CMS pharmacology Proctored 2023 Update Questions and
Answers with complete solution
A nurse is reviewing a client's 0800 Laboratory values at 1100. The nurse notes
that the client received heparin at 1100. Which of the following laboratory values
warrants an incident report ?
aPTT 90 seconds
A nurse is caring for a client who develops an anaphylactic reaction to IV
antibiotic administration. After assessing a client's respiratory status and
stopping the medication infusion, which of the following actions should the nurse
take next?
Administer Epinephrine IM
A nurse is caring for a client who is taking triamterene. For which of the following
laboratory values should the nurse withhold the medication?
Potassium 5.3 mEq/ L
A nurse is preparing to administer digoxin orally to a client. Identify the sequence
of steps the nurse should take. (Move the steps into the box on the right, placing
them in the order of performance. Use all the steps)
Obtain the client's apical heart rate
Remove the medication from the dispensing system
Open the medication package
Compare the client's wristband to the medication administration record
Document administration of the medication
A nurse is reviewing the list of current medications for a client who is to start a
new prescription for carbamazepine. The nurse should identify which of the
following medications interacts with carbamazepine?
estrogen-containing contraceptives
A nurse is providing teaching to a client who has a new prescription for
clozapine. Which of the following statements should the nurse include in the
teaching?
Notify your provider if you develop a fever while taking this medication"
you should have your WBC monitor every week
A nurse is reviewing the medication list of a client who has erectile dysfunction
and is requesting for prescription for sildenafil. the nurse should identify which of
the following medications is a contraindication for receiving medication?
nitroglycerin
A nurse in a medical surgical unit is preparing to administer an influenza vaccine
to a client. The client tells the nurse I no longer want this vaccine. Which of the
following responses should the nurse make?
the influenza vaccine this strongly and coverage but I understand you would like to
decline right now
A nurse is discussing adverse reactions to pain medications in older adults
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 applies
,multiple health problems
decrease percentage of body fat
decreased renal function
A nurse is reviewing a client's medical record before administering
acetaminophen 650 mg by mouth every 6 hours. Which of the following findings
indicate a need for the nurse to notify the provider?
history of alcohol use disorder
a nurse is caring for a client who has hyponatremia and is receiving an infusion
of a prescribed hypertonic solution. Which of the following findings should
indicate to the nurse that the treatment is effective?
improve cognition
A nurse is reviewing the laboratory results of a client who is receiving genital
medicine for Staphylococcus. Which of the following findings should the nurse
report to there immediately?
fasting blood glucose 130 mg
A nurse is reviewing the laboratory results of a client who is receiving Heparin by
continuous IV infusion. Which of the following Results indicates the nurse should
decrease the infusion rate?
aPTT 90 sec
The nurse is caring for a client who has diabetes mellitus and is taking
Pioglitazone. The nurse should plan to monitor the client for which of the
following adverse effects?
orthostatic hypotension
A nurse is caring for a client who is receiving ceftriaxone intravenously. Which of
the following manifestations should the nurse identify as an allergic reaction?
Hypotension
A nurse is reviewing the laboratory results of a client who received a dose of
sodium polystyrene sulfonate. Which of the following findings should a nurse
identify as an indication that the medication has been effective?
calcium 8 mg- under normal range
potassium 4.6 meq- in normal range
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 has an adverse effect of the medication?
hypokalemia
A nurse recently administered filgrastim intravenously to a client who has cancer
and is receiving cytotoxic chemotherapy. For which of the following data,
discovered after the medication was administered, should the nurse file an
incident report?
The medication vial sat at room temperature for 2 hours before it was administered.
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 indicate a therapeutic response to the medication?
I have noticed I'm not as cold as I used to be
,a nurse is receiving the laboratory results of a client who has rheumatoid arthritis
and a prescription for cyclosporine. The nurse should report which of the
following laboratory results of the provider?
creatinine 2.8 mg
A nurse is teaching a newly-licensed nurse about expired medication. Which of
the following instructions should the nurse include in the teaching?
return the medication to the pharmacy
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?
increased respiratory rate
a nurse is preparing to administer Heparin subcutaneously to a client. Which of
the following should the nurse plan to minimize bleeding following the injection?
grasp skin between thumb and forefinger throughout the injection
A nurse is caring for an older adult client who is taking Prednisone for long term
treatment for rheumatoid arthritis. The nurse should monitor the client for which
of the following adverse reactions to the drug?
bone loss
A nurse is interviewing a client who reports a desire to quit smoking. Which of
the following prescriptions should the nurse expect the provider to prescribe?
bupropion
A nurse is teaching a client about self-administration of an enoxaparin. Which of
the following instructions should the nurse include to select all that applies?
alternate the injection site between the sides of the abdomen
grasp the skin between the thumb and forefinger while injecting the medication
insert the entire length of the needle into the skin during injection
a nurse is assessing a client who is in septic shock and is receiving dopamine by
continuous IV infusion. Which of the following findings indicates that the nurse
should increase the rate of the infusion?
headache
A nurse is reviewing the laboratory report of a client who has bipolar disorder
prior to the administration of lithium carbonate. The client's lithium level is 2.6
meq. Which of the following actions should the nurse take?
prepare the client for hemodialysis
A nurse is interviewing a client who was newly admitted prior to administering
medication. The client tells the nurse, " I forgot to tell the doctor I like albuterol
for asthma". for which of the following medications should the nurse withhold the
dose and notify the provider?
propranolol
A nurse is teaching a client who is to start taking clopidogrel. the nurse should
instruct the client to Monitor and Report which of the following adverse effects of
the medication?
blurred vision
A nurse is providing teaching to a client who has a new prescription for
paroxetine. the nurse should instruct the client to monitor which of the following
adverse effects?
