Question 1

Which client statement indicates a need for additional education about interferon injections for multiple sclerosis?

Accepted Answer

Answer reason: Heat can exacerbate multiple sclerosis symptoms and is not recommended for interferon-related myalgias; management is with antipyretics/analgesics. Nausea/anorexia are expected effects, jaundice must be reported, and acetaminophen for fever is appropriate.

Question 2

Which existing client condition causes the nurse to contact the prescribing health care provider before giving the initial dose of propylthiouracil (PTU) to a client diagnosed with Graves disease?

Accepted Answer

Answer reason: PTU can potentiate the effects of anticoagulants, increasing bleeding risk; the prescriber should be contacted for potential dose adjustments and monitoring. Hypertension, slurred speech, or feeling cold are not direct contraindications to the first PTU dose.

Question 3

Which instructions should a nurse provide to a patient prescribed lisinopril for hypertension?

Accepted Answer

Answer reason: ACE inhibitors like lisinopril can cause first-dose and orthostatic hypotension; teaching to rise slowly helps prevent dizziness and falls. Avoiding all potassium-rich foods is overly restrictive (avoid K+ supplements/salt substitutes instead). A high-fat meal is unnecessary, cough should be reported but safety priority is orthostatic risk, and antihypertensives should not be stopped abruptly.

Question 4

Which teaching point should the nurse include when instructing a client with hypertension about the newly prescribed medication diltiazem?

Accepted Answer

Answer reason: Diltiazem is a calcium channel blocker metabolized by CYP3A4; grapefruit juice inhibits CYP3A4 and can raise drug levels, increasing risk of bradycardia/hypotension. Cough is linked to ACE inhibitors, increased urination to diuretics, and potassium diet changes to diuretics or ACE inhibitors—not diltiazem.

Question 5

Which client statement requires further assessment by the nurse for a client diagnosed with tuberculosis and receiving isoniazid, rifampin, and pyrazinamide?

Accepted Answer

Answer reason: Alcohol use with isoniazid and pyrazinamide increases risk of severe hepatotoxicity; this behavior requires further assessment and education. The other statements reflect appropriate actions or noncritical changes.

Question 6

A client is prescribed fluticasone propionate for asthma. What education should the nurse provide regarding fluticasone propionate?

Accepted Answer

Answer reason: Fluticasone propionate is an inhaled corticosteroid used for maintenance therapy, not for acute attacks. Rinsing the mouth after use prevents oral candidiasis, a common adverse effect. The other options are unsafe or incorrect.

Question 7

A client is prescribed diphenhydramine for allergic rhinitis. What education should the nurse provide regarding diphenhydramine?

Accepted Answer

Answer reason: Diphenhydramine is a first-generation antihistamine that commonly causes CNS depression and drowsiness; patients should avoid driving or operating machinery due to sedation risk.

Question 8

A client is prescribed prednisone for the management of an autoimmune disorder. What education should the nurse provide regarding prednisone?

Accepted Answer

Answer reason: Prednisone (a glucocorticoid) can cause hyperglycemia; clients should monitor blood glucose. It should be taken with food, not on an empty stomach, and should not be stopped abruptly. While calcium/vitamin D intake may be advised, monitoring glucose addresses a key adverse effect.

Question 9

A client with chronic obstructive pulmonary disease (COPD) is prescribed bronchodilator medication. What should the nurse instruct the client about the use of bronchodilators?

Accepted Answer

Answer reason: Many COPD inhalers include an inhaled corticosteroid with bronchodilators; ICS can cause oral candidiasis, so the client should rinse the mouth after each use to prevent thrush. The other options are incorrect patient teaching.

Question 10

What effect should the nurse caution sexually active female clients taking isoniazid (INH) about?

Accepted Answer

Answer reason: Isoniazid, like many antibiotics, can disrupt normal vaginal flora and predispose to candidal vaginitis; other listed effects are not associated with INH.

