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1.The client is being treated with phenelzine sulfate (Nardil), a monoamine oxidase inhibitor (MAOI) antidepressant. The nurse observes the client eating a lunch of yogurt, sliced bananas, and chocolate milk. In addition to notifying the MD, what action will the nurse take to monitor for a serious food-drug interaction? P.101 Monitor client's body temperature for elevation above normal. Observe client for respiratory depression. Test a urine specimen for glucose and ketones. Monitor client for elevated blood pressure. 2. A loading dose of digoxin (Lanoxin) is given to a client newly diagnosed with atrial fibrillation. The nurse begins instructing the client about the medication and the importance of monitoring the heart rate. An expected outcome of the education program will be: p.265 a return demonstration of palpating the radial pulse. a return demonstration of how to take the medication. verbalization of why the client has atrial fibrillation. verbalization of the need for the medication. 3. Propantheline bromide (Pro-Banthine) is ordered for a client who has cholecystitis. What is the primary purpose for administering this drug to clients who have cholecystitis? p. To increase bile production. To decrease biliary spasm. To treat infection. To relieve nausea. 4. The client has been prescribed lisinopril (Prinivil) as treatment for hypertension. Which of the following electrolyte imbalances may occur in clients who take this drug? P. 246 Hyponatremia. Hypocalcemia. Hyperkalemia .

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Hypermagnese mia. 5. A transfusion reaction is suspected. The transfusion is stopped and the MD notified. The next appropriate nursing action would be to: p.337 Change all IV tubing to prevent additional infusion of blood cells. Keep the IV line open with saline until further orders. Arrange for the laboratory to pick up the remaining unit of blood. Collect a urine specimen from the client 6. A critical nursing intervention to protect a client who has received tissue plasminogen activator (t-PA) or alteplase recombinant (Activase) therapy includes: p. using the radial artery to obtain blood gas samples. maintaining arterial pressure for 10 seconds. administering intramuscular injections. encouraging physical activity. 7. A client has been diagnosed with atrial fibrillation. The physician ordered warfarin sodium (Coumadin) to be taken on a daily basis. The nurse will instruct the client to avoid using which of the following over-the-counter medications while taking warfarin? P.312 Aspiri n. Benadr yl. Lanoxi n. Sudafe d. 8. The physician has prescribed amiodarone (Cordarone) for a client with cardiomyopathy. The nurse understands that the client's rhythm should be monitored to determine the effectiveness of the medication in controlling: p.285 sinus node dysfunction. heart block.

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severe bradycardia. life-threatening ventricular dysrhythmias. 9. A client has been prescribed hydrochlorothiazide (HydroDIURIL) for treatment of heart failure. For which of the following symptoms should the nurse monitor the client? P.237 Urinary retention. Muscle weakness. Confusion. Diaphoresis. 10. The nurse can anticipate side effects of hydrochlorothiazide because it is classified as: p.237 An aldosterone inhibitor. A carbonic anhydrase inhibitor. A potassium-sparing drug. A potassiumwasting drug. 11. Magnesium hydroxide (Milk of Magnesia) is the routine laxative order to prevent or correct constipation. For which client would the nurse question the order? P.359 An elderly woman with potential for fecal impaction. A client with chronic renal failure who is admitted for shunt revision. A man who is recovering from total knee replacement. An older man who is being treated for pneumonia. 12. Which client information, documented during an assessment, would be a contraindication to the client receiving verapamil (Calan)? P.251 Epigastric pain and treatment for a peptic ulcer. Hypertension and angina on exertion.

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History of asthma and allergic bronchitis. Hypotension associated with bradycardia. 13. Based on the peak action of furosemide (Lasix) PO, the nurse will evaluate the drug's effects in: p.234 30-45 minutes. 1-2 hours. 3-4 hours. 6-8 hours. 14. The nurse is preparing to administer blood to an otherwise healthy client who requires postoperative blood replacement. The nurse is aware that the blood administration set must include: p.325 a micron mesh filter. a nonfiltered administration blood set. a special leukocyte-poor filter. a microdrip administration set. 15. Which of the following baseline laboratory data should be established before a client is started on tissue plasminogen activator (t-PA) or alteplase recombinant (Activase)? P. Potassium level. Lee-White clotting time. Hemoglobin, hematocrit, and platelet count. Blood glucose level. 16. While teaching the client about taking newly prescribed oral metronidazole (Flagyl), the nurse advises the client about which of the following? P.599 To take with food to minimize the metallic or bitter taste. That visual disturbances are a common side effect.