, Drowsiness
A nurse is administering ferrous sulfate elixir to a client who has iron deficiency
anemia. Which of the following actions should the nurse take?
administer the medication through a straw
A nurse is caring for a client who is receiving Total parenteral Nutrition. Which of
the following actions should the nurse take?
monitor the client's weight daily
a nurse is assessing a client who has hypermagnesemia. Which of the following
medications should the nurse prepare to administer?
calcium gluconate
a nurse is caring for a client who is receiving hospice care and has a prescription
for fentanyl buccal film. Which of the following methods should the nurse use to
administer this medication?
insert the medication against the mucosal membrane of the cheek
A client who has Graves disease is prescribed methimazole. Which of the
following effects should the nurse expect to see after the clients take the
medication after 2 months?
increase sleeping
A nurse is assessing a client who has Graves disease and is taking methimazole.
Which of the following findings indicate that the client needs a lower dose of the
medication?
exophthalmos
A nurse is planning to administer a controlled substance to a client who is
experiencing pain. Which of the following actions should the nurse plan to take
first?
Identify the client using two identifiers
a nurse accidentally administers the medication Metformin instead of metoprolol
to a client which of the following actions should the nurse take?
check the client's glucose level
A nurse is providing discharge teaching to a client who is prescribed
spironolactone. Which of the following statements by the client indicates an
understanding of the teaching?
I will limit potassium rich foods in my diet
A nurse is caring for a client who has a major depression and a new prescription
for citalopram. Which of the following adverse effects is the nurse to report to the
provider?
confusion
A nurse is providing teaching to a client who has gastric ulcer and a new
prescription for ranitidine. Which of the following statements does the client
indicate an understanding of the teaching?
I should not take in and Anti Acid within 1 hour of taking his medication
A nurse is preparing to administer amphotericin B lipid complex via intermittent
IV bolus to a client who has infected endocarditis. Which of the following actions
should the nurse take?
administer the medication over 2 hours
Answers with complete solution
A nurse is reviewing a client's 0800 Laboratory values at 1100. The nurse notes
that the client received heparin at 1100. Which of the following laboratory values
warrants an incident report ?
aPTT 90 seconds
A nurse is caring for a client who develops an anaphylactic reaction to IV
antibiotic administration. After assessing a client's respiratory status and
stopping the medication infusion, which of the following actions should the nurse
take next?
Administer Epinephrine IM
A nurse is caring for a client who is taking triamterene. For which of the following
laboratory values should the nurse withhold the medication?
Potassium 5.3 mEq/ L
A nurse is preparing to administer digoxin orally to a client. Identify the sequence
of steps the nurse should take. (Move the steps into the box on the right, placing
them in the order of performance. Use all the steps)
Obtain the client's apical heart rate
Remove the medication from the dispensing system
Open the medication package
Compare the client's wristband to the medication administration record
Document administration of the medication
A nurse is reviewing the list of current medications for a client who is to start a
new prescription for carbamazepine. The nurse should identify which of the
following medications interacts with carbamazepine?
estrogen-containing contraceptives
A nurse is providing teaching to a client who has a new prescription for
clozapine. Which of the following statements should the nurse include in the
teaching?
Notify your provider if you develop a fever while taking this medication"
you should have your WBC monitor every week
A nurse is reviewing the medication list of a client who has erectile dysfunction
and is requesting for prescription for sildenafil. the nurse should identify which of
the following medications is a contraindication for receiving medication?
nitroglycerin
A nurse in a medical surgical unit is preparing to administer an influenza vaccine
to a client. The client tells the nurse I no longer want this vaccine. Which of the
following responses should the nurse make?
the influenza vaccine this strongly and coverage but I understand you would like to
decline right now
A nurse is discussing adverse reactions to pain medications in older adults
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 applies
,multiple health problems
decrease percentage of body fat
decreased renal function
A nurse is reviewing a client's medical record before administering
acetaminophen 650 mg by mouth every 6 hours. Which of the following findings
indicate a need for the nurse to notify the provider?
history of alcohol use disorder
a nurse is caring for a client who has hyponatremia and is receiving an infusion
of a prescribed hypertonic solution. Which of the following findings should
indicate to the nurse that the treatment is effective?
improve cognition
A nurse is reviewing the laboratory results of a client who is receiving genital
medicine for Staphylococcus. Which of the following findings should the nurse
report to there immediately?
fasting blood glucose 130 mg
A nurse is reviewing the laboratory results of a client who is receiving Heparin by
continuous IV infusion. Which of the following Results indicates the nurse should
decrease the infusion rate?
aPTT 90 sec
The nurse is caring for a client who has diabetes mellitus and is taking
Pioglitazone. The nurse should plan to monitor the client for which of the
following adverse effects?
orthostatic hypotension
A nurse is caring for a client who is receiving ceftriaxone intravenously. Which of
the following manifestations should the nurse identify as an allergic reaction?
