn site 11.) The health care provider has prescribed silver
sulfadiazine (Silvadene) for the client with a partial-
6.) The burn client is receiving treatments of thickness burn, which has cultured positive for
topical mafenide acetate (Sulfamylon) to the site of gram-negative bacteria. The nurse is reinforcing
Page 1 of 35
,information to the client about the medication. 3. Pulmonary fibrosis
Which statement made by the client indicates a lack 4. Orthostatic hypotension
of understanding about the treatments?
1. "The medication is an antibacterial." 16.) The clinic nurse is reviewing a teaching plan
2. "The medication will help heal the burn." for the client receiving an antineoplastic
3. "The medication will permanently stain my skin." medication. When implementing the plan, the nurse
4. "The medication should be applied directly to the tells the client:
wound." 1. To take aspirin (acetylsalicylic acid) as needed
for headache
12.) A nurse is caring for a client who is receiving 2. Drink beverages containing alcohol in moderate
an intravenous (IV) infusion of an antineoplastic amounts each evening
medication. During the infusion, the client 3. Consult with health care providers (HCPs) before
complains of pain at the insertion site. During an receiving immunizations
inspection of the site, the nurse notes redness and 4. That it is not necessary to consult HCPs before
swelling and that the rate of infusion of the receiving a flu vaccine at the local health fair
medication has slowed. The nurse should take
which appropriate action? 17.) The client with ovarian cancer is being treated
1. Notify the registered nurse. with vincristine (Oncovin). The nurse monitors the
2. Administer pain medication to reduce the client, knowing that which of the following
discomfort. indicates a side effect specific to this medication?
3. Apply ice and maintain the infusion rate, as 1. Diarrhea
prescribed. 2. Hair loss
4. Elevate the extremity of the IV site, and slow the 3. Chest pain
infusion. 4. Numbness and tingling in the fingers and toes
13.) The client with squamous cell carcinoma of 18.) The nurse is reviewing the history and physical
the larynx is receiving bleomycin intravenously. examination of a client who will be receiving
The nurse caring for the client anticipates that asparaginase (Elspar), an antineoplastic agent. The
which diagnostic study will be prescribed? nurse consults with the registered nurse regarding
1. Echocardiography the administration of the medication if which of the
2. Electrocardiography following is documented in the client's history?
3. Cervical radiography 1. Pancreatitis
4. Pulmonary function studies 2. Diabetes mellitus
3. Myocardial infarction
14.) The client with acute myelocytic leukemia is 4. Chronic obstructive pulmonary disease
being treated with busulfan (Myleran). Which
laboratory value would the nurse specifically 19.) Tamoxifen is prescribed for the client with
monitor during treatment with this medication? metastatic breast carcinoma. The nurse understands
1. Clotting time that the primary action of this medication is to:
2. Uric acid level 1. Increase DNA and RNA synthesis.
3. Potassium level 2. Promote the biosynthesis of nucleic acids.
4. Blood glucose level 3. Increase estrogen concentration and estrogen
response.
15.) The client with small cell lung cancer is being 4. Compete with estradiol for binding to estrogen in
treated with etoposide (VePesid). The nurse who is tissues containing high concentrations of receptors.
assisting in caring for the client during its
administration understands that which side effect is 20.) The client with metastatic breast cancer is
specifically associated with this medication? receiving tamoxifen. The nurse specifically
1. Alopecia monitors which laboratory value while the client is
2. Chest pain taking this medication?
1. Glucose level
Page 2 of 35
,2. Calcium level The nurse tells the client to:
3. Potassium level 1. Freeze the insulin.
4. Prothrombin time 2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
21.) A nurse is assisting with caring for a client 4. Keep the insulin at room temperature.
with cancer who is receiving cisplatin. Select the
adverse effects that the nurse monitors for that are 26.) Glimepiride (Amaryl) is prescribed for a client
associated with this medication. Select all that with diabetes mellitus. A nurse reinforces
apply. instructions for the client and tells the client to
1. Tinnitus avoid which of the following while taking this
2. Ototoxicity medication?
3. Hyperkalemia 1. Alcohol
4. Hypercalcemia 2. Organ meats
5. Nephrotoxicity 3. Whole-grain cereals
6. Hypomagnesemia 4. Carbonated beverages
22.) A nurse is caring for a client after 27.) Sildenafil (Viagra) is prescribed to treat a
thyroidectomy and notes that calcium gluconate is client with erectile dysfunction. A nurse reviews the
prescribed for the client. The nurse determines that client's medical record and would question the
this medication has been prescribed to: prescription if which of the following is noted in the