Question 11

Which of the following is an important nursing consideration for a patient with acromegaly being treated with octreotide, a growth hormone receptor antagonist?

Accepted Answer

Answer reason: Octreotide (a somatostatin analog) can inhibit insulin and alter glucose regulation, increasing the risk of hyperglycemia; blood glucose monitoring is a key nursing consideration.

Question 12

A patient with heart failure is receiving an osmotic diuretic alongside other diuretics; what potential complication should the nurse monitor for?

Accepted Answer

Answer reason: Osmotic diuretics (e.g., mannitol) initially expand intravascular volume by pulling fluid into the bloodstream, which can precipitate or worsen heart failure and lead to pulmonary edema—i.e., fluid overload.

Question 13

Which medication should be held for 48 hours before and after cardiac catheterization in a client with type II diabetes mellitus?

Accepted Answer

Answer reason: Iodinated contrast used in cardiac catheterization can precipitate acute kidney injury, increasing metformin accumulation and risk of lactic acidosis. Therefore, metformin is held 48 hours before and after the procedure.

Question 14

A client is admitted with severe pain and is prescribed morphine sulfate. What is the priority nursing action before administering morphine sulfate?

Accepted Answer

Answer reason: Opioids like morphine can cause respiratory depression. Before administration, the priority is to assess respiratory rate and withhold if it is low, as airway/breathing takes precedence over other assessments.

Question 15

A client is prescribed prednisone for an autoimmune disorder. What education should the nurse provide regarding prednisone?

Accepted Answer

Answer reason: Prednisone is an immunosuppressive corticosteroid, increasing susceptibility to infection. Clients should avoid exposure to crowds and sick contacts. It should not be taken on an empty stomach and should not be stopped abruptly.

Question 16

A client is prescribed levofloxacin for a respiratory infection. What education should the nurse provide regarding levofloxacin?

Accepted Answer

Answer reason: Fluoroquinolones like levofloxacin can cause crystalluria; encouraging increased fluid intake helps prevent crystal formation in the urine. Clients should avoid dairy/antacids that reduce absorption and should not stop therapy for mild GI upset.

Question 17

A client is prescribed enoxaparin for deep vein thrombosis (DVT) prophylaxis. What is the primary nursing consideration during enoxaparin therapy?

Accepted Answer

Answer reason: Enoxaparin is a low-molecular-weight heparin anticoagulant; the primary risk is bleeding. Monitor for bruising, hematuria, melena, and other hemorrhage signs. It is given subcutaneously, not IM; infection and ICP are not primary concerns.

Question 18

A client is prescribed enoxaparin (Lovenox) for deep vein thrombosis (DVT) prophylaxis. What is the primary nursing consideration during enoxaparin therapy?

Accepted Answer

Answer reason: Enoxaparin is a low-molecular-weight heparin anticoagulant; the primary risk is bleeding. Nurses should monitor for bruising, hematuria, melena, and other bleeding signs.

Question 19

A client is prescribed a nonsteroidal anti-inflammatory drug (NSAID) for pain relief. What education should the nurse provide regarding NSAID use?

Accepted Answer

Answer reason: NSAIDs increase risk of GI irritation and bleeding; clients should be taught to watch for black, tarry stools, coffee-ground emesis, or abdominal pain. They should not be taken on an empty stomach, immediate relief is not guaranteed, and hydration is less critical than monitoring for GI bleeding.

Question 20

A patient is prescribed warfarin (Coumadin) after a mechanical valve replacement. Which food should they limit to avoid interference with the medication?

Accepted Answer

Answer reason: Spinach is high in vitamin K, which counteracts warfarin and can lower INR. Patients should limit or keep a consistent intake of vitamin K–rich leafy greens.

Question 21

Which TB drug causes orange discoloration of body fluids?

Accepted Answer

Answer reason: Rifampin commonly causes orange-red discoloration of urine, tears, sweat, and other body fluids; the others do not.

Question 22

A client is prescribed enoxaparin for deep vein thrombosis (DVT) prophylaxis. What is the primary nursing consideration during enoxaparin therapy?

