- A nurse in the intensive care unit (ICU) is caring for a client with heart failure. The client is receiving a dobutamine infusion. Which finding would indicate the medication is effective?
a. Decreased blood pressure
b. Increased heart rate
c. Increased cardiac output
d. Decreased blood glucose level
2. A nurse caring for a client who is prescribed long-term antilipemic drugs should assess the client for which adverse effect?
a. Altered vitamin absorption
b. Diarrhea
c. Hypotension
d. Hypercholesterolemia
3. A nurse is caring for a client who was prescribed sildenafil. Which medication is most concerning if taken with sildenafil?
a. Oral acetaminophen
b. Intravenous furosemide
c. Oral potassium supplements
d. Sublingual nitroglycerin
4. The nurse understands that children under the age of ___ should not take loratadine because it may cause ___.
a. Two years, six months, or 18 years
b. Seizures ?
5. The nurse is caring for a client taking losartan. The nurse should assess for which adverse effect?
a. Constipation
b. Angioedema
c. Palpitations
d. Hypertension
6. Which drug is classified as an expectorant?
a. Guaifenesin
b. Benzonate
c. Dextromorthaphan
d. Fluticasone
7. A nurse is caring for a client with a new prescription for propranolol. The nurse should notify the healthcare provider about the client’s history of which condition?
a. Glaucoma
b. Depression
c. Migraines
d. Asthma
8. A client with osteoarthritis asks the nurse if it is safe to take aspirin. Which finding in the client’s history is a contraindication?
a. Migraine headaches
b. History of gastric ulcers
c. Current glaucoma
d. Transient ischemic attack (TIA)
9. The nurse is caring for a client receiving intravenous nitroglycerin. The nurse should monitor the client for which adverse effect?
a. Peripheral neuropathy
b. Hypotension
c. Myocardial infarction
d. Angina
10. A nurse is caring for a client receiving intravenous heparin. What is the PRIORITY nursing intervention?
a. Monitor complete blood count (CBC)
b. Monitor potassium levels
c. Monitor for constipation
d. Monitor for lipohypertrophy
11. The nurse is providing education to a client prescribed clonidine for hypertension. Which instruction should the nurse indicate?
a. “Do not stop abruptly as it can cause rebound hypertension”
b. “Increase salt in your diet when taking clonidine”
c. “If you miss your dose, take two pills with your next dose”
d. “Clonidine may increase your blood pressure”
12. The nurse is caring for a client with chest congestion. Which class of drugs should the nurse recommend to assist in mobilizing secretions?
a. Antitussive
b. Antihistamine
c. Anticholinergic
d. Expectorant
13. A client has a new prescription for metoprolol after a myocardial infarction (MI). The nurse recalls a beta blocker is indicated after an MI for which effect?
a. To maintain a client’s blood pressure
b. To dilate coronary arteries
c. To treat the client’s heart failure
d. To protect the heart from further ischemia
14. A nurse receives a handoff shift report. The nurse knows which client(s) would be candidates for anticoagulation therapy? Select All That Apply
a. A 29 year old with deep vein thrombosis
b. A 45 year old client with atrial fibrillation
c. A 68 year old with a hemorrhagic stroke
d. A 36 year old with an artificial heart valve
e. A 52 year old with thrombocytopenia
15. The nurse is providing discharge teaching for a client prescribed enoxaparin. Which education should the nurse include?
a. “Rotate sites when administering enoxaparin”
b. “Bruising is expected when taking enoxaparin”
c. “Do not crush your dose of enoxaparin”
d. “You will need to go for regular lab draws while taking enoxaparin”
16. A nurse is providing education to a client with a new order for an anticoagulant. How should the nurse explain the indication of use for this drug class?
a. Lyses clots
b. Prevents thrombus formation
c. Reverses heparin toxicity
d. Prevents platelet adhesion
17. A nurse is caring for a client who is prescribed theophylline. The nurse should monitor the client for which adverse effect?