1. Treat thyroid storm. client's history?
2. Prevent cardiac irritability. 1. Neuralgia
3. Treat hypocalcemic tetany. 2. Insomnia
4. Stimulate the release of parathyroid hormone. 3. Use of nitroglycerin
4. Use of multivitamins
23.) A client who has been newly diagnosed with
diabetes mellitus has been stabilized with daily 28.) The health care provider (HCP) prescribes
insulin injections. Which information should the exenatide (Byetta) for a client with type 1 diabetes
nurse teach when carrying out plans for discharge? mellitus who takes insulin. The nurse knows that
1. Keep insulin vials refrigerated at all times. which of the following is the appropriate
2. Rotate the insulin injection sites systematically. intervention?
3. Increase the amount of insulin before unusual 1. The medication is administered within 60
exercise. minutes before the morning and evening meal.
4. Monitor the urine acetone level to determine the 2. The medication is withheld and the HCP is called
insulin dosage. to question the prescription for the client.
3. The client is monitored for gastrointestinal side
24.) A nurse is reinforcing teaching for a client effects after administration of the medication.
regarding how to mix regular insulin and NPH 4. The insulin is withdrawn from the Penlet into an
insulin in the same syringe. Which of the following insulin syringe to prepare for administration.
actions, if performed by the client, indicates the
need for further teaching? 29.) A client is taking Humulin NPH insulin daily
1. Withdraws the NPH insulin first every morning. The nurse reinforces instructions for
2. Withdraws the regular insulin first the client and tells the client that the most likely
3. Injects air into NPH insulin vial first time for a hypoglycemic reaction to occur is:
4. Injects an amount of air equal to the desired dose 1. 2 to 4 hours after administration
of insulin into the vial 2. 4 to 12 hours after administration
3. 16 to 18 hours after administration
25.) A home care nurse visits a client recently 4. 18 to 24 hours after administration
diagnosed with diabetes mellitus who is taking
Humulin NPH insulin daily. The client asks the 30.) A client with diabetes mellitus visits a health
nurse how to store the unopened vials of insulin. care clinic. The client's diabetes mellitus previously
Page 3 of 35
, had been well controlled with glyburide (DiaBeta) metformin and may be treated with acetaminophen
daily, but recently the fasting blood glucose level (Tylenol).
has been 180 to 200 mg/dL. Which medication, if
added to the client's regimen, may have contributed 34.) A client with Crohn's disease is scheduled to
to the hyperglycemia? receive an infusion of infliximab (Remicade). The
1. Prednisone nurse assisting in caring for the client should take
2. Phenelzine (Nardil) which action to monitor the effectiveness of
3. Atenolol (Tenormin) treatment?
4. Allopurinol (Zyloprim) 1. Monitoring the leukocyte count for 2 days after
the infusion
31.) A community health nurse visits a client at 2. Checking the frequency and consistency of bowel
home. Prednisone 10 mg orally daily has been movements
prescribed for the client and the nurse reinforces 3. Checking serum liver enzyme levels before and
teaching for the client about the medication. Which after the infusion
statement, if made by the client, indicates that 4. Carrying out a Hematest on gastric fluids after
further teaching is necessary? the infusion is completed
1. "I can take aspirin or my antihistamine if I need
it." 35.) The client has a PRN prescription for
2. "I need to take the medication every day at the loperamide hydrochloride (Imodium). The nurse
same time." understands that this medication is used for which
3. "I need to avoid coffee, tea, cola, and chocolate condition?
in my diet." 1. Constipation
4. "If I gain more than 5 pounds a week, I will call 2. Abdominal pain
my doctor." 3. An episode of diarrhea
4. Hematest-positive nasogastric tube drainage
32.) Desmopressin acetate (DDAVP) is prescribed
for the treatment of diabetes insipidus. The nurse 36.) The client has a PRN prescription for
monitors the client after medication administration ondansetron (Zofran). For which condition should
for which therapeutic response? this medication be administered to the postoperative
1. Decreased urinary output client?
2. Decreased blood pressure 1. Paralytic ileus
3. Decreased peripheral edema 2. Incisional pain
4. Decreased blood glucose level 3. Urinary retention
4. Nausea and vomiting
33.) The home health care nurse is visiting a client
who was recently diagnosed with type 2 diabetes 37.) The client has begun medication therapy with
mellitus. The client is prescribed repaglinide pancrelipase (Pancrease MT). The nurse evaluates
(Prandin) and metformin (Glucophage) and asks the that the medication is having the optimal intended
nurse to explain these medications. The nurse benefit if which effect is observed?
