1. Question: Which response best supports the observations that the nurse identifies in a client who is experiencing a place bo effect?
2. Question: Methylphenidate HCl (Concerta) is prescribed for daily administration to a 10-year-old child with attention deficit-hyper activity disorder (ADHD).In preparing a teaching plan for the parents of this child newly diagnosed with ADHD, which instruction is most important for the nurse to provide to the parents?
3. Question: Which physiologic mechanism explains a drug's increased metabolism that is triggered by a disease process?
4. Question: The health care provider prescribes ipratropium (Atrovent) for a client. An allergic reaction to which other medication would cause the nurse to question the prescription for Atrovent?
5. Question: A42-year-oldclient is admitted to the emergency department after taking an over dose of a mitripty line (Elavil) in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac & central nervous system effects of a mitripty line (Elavil)?
6. Question: A client who is hypertensive receives a prescription for hydro chloro thiazide (HCTZ)–thiazidediuretic cause potassium wasting in the urine. When teaching about the side effects of this drug, which symptoms are most important for the nurse to instruct the client to report?
7. Question: The nurse is preparing to apply a surface an esthetic agent for a client. Which action should the nurse implement to reduce the risk of systemic absorption?
8. Question: The healthcare provider prescribes cisplatin (Platinol) to be administered in 5 % dextrose & 0.45 % normal saline with mannitol (Osmitrol) added. Which assessment parameters would be most helpful to the nurse in evaluating the effectiveness of the Osmitroltherapy?
9. Question: A19-year-oldmaleclient who has sustained a severe head injury is intubated & placed on assisted mechanical ventilation. To facilitate optimal ventilation & prevent the client from "fighting" the ventilator, the healthcare provider administers pancuronium bromide (Pavulon) IV, with adjunctive opioid analgesia. What medication should the nurse maintain at the client's bedside?
10. Question: The nurse is reviewing a client's laboratory results before a procedure in which an euro muscular blocking agent is a standing order. Which finding should the nurse report to the health care provider?
11. Question: A female client with myasthenia gravis is taking a cholinesterase inhibitor & asks the nurse what can be done to remedy her fatigue & difficulty swallowing. What action should the nurse implement?
12. Question: A client receives pancuronium (Pavulon), a long-acting, non depolarizing neuromuscular blocker, during surgical anesthesia. Which client situation should alert the nurse to evaluate the client for a prolonged muscle relaxation response to this medication?
13. Question: A client is ordered 22 mg of gentamicinby IMinjection. The drug is available in 20 mg/2mL. How many mL should be administered?
14. Question: A client is receiving oral grise of ulvin (Grisactin) for a persistent tine a corporis infection. Which response by the client indicates an accurate understanding of the drug teaching conducted by the nurse?
15. Question: The nurse has completed diabetic teaching for a client who has been newly diagnosed with diabetes mellitus. Which statement by this client would indicate to the nurse that further teaching is needed?
16. Question: The nurse is evaluating a client's understanding of the prescribed antilipemic drug lovastatin (Mevacor). Which client statement indicates that further teaching is needed?
17. Question: A client with acute lymphocytic leukemia is to begin chemotherapy today. The healthcare provider's prescription specifies that ondansetron (Zofran) is to be administered IV30 minutes prior to the infusion of cisplatin (Platinol). What is the rationale for administering Zofran prior to the chemotherapy induction?
18. Question: A client who arrives in the postanes the sia care unit (PACU) after surgery is not awake from general anesthesia. Which action should the nurse implement first?
19. Question: Which class of antineoplastic chemotherapy agents resembles the essential elements required for DNA & RNA synthesis & inhibits enzymes necessary for cellular function & replication?
20. Question: A client who is HIV-positive is receiving combination therapy with the antiviral medication zidovudine (Retrovir). Which instruction should the nurse include in this client's teaching plan?
21. Question: During administration of theophylline (Theo-Dur), the nurse should monitor for signs of toxicity. Which symptom would cause the nurse to suspect Theo-Durtoxicity?
22. Question: Amoxicillin, 500 mg PO every 8 hours, is prescribed for a client with an infection. The drug is available in asuspensionof125mg/5mL. How many milliliters should the nurse administer with each dose?
23. Question: A 45-year-old female client is receiving alprazolam (Xanax) for anxiety. Which client behaviors would indicate that the drug is effective?
24. Question: Which parameters most important for the nurse to check prior to administering a subcutaneous injection of heparin?
