Ch.1

1. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication

has a long half‐life of 4 days. how many times per day should the nurse expect to administer this

medication?

A. One

B. Two

C. Three

D. Four

2. A staff educator is reviewing medication dosages and factors that influence medication

metabolism with a group of nurses at an in‐service presentation. Which of the following factors

should the educator include as a reason

to administer lower medication dosages? (Select all that apply.)

1. Increased renal excretion

2. Increased medication‐metabolizing enzymes

3. Liver failure

4. Peripheral vascular disease

5. Concurrent use of medication the same pathway metabolizes

3. A nurse is preparing to administer eye drops to a client. Which of the following actions should

the nurse take? (Select all that apply.)

1. have the client lie on her side.

2. Ask the client to look up at the ceiling.

3. Tell the client to blink when the drops enter her eye.

4. Drop the medication into the center of the client’s conjunctival sac.

5. Instruct the client to close her eye gently after instillation.

4. A nurse is completing discharge teaching for a client who has a

new prescription for transdermal patches. Which of the following statements should the nurse

identify as an indication that the client understands the instructions?

A. “I will clean the site with an alcohol swab before I apply the patch.”

B. “I will rotate the application sites weekly.” 

C.“I will apply the patch to an area of skin with no hair.”

D.“I will place the new patch on the site of the old patch.”

5. A nurse reviewing a client’s medical record notes a new prescription for verifying the trough

level of the client’s medication. Which of the following actions should the nurse take?

A. Obtain a blood specimen immediately prior to administering the next dose of medication.

B. Verify that the client has been taking the medication for 24 hr before obtaining a blood

specimen.

C. Ask the client to provide a urine specimen after the next dose of medication.

D. Administer the medication, and obtain a blood specimen 30 min later.

Ch.2

1. A nurse is preparing a client’s medications. Which of the following actions should the

nurse take in following legal practice guidelines? (Select all that apply.)

A. maintain skill competency.

B. Determine the dosage.

C. monitor for adverse effects.

D. Safeguard medications.

E. Identify the client’s diagnosis.

2. A nurse reviewing a client’s health record notes a new prescription for lisinopril 10 mg

PO once every day. The nurse should identify this as which of the following types of

prescription?

A. Single

B. Stat

C. Routine

D. Standing

3. A nurse is reviewing a new prescription for ondansetron 4 mg PO PRN for nausea and

vomiting for a client who has hyperemesis gravidarum. The nurse should clarify which of the

following parts of the prescription with the provider?

A. Name

B. Dosage 

C. Route

D. Frequency

4. A nurse is admitting a client and completing a preassessment before administering

medications. Which of the following data

should the nurse include in the preassessment? (Select all that apply.)

A. Use of herbal teas

B. Daily fluid intake

C. Current health status

D. Previous surgical history E. Food allergies

5. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone

prescription. Which of the following statements should the nurse identify as an indication that the

newly licensed nurse understands the process?

A. “A second nurse enters the prescription into the client’s medical record.”

B. “Another nurse should listen to the phone call.”

C.“The provider can clarify the prescription when he signs the health record.”

D.“I should omit the ‘read back’ if this is a one‐time prescription.”

Ch. 3

1. A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is

vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop

factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to

deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing

zero.)

2. A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount

available

is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30

min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the

nearest whole number. Do not use a trailing zero.) 

3. A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is

furosemide oral solution 10 mg/1 mL. how many mL should the nurse administer? (Round the

answer to the nearest whole number. Do not use a trailing zero.)

4. A nurse is preparing to administer haloperidol 2 mg PO every 12 hr. The amount available is

haloperidol 1 mg/tablet. how many tablets should the nurse administer? (Round the answer to the

nearest whole number. Do not use a trailing zero.)

5. A nurse is preparing to administer amoxicillin 20 mg/kg/day PO to divide equally every 12 hr

to a preschooler who weighs 44 lb. The amount available is amoxicillin suspension 250 mg/5

mL. how many mL should the nurse administer per dose? (Round the answer to the nearest

whole number. Do not use a trailing zero.)