should reinforce which instructions to the client? 1. Weight loss
Select all that apply. 2. Relief of heartburn
1. Diarrhea can occur secondary to the metformin. 3. Reduction of steatorrhea
2. The repaglinide is not taken if a meal is skipped. 4. Absence of abdominal pain
3. The repaglinide is taken 30 minutes before
eating. 38.) An older client recently has been taking
4. Candy or another simple sugar is carried and used cimetidine (Tagamet). The nurse monitors the client
to treat mild hypoglycemia episodes. for which most frequent central nervous system side
5. Metformin increases hepatic glucose production effect of this medication?
to prevent hypoglycemia associated with 1. Tremors
repaglinide. 2. Dizziness
6. Muscle pain is an expected side effect of
Page 4 of 35
hyperparathyroidism and notes that the client's which of the following indicates that a systemic
serum calcium level is 13 mg/dL. Which medication effect has occurred?
should the nurse prepare to administer as prescribed 1.Hyperventilation
to the client? 2.Elevated blood pressure
1. Calcium chloride 3.Local pain at the burn site
2. Calcium gluconate 4.Local rash at the burn site
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D 7.) Isotretinoin is prescribed for a client with severe
acne. Before the administration of this medication,
2.) Oral iron supplements are prescribed for a 6- the nurse anticipates that which laboratory test will
year-old child with iron deficiency anemia. The be prescribed?
nurse instructs the mother to administer the iron 1. Platelet count
with which best food item? 2. Triglyceride level
1. Milk 3. Complete blood count
2. Water 4. White blood cell count
3. Apple juice
4. Orange juice 8.) A client with severe acne is seen in the clinic
and the health care provider (HCP) prescribes
3.) Salicylic acid is prescribed for a client with a isotretinoin. The nurse reviews the client's
diagnosis of psoriasis. The nurse monitors the medication record and would contact the (HCP) if
client, knowing that which of the following would the client is taking which medication?
indicate the presence of systemic toxicity from this 1. Vitamin A
medication? 2. Digoxin (Lanoxin)
1. Tinnitus 3. Furosemide (Lasix)
2. Diarrhea 4. Phenytoin (Dilantin)
3. Constipation
4. Decreased respirations 9.) The nurse is applying a topical corticosteroid to
a client with eczema. The nurse would monitor for
4.) The camp nurse asks the children preparing to the potential for increased systemic absorption of
swim in the lake if they have applied sunscreen. The the medication if the medication were being applied
nurse reminds the children that chemical sunscreens to which of the following body areas?
are most effective when applied: 1. Back
1. Immediately before swimming 2. Axilla
2. 15 minutes before exposure to the sun 3. Soles of the feet
3. Immediately before exposure to the sun 4. Palms of the hands
4. At least 30 minutes before exposure to the sun
10.) The clinic nurse is performing an admission
5.) Mafenide acetate (Sulfamylon) is prescribed for assessment on a client. The nurse notes that the
the client with a burn injury. When applying the client is taking azelaic acid (Azelex). Because of the
medication, the client complains of local discomfort medication prescription, the nurse would suspect
and burning. Which of the following is the most that the client is being treated for:
appropriate nursing action? 1. Acne
1. Notifying the registered nurse 2. Eczema
2. Discontinuing the medication 3. Hair loss
3. Informing the client that this is normal 4. Herpes simplex
4. Applying a thinner film than prescribed to the
burn site 11.) The health care provider has prescribed silver
sulfadiazine (Silvadene) for the client with a partial-
6.) The burn client is receiving treatments of thickness burn, which has cultured positive for
topical mafenide acetate (Sulfamylon) to the site of gram-negative bacteria. The nurse is reinforcing
Page 1 of 35
,information to the client about the medication. 3. Pulmonary fibrosis
Which statement made by the client indicates a lack 4. Orthostatic hypotension
of understanding about the treatments?