Hypotension
A nurse is reviewing the laboratory results of a client who received a dose of
sodium polystyrene sulfonate. Which of the following findings should a nurse
identify as an indication that the medication has been effective?
calcium 8 mg- under normal range
potassium 4.6 meq- in normal range
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 has an adverse effect of the medication?
hypokalemia
A nurse recently administered filgrastim intravenously to a client who has cancer
and is receiving cytotoxic chemotherapy. For which of the following data,
discovered after the medication was administered, should the nurse file an
incident report?
The medication vial sat at room temperature for 2 hours before it was administered.
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 indicate a therapeutic response to the medication?
I have noticed I'm not as cold as I used to be
,a nurse is receiving the laboratory results of a client who has rheumatoid arthritis
and a prescription for cyclosporine. The nurse should report which of the
following laboratory results of the provider?
creatinine 2.8 mg
A nurse is teaching a newly-licensed nurse about expired medication. Which of
the following instructions should the nurse include in the teaching?
return the medication to the pharmacy
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?
increased respiratory rate
a nurse is preparing to administer Heparin subcutaneously to a client. Which of
the following should the nurse plan to minimize bleeding following the injection?
grasp skin between thumb and forefinger throughout the injection
A nurse is caring for an older adult client who is taking Prednisone for long term
treatment for rheumatoid arthritis. The nurse should monitor the client for which
of the following adverse reactions to the drug?
bone loss
A nurse is interviewing a client who reports a desire to quit smoking. Which of
the following prescriptions should the nurse expect the provider to prescribe?
bupropion
A nurse is teaching a client about self-administration of an enoxaparin. Which of
the following instructions should the nurse include to select all that applies?
alternate the injection site between the sides of the abdomen
grasp the skin between the thumb and forefinger while injecting the medication
insert the entire length of the needle into the skin during injection
a nurse is assessing a client who is in septic shock and is receiving dopamine by
continuous IV infusion. Which of the following findings indicates that the nurse
should increase the rate of the infusion?
headache
A nurse is reviewing the laboratory report of a client who has bipolar disorder
prior to the administration of lithium carbonate. The client's lithium level is 2.6
meq. Which of the following actions should the nurse take?
prepare the client for hemodialysis
A nurse is interviewing a client who was newly admitted prior to administering
medication. The client tells the nurse, " I forgot to tell the doctor I like albuterol
for asthma". for which of the following medications should the nurse withhold the
dose and notify the provider?
propranolol
A nurse is teaching a client who is to start taking clopidogrel. the nurse should
instruct the client to Monitor and Report which of the following adverse effects of
the medication?
blurred vision
A nurse is providing teaching to a client who has a new prescription for
paroxetine. the nurse should instruct the client to monitor which of the following
adverse effects?
, Drowsiness
A nurse is administering ferrous sulfate elixir to a client who has iron deficiency
anemia. Which of the following actions should the nurse take?
administer the medication through a straw
A nurse is caring for a client who is receiving Total parenteral Nutrition. Which of
the following actions should the nurse take?
monitor the client's weight daily
a nurse is assessing a client who has hypermagnesemia. Which of the following
medications should the nurse prepare to administer?
calcium gluconate
a nurse is caring for a client who is receiving hospice care and has a prescription
for fentanyl buccal film. Which of the following methods should the nurse use to
administer this medication?
insert the medication against the mucosal membrane of the cheek
A client who has Graves disease is prescribed methimazole. Which of the
following effects should the nurse expect to see after the clients take the
medication after 2 months?
increase sleeping
A nurse is assessing a client who has Graves disease and is taking methimazole.
Which of the following findings indicate that the client needs a lower dose of the
medication?
exophthalmos
A nurse is planning to administer a controlled substance to a client who is
experiencing pain. Which of the following actions should the nurse plan to take
first?
Identify the client using two identifiers
a nurse accidentally administers the medication Metformin instead of metoprolol
to a client which of the following actions should the nurse take?
check the client's glucose level
A nurse is providing discharge teaching to a client who is prescribed
spironolactone. Which of the following statements by the client indicates an
understanding of the teaching?
I will limit potassium rich foods in my diet
A nurse is caring for a client who has a major depression and a new prescription
for citalopram. Which of the following adverse effects is the nurse to report to the
provider?
confusion
A nurse is providing teaching to a client who has gastric ulcer and a new
prescription for ranitidine. Which of the following statements does the client
indicate an understanding of the teaching?
I should not take in and Anti Acid within 1 hour of taking his medication
A nurse is preparing to administer amphotericin B lipid complex via intermittent
IV bolus to a client who has infected endocarditis. Which of the following actions
should the nurse take?
administer the medication over 2 hours