a. Bradycardia
b. Hypotension
c. Palpitations
d. Drowsiness
18. The nurse is caring for a client with liver disease. Which angiotensin-converting enzyme (ACE) inhibitor should the nurse anticipate the healthcare provider will prescribe?
a. Lisinopril
b. Valsartan
c. Propranolol
d. Diltiazem
19. Drag the medications that are adrenergic antihypertensive drugs to the box on the right
a. Clopidogrel
b. Diphenhydramine
c. Clonidine
d. Lisinopril
e. Metoprolol
f. Carvedilol
20. The nurse is caring for a client receiving intravenous heparin. Which finding indicates a therapeutic effect of the drug?
a. Increased angina
b. Bleeding
c. Decreased blood pressure
d. Improved circulation
21. Inhaled corticosteroids such as ___ are ___ in clients with asthma.
a. Fluticasone, albuterol, benzonatate
b. Used as prevention?
22. A nurse is providing education to a client who is prescribed an adrenergic decongestant nasal spray. Which instruction should the nurse include in the education?
a. Limit the use of this spray to 3 days
b. Continue the spray until nasal stuffiness has resolved
c. You will not see effects for at least 3 days
d. Avoid the use of this spray if a fever develops
23. A nurse is educating a client with a new prescription for clopidogrel. Which instruction should the nurse include?
a. “You should take this medication with food”
b. “You may need to stop taking this medication before having a surgery or procedure”
c. “You may have black-colored stools when taking this medication”
d. “This medication should be taken three times daily”
24. Angiotensin II receptor blockers may be prescribed for clients with hypertension instead of an angiotensin-converting enzyme (ACE) inhibitor. What is the most common limiting factor in the use of ACE inhibitors?
a. Nausea
b. Urinary tract infection
c. Persistent cough
d. Vertigo
25. The nurse is providing discharge teaching to a client prescribed warfarin. What should the nurse include in the education?
a. “It is safer to use an electric razor when taking warfarin”
b. “Increase the amount of garlic in your diet”
c. “You can continue to play contact sports when taking warfarin”
d. “Bruising is expected when you are taking warfarin”
26. A client with a history of chronic stable angina develops chest pain while walking. The client stops walking and places one nitroglycerin tablet under their tongue. After 5 minutes, the chest pain has only improved slightly. What is the MOST appropriate action to take next?
a. Wait 10 more minutes and take an additional dose of nitroglycerin
b. Swallow a second tablet immediately
c. Drive home
d. Take an additional dose of nitroglycerin
27. The nurse is caring for a client receiving valsartan/sacubitril. The nurse knows that valsartan/sacubitril is prescribed for ___ and should not be given to clients with ___.
a. Heart failure, hypertension, or angina
b. Type 1 diabetes, hypokalemia, or a history of angioedema
28. The nurse is providing education to a client prescribed rivaroxaban. Which information should the nurse include? Select All That Apply
a. Rivaroxaban can cause clots in clients with atrial fibrillation
b. Rivaroxaban is taken as an oral medication
c. Rivaroxaban may be used to reduce the risk of stroke
d. Abnormal bleeding should be reported to a healthcare provider
e. Epidural anesthesia is not safe for clients taking rivaroxaban
29. A nurse is educating a client about their new prescription for atenolol to treat their hypertension. Which statement by the client BEST indicates understanding of the teaching? Select Apply That Apply
a. “Atenolol can cause me to feel anxious and jittery”
b. “I should take the medication with food to prevent stomach upset”
c. “I can take atenolol as needed when I feel my blood pressure rising”
d. “Atenolol can cause my heart rate to slow down”
e. “I’ll stop taking the medication when my blood pressure is normal”
30. The nurse should recommend an antitussive medication for a client with which condition?
a. Has a productive cough
b. Takes an opioid for chronic pain
c. Has a cough resulting from pneumonia
d. Has an abdominal incision closed with staples
31. A nurse should recognize that anticoagulants are indicated to ___ or to ___.
a. Prevent platelet aggregation, prevent thromboembolic events, or prevent epistaxis
b. Treat deep vein thrombosis?