Accepted Answer

Answer reason: Enoxaparin (LMWH) is an anticoagulant; the foremost safety concern is hemorrhage. The priority nursing action is to monitor for signs of bleeding. Platelets should also be monitored for HIT, but bleeding assessment is the primary consideration.

Question 23

A client with rheumatoid arthritis is prescribed methotrexate. What is the primary nursing consideration during methotrexate therapy?

Accepted Answer

Answer reason: Methotrexate is an immunosuppressant that can cause bone marrow suppression, increasing the risk for infection. Priority nursing action is to monitor for signs of infection. The other options are not primary considerations for this drug.

Question 24

A client is admitted with a pulmonary embolism and is prescribed enoxaparin (Lovenox). What laboratory value should the nurse monitor closely during enoxaparin therapy?

Accepted Answer

Answer reason: Enoxaparin (LMWH) does not require routine aPTT or INR monitoring. The key lab to monitor is platelet count to detect heparin-induced thrombocytopenia.

Question 25

A client is receiving intravenous (IV) fentanyl for pain management. What is the priority nursing assessment before administering fentanyl?

Accepted Answer

Answer reason: Opioids such as fentanyl can cause life-threatening respiratory depression. Airway/breathing take priority, so assess respiratory rate (and hold if low) before administration.

Question 26

A client is receiving intravenous (IV) furosemide for heart failure. What laboratory value should the nurse monitor closely during furosemide therapy?

Accepted Answer

Answer reason: Furosemide is a loop diuretic that increases renal potassium excretion, placing the client at risk for hypokalemia and dysrhythmias; therefore potassium must be monitored most closely.

Question 27

A client is prescribed alprazolam for anxiety. What education should the nurse provide regarding alprazolam?

Accepted Answer

Answer reason: Alprazolam is a benzodiazepine that commonly causes sedation and drowsiness; dosing at bedtime reduces daytime impairment. It does not require an empty stomach or milk, and tyramine restrictions apply to MAOIs, not benzodiazepines.

Question 28

Which assessment finding in a patient with acute coronary syndrome receiving nitroglycerin requires immediate intervention?

Accepted Answer

Answer reason: Nitroglycerin can cause significant hypotension; a BP of 90/60 mmHg indicates potentially dangerous hemodynamic compromise requiring immediate intervention. Headache and flushing are expected effects, and HR 80 is normal.

Question 29

A patient’s current medication list includes warfarin and amiodarone; which assessment should the nurse perform?

Accepted Answer

Answer reason: Amiodarone inhibits warfarin metabolism, increasing INR and bleeding risk; priority assessment is for signs of bleeding.

Question 30

When assessing a client prescribed pyridostigmine, which side effect should the nurse ask the client about?

Accepted Answer

Answer reason: Pyridostigmine, an acetylcholinesterase inhibitor for myasthenia gravis, increases acetylcholine at the neuromuscular junction, commonly causing muscarinic and nicotinic effects such as muscle cramps/fasciculations. Mouth ulcers, depression, and weight gain are not typical adverse effects.

Question 31

Which of the following tests should be performed before beginning prescription of Accutane?

Accepted Answer

Answer reason: Isotretinoin (Accutane) is highly teratogenic; pregnancy is an absolute contraindication. A pregnancy test is required before initiation. Calcium, apical pulse, and creatinine are not baseline requirements for Accutane.

Question 32

When caring for a client receiving prolonged aspirin therapy, the nursing staff should be alert for symptoms of what condition?

Accepted Answer

Answer reason: Aspirin irreversibly inhibits platelet COX-1, reducing thromboxane A2 and platelet aggregation, which prolongs bleeding time. The other options are not typical adverse effects of prolonged aspirin therapy.

Question 33

A patient frequently taking calcium carbonate should be advised that this practice may lead to which condition?

