1.) A nurse is assessing a client who is receiving intravenous therapy. The nurse should idenfy
which of the following ndings as a manifestaon of
... [Show More] uid volume excess?
a. Decreased bowel sounds
b. Distended neck veins
c. Bilateral muscle weakness
d. Thread pulse
2.) A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed
hypertonic soluon. Which of the following ndings should indicate to the nurse that the
treatment is e&ecve?
a. Absent Chvostek’s sign
b. Improved cognion
c. Decreased voming
d. Cardiac arrhythmias absent
3.) A nurse is teaching a client who has a new prescripon for a nitroglycerin transdermal patch.
Which of the following instrucons should the nurse include?
a. “Disconnue the patch if you experience a headache.”
b. “Apply a new patch if you have chest pain.”
c. “Cover the patch with dry gauze when taking a shower.”
d. “Remove the patch prior to going to bed.”
4.) A nurse is reviewing he laboratory results of a client who has a prescripon for sodium
polystyrene sulfonate (Kayexalate) every 6 hr. which of the following should the nurse report to
the provider?
a. Creanine 0.72 mg/dL
b. Sodium 138 mEq/L
c. Magnesium 2 mEq/L
d. Potassium 5.2 mEq/L - Hyperkalemia (serum potassium level greater than 5.0 mEq/L)
increases the client risk for fatal cardiac dysrhythmias. Kayexalate is used to decrease
the serum potassium level, so the PN should monitor the client's serum potassium level
5.) A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of
the following outcomes indicates that the client is adhering to the medicaon regimen?
a. The client has a negave sputum culture
b. The client tests negave for HIV
c. The client has a posive puried protein derivave test
d. The client’s liver funcon test results are within the expected reference range
6.) A client is caring for a client who develops an anaphylacc reacon to IV administraon. A=er
assessing the client’s respiratory status and stopping the medicaon infusion. Which of the
following acons should the nurse take next?
a. Replace the infusion with 0.9% sodium chloride
b. Give diphenhydramine IM
c. Elevate the client’s legs and feet
d. Administer epinephrine IM
7.) A nurse is caring for a client who is taking sertraline and reports a desire to begin taking
supplements. Which of the following supplements should the nurse advise the client to avoid?
a. St. John’s Wort
b. Ginger root
c. Black cohosh
d. Coenzyme Q10
8.) A nurse is caring for a client who has heart failure and a new prescripon for lisinopril. For which
of the following adverse e&ects should the nurse monitor when administering lisinopril?
a. Bradycardia
b. Hypokalemia
c. Tinnitus
d. Hypotension
9.) A nurse is assessing a client who is receiving heparin IV connuous IV. The client has an PPT of 90
seconds. They should monitor the client for which of the following changes in their vital signs?
a. Decreased temperature
b. Increased pulse rate
c. Decreased respiratory rate
d. Increased blood pressure
10.) A nurse is preparing to administer medicaon to a client and discovers a medicaon error. The
nurse should recognize that which of the following sta& members is responsible for compleng
an incident report?
a. The quality improvement commiEee
b. The nurse who iden2es the error
c. The nurse who caused the error
d. The charge nurse
11.) A nurse is planning care for a client who is receiving morphine via connuous epidural infusion.
The nurse should monitor the client for which of the following?
a. Pruritus – Sign of allergic reac'on to morphine
b. Cough
c. Tachypnea
d. Gastric bleeding
12.)A nurse is preparing to administer digoxin orally to a client. Idenfy 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.)
a. Obtain the client’s apical heart rate
b. Remove the medicaon from the dispensing system
c. Open the medicaon package
d. Compare the client’s wristband to the medicaon administraon record
e. Document administraon of the medicaon
13.) A nurse is reviewing the medical record of an adult client who has a fever and a prescripon for
acetaminophen. Which of the following ndings should the nurse idenfy as a contraindicaon
for receiving this medicaon?
a. Alcohol use disorder
b. Chronic kidney disease
c. Hepas B vaccine within the last week
d. Diabetes mellitus
14.) A home health nurse is vising a client who has heart failure and a prescripon for furosemide.