25. Question: A client is receiving anti infective drug therapy for a postoperative infection. Which complaint should alert the nurse to the possibility that the client has contracted a super infection?
26. Question: A client is taking famotidine (Pepcid). Which client statement should the nurse furtherassessbecauseitmayindicatethattheclientisexperiencingasideeffectofthisdrug?
27. Question: A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferred injections ite to administer this immunization?
28. Question: Prior to administering a scheduled dose of digoxin (Lanoxin), the nurse reviews theclient'scurrentserumdigoxinlevel,whichis1.3ng/dL.Whichactionshouldthenurseimplement?
29. Question: The nurse is preparing to administer a secondary infusion of a dobutamine solution to a client. The nurse notes that the solution is brown in color. Which action should the nurse implement?
30. Question: A client is being discharged with a prescription for sulfasalazine (Azulfidine) to treat ulcerative colitis. Which instruction should the nurse provide to this client prior to discharge?
31. Question: A psychiatric client is discharged from the hospital with a prescription for haloperidol (Haldol).Which instruction should the nurse include in the discharge teaching plan for this client?
32. Question: In addition to nitrate therapy, a client is receiving nifedipine (Procardia), 10 mg PO every 6 hours. The nurse should plan to observe for which common side effect of this treatment regimen?
33. Question: A client is receiving pyridos tigmine bromide (Mestinon) to control the symptoms ofmyasthenia gravis. Which client behavior would indicate that the drug therapy is effective?
34. Question: An older client who had a colon resection yesterday is receiving a constant dose of hydro mor phone (Dilaudid) via a patient-controlled analgesia (PCA) pump. Whichassessmentfindingismostsignificant&requiresthat thenurseintervene?
35. Question: The nurse is preparing to administer amphotericin B (Fungizone) IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication?
36. Question: Me then a minem &elate (M&elamine) is prescribed for a client with a urinary tract infection & renal calculi. Which finding indicates to the nurse that the medication is effective?
37. Question: Mino cycline (Minocin), 50 mg PO every 8 hours, is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? (Select all that apply.)
38. Question: A male client asks the nurse why condoms should not be lubricated withthespermicidenonoxynol-9.Which response is best for the nurse to provide?
39. Question: The health care provider prescribes the H₂ antagonist famotidine (Pepcid), 20 mg PO in the morning & at bedtime. Which statement regarding the action of H₂ antagonists offers the correct rationale for administering the medication at bed time?
40. Question: Dopamine (Intropin) is administered to a client who is hypotensive. Which finding should the nurse identify as a therapeutic response?
41. Question: The health care provider prescribes carbamazepine (Tegretol) for a child whose tonic-clonic seizures have been poorly controlled. The nurse informs the mother that the child must have blood tests every week. The mother asks why so many blood tests are necessary. Which complication is assessed through frequent laboratory testing that the nurse should explain to this mother?
42. Question: The nurse is preparing a teaching plan for a client who has received a new prescription for levothyroxine sodium (Synthroid).Which instruction should be included?
43. Question: Two hours after taking the first dose of penicillin, a client arrives at the emergency department complaining of feeling ill, exhibiting hives, having difficulty breathing, &. These findings are consistent with which client response that requires immediate action?
44. Question: A child with cystic fibrosis is receiving ticarcillindi sodium (Ticar)

For Pseudomonas pneumonia. For which adverse effect should the nurse assess & report promptly to the health care provider?

45. Question: A client with metastatic cancer who has been receiving fentanyl (Duragesic) for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which intervention should the nurse initiate?
46. Question: A client is receiving acyclovir sodium (Zovirax) IV for a severe herpes simplex infection. Which intervention should the nurse implement during this drug therapy?
47. Question: During the initial nursing assessment history, a client tells the nurse that he is taking tetra cycline hydrochloride (Sumycin) for urethritis.Which medication taken concurrently with Sumycin could interfere with its absorption?
48. Question: The nurse is reviewing prescribed medications with a female client who is preparing for discharge. The client asks the nurse why the oral dose of an opioid an algesicis higher

Than the IV dose that she received during hospitalization. Which response is best for the nurse to provide?

49. Question: The health care provider prescribes the anticonvulsant carbamazepine (Tegretol) for an adolescent client with a seizure disorder.The nurse should instruct the client to notify the healthcare provider if which condition occurs?
50. Question: During therapy with isoniazid (INH), it is most important for the nurse to monitor which laboratory value closely?