6. A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The

amount available is heparin injection 20,000 units/mL. how many mL should the nurse

administer per dose? (Round the answer to the nearest tenth. Do not use a trailing zero.)

7. A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The

amount available is acetaminophen liquid 500 mg/5 mL. how many mL should the nurse

administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do

not use a trailing zero.) 

8. A nurse is preparing to administer dextrose 5% in water (D5W)750 mL IV to infuse over 6 hr.

The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest

whole number. Do not use a trailing zero.)

Ch 4.

1. A nurse is assessing a client’s

IV infusion site. Which of the following findings should the nurse identify as an indication of

phlebitis? (Select all that apply.)

A. Pallor

B. Dampness

C. Erythema

D. Coolness

E. Pain

2. A nurse manager is reviewing the facility’s policies for IV therapy with the members of his

team. The nurse manager should remind the team that which of the following techniques helps

minimize the

risk of catheter embolism?

A. Performing hand hygiene before and after IV insertion

B. Rotating IV sites at least every 72 hr

C. minimizing tourniquet time

D. Avoiding reinserting the needle into an IV catheter

3. A nurse is preparing to initiate IV therapy for an older adult client. Which of the following

actions should the nurse plan to take?

A. Use a disposable razor to remove excess hair on the extremity.

B. Select the back of the client’s hand to insert the IV catheter.

C. Distend the veins by using a blood pressure cuff.

D. Direct the client to raise his arm above his heart.

4. A nurse assessing a client’s IV catheter insertion site notes a hematoma. Which of the

following actions should the nurse take? (Select all that apply.)

A. Stop the infusion.

B. Apply alcohol to the insertion site.

C. Apply warm compresses to the insertion site

D. Elevate the client’s arm.

E. Obtain a specimen for culture at the insertion site. 

Ch 6.

1. A nurse is preparing to administer medications to a 4‐month‐old infant. Which of the

following pharmacokinetic principles should the nurse consider when administering medications

to this client? (Select all that apply.)

1. Infants have a more rapid gastric emptying time.

2. Infants have immature liver function.

3. Infants’ blood‐brain barrier is poorly developed.

4. Infants have an increased ability to absorb topical medications.

5. Infants have an increased number of protein‐binding sites.

2. A nurse in a provider’s office is reviewing the medical record of

a client who is pregnant and is at

her first prenatal visit. Which of the following immunizations may the nurse administer safely to

this client?

A. Varicella vaccine

B. Rubella vaccine

C. Inactivated influenza vaccine

D. measles vaccine

3. A nurse on a medical‐surgical unit administers a hypnotic medication to an older adult client at

2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast.

Which of

the following factors should the nurse identify as a possible reason for the client’s drowsiness?

A. Reduced cardiac function

B. First‐pass effect

C. Reduced hepatic function

D. Increased gastric motility

Ch. 25

1. A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled

syringe of enoxaparin 40 mg/0.4 mL to an

adult client following hip arthroplasty. Which of the following actions should the nurse

plan to take?

a. Expel the air bubble from the prefilled syringe before injecting.

b. Insert the needle completely into the client’s tissue.

c. Administer the injection in the client’s thigh.

d. Aspirate carefully after inserting the needle into the client’s skin. 

2. A nurse is caring for a hospitalized client who is receiving IV heparin for a deep‐vein

thrombosis. The client begins vomiting blood. After the heparin has been stopped, which

of the following medications should the nurse prepare to administer?

A. Vitamin k1

B. Atropine

C. Protamine

D. Calcium gluconate

3. A nurse is planning to administer IV alteplase to a client who is demonstrating manifestations

of

a massive pulmonary embolism. Which of the following interventions should the nurse plan to

take?

A. Administer Im enoxaparin along with the alteplase dose.

B. hold direct pressure on puncture sites for up to 30 min.

C. Administer aminocaproic acid IV prior to alteplase infusion.

D. Prepare to administer alteplase within 8 hr of manifestation onset.

4. A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify

which of

the following manifestations as adverse effects of daily aspirin therapy? (Select all that apply.)