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To monitor for urinary retention. That alcohol should be avoided until the last dose is taken. 17. The nurse administers spironolactone (Aldactone) knowing that it is classified as: p.239 An aldosterone antagonist. A carbonic anhydrase inhibitor. A thiazide. An osmotic diuretic 18. The nurse is preparing to administer an ordered dose of meperidine hydrochloride (Demerol) 100 mg PO to a client with postoperative pain. The drug data on Demerol indicates that this is a Schedule II controlled substance. The nurse takes which of the following actions based on this information? Use special storage and documentation procedures for administering this drug. Explains to the client that this drug has a low potential for abuse. Has another licensed nurse witness the administration of the drug and co-sign the documentation of the drug. Warns the client that the drug is highly addictive. 19. A client with asthma asks the nurse if she should use her salmeterol (Serevent) inhaler when she exercises and experiences wheezing and shortness of breath. The nurse's best response is which of the following? P.206 "Yes, use the inhaler immediately for these symptoms." "No, this drug is a maintenance drug, not a rescue inhaler." "Use the inhaler 5 minutes before you exercise to prevent the wheezing." "This inhaler is for allergic rhinitis, not asthma." 20. A nurse is providing medication instruction to an elderly client with type 2 diabetes mellitus who takes glyburide (Micronase) 1.25 mg PO daily. Which statement, if made by the client, indicates that further instruction about the medication is needed? P.490 "I take the tablet before breakfast every day."

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"If I forget the dose on one day, I will take two tablets the next day." "I will avoid drinking alcohol while taking this drug." "I will visit the clinic every 2 weeks to have my blood glucose level checked." 21. A client is receiving digoxin (Lanoxin). His pulse range is normally 70 to 76 bpm. After assessing the apical pulse for 1 minute and finding it to be 60 bpm, the nurse should initially. P.265 call the physician for orders. withhold the digoxin. administer the digoxin. notify the charge nurse. 22. A 9-month-old client has been diagnosed with Hirschsprung's disease. At this time, the child is admitted to the hospital for a temporary colostomy; preoperatively, the doctor orders kanamycin. The nurse caring for this child should know that kanamycin is being given to: p.600 Increase peristalsis. Decrease amount of GI secretions. Promote passage of stool and flatus. Decrease number of intestinal flora. 23. The nurse evaluates that the immunocompromised client best understands use of topical acyclovir (Zovirax) for treating genital herpes when the client makes which of the following statements? P.605 "I need to wash my hands for at least 10 seconds with a teaspoon of antibacterial soap before and after application of the drug." "My sister isn't immunocompromised, but she has genital herpes and should use acyclovir, too." "I need to use a different finger cot when getting ointment and applying the ointment to each sore to prevent self-inoculation in other areas." "Acyclovir has been around a long time. I know there have to be newer drugs that are better to treat my genital herpes." 24. A client has been prescribed digoxin (Lanoxin). Which of the following symptoms should the nurse tell the client to report as a potential indication of digitalis toxicity?p.265

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Urticaria. Shortness of breath. Visual disturbances. Hypertension 25. The client received NPH insulin 30 units SC at 7:30 am. Which data will the nurse use to evaluate the client for the drug's therapeutic effectiveness? P.484 Client's blood pressure 2 hours after dose of drug. Client's appetite and food intake at lunch. Client's blood sugar level at 4:30 pm. Client's oxygen saturation level before drug dose. 26, Elixir of digoxin (Lanoxin) is available with 0.05 mg of the drug in 1 mL of solution. How much of this elixir should the nurse administer if the physician's order reads "0.125 mg PO bid"? 2 mL. 2.25 mL. 2.5 mL. 2.75 mL. 27. The nurse is administering tetracycline hydrochloride (Tetracyn) 500 mg to a client with a gonorrhea infection. Which of the following nursing actions is indicated in this situation? p.578 Administer the drug with meals. Give the drug with a full glass of milk to prevent gastric irritation. Give the drug on an empty stomach with a full glass of water. Give the drug with a glass of orange juice or other source of vitamin C.

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28. Your client is started on simvastatin (Zocor) as a component of cholesterol management. Which of the following laboratory tests would need to be monitored while on this therapy? p.297 CBC. Serum glucose. Total protein. Liver function tests. 29. The nurse is to administer pancreatin to a child with cystic fibrosis. To evaluate the effect of this medication, the nurse should know that the primary purpose of this medication is to increase the absorption of: p. Glucose. Vitamin C. Sodium chloride. Fats. 30. A client is receiving a unit of packed red blood cells. Before the transfusion started, the client's blood pressure was 90/50 mm Hg, pulse rate 100 bpm, respirations 20 breaths/minute, and temperature 98 degrees F (36.7 degrees C). Fifteen minutes after the transfusion starts, the client's blood pressure is 92/54 mm Hg, pulse 100 bpm, respirations 18 breaths/minute, and temperature is 101.4 degrees F (38.6 degrees C). The nurse should first: stop the transfusion. raise the head of the bed. obtain an order for antibiotics. offer the client a cool washcloth. 31. The nurse should instruct a client who is taking dexamethasone (Decadron) and furosemide (Lasix) to observe for signs of hypokalemia, which include: p. excitability. muscle weakness.