51. Question: A client with mild parkinsonism is started on oral amantadine (Symmetrel). Which statement accurately describes the action of this medication?
52. Question: Which statement indicates that client teaching regarding the administration of the chemotherapeutic agent daunorubicin HCl (Cerubidine) has been effective?
53. Question: When providing nursing care for a client receiving pyridostigmine bromide (Mestinon) form yasthenia gravis, which nursing intervention has the highest priority?
54. Question: Which factor is most important to ensure compliance when planning to teach a client about a drug regimen?
55. Question: Which question should the nurse ask a client prior to the initiation of treatment with IV infusions of gentamicin sulfate (Garamycin)?
56. Question: A female client with tri chomonias is (Trichomonas vaginalis) receives a prescription form etronidazole (Flagyl).Which instruction is most important for the nurse toi ncludethisclient'steaching plan?
57. Question: A 26-year-old primigravida client is experiencing increasing discomfort & anxiety during the active phase of labor. She requests something for pain. Which analgesic should the nurse anticipate administering?
58. Question: In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nursewrites a nursing diagnosis of Alteration in nutrition: less than body requirements, relatedto inadequate digestion of nutrients. Which intervention would best meet this child'sneeds?
59. Question: The charge nurse is reviewing the admission history & physical data for four clients newly admitted to the unit. Which client is at greatest risk for adverse reactions to medications?
60. Question: A male client with prostatic carcinoma has arrived for his scheduled dose of docetaxel(Taxotere) chemotherapy. What symptom would indicate a need for an immediate response by the nurse prior to implementing another dose of this chemotherapeutic agent?
61. Question: A 67-year-old client is discharged from the hospital with a prescription for digoxin (Lanoxin), 0.25 mg daily. Which instruction should the nurse include in this client's discharge teaching plan?
62. Question: The nurse is preparing a plan of care for a client receiving the gluco corticoidme thylprednisolone (Solu-Medrol).Whichnursingdiagnosisreflectsaproblemrelatedtothismedicationthat should be included in the care plan?
63. Question: A client receives a prescription for theophylline (Theo-Dur) PO to be initiated in the morning after the dose of theophylline IV is complete. The nurse determines that atheophyllineleveldrawnyesterdaywas22mcg/mL. Based on this information, which action should the nurse implement?
64. Question: A client has a positive skin test for tuberculosis. Which prophylactic drug should the nurse expect to administer to this client?
65. Question: When caring for a client on digoxin (Lanoxin) therapy, the nurse knows to be alert for digoxin (Lanoxin) toxicity. Which finding would predispose this client to developing digoxin toxicity?
66. Question: Which medication is use fulin treating digoxin (Lanoxin) toxicity?
67. Question: A client is prescribed a cholinesterase inhibitor, & a family member asks the nurse how this medication works. Which pharmaco physiologic explanation should the nurse use to describe this class of drug?
68. Question: Dopamine (Intropin), 5 mcg/kg/min, is prescribed for a client who weighs 105 kg. The nurse mixes 400 mg of dopaminein 250 mLD₅ W for IV administration via an infusion pump. What is the hourly rate that the nurse should set on the pump?
69. Question: A 4-year-old child is receiving chemotherapy for acute lymphocytic leukemia. Which laboratory result should the nurse examine to assess the child's risk for infection?
70. Question: A lidocaine IV infusion at 4 mg/min via infusion pump is prescribed for a client having premature ventricular contractions (PVCs). The available premixed infusion contains 2mg/mL of D₅W. How many milliliters per hour should the nurse program the pump to deliver to this client?
71. Question: A chemotherapeutic regimen with doxorubicin HCl (Adriamycin) is being planned for aclient recently diagnosed with cancer. What diagnostic test results should the nursereviewprior to initiatingthis treatment?
72. Question: A client with angina pectoris is instructed to take sub lingual nitrogly cerintablets PRN for chest pain. Which instruction should the nurse include in the client's teaching plan?
73. Question: Which nursing intervention has the highest priority during IV administration of mechlore thamine HCl (nitrogen mustard) & actinomycin (Actinomycin D)?
74. Question : A female client is receiving tamoxifen (Nolvadex) following surgery for breast cancer. She reports the onset of hot flashes to the nurse. Which intervention should the nurse implement?
75. Question: A mother brings her 18-month-old child to the community health center because the child has had "bad diarrhea" for the last 3 days. She states, "I bought some of this liquid at the pharmacy & gave my daughter a half-ounce." The nurse sees that the bottle contains loperamide (Imodium AD). Which intervention is most important for the nurse to implement initially?