A. hypertension

B. Coffee‐ground emesis

C. Tinnitus

D. Paresthesias of the extremities

E. Nausea

Ch. 26

1. A nurse is caring for a client who is receiving daily doses of oprelvekin. Which of the

following laboratory values should the nurse monitor to determine effectiveness of this

medication?

A. hemoglobin

B. Absolute neutrophil count

C. Platelet count

D. Total white blood count 

2. A nurse is preparing to administer filgrastim for the first time to a client who has just

undergone a bone marrow transplant. Which of the following interventions is appropriate?

A. Administer IM in a large muscle mass to prevent injury.

B. Ensure that the medication is refrigerated until just prior to administration.

C. Shake vial gently to mix well before withdrawing dose.

D. Discard vial after removing one dose of the medication.

3. A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse

should identify which of the following findings as an adverse effect of this medication? (Select

all that apply)

A. Leukocytosis

B. hypertension

C. Edema

D. Blurred vision

E. headache

4. A nurse is assessing a client who has chronic neutropenia and who has been receiving

filgrastim. Which of the following actions should the nurse take to assess for an adverse effect of

filgrastim?

A. Assess for bone pain.

B. Assess for right lower quadrant pain.

C. Auscultate for crackles in the bases of the lungs.

D. Auscultate the chest to listen for a heart murmur.

Ch. 27

1. A nurse is preparing to administer a transfusion of 300 mL of pooled platelets for a client

who has severe thrombocytopenia. The nurse should plan to administer the transfusion

over which of the following time frames?

A. Within 30 min/unit

B. Within 60 min/unit

C. Within 2 hr/unit

D. Within 4 hr/unit

2. A nurse is transfusing a unit of packed red blood cells (PRBCs) for a client who has

anemia due to chemotherapy. The client reports a sudden headache and chills. The

client’s temperature is 2° F higher than her baseline. In addition to notifying the provider,

which of the following actions should the nurse take? (Select all that apply.)

A. Stop the transfusion.

B. Place the client in an upright position with feet down.

C. Remove the blood bag and tubing from the IV catheter. 

D. Obtain a urine specimen.

E. Infuse dextrose 5% in water through the IV.

3. A nurse is preparing to transfuse a unit of packed red blood cells (PRBCs) for a client who has

severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

A. Ensure that the client has a patent IV line before obtaining blood product from the

refrigerator.

B. Obtain help from another nurse to confirm the correct client and blood product.

C. Take a complete set of vital signs before beginning transfusion and periodically during the

transfusion.

D. Stay with the client for the first 15 to 30 min of the transfusion.

4. A nurse is caring for a hospitalized client who has an activated partial thromboplastin time

(aPTT) greater than 1.5 times the expected reference range. Which of the following blood

products should the nurse prepare to transfuse?

A. Whole blood

B. Platelets

C. Fresh frozen plasma

D. Packed red blood cells

Ch 33.

1. A nurse is providing teaching for a client who has gout and a new prescription for allopurinol.

For which of the following adverse effects should the client be taught to monitor? (Select all that

apply.)

A. Stomatitis

B. Insomnia

C. Nausea

D. Rash

E. Increased gout pain

5. A nurse is evaluating teaching

for a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the

following statements by the client indicates understanding of the teaching?

A. “I will be sure to return to the clinic at least once a year to have my blood drawn while I’m

taking methotrexate.”

B. “I will take this medication on an empty stomach.”

C.“I’ll let the doctor know if I develop sores in my mouth while taking this medication.

D.“I should stop taking oral contraceptives while I’m taking methotrexate.” 

Ch. 34

1. A nurse is providing teaching to a client who is taking raloxifene to prevent postmenopausal

osteoporosis. The nurse should advise the client that which of the following are adverse effects

of this medication? (Select all that apply.)

A. hot flashes

B. Lump in breast

C. Swelling or redness in calf

D. Shortness of breath

E. Difficulty swallowing

2. A nurse is teaching a client who has osteoporosis and a new prescription for alendronate.

Which of the following instructions should the nurse provide? (Select all that apply.)

A. Take medication in the morning before eating.

B. Chew tablets to increase bioavailability.

C. Drink an 8 oz glass of water with each tablet.

D. Take medication with an antacid if heartburn occurs.

E. Avoid lying down after taking this medication.

3. A nurse is caring for a client who has a new prescription for calcitonin‐salmon for

osteoporosis. Which of the following tests should the nurse tell the client to expect before

beginning this medication?