1. "The medication is an antibacterial." 16.) The clinic nurse is reviewing a teaching plan
2. "The medication will help heal the burn." for the client receiving an antineoplastic
3. "The medication will permanently stain my skin." medication. When implementing the plan, the nurse
4. "The medication should be applied directly to the tells the client:
wound." 1. To take aspirin (acetylsalicylic acid) as needed
for headache
12.) A nurse is caring for a client who is receiving 2. Drink beverages containing alcohol in moderate
an intravenous (IV) infusion of an antineoplastic amounts each evening
medication. During the infusion, the client 3. Consult with health care providers (HCPs) before
complains of pain at the insertion site. During an receiving immunizations
inspection of the site, the nurse notes redness and 4. That it is not necessary to consult HCPs before
swelling and that the rate of infusion of the receiving a flu vaccine at the local health fair
medication has slowed. The nurse should take
which appropriate action? 17.) The client with ovarian cancer is being treated
1. Notify the registered nurse. with vincristine (Oncovin). The nurse monitors the
2. Administer pain medication to reduce the client, knowing that which of the following
discomfort. indicates a side effect specific to this medication?
3. Apply ice and maintain the infusion rate, as 1. Diarrhea
prescribed. 2. Hair loss
4. Elevate the extremity of the IV site, and slow the 3. Chest pain
infusion. 4. Numbness and tingling in the fingers and toes
13.) The client with squamous cell carcinoma of 18.) The nurse is reviewing the history and physical
the larynx is receiving bleomycin intravenously. examination of a client who will be receiving
The nurse caring for the client anticipates that asparaginase (Elspar), an antineoplastic agent. The
which diagnostic study will be prescribed? nurse consults with the registered nurse regarding
1. Echocardiography the administration of the medication if which of the
2. Electrocardiography following is documented in the client's history?
3. Cervical radiography 1. Pancreatitis
4. Pulmonary function studies 2. Diabetes mellitus
3. Myocardial infarction
14.) The client with acute myelocytic leukemia is 4. Chronic obstructive pulmonary disease
being treated with busulfan (Myleran). Which
laboratory value would the nurse specifically 19.) Tamoxifen is prescribed for the client with
monitor during treatment with this medication? metastatic breast carcinoma. The nurse understands
1. Clotting time that the primary action of this medication is to:
2. Uric acid level 1. Increase DNA and RNA synthesis.
3. Potassium level 2. Promote the biosynthesis of nucleic acids.
4. Blood glucose level 3. Increase estrogen concentration and estrogen
response.
15.) The client with small cell lung cancer is being 4. Compete with estradiol for binding to estrogen in
treated with etoposide (VePesid). The nurse who is tissues containing high concentrations of receptors.
assisting in caring for the client during its
administration understands that which side effect is 20.) The client with metastatic breast cancer is
specifically associated with this medication? receiving tamoxifen. The nurse specifically
1. Alopecia monitors which laboratory value while the client is
2. Chest pain taking this medication?
1. Glucose level
Page 2 of 35
,2. Calcium level The nurse tells the client to:
3. Potassium level 1. Freeze the insulin.
4. Prothrombin time 2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
21.) A nurse is assisting with caring for a client 4. Keep the insulin at room temperature.
with cancer who is receiving cisplatin. Select the
adverse effects that the nurse monitors for that are 26.) Glimepiride (Amaryl) is prescribed for a client
associated with this medication. Select all that with diabetes mellitus. A nurse reinforces
apply. instructions for the client and tells the client to
1. Tinnitus avoid which of the following while taking this
2. Ototoxicity medication?
3. Hyperkalemia 1. Alcohol
4. Hypercalcemia 2. Organ meats
5. Nephrotoxicity 3. Whole-grain cereals
6. Hypomagnesemia 4. Carbonated beverages
22.) A nurse is caring for a client after 27.) Sildenafil (Viagra) is prescribed to treat a
thyroidectomy and notes that calcium gluconate is client with erectile dysfunction. A nurse reviews the
prescribed for the client. The nurse determines that client's medical record and would question the
this medication has been prescribed to: prescription if which of the following is noted in the
1. Treat thyroid storm. client's history?
2. Prevent cardiac irritability. 1. Neuralgia
3. Treat hypocalcemic tetany. 2. Insomnia
4. Stimulate the release of parathyroid hormone. 3. Use of nitroglycerin
4. Use of multivitamins
23.) A client who has been newly diagnosed with
diabetes mellitus has been stabilized with daily 28.) The health care provider (HCP) prescribes
insulin injections. Which information should the exenatide (Byetta) for a client with type 1 diabetes
nurse teach when carrying out plans for discharge? mellitus who takes insulin. The nurse knows that
1. Keep insulin vials refrigerated at all times. which of the following is the appropriate
2. Rotate the insulin injection sites systematically. intervention?
3. Increase the amount of insulin before unusual 1. The medication is administered within 60
exercise. minutes before the morning and evening meal.