The nurse idenes that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which
of the following acons should the nurse take rst?
a. Encourage the client to dangle the legs while siIng in a chair
b. Teach the client about foods low in sodium
c. Determine medicaon adherence by the client
d. Nofy the provider of the client’s weight gain
15.) A nurse is preparing to administer the inial dose of penicillin G IM to a client. The nurse should
monitor for which of the following as an indicaon of an allergic reacon following the injecon?
a. Urcaria
b. Bradycardia
c. Pallor
d. Dyspepsia
16.)A nurse is teaching a client who has angina a new prescripon for sublingual nitroglycerin
tablets. Which of the following instrucons should the nurse include in the teaching?
a. “Discard any tablets you do not use every 6 months.”
b. “Take one tablet each morning 30 minutes prior to eang.”
c. “Keep the tablets at room temperature in their original glass bo8le.”
d. “Place the tablet between your cheek and gum to dissolve.”
17.) A nurse is providing teaching to a client who has a new prescripon for theophylline, a
sustained-released capsule. Which of the following statements by the client indicates an
understanding of the teaching?
a. “I can take my medicaon in the morning with my co9ee.”
b. “I may sprinkle the medicaon in applesauce.”
c. “I should limit my uid intake while on this medicaon.”
d. “I will need to have blood levels drawn.”
18.)A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to
client who has diabetes mellitus following acons should the nurse take rst?
a. Withdraw the regular insulin from the viral
b. Withdraw the NPH insulin form the vial
c. Inject air into the NPH vial
d. Inject air into the regular insulin vial
19.)A nurse is preparing to administer subcutaneous heparin to a client. Which of the following
should the nurse take?
a. Massage the site a=er administering the medicaon
b. Use a 21-gauge needle for the injecon
c. Aspirate before injecng the medicaon
d. Insert the needle at least 5 cm (2 in) from the umbilicus
20.)A nurse is caring for a client who has a prescripon for amoxicillin. Which of the following
ndings indicates the client is experiencing an allergic reacon?
a. Nausea
b. Cardiac dysrhythmia
c. Laryngeal edema
d. Insomnia
21.)A nurse is teaching a newly licensed nurse about medicaon reconciliaon. The nurse should
instruct the newly licensed nurse to perform medicaon reconciliaon for which of the
following?
a. A client who has a referral for social services
b. A client who is transdermal to radiology
c. A client who is transferal to a step-down unit
d. A client who has a consultaon for physical therapy
22.)A nurse is reviewing the laboratory values of a client who is taking atorvastan. Which of the
following laboratory values indicates the treatment has been e&ecve?
a. BUN 15 mg/dL
b. Blood glucose 90 mg/dL
c. Urine specic gravity 1.020
d. LDL 120 mg/dL
23.)A nurse is receiving a medicaon prescripon by telephone from a provider. The provider states,
“Administer 6 milligrams of morphine IV push every 3 hours as needed for acute pain.” How
should the nurse transcribe the prescripon in the client’s medical record?
a. Morphine 6 mg IV push every 3 hr PRN acute pain
b. MSO 6 mg IV push every 3 hr PRN acute pain
c. MS 6 mg IV push every 3 hr PRN acute pain
d. Morphine 6.0 mg IV push every 3 hr PRN acute pain
24.)A nurse is assessing a client’s IV infusion site and notes that the site is cool and edematous.
Which of the following acons should the nurse take?
a. Show the IV soluon rate
b. Iniate a new IV distal to the inial site
c. Maintain the extremity below the level of the heart
d. Apply a warm, moist compress
25.)A nurse is providing teaching to a client who has a new prescripon for clozapine. Which of the
following statements should the nurse include in the teaching?
a. “Diarrhea is a common adverse e&ect of this medicaon.”
b. “Ringing in the ears is an expected adverse e&ect of this medicaon.”
c. “Nofy your provider if you develop a fever while taking this medicaon.”
d. “You might experience weight loss while taking this medicaon.”
26.)A nurse is teaching a client about oral contracepve. Which of the following informaon should [Show Less]