A. Skin test for allergy to the medication

B. ECG to rule out cardiac dysrhythmias

C. mantoux test to rule out exposure to tuberculosis

D. Liver function tests to assess risk for medication toxicity

4. A nurse is caring for a young adult client whose serum calcium is 8.8 mg/dL. Which of the

following medications should the nurse anticipate administering to this client?

A. Calcitonin‐salmon

B. Calcium carbonate

C. Zoledronic acid

D. Ibandronate 

5. A nurse is providing instruction to a client who has a new prescription for calcitonin‐salmon

for postmenopausal osteoporosis. Which of the following instructions should the nurse include in

the teaching?

A. Swallow tablets on an empty stomach with plenty of water.

B. Watch for skin rash and redness when applying calcitonin‐salmon topically.

C. mix the liquid medication with juice and take it after meals.

D. Alternate nostrils each time calcitonin‐salmon is inhaled.

Ch 39.

1. a nurse is teaching clients in an outpatient facility about the use

of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the

nurse tell the clients to expect a peak effect 1 to 5 hr after administration?

A. insulin glargine

B. NPH insulin

C. Regular insulin

D. insulin lispro

2. a nurse is caring for a client in an outpatient facility who has been taking acarbose for type 2

diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor?

A. WbC

B. serum potassium

C. Platelet count

D. liver function tests

4. a nurse is providing teaching for a client who has a new prescription for metformin. Which of

the following adverse effects of metformin should the nurse instruct the client to report to the

provider?

A. somnolence

B. Constipation

C. Fluid retention

D. Weight gain

Ch. 40

1. A nurse is caring for a client who is taking propylthiouracil. For which of the following

adverse effects of this medication should the nurse monitor?

A. Bradycardia

B. Insomnia

C. heat intolerance

D. Weight loss 

3. A nurse is caring for an older adult client in a long‐term care facility who has hypothyroidism

and a new prescription for levothyroxine. Which of the following dosage schedules should the

nurse expect for this client?

A. The client will start at a high dose, and the dose will

be tapered as needed.

B. The client will remain on the initial dosage during the course of treatment.

C. The client’s dosage will be adjusted daily based on blood levels.

D. The client will start on a low dose, which will be gradually increased.

6. A nurse is admitting a client to an acute care facility for a total hip arthroplasty. The client

takes hydrocortisone for Addison’s disease. Which of the following actions is the nurse’s

priority?

A. Administering a supplemental dose of hydrocortisone

B. Instructing the client about coughing and deep breathing

C. Collecting additional information from the client about his history of Addison’s disease

D. Inserting an indwelling urinary catheter

CH 41.

1. A nurse is caring for several clients who came to the clinic for a seasonal influenza

immunization. The nurse should identify that which of the following clients is a candidate to

receive the vaccine via nasal spray rather than an injection?

A. 1‐year‐old who has no health problems

B. 17‐year‐old who has a hypersensitivity to penicillin

C. 25‐year‐old who is pregnant

D. 52‐year‐old who takes a multivitamin supplement

2. A nurse is teaching a group of new parents about immunizations. The nurse should instruct the

parents that the series for which of the following vaccines is completed prior to the first

birthday?

A. Pneumococcal conjugate vaccine

B. meningococcal conjugate vaccine

C. Varicella vaccine

D. Rotavirus vaccine

3. A nurse at a provider’s office is preparing to administer RV, DTaP, hib, PCV13, and IPV

immunizations to a 4‐month‐old infant. Which of the following actions should the nurse plan to

take? (Select all that apply.)

A. Administer IPV orally.

B. Administer subcutaneous injections in the anterolateral thigh. 

C. Administer Im injections in the deltoid muscle.

D. Give the infant his pacifier during vaccine injections.

E. Teach parents to give aspirin on a schedule for 24 hr after immunization.

4. A 12‐month‐old child just received the first measles, mumps, and rubella (mmR) vaccine. For

which of the following possible reactions to this vaccine should the nurse teach the parents to

monitor? (Select all that apply.)