Accepted Answer

Answer reason: Calcium carbonate antacids can cause acid rebound by stimulating gastrin release, leading to increased gastric acid after use. They are more associated with constipation than diarrhea; water retention and bone demineralization are not typical effects.

Question 34

What is the most appropriate nursing action when a patient taking an SSRI develops a rash?

Accepted Answer

Answer reason: A new rash on an SSRI can indicate a hypersensitivity reaction or serious cutaneous adverse effect; the nurse should notify the provider immediately rather than treat topically or simply monitor.

Question 35

A client is prescribed ciprofloxacin for a urinary tract infection. What education should the nurse provide regarding ciprofloxacin?

Accepted Answer

Answer reason: Fluoroquinolones like ciprofloxacin can cause photosensitivity; patients should avoid excessive sunlight. Antacids decrease absorption, food is not required, and therapy should be completed even if symptoms improve.

Question 36

A client is prescribed ranolazine for chronic angina. What education should the nurse provide regarding ranolazine?

Accepted Answer

Answer reason: Grapefruit inhibits CYP3A, increasing ranolazine levels and QT-prolongation risk; therefore it should be avoided. Ranolazine can be taken with or without food, should not be taken specifically with antacids, and should not be discontinued without provider guidance.

Question 37

A client is prescribed lisinopril for hypertension. What education should the nurse provide regarding lisinopril?

Accepted Answer

Answer reason: ACE inhibitors like lisinopril can cause hyperkalemia. Clients should avoid potassium-containing salt substitutes. The drug does not require an empty stomach, potassium intake should not be increased, and BP reduction is not immediate.

Question 38

A client is prescribed nitroglycerin for angina. What education should the nurse provide regarding nitroglycerin?

Accepted Answer

Answer reason: Nitrates taken with PDE-5 inhibitors (e.g., sildenafil) can cause profound hypotension and are contraindicated, so clients must avoid concurrent use.

Question 39

A client is prescribed sertraline for depression. What education should the nurse provide regarding sertraline?

Accepted Answer

Answer reason: SSRIs like sertraline carry a black box warning for increased suicidal thoughts, especially early in therapy. Patients should be taught to monitor and report suicidal ideation. Effects are not immediate, medication should not be stopped abruptly, and it does not need to be taken on an empty stomach.

Question 40

The mother of a two month-old baby calls the nurse at a well-baby clinic two days after the first DTaP immunization. She reports that the baby feels very warm, has cried inconsolably for as long as three hours, and has had several shaking spells. The response of the nurse should be to?

Accepted Answer

Answer reason: Fever with prolonged inconsolable crying and shaking spells after DTaP indicate a severe adverse reaction with risk of encephalopathy/seizures. The safest action is to activate EMS for immediate evaluation and monitored transport.

Question 41

Which medication is most likely causing palpitations and shortness of breath after a client accidentally doubled her daily dose for one week?

Accepted Answer

Answer reason: Excess levothyroxine can produce hyperthyroid effects such as tachycardia, palpitations, and dyspnea. The other drugs would more likely cause bradycardia (atenolol), visual/GI arrhythmic toxicity (digoxin), or volume-electrolyte issues (furosemide).

Question 42

What is essential for the nurse to monitor in a client receiving desmopressin for diabetes insipidus?

Accepted Answer

Answer reason: Desmopressin can cause water retention and dilutional hyponatremia; monitoring serum sodium is essential to detect this adverse effect.

Question 43

Prolonged use of omeprazole can cause deficiency of which vitamin or mineral?

Accepted Answer

Answer reason: Chronic PPI therapy reduces gastric acid needed to release vitamin B12 from food, decreasing absorption and leading to B12 deficiency.

Question 44

What symptom would be a warning sign of potential withdrawal syndrome in a client with a history of depression who is considering stopping their SSRI medication?

Accepted Answer

Answer reason: SSRI discontinuation syndrome commonly presents with dizziness, flu-like symptoms, insomnia, and sensory disturbances; constipation, weight gain, and increased energy are not typical withdrawal signs.