32. The nurse is caring for a group of clients. Which client would the nurse anticipate being prescribed aspirin?
a. A 48 year old with a gastric ulcer
b. An 11 year old client with a fever
c. A 25 year old client diagnosed with thrombocytopenia
d. A 68 year old client for stroke prevention
33. A nurse is preparing to administer a calcium channel blocker to a client with cardiac dysrhythmias. The nurse should monitor for which adverse effect?
a. Hypothermia
b. Myopathy
c. Ototoxicity
d. Hypotension
34. The nurse is educating a client with a new prescription for nitroglycerin patches. Which client statement indicates further education is needed?
a. “I will apply the patch as soon as I feel any chest pain”
b. “I will rotate application sites”
c. “I will leave the patch on during activity”
d. “I will remove the patch for 8 hours each night”
35. A nurse is educating a client about enoxaparin. Which instruction should the nurse include in the education?
a. “You will need to go for regular lab monitoring”
b. “Report bruising to your healthcare provider”
c. “Enoxaparin was prescribed to break down clots”
d. “Avoid foods high in vitamin K while taking enoxaparin”
36. A nurse is administering a medicated inhaler containing a beta2-agonist to a child having an acute asthma attack. What is the mechanism of action of beta2-agonists?
a. To dilate bronchioles
b. To reduce inflammation
c. To identify asthma allergies
d. To liquefy secretions
37. The nurse is educating a client on the adverse effects of lisinopril. Which client statement indicates further education is required?
a. “I will decrease potassium in my diet”
b. “I will call my provider if I experience dizziness”
c. “Swelling of the lips is expected when taking lisinopril”
d. “I will monitor my blood pressure at home”
38. A nurse is caring for a client who is prescribed montelukast. Which education should the nurse plan to provide?
a. The medication should be kept on hand to treat acute asthma attacks
b. The medication should be taken every day on a continuous schedule, even if symptoms improve
c. When the symptoms improve, the dosing schedule can be tapered and eventually discontinued
d. The proper technique for inhalation must be followed
39. A nurse is preparing to administer a client’s digoxin prescribed for atrial fibrillation. Which action should the nurse take before administering the medication?
a. Assess the client’s apical pulse
b. Weigh the client
c. Obtain the client’s blood pressure
d. Offer the client a snack
40. The nurse understands that diphenhydramine is recommended for clients experiencing ___ or ___.
a. Allergic rhinitis, chronic obstructive pulmonary disease (COPD), or acute asthma attack
b. ?
41. A client prescribed warfarin presents to the emergency department with epistaxis and hematuria. Which medication should the nurse anticipate administering?
a. Flumazenil
b. Vitamin K
c. Protamine sulfate
d. Acetylcysteine
42. A nurse is caring for a client with a new prescription for hydralazine. The nurse will monitor for which adverse effect of this drug?
a. Hyperkalemia
b. Tachycardia
c. Angina
d. Hypertension
43. The nurse is caring for a client experiencing hallucinations. Which medication should the nurse recognize as being the MOST likely to cause hallucinations?
a. Fexofenadine
b. Montelukast
c. Albuterol
d. Fluticasone
44. A nurse is educating a client about cholestyramine. Drag the statements the nurse should include in the education to the box on the right.
a. “Mix this medication in water”
b. “Do not take other drugs at the same time as you take your cholestyramine”
c. “Myopathy is an adverse effect of this drug”
d. “This medication should only be taken on an empty stomach”
e. “Decrease foods high in fat and cholesterol”
45. A nurse is caring for a client receiving a heparin infusion. Which drug would the nurse anticipate administering if the client experienced excessive bleeding?
a. Andexanet alfa
b. Enoxaparin
c. Protamine sulfate
d. Vitamin K
46. The nurse is caring for a client who takes fexofenadine. Which property of this drug results in dryness of the mouth?