4. Monitor the urine acetone level to determine the 2. The medication is withheld and the HCP is called
insulin dosage. to question the prescription for the client.
3. The client is monitored for gastrointestinal side
24.) A nurse is reinforcing teaching for a client effects after administration of the medication.
regarding how to mix regular insulin and NPH 4. The insulin is withdrawn from the Penlet into an
insulin in the same syringe. Which of the following insulin syringe to prepare for administration.
actions, if performed by the client, indicates the
need for further teaching? 29.) A client is taking Humulin NPH insulin daily
1. Withdraws the NPH insulin first every morning. The nurse reinforces instructions for
2. Withdraws the regular insulin first the client and tells the client that the most likely
3. Injects air into NPH insulin vial first time for a hypoglycemic reaction to occur is:
4. Injects an amount of air equal to the desired dose 1. 2 to 4 hours after administration
of insulin into the vial 2. 4 to 12 hours after administration
3. 16 to 18 hours after administration
25.) A home care nurse visits a client recently 4. 18 to 24 hours after administration
diagnosed with diabetes mellitus who is taking
Humulin NPH insulin daily. The client asks the 30.) A client with diabetes mellitus visits a health
nurse how to store the unopened vials of insulin. care clinic. The client's diabetes mellitus previously
Page 3 of 35
, had been well controlled with glyburide (DiaBeta) metformin and may be treated with acetaminophen
daily, but recently the fasting blood glucose level (Tylenol).
has been 180 to 200 mg/dL. Which medication, if
added to the client's regimen, may have contributed 34.) A client with Crohn's disease is scheduled to
to the hyperglycemia? receive an infusion of infliximab (Remicade). The
1. Prednisone nurse assisting in caring for the client should take
2. Phenelzine (Nardil) which action to monitor the effectiveness of
3. Atenolol (Tenormin) treatment?
4. Allopurinol (Zyloprim) 1. Monitoring the leukocyte count for 2 days after
the infusion
31.) A community health nurse visits a client at 2. Checking the frequency and consistency of bowel
home. Prednisone 10 mg orally daily has been movements
prescribed for the client and the nurse reinforces 3. Checking serum liver enzyme levels before and
teaching for the client about the medication. Which after the infusion
statement, if made by the client, indicates that 4. Carrying out a Hematest on gastric fluids after
further teaching is necessary? the infusion is completed
1. "I can take aspirin or my antihistamine if I need
it." 35.) The client has a PRN prescription for
2. "I need to take the medication every day at the loperamide hydrochloride (Imodium). The nurse
same time." understands that this medication is used for which
3. "I need to avoid coffee, tea, cola, and chocolate condition?
in my diet." 1. Constipation
4. "If I gain more than 5 pounds a week, I will call 2. Abdominal pain
my doctor." 3. An episode of diarrhea
4. Hematest-positive nasogastric tube drainage
32.) Desmopressin acetate (DDAVP) is prescribed
for the treatment of diabetes insipidus. The nurse 36.) The client has a PRN prescription for
monitors the client after medication administration ondansetron (Zofran). For which condition should
for which therapeutic response? this medication be administered to the postoperative
1. Decreased urinary output client?
2. Decreased blood pressure 1. Paralytic ileus
3. Decreased peripheral edema 2. Incisional pain
4. Decreased blood glucose level 3. Urinary retention
4. Nausea and vomiting
33.) The home health care nurse is visiting a client
who was recently diagnosed with type 2 diabetes 37.) The client has begun medication therapy with
mellitus. The client is prescribed repaglinide pancrelipase (Pancrease MT). The nurse evaluates
(Prandin) and metformin (Glucophage) and asks the that the medication is having the optimal intended
nurse to explain these medications. The nurse benefit if which effect is observed?
should reinforce which instructions to the client? 1. Weight loss
Select all that apply. 2. Relief of heartburn
1. Diarrhea can occur secondary to the metformin. 3. Reduction of steatorrhea
2. The repaglinide is not taken if a meal is skipped. 4. Absence of abdominal pain
3. The repaglinide is taken 30 minutes before
eating. 38.) An older client recently has been taking
4. Candy or another simple sugar is carried and used cimetidine (Tagamet). The nurse monitors the client
to treat mild hypoglycemia episodes. for which most frequent central nervous system side
5. Metformin increases hepatic glucose production effect of this medication?
to prevent hypoglycemia associated with 1. Tremors
repaglinide. 2. Dizziness
6. Muscle pain is an expected side effect of
Page 4 of 35