76. Question: The nurse performs a client assessment prior to the administration of a prescribed dose of dipyridamole & aspirin (Aggrenox) PO. The nurse notes that the client's carotid bruit is louder than previously assessed. Which action should the nurse implement?
77. Question: A client who has trouble swallowing pills intermittently has been prescribed venlafaxine (Effexor XR) for depression. The medication comes in capsule form. What should the nurse include in  the discharge teaching plan for this client?
78. Question: When developing a written nursing care plan for a client receiving chemotherapy for treatment of cancer, the nurse writes," Assesse a chvoiding for hematuria."The administration of which type of chemotherapeutic agent would prompt the nurse to add this intervention?
79. Question: The nurse knows that certain anti psychotic drugs cause extra pyramidal symptoms. Which extra pyramidal symptom is a permanent & irreversible adverse effect of long-term phenothiazine administration?
80. Question: A 6-year-old child is admitted to the emergency department with status epilepticus. His parents report that his seizure disorder has been managed with phenytoin (Dilantin), 50mg PO bid, for the past year. Which drug should the nurse plan to administer in the emergency department?
81. Question: The health care provider has prescribed a low-molecular-weight heparin, enoxaparin (Lovenox) prefilled syringe, 30mg/0.3 mL IV every 12 hours, for a client following hip replacement. Prior to administering the first dose, which intervention is most important for the nurse to implement?
82. Question: Thehealthcareproviderprescribesoralcontraceptivesforaclientwhowantstopreventpregnancy. Which information is the most important for the nurse to provide to this client?
83. Question: A male client who has chronic back pain is on long-term pain medication management &asks the nurse why his pain relief therapy is not as effective as it was 2 months ago. How should the nurse respond?
84. Question: A client with a dislocated shoulder is being prepared for a closed manual reduction using conscious sedation. Which medication should the nurse explain as a sedative used during the procedure?
85. Question: A pediatric client is discharged home with multiple prescriptions for medications. Which information should the nurse provide that is most helpful to the parents when managing the medication regimens?
86. Question: For which client(s) should the nurse withhold the initial dose of a cyclo oxygenase 2(COX-2) inhibit or until notifying the healthcare provider? (Select all that apply.)
87. Question: To evaluate whether the administration of an anti hypertensive medication has caused a therapeutic effect, which action should the nurse implement?
88. Question: A client is experiencing an adverse effect of the gastrointestinal stimulant metoclopramide HCl (Reglan). Which has assessment finding would require immediate intervention by the nurse?
89. Question: The nurse plans to draw blood samples for the determination of peak & trough levels of gentamicin sulfate (Garamycin) in a client receiving IV doses of this medication. When should the nurse plan to obtain the peak level?
90. Question: A client who is experiencing an acute attack of gouty arthritis is prescribed colchicines (Colcrys) USP, 1 mg PO daily. Which information is most important for the nurse to provide the client?
91. Question: A client with viral influenza is receiving vitamin C, 1000 mg PO daily, & acetaminophenelixir, 650 mg PO every 4 hours PRN. The nurse calls the health care provider to report that the client has developed diarrhea. Which change in prescriptions should the nurse anticipate?
92. Question: A client with metastatic cancer reports severe continuous pain. Which route ofadministrationshouldthenurseusetoprovidethemosteffectivecontinuousanalgesia?
93. Question: A client who is receiving chlorpromazine HCl (Thorazine) to control his psychotic behavior also has a prescription for benztropine (Cogentin). When teaching the client & /or significant others about these medications, what should the nurse explain about the use of benztropine (Cogentin) in the treatment plan for this client?
94. Question: A client with chronic gouty arthritis is talking allopurinol (Zyloprim), 100 mg PO daily. Which laboratory serum level should the nurse report to the health care provider to determine the therapeutic outcome?
95. Question: A client who is HIV-positive is receiving epoetinalfa (Epogen) for the management of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the healthcare provider?
96. Question: Which instruction should the nurse include in the teaching plan for a client who is receiving phenytoin (Dilantin) for seizure control?
97. Question: A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I need to take all of these medications for TB? "What information should the nurse provide?
98. Question: When providing client teaching about the administration of methylphenidate (Ritalin) to aparent of a child diagnosed with ADHD, which instruction should the nurse include in the teaching plan?