a. Cholinergic
b. Antitussive
c. Decongestant
d. Anticholinergic
47. The nurse is caring for a client who experiences a mild allergic reaction to a medication. Which INITIAL action should be included in the plan of care?
a. Administer an inhaled bronchodilator
b. Administer oral steroids
c. Administer an antihistamine
d. Administer intravenous epinephrine
48. Which condition is a contraindication to taking an HMG-CoA Reductase inhibitor?
a. Hypertension
b. Impaired renal function
c. Elevated cholesterol
d. Pregnancy
49. Which nursing consideration is correct regarding the administration of milrinone?
a. Milrinone should not be administered to clients with heart failure
b. Milrinone is an oral medication with a long onset and half-life
c. Milrinone should be given in a separate intravenous line from furosemide
d. Milrinone is only available in subcutaneous form
50. The nurse is educating a client with a new prescription for warfarin. Which food should the nurse instruct the client to limit in their diet?
a. Dairy
b. Deli meat
c. Coffee
d. Kale
51. A client is prescribed digoxin secondary to heart failure. What assessment finding(s) would be most concerning to the nurse? Select All That Apply
a. Green-yellow halos around lights
b. Vomiting
c. A dry mouth
d. Diarrhea
e. A heart rate above baseline vitals
f. Floaters in the visual fields
52. The nurse is caring for a client taking lisinopril. The nurse understands that ___ and ___ are adverse effects of the drug.
a. Angioedema, productive cough, or hypertension
b. Hypokalemia, hyperuricemia, or hyperkalemia
53. The nurse is educating a client about the use of enteric-coated aspirin. Which statement should the nurse include?
a. “Cut the tablet in half if you experience any stomach upset”
b. “Report abnormal bruising to your healthcare provider”
c. “If you miss your dose, you can double the next dose”
d. “Do not crush the enteric coated aspirin”
54. What is the action of albuterol?
a. Albuterol works by blocking acetylcholine
b. Albuterol works by preventing inflammation
c. Albuterol works by dilating the bronchioles
d. Albuterol works by preventing the release of histamine
55. Review the list of clients on the left. Drag the clients that may require a lower dose of verapamil to the box on the right.
a. A 48 year old client with cirrhosis of the liver
b. A 50 year old client with a history of migraines
c. A 76 year old client with hypertension
d. A 59 year old client diagnosed with renal failure
e. A 36 year old client diagnosed with cardiac dysrhythmias
56. A nurse is caring for a client with a new prescription for warfarin. The nurse should instruct the client to avoid eating garlic due to which potential interaction?
a. Garlic will slow the absorption of warfarin
b. Garlic combined with warfarin can result in hepatotoxicity
c. Garlic will reduce the efficacy of warfarin
d. Garlic will increase the anticoagulation effect of warfarin
57. A nurse is caring for a male client with a new prescription for atenolol. Which potential adverse effect(s) should the nurse include when educating this client? Select All That Apply
a. Bradycardia
b. Impotence
c. Hypotension
d. Hyperkalemia
e. Angioedema
58. A nurse is caring for a client taking nitroglycerin. Which adverse effect is an expected finding? a. Headache
b. Hypertension
c. Angina
d. Erectile dysfunction
59. The nurse is caring for a pregnant client. Which antihypertensive drug prescribed by the healthcare provider should the nurse question?
a. Hydralazine
b. Valsartan
c. Clonidine
d. Methyldopa
60. Which instruction should the nurse include when educating clients about using metered dose inhalers (MDI)?
a. “Wait ten minutes between each puff”
b. “Exhale completely before administering the puff of medication”
c. “Spacers should not be used with metered dose inhalers”
d. “Use one puff in each nostril”
61. A nurse is caring for a client with a continuous intravenous infusion of heparin. The healthcare provider prescribes warfarin by mouth (PO) without discontinuing the heparin. What is the purpose for both drugs to be administered at this time?