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diarrhea. increased thirst. 32. A child is to receive dexamethasone (Decadron) intravenously at the ordered dosage of 7.6 mg. The drug concentration in the vial is 4 mg/mL. Which of the following amounts would the nurse administer? p. 0.05 mL. 0.72 mL. 1.9 mL. 3.8 mL. 33. The nurse would recognize prednisone toxicity if which of the following occurred? P.212 Tinnitus. Exfoliative dermatitis. Glucosuria. Nausea and vomiting. 34. The nurse administers the 4:00 pm dose of isophane insulin suspension (NPH) 10 units without monitoring the client's blood glucose level. The client has a hypoglycemic reaction at 6:00 pm involving seizure activitiy and a comatose state lasting several hours. Which of the following best describes the factors involved in this situation? p. The client experienced an idiosyncratic reaction to the drug. The client experienced an allergic reaction to the drug. The standard of care to assess the client's blood glucose before administering the drug was not followed. The nurse did not adhere to one or more of the "six rights" of medication administration. 35. The client taking warfarin (Coumadin) asks the nurse, "Why can't I eat broccoli and cabbage? I thought vegetables of all types are good nutritional sources." The nurse will utilize which of the following pieces of information in a response to the client? P.312 The client is correct; green leafy vegetables should be included in daily food intake.

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These food sources increase the effects of warfarin and may lead to dangerous bleeding problems. These food sources contain vitamin K, which decreases effects of the drug. These food sources contain vitamin C, which decreases effects of the drug. 36. The nurse should complete which of the following assessments on a client who has received tissue plasminogen activator (t-PA) or alteplase recombinant (Activase) therapy? p.319 Neurologic signs frequently throughout the course of therapy. Excessive bleeding every hour for the first 8 hours. Blood glucose level. Arterial blood gases. 37. A client who has asthma is taking albuterol (Ventolin) to treat bronchospasms. The nurse should anticipate that the client may experience which of the following adverse effects as a result of taking this drug? Select all that apply. P.206 Lethargy. Nausea. Headache . Nervousn ess. Constipati on. 38. The nurse is administering an intraveous potassium chloride supplement to a client who has heart failure. When developing a plan of care for this client, which of the following should the nurse incorporate into the care plan? P.377 Hyperkalemia will intensify the action of the client's digitalis preparation. The client's potassium levels will be unaffected by his potassium-sparing diuretic. The administration of the intravenous potassium chloride should not exceed 10 mEq/hour or a concentration of 40 mEq/L. Metabolic alkalosis will increase the client's serum potassium levels. 39. If treatment with thyroid hormone is effective, the nurse should expect: p.502

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Diuresis, a decrease in pulse rate, and an increase in blood pressure. Diuresis, a widening pulse pressure, and an increase in both temperature and respiratory rate. Increased pulse rate, decreased respiratory rate, and decreased puffiness. Weight loss, increased diastolic blood pressure, and decreased pulse rate. 40. The client is taking theophylline (TheoDur) to treat asthma. The client complains of nausea and vomiting and headache; the laboratory data shows an elevated serum theophylline level at 22 mcg/mL. Which of the following is the most appropriate action for the nurse to take? p.208 Explain to the client that this is an expected side effect of the drug. Call the prescriber to report signs and symptoms of theophylline toxicity. Call the prescriber to get an order for antiemetic medication to reduce client's symptoms. Stop the ordered doses of TheoDur for 24 hours. 41. A 28-year-old female client is prescribed danazol (Danocrine) for endometriosis. Which of the following would the nurse include as a side effect when teaching the client about the drug? p. Headaches. Weight loss. Increased libido. Hair loss 42. Which supplement would the nurse not ordinarily administer to the client receiving spironolactone?p.239 Vitamin B6. Potassium chloride. Ascorbic acid. Calcium carbonate.

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43. The nurse is caring for a client who is experiencing an acute exacerbation of Crohn's disease. The nurse has received an order to add 20 mEq of potassium chloride to a 1,000 ml bottle of IV fluids. The nurse has a 30 ml multiple-dose vial of potassium chloride. The label reads: 2 mEq/ml. How many mL would the nurse add to the IV fluids? 10 mL 44. Assessment for the side effects of hydrochlorothiazide includes signs of:p.238 Hypernatre mia. Hyperkalemi a. Hypochlore mia. Hypouricemi a. 45. The nurse is preparing to administer 0.1 mg of digoxin (Lanoxin) IV. Digoxin comes in a concentration of 0.5 mg/2 mL. How many milliliters should the nurse administer? p.265 0.2 mL. 0.4 mL. 2.2 mL. 2.5 mL. 46. Which of the following serologic tests should the nurse have on the chart before a client is started on tissue plasminogen activator (tPA) or alteplase recombinant (Activase)? P.319 Activated partial prothrombin time (aPTT). Potassium level. Lee-White clotting time. Fibrin split product (FSP). 47. A client has been prescribed furosemide (Lasix) 80 mg twice daily. The cardiac monitor technician informs the nurse that the client has started having rare premature ventricular contractions followed by runs of bigeminy lasting 2 minutes. During the assessment, the nurse determines that the client is asymptomatic and has stable vital signs. Which of the following actions should the nurse perform next? p.234 Call the physician.