Question 45

What is the appropriate nursing action for a patient taking Lisinopril who complains of a persistent dry cough?

Accepted Answer

Answer reason: Persistent dry cough is a common adverse effect of ACE inhibitors like lisinopril due to bradykinin. The appropriate action is to switch to an ARB (e.g., losartan) rather than continue, suppress the cough, or just reduce the dose.

Question 46

A client is prescribed warfarin (Coumadin) therapy. What dietary education should the nurse provide regarding vitamin K intake?

Accepted Answer

Answer reason: Warfarin’s effect is reduced by vitamin K; patients should not increase or supplement vitamin K and are commonly instructed to avoid high-vitamin K foods. Among the options, avoiding vitamin K–rich foods is the safest teaching.

Question 47

A client is admitted with rheumatoid arthritis and is prescribed methotrexate. What laboratory value should the nurse monitor closely during methotrexate therapy?

Accepted Answer

Answer reason: Methotrexate can cause bone marrow suppression; monitor CBC for leukopenia, anemia, and thrombocytopenia.

Question 48

A client is prescribed aspirin for pain relief. What instruction should the nurse provide regarding the use of aspirin?

Accepted Answer

Answer reason: Concurrent use of aspirin with other NSAIDs increases the risk of GI irritation/bleeding and can interfere with aspirin’s antiplatelet effect. Therefore clients should avoid combining them.

Question 49

Which finding indicates that a client receiving torsemide 5 mg orally daily is experiencing an adverse effect related to the medication?

Accepted Answer

Answer reason: Torsemide is a loop diuretic that increases renal potassium excretion. A potassium level of 3.1 mEq/L indicates hypokalemia, a known adverse effect that can lead to muscle weakness and cardiac dysrhythmias. The other listed values are within normal limits.

Question 50

Which patient population is at highest risk for developing complications related to low-molecular-weight heparin therapy?

Accepted Answer

Answer reason: Low-molecular-weight heparins are primarily eliminated by the kidneys. In patients with renal impairment, drug accumulation can occur, significantly increasing the risk of bleeding complications. Pregnancy alone does not confer the highest complication risk compared with impaired renal clearance.

Train with a large NCLEX question bank and jump into a full exam-style simulator

Adverse Effects-Contraindications NCLEX Practice Test

Continue Learning

Which client statement indicates a need for additional education about interferon injections for multiple sclerosis?

Which existing client condition causes the nurse to contact the prescribing health care provider before giving the initial dose of propylthiouracil (PTU) to a client diagnosed with Graves disease?

Which instructions should a nurse provide to a patient prescribed lisinopril for hypertension?

Which teaching point should the nurse include when instructing a client with hypertension about the newly prescribed medication diltiazem?

Which client statement requires further assessment by the nurse for a client diagnosed with tuberculosis and receiving isoniazid, rifampin, and pyrazinamide?

A client is prescribed fluticasone propionate for asthma. What education should the nurse provide regarding fluticasone propionate?

A client is prescribed diphenhydramine for allergic rhinitis. What education should the nurse provide regarding diphenhydramine?

A client is prescribed prednisone for the management of an autoimmune disorder. What education should the nurse provide regarding prednisone?

A client with chronic obstructive pulmonary disease (COPD) is prescribed bronchodilator medication. What should the nurse instruct the client about the use of bronchodilators?

What effect should the nurse caution sexually active female clients taking isoniazid (INH) about?

Which of the following is an important nursing consideration for a patient with acromegaly being treated with octreotide, a growth hormone receptor antagonist?

A patient with heart failure is receiving an osmotic diuretic alongside other diuretics; what potential complication should the nurse monitor for?

Which medication should be held for 48 hours before and after cardiac catheterization in a client with type II diabetes mellitus?

A client is admitted with severe pain and is prescribed morphine sulfate. What is the priority nursing action before administering morphine sulfate?

A client is prescribed prednisone for an autoimmune disorder. What education should the nurse provide regarding prednisone?