A. Rash

B. Swollen glands

C. Bruising

D. headache

E. Inconsolable crying

5. A nurse is caring for a group of clients who are not protected against varicella. The nurse

should prepare to administer the varicella vaccine at this time to which of the following clients?

A. 24‐year‐old woman in the third trimester of pregnancy

B. 12‐year‐old child who has a severe allergy to neomycin

C. 2‐month‐old infant who has no health problems

D. 32‐year‐old man who has essential hypertension

Ch. 44

3. A nurse is obtaining a medication history from a client who is to receive imipenem‐cilastatin

IV to treat an infection. Which of the following medications the client also receives puts him at

risk for a medication interaction?

A. Regular insulin

B. Furosemide

C. Valproic acid

D. Ferrous sulfate

Ch. 45

1. A nurse is teaching a client about taking tetracycline to treat a GI infection due to

Helicobacter

pylori. Which of the following statements should the nurse identify as an indication that the

client understands the instructions?

A. “I will take this medication with 8 ounces of milk.”

B. “I will let my doctor know if I start having diarrhea.”

C.“I can stop taking this medication when I feel completely well.”

D.“I can take this medication just before bedtime.” 

2. A nurse is administering gentamicin by IV infusion at 0900. The medication will take 1 hr to

infuse. When should the nurse plan to obtain a blood sample for a peak serum level of

gentamicin?

A. 1000

B. 1030

C. 1100

D. 1130

3. A nurse is caring for a client who is starting a course of gentamicin IV for a serious respiratory

infection. For which of the following manifestations should the nurse monitor as an adverse

effect of this medication? (Select all that apply.)

A. Pruritus

B. hematuria

C. muscle weakness

D. Difficulty swallowing

E. Vertigo

Ch. 46

2. A nurse is teaching a client

who has a new prescription for nitrofurantoin. Which of the following information should the

nurse include? (Select all that apply.)

A. Observe for bruising on the skin.

B. Take the medication with milk or meals.

C. Expect brown discoloration of urine.

D. Crush the medication if it is difficult to swallow.

E. Expect insomnia when taking it.

3. A nurse is teaching a female client who has a severe UTI about ciprofloxacin. Which of

the following information about adverse reactions should the nurse include? (Select all that

apply.)

A. Observe for pain and swelling of the Achilles tendon.

B. Watch for a vaginal yeast infection.

C. Expect excessive nighttime perspiration.

D. Inspect the mouth for cottage cheese‐like lesions.

E. Take the medication with a dairy product.

4. A nurse is planning discharge teaching for a female client who has a new prescription for

trimethoprim‐sulfamethoxazole. Which of the following information should the nurse include? 

A. Take the medication even if pregnant.

B. maintain a fluid restriction while taking it.

C. Take it on an empty stomach.

D. Stop taking it when manifestations subside.

5. A nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the

following actions should the nurse take?

A. Administer a concentrated solution.

B. Infuse the medication over 60 min.

C. Infuse the solution through the primary IV fluid’s tubing.

D. Choose a small peripheral vein for administration.

Ch. 47

1. a nurse is caring for a client who has diabetes mellitus, pulmonary tuberculosis, and a new

prescription for isoniazid. Which of the following supplements should the nurse expect to

administer to prevent an adverse effect of inH?

a. ascorbic acid

b. Pyridoxine

c. Folic acid

d. cyanocobalamin

4. a nurse is teaching a client who is beginning a course of metronidazole to treat an infection.

For which of the following adverse effects should the nurse instruct the client as a priority to stop

taking metronidazole and notify the provider?

a. Metallic taste

b. nausea

c. ataxia

d. dark‐colored urine

5. a nurse is teaching a client who has active tuberculosis about his treatment regimen. the client

asks why he must take four different medications. Which of the following responses should the

nurse make?

A. “Four medications decrease the risk for a severe allergic reaction.”

B. “Four medications reduce the chance that the bacteria will become resistant.”

C.“Four medications reduce the risk for adverse reactions”

D.“Four medications decrease the chance of having a positive tuberculin skin test.”