a. The heparin should be continued until the warfarin reaches a therapeutic level
b. Intravenous heparin and oral warfarin work together to dissolve clots
c. This is a medication error as heparin and warfarin should not be given together
d. The heparin will allow the warfarin to reach a therapeutic level faster
62. The nurse is caring for a client with a new prescription for ipratropium. Which client statement indicates further teaching is needed?
a. “I will report blurry vision to my healthcare provider”
b. “I will use this medication only when I have an asthma attack”
c. “I will report urinary retention to my healthcare provider”
d. “This medication can be used in my nebulizer”
63. The nurse is providing instruction to a client who has prescriptions for two inhalers. The nurse instructs the client to use ___ first and then ___.
a. Albuterol, fluticasone, or montelukast
b. Albuterol, budesonide, or montelukast
64. A client with asthma receives prescriptions for multiple different types of inhalers. The client questions the nurse about the need for several inhalers to manage symptoms and why they can’t just use the albuterol. Which represents the correct response by the nurse?
a. “The albuterol is only for times when your airway is tight, and you are short of breath”
b. “Albuterol is made to be used every day to ensure that your airway stays open”
c. “Albuterol is designed to mobilize your secretions and help you cough them up”
d. “The albuterol inhaler is designed to prevent asthma attacks from ever happening”
65. A nurse is caring for a client with a new prescription for fluticasone. Which client history condition should the nurse report to the healthcare provider?
a. Diabetes
b. Hypertension
c. Glaucoma
d. Kidney failure
66. The nurse is caring for a client who is prescribed simvastatin. Which laboratory test does the nurse anticipate the healthcare provider will order?
a. Thyroid function
b. Renal function
c. Liver enzymes
d. Prothrombin time (PT)
67. A nurse is caring for a client with a new prescription for warfarin. The nurse should instruct the client to report which symptom(s) to the healthcare provider? Select Apply That Apply
a. Epistaxis
b. Hematuria
c. Photosensitivity
d. Ecchymosis
e. Dry mouth
68. A nurse is caring for a client with a new prescription for doxazosin. Which adverse effect(s) should the nurse include in the discharge education? Select All That Apply
a. Angioedema
b. Headaches
c. Dry cough
d. First dose orthostatic hypotension
e. Dizziness
69. A nurse is caring for a client prescribed a codeine antitussive. The nurse should be MOST concerned about administering this medication to which client?
a. A client with a nonproductive cough
b. A client with diarrhea
c. A client with hypertension
d. A client with a history of alcohol abuse
70. After the nurse gives a client simvastatin, the client states that they are having an increase in muscle pain. Which action should the nurse take NEXT?
a. Notify the healthcare provider
b. Document the findings
c. Encourage the client to stretch
d. Administer the prescribed ibuprofen
71. A client prescribed heparin reports a headache rated 3/10 to the nurse. Which medication would be most appropriate to administer to this client?
a. Acetaminophen
b. Aspirin
c. Ibuprofen
d. Morphine
72. A nurse is preparing to administer a client’s prescribed atenolol. Which assessment finding should cause the nurse to withhold the medication?
a. Blood pressure 158/92 mm Hg
b. Heart rate 52 bpm
c. Respiratory rate 18 bpm
d. Oxygen saturation 95%
73. A nurse is educating a client about the new prescription for fluticasone. Which instruction should the nurse include?
a. “Skip the morning dose if you do not have any symptoms”
b. “Use this medication to relieve an acute attack”
c. “Rinse your mouth after each use”
d. “Check your blood pressure before each dose”
74. Which condition should the nurse recognize as a contraindication for a client to take an adrenergic decongestant?
a. Hypotension
b. Alcohol abuse
c. Hyperthyroidism
d. Nasal congestion
75. A nurse is caring for a client who has been prescribed an angiotensin-converting enzyme (ACE) inhibitor. Drag the expected therapeutic outcomes to the box to the right.
a. Reversal of hyperkalemia
b. Increased heart rate
c. Decreased blood pressure
d. Improved survival after myocardial infarction
e. Decreased cholesterol level