A client is prescribed levofloxacin for a respiratory infection. What education should the nurse provide regarding levofloxacin?

A client is prescribed enoxaparin for deep vein thrombosis (DVT) prophylaxis. What is the primary nursing consideration during enoxaparin therapy?

A client is prescribed enoxaparin (Lovenox) for deep vein thrombosis (DVT) prophylaxis. What is the primary nursing consideration during enoxaparin therapy?

A client is prescribed a nonsteroidal anti-inflammatory drug (NSAID) for pain relief. What education should the nurse provide regarding NSAID use?

A patient is prescribed warfarin (Coumadin) after a mechanical valve replacement. Which food should they limit to avoid interference with the medication?

Which TB drug causes orange discoloration of body fluids?

A client is prescribed enoxaparin for deep vein thrombosis (DVT) prophylaxis. What is the primary nursing consideration during enoxaparin therapy?

A client with rheumatoid arthritis is prescribed methotrexate. What is the primary nursing consideration during methotrexate therapy?

A client is admitted with a pulmonary embolism and is prescribed enoxaparin (Lovenox). What laboratory value should the nurse monitor closely during enoxaparin therapy?

A client is receiving intravenous (IV) fentanyl for pain management. What is the priority nursing assessment before administering fentanyl?

A client is receiving intravenous (IV) furosemide for heart failure. What laboratory value should the nurse monitor closely during furosemide therapy?

A client is prescribed alprazolam for anxiety. What education should the nurse provide regarding alprazolam?

Which assessment finding in a patient with acute coronary syndrome receiving nitroglycerin requires immediate intervention?

A patient’s current medication list includes warfarin and amiodarone; which assessment should the nurse perform?

When assessing a client prescribed pyridostigmine, which side effect should the nurse ask the client about?

Which of the following tests should be performed before beginning prescription of Accutane?

When caring for a client receiving prolonged aspirin therapy, the nursing staff should be alert for symptoms of what condition?

A patient frequently taking calcium carbonate should be advised that this practice may lead to which condition?

What is the most appropriate nursing action when a patient taking an SSRI develops a rash?

A client is prescribed ciprofloxacin for a urinary tract infection. What education should the nurse provide regarding ciprofloxacin?

A client is prescribed ranolazine for chronic angina. What education should the nurse provide regarding ranolazine?

A client is prescribed lisinopril for hypertension. What education should the nurse provide regarding lisinopril?

A client is prescribed nitroglycerin for angina. What education should the nurse provide regarding nitroglycerin?

A client is prescribed sertraline for depression. What education should the nurse provide regarding sertraline?

The mother of a two month-old baby calls the nurse at a well-baby clinic two days after the first DTaP immunization. She reports that the baby feels very warm, has cried inconsolably for as long as three hours, and has had several shaking spells. The response of the nurse should be to?

Which medication is most likely causing palpitations and shortness of breath after a client accidentally doubled her daily dose for one week?

What is essential for the nurse to monitor in a client receiving desmopressin for diabetes insipidus?

Prolonged use of omeprazole can cause deficiency of which vitamin or mineral?

What symptom would be a warning sign of potential withdrawal syndrome in a client with a history of depression who is considering stopping their SSRI medication?

What is the appropriate nursing action for a patient taking Lisinopril who complains of a persistent dry cough?

A client is prescribed warfarin (Coumadin) therapy. What dietary education should the nurse provide regarding vitamin K intake?

A client is admitted with rheumatoid arthritis and is prescribed methotrexate. What laboratory value should the nurse monitor closely during methotrexate therapy?

A client is prescribed aspirin for pain relief. What instruction should the nurse provide regarding the use of aspirin?

Which finding indicates that a client receiving torsemide 5 mg orally daily is experiencing an adverse effect related to the medication?

Which patient population is at highest risk for developing complications related to low-molecular-weight heparin therapy?

Think you’re ready for the NCLEX?

Leave a Reply Cancel reply