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Check the client's potassium level. Summon the nurse manager. Administer potassium. 48. The physician orders an IV solution of 1 liter of 5% dextrose in normal saline to be administered to a client over 6 hours. The nurse calculates the administration rate and sets the IV controller to which of the following rates? 50 mL per hour. 100 mL per hour. 166 mL per hour. 200 mL per hour. 49. As part of the treatment plan, a client is prescribed steroids to treat ulcerative colitis. The nurse should assess the client for which of the following common complications related to steroid therapy? p. peptic ulcer. hypoglyce mia. tachycardi a. Renal failure 50. The nurse instructs the client in mixing and administering Regular and NPH Insulin. Which of the following statements indicates that the client needs additional instruction? p.485 "I draw up the Regular insulin first." "I shake the bottle of NPH insulin before drawing it up." "I store the insulin in a cool place." "I insert the needle at a 90-degree angle." 51. While aminophylline is infusing, the nurse should plan to closely monitor the client's: p.

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Level of consciousness. Blood pressure. Cardiac rhythm. Temperature. 52. The antidote for heparin is: vitamin K. warfarin (Coumadin). thrombin. protamine sulfate. 53. The nurse knows that the best time to give oral iron preparations is: p.373 With meals, to decrease gastric upset. 1 hour before eating, to enhance absorption. 1 hour after eating, to slow absorption. At bedtime. 54. Client teaching includes the early side effects of theophylline administration, which are: p.208 Tachycardia and palpitations. Anorexia, nausea, and vomiting. Restlessness and tremors. Headache and insomnia 55. The nurse is teaching a client who is taking dexamethasone (Decadron) for cerebral edema about early symptoms of Cushing's disease. Which of the following is a symptom of hyperadrenocorticism? Hypotension.

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Increased urinary frequency. Increased muscle mass. Easy bruising 56. A newly diagnosed type 1 diabetic client asks the nurse, "Why do I have to take two shots of insulin? Shouldn't one shot be enough?" The best response for the nurse to make is which of the following? "A single shot of long-acting insulin would be preferable." "You might be able to change to oral medications soon." "Two shots will give you better control and decrease complications." "I will ask the physician to change your insulin schedule." 57. The nurse is to administer 100 mg of aminophylline IV. The ampule contains 500 mg (gr 7 1/2) of aminophylline in 10 mL of solution. How much solution should the nurse withdraw from the ampule? 2 mL. 4 mL. 6 mL. 8 mL 58. The doctor orders aminophylline, 100 mg via IV, for a child who is having an acute asthmatic attack. The nurse should know that the main reason the doctor ordered aminophylline is because it is a(n): p. Bronchodila tor. Anticholinerg ic. Expectorant. Mucolytic agent. 59. The primary objective in giving prednisone along with aspirin for acute rheumatoid arthritis is to: p.

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Inhibit the autoimmune factors associated with rheumatoid arthritis. Prevent further joint destruction. Decrease inflammation and suppress symptomatology. Increase glucose levels for tissue repair. 60. A client takes isosorbide dinitrate (Isordil) as an antianginal medication. Which of the following statements indicates that the client understands the side effects of the drug? p.274 "I should take my pulse before taking the medication." "I should take Isordil with food." "I will need to change positions slowly so I won't get dizzy." "It is important that I report any swelling in my ankles." 61. A client who is taking several prescribed oral medications in treatment of congestive heart failure tells the nurse, "I'm going to take these at breakfast." Which response by the nurse is most appropriate? "Let's look at each medication to find out the best time to take the drug." "That depends on what you eat at breakfast." "That's a great idea." "What time do you usually have breakfast?" 62. The client has been taking famotidine (Pepcid) at home. The nurse prepares a teaching plan for the client indicating that the medication acts primarily to achieve which of the following? p.344 Inhibit gastric acid secretions. Neutralize acid in the stomach. Shorten the time required for digestion in the stomach. Improve the mixing of foods and gastric secretions.

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63. A woman is using progestin injections (Depo-Provera, DMPA) for contraception. The nurse instructs the client to return for an appointment in: p. 1 month. 3 month s. 4 months. 6 months.