99. Question: A client taking linezolid (Zyvox) at home for an infected foot ulcer calls the home care nurse to report the onset of watery diarrhea. Which intervention should the nurse implement?
100. Question: A female client is receiving tetracycline (Vibramycin) for acne. Which client teaching should the nurse include?

101. Question: A client with Tourette's syndrome takes haloperidol (Haldol) to control tics &vocalizations. The client has become increasingly drowsy over the past 2 days & reports becoming dizzy when changing from a supine to sitting position. Which action should the nurse take?
102. Question: Thenurseisassessingastuporousclientintheemergencydepartmentwhoissuspectedof overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose?
103. Question: The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes a tropine sulfate (Atropine), IMSTAT. What is the primary purpose for administering this drug to the child at this time?
104. Question: The nurse is scheduling a client's antibiotic peak & trough levels with the laboratory personnel. What is the best schedule for drawing the trough level?
105. Question: A client receiving a continuous infusion of heparin IV starts to hemorrhage from anarterial access site. Which medication should the nurse anticipate administering to prevent further heparin-induced hemorrhaging?
106. Question: Following the administration of sublingualnitrogly cerin, which assessment finding indicates that the medication was effective?
107. Question: A client being treated for an acute myocardial infarction is to receive the tissue plasminogen activator alteplase (Activase). The nurse would be correct in providing which explanation to the client regarding the purpose of this drug?
108. Question: A child is being treated with mebendazole (Vermox) for pinworms. Which type of dietshould the mother be instructed to feed the child while the child is receiving thismedication?
109. Question: Which assessment datum indicates to the nurse that a dose of granisetron (Kytril) administered IV prior to chemotherapy has had the desired effect?
110. Question: In administering the anti infective agent chloramphenicol (Chloromycetin) IV to a client with bacterial meningitis, the nurse observes the client closely for signs of bone marrow depression. Which laboratory data would be most important for the nurse to monitor?
111. Question: An older client is receiving a water-soluble drug that is more than the average dose for a young adult. Which action should the nurse implement first?
112. Question: A client receives an antihypertensive agent daily. Which action is most important for the nurse to implement prior to administering the medication?
113. Question: Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin administration?
114. Question: The nurse is preparing to administer the disease-modifying anti rheumatic drug (DMARD) methotrexate (Rheumatrex) to a client diagnosed with rheumatoid arthritis. Which intervention is most important to implement prior to administering this medication?
115. Question: Which instructions should the nurse provide to an adolescent female client who is initiating treatment with is otretino in (Accutane) for acne vulgaris? (Select all that apply.)
116. Question: The nurse is administering the early morning dose of insulin as part (Novo Log), 5 units subcutaneously, to a client with diabetes mellitus type 1. The client's finger stick serum glucose level is 140 mg/dL. Considering the onset of insulin aspart (NovoLog), when should the nurse ensure that the client's breakfast be given?
117. Question: A 3-year-old boy is admitted to the emergency department after ingesting an unknown amount of phenobarbital (Luminal) elixir prescribed for his brother's seizure disorder. Which nursing intervention should the nurse implement first?
118. Question: A primigravida at 34 weeks of gestation is admitted to labor & delivery in preterm labor. She is started on a terbutaline sulfate (Brethine) continuous IV infusion via pump. Thistherapy is ineffective, & the baby is delivered vaginally. For which complication should the nurse monitor in this infant during the first few hours after delivery?
119. Question: The apical heart rate of an infant receiving digoxin (Lanoxin) for congestive heart failureis80 beats/min. Which intervention should the nurse implement first?
120. Question: Thenurseisprovidingdischargeinstructionstoaclientwhohasreceivedaprescriptionfor an antibiotic that is hepatotoxic. Which information should the nurse include in the instructions?
121. Question: A 55-year-old client was diagnosed with schizophrenia 5 years earlier. Numerous hospitalizations have occurred since the diagnosis because of noncompliance with the prescribed medication regimen. Which drug might work best for this particular client?
122. Question: The nurse notes that the hemoglobin level of a client receiving darbepoetinalfa (Aranesp) has increased from 6 to 10 g/dL over the first 2 weeks of treatment. Which action should the nurse take?
123. Question: A female client who has started long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers & milk. Which is the best response by the nurse?
124. Question: Which intervention is most important for a nurse to implement prior to administering a tropine PO?
125. Question: A client experiencing dysrhythmiasis given quini dine (Quinidex), 300 mg PO every 6 hours. The nurse plans to observe this client for which common side effect associated with the use of this medication?