ACTUAL EXAM QUESTIONS WITH DETAILED
VERIFIED ANSWERS WITH RATIONALES /A+
GRADE ASSURED
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serumcalcium
level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the
client?
• Calcium chloride
• Calcium gluconate
• Calcitonin (Miacalcin)
• Large doses of vitamin D 3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia.
Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be
avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that theclient
is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that
the client is being treated for:
• Acne
• Eczema
• Hair loss
• Herpes simplex 1. Acne
Rationale:
,Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by
suppressing the growth of Propionibacterium acnes and decreasing the proliferation ofkeratinocytes.
Options 2, 3, and 4 are incorrect.
100.) Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus
seropositive. The nurse reinforces medication instructions and tells the client to:
• Avoid sun exposure.
• Eat low-calorie foods.
• Eat foods that are low in fat.
• Take the medication on an empty stomach. 1. Avoid sun exposure.
Rationale:
Saquinavir (Invirase) is an antiretroviral (protease inhibitor) used with other antiretroviral
medications to manage human immunodeficiency virus infection. Saquinavir is administered with
meals and is best absorbed if the client consumes high-calorie, high-fat meals. Saquinavircan cause
photosensitivity, and the nurse should instruct the client to avoid sun exposure.
101.) Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the interventions
that the nurse includes when administering this medication. Select all that apply.
• Restrict fluid intake.
• Instruct the client to avoid alcohol.
• Monitor hepatic and liver function studies.
• Administer the medication with an antacid.
• Instruct the client to avoid exposure to the sun.
• Administer the medication on an empty stomach. 2. Instruct the client to avoid alcohol.
3. Monitor hepatic and liver function studies.
5. Instruct the client to avoid exposure to the sun.
Rationale:
Ketoconazole is an antifungal medication. It is administered with food (not on an empty stomach)
and antacids are avoided for 2 hours after taking the medication to ensure absorption.The
medication is hepatotoxic and the nurse monitors liver function studies. The client is instructed to
avoid exposure to the sun because the medication increases photosensitivity. Theclient is also
,instructed to avoid alcohol. There is no reason for the client to restrict fluid intake. In fact, this could
be harmful to the client.
102.) A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurseshould
monitor for which adverse effects of the medication? Select all that apply.
• Rash
• Hepatotoxicity
• Hyperglycemia
• Peripheral neuropathy
• Reduced bone mineral density 1. Rash
2. Hepatotoxicity
Rationale:
Nevirapine (Viramune) is a non-nucleoside reverse transcriptase inhibitors (NRTI) that is used to
treat HIV infection. It is used in combination with other antiretroviral medications to treat HIV.
Adverse effects include rash, Stevens-Johnson syndrome, hepatitis, and increased transaminase
levels. Hyperglycemia, peripheral neuropathy, and reduced bone density are not adverse effects of
this medication.
103.) A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the
treatment of a schizophrenic disorder. Which laboratory study prescribed for the client will the
nurse specifically review to monitor for an adverse effect associated with the use of this
medication?
• Platelet count
• Cholesterol level
• White blood cell count
• Blood urea nitrogen level 3. White blood cell count
Rationale:
Hematological reactions can occur in the client taking clozapine and include agranulocytosis andmild
leukopenia. The white blood cell count should be checked before initiating treatment and should be
monitored closely during the use of this medication. The client should also be monitored for signs
indicating agranulocytosis, which may include sore throat, malaise, and fever. Options 1, 2, and 4
are unrelated to this medication.
, 104.) Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic.
The nurse is collecting data on the client and is providing instructions regarding the use ofthis
medication. Which is most important for the nurse to determine before administration of this
medication?
• A history of hyperthyroidism
• A history of diabetes insipidus
• When the last full meal was consumed
• When the last alcoholic drink was consumed 4. When the last alcoholic drink was consumed
Rationale:
Disulfiram is used as an adjunct treatment for selected clients with chronic alcoholism who want
to remain in a state of enforced sobriety. Clients must abstain from alcohol intake for at least 12
hours before the initial dose of the medication is administered. The most important data are to
determine when the last alcoholic drink was consumed. The medication is used with caution in
clients with diabetes mellitus, hypothyroidism, epilepsy, cerebral damage, nephritis, and hepatic
disease. It is also contraindicated in severe heart disease, psychosis, or hypersensitivity related to the
medication.
105.) A nurse is collecting data from a client and the client's spouse reports that the client is taking
donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this clientmay have
based on the use of this medication?
• Dementia
• Schizophrenia
• Seizure disorder
• Obsessive-compulsive disorder 1. Dementia
Rationale:
Donepezil hydrochloride is a cholinergic agent used in the treatment of mild to moderate dementia
of the Alzheimer type. It enhances cholinergic functions by increasing the concentration of
acetylcholine. It slows the progression of Alzheimer's disease. Options 2, 3, and4 are incorrect.
106.) Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client
regarding the administration of the medication. Which statement by the client indicates an
understanding about administration of the medication?