1. A client receiving methotrexate for cancer reports
mouth
sores. What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral
care
is essential to prevent infection and discomfort.
2. A client on sertraline reports increased restlessness
and
confusion. What should the nurse suspect?
A. Extrapyramidal symptoms
B. Lithium toxicity
C. Serotonin syndrome
D. Neuroleptic malignant syndrome
Answer: C
Rationale: Serotonin syndrome includes agitation,
confusion,
tachycardia, and hyperreflexia.
3. A client with chronic constipation uses magnesium
citrate
daily. What risk should the nurse discuss?
A. Hypertension
B. Hypernatremia
C. Electrolyte imbalance
D. Dehydration
Answer: C
Rationale: Chronic laxative use, especially osmotic types
like
magnesium citrate, causes fluid and electrolyte imbalances.
4. A client asks about insulin glargine (Lantus). What is the
correct response?
A. “It works immediately.”
B. “It peaks in 4 hours.”
C. “It has no peak and lasts 24 hours.”
D. “It must be mixed with regular insulin.”
Answer: C
Rationale: Glargine is a long-acting insulin with no
pronounced
peak, providing steady glucose control.
5. A client prescribed clopidogrel should avoid which overthe
, counter medication?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Guaifenesin
Answer: B
Rationale: NSAIDs like ibuprofen increase bleeding risk
when
combined with antiplatelet agents like clopidogrel.
6. A client with myasthenia gravis is prescribed
neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic
crisis,
requiring dosage adjustment.
7. Which lab value should be monitored regularly for a
client on
statins?
A. BUN
B. AST and ALT
C. Sodium
D. Hematocrit
Answer: B
Rationale: Statins can cause liver damage. Monitor liver
enzymes
(AST/ALT).
8. A client with COPD is on prednisone. Which instruction
is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding
and
ulcers. Tarry stools may indicate bleeding.
9. A client taking phenytoin shows swollen, bleeding gums.
What
should the nurse recommend?
A. Discontinue the drug
mouth
sores. What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral
care
is essential to prevent infection and discomfort.
2. A client on sertraline reports increased restlessness
and
confusion. What should the nurse suspect?
A. Extrapyramidal symptoms
B. Lithium toxicity
C. Serotonin syndrome
D. Neuroleptic malignant syndrome
Answer: C
Rationale: Serotonin syndrome includes agitation,
confusion,
tachycardia, and hyperreflexia.
3. A client with chronic constipation uses magnesium
citrate
daily. What risk should the nurse discuss?
A. Hypertension
B. Hypernatremia
C. Electrolyte imbalance
D. Dehydration
Answer: C
Rationale: Chronic laxative use, especially osmotic types
like
magnesium citrate, causes fluid and electrolyte imbalances.
4. A client asks about insulin glargine (Lantus). What is the
correct response?
A. “It works immediately.”
B. “It peaks in 4 hours.”
C. “It has no peak and lasts 24 hours.”
D. “It must be mixed with regular insulin.”
Answer: C
Rationale: Glargine is a long-acting insulin with no
pronounced
peak, providing steady glucose control.
5. A client prescribed clopidogrel should avoid which overthe
, counter medication?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Guaifenesin
Answer: B
Rationale: NSAIDs like ibuprofen increase bleeding risk
when
combined with antiplatelet agents like clopidogrel.
6. A client with myasthenia gravis is prescribed
neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic
crisis,
requiring dosage adjustment.
7. Which lab value should be monitored regularly for a
client on
statins?
A. BUN
B. AST and ALT
C. Sodium
D. Hematocrit
Answer: B
Rationale: Statins can cause liver damage. Monitor liver
enzymes
(AST/ALT).
8. A client with COPD is on prednisone. Which instruction
is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding
and
ulcers. Tarry stools may indicate bleeding.
9. A client taking phenytoin shows swollen, bleeding gums.
What
should the nurse recommend?
A. Discontinue the drug