Question 1

A client is prescribed atorvastatin for hypercholesterolemia. What is the primary therapeutic effect of atorvastatin?

Accepted Answer

Answer reason: Atorvastatin, an HMG-CoA reductase inhibitor, decreases hepatic cholesterol synthesis and increases LDL receptors, leading to reduced total cholesterol and LDL as the primary therapeutic effect.

Question 2

Which clinical manifestation should decrease when nesiritide is effective in a client with acute heart failure and pulmonary edema?

Accepted Answer

Answer reason: Nesiritide (recombinant BNP) causes vasodilation and promotes natriuresis, reducing preload and pulmonary capillary wedge pressure. This relieves pulmonary edema and improves dyspnea. Hypotension is an adverse effect, and it does not treat angina or premature beats.

Question 3

What medication should be readily available prior to the arrival of a patient who attempted suicide by ingesting ethylene glycol?

Accepted Answer

Answer reason: Ethylene glycol poisoning is treated with fomepizole, an alcohol dehydrogenase inhibitor that prevents formation of toxic metabolites. Naloxone treats opioid overdose, deferoxamine treats iron toxicity, and acetylcysteine treats acetaminophen overdose.

Question 4

Which medication should be added to a long-term proton pump inhibitor regimen in a patient with gastroesophageal reflux disease to enhance esophageal motility?

Accepted Answer

Answer reason: Metoclopramide is a prokinetic agent that increases lower esophageal sphincter tone and enhances gastric emptying, improving esophageal motility. Omeprazole and pantoprazole are PPIs and famotidine is an H2 blocker; they reduce acid but do not enhance motility.

Question 5

Which of the following signs indicates an expected side effect of intravenous magnesium sulfate?

Accepted Answer

Answer reason: Drowsiness/sedation is a common, expected effect of IV magnesium sulfate. Oliguria, loss of deep tendon (knee-jerk) reflexes, and respiratory depression indicate magnesium toxicity and require intervention.

Question 6

What is the antidote for an accidental overdose of Atenolol in a 76-year-old male with bradycardia and hypotension?

Accepted Answer

Answer reason: Atenolol is a beta-blocker; overdose causes bradycardia and hypotension. Glucagon increases cAMP independently of beta-receptors, improving heart rate and contractility, making it the antidote of choice.

Question 7

What is the primary reason for administering mannitol to a patient with increased intracranial pressure (ICP)?

Accepted Answer

Answer reason: Mannitol is an osmotic diuretic that creates an osmotic gradient, drawing water from brain tissue into the intravascular space to reduce cerebral edema and ICP. Increased urine output is a secondary effect and it does not reduce CSF production.

Question 8

Which of the following medications is the safest to administer to adults needing assistance in falling asleep?

Accepted Answer

Answer reason: Benzodiazepines are sedative-hypnotics with a wider safety margin than barbiturates and are commonly used short term for insomnia. SSRIs are antidepressants that may worsen insomnia, and the nonspecific category 'minor tranquilizers' is not preferred.

Question 9

A client is prescribed levothyroxine for hypothyroidism. What is the primary nursing consideration during levothyroxine therapy?

Accepted Answer

Answer reason: Levothyroxine dosing is guided by TSH and free T4 values; monitoring thyroid function tests evaluates therapeutic effectiveness and prevents over- or under-replacement.

Question 10

A client is admitted with a suspected overdose of acetaminophen. What intervention is essential in the early management of acetaminophen toxicity?

Accepted Answer

Answer reason: N-acetylcysteine is the specific antidote for acetaminophen toxicity; given early (ideally within 8–10 hours) it replenishes glutathione and prevents hepatic injury. Naloxone is for opioid overdose, vitamin K is for warfarin reversal, and activated charcoal may reduce absorption but is not the essential antidotal therapy.

Question 11

A client with hypothyroidism asks the nurse if she will still need to take thyroid medication during the pregnancy. The nurse's response is based on the knowledge that?

Accepted Answer

Answer reason: Pregnant clients with hypothyroidism should continue levothyroxine; dose regulation is often more difficult because pregnancy increases thyroid demands and gland size, often requiring higher doses. Options A, C, and D are incorrect: fetal TSH does not replace maternal therapy, metabolism increases (not slows), and levothyroxine is safe and necessary for fetal growth.

Question 12

What medication is anticipated to be ordered for a patient with organophosphate poisoning experiencing muscle tremors, severe drooling, and diaphoresis?

Accepted Answer

Answer reason: Organophosphates inhibit acetylcholinesterase causing cholinergic excess (salivation, diaphoresis, bronchial secretions). Atropine, a muscarinic antagonist, reverses these muscarinic effects.

Question 13

Which type of insulin is prescribed for a client with diabetic ketoacidosis?

Accepted Answer

Answer reason: DKA is treated with IV regular insulin to rapidly decrease ketogenesis and blood glucose; regular insulin is the only insulin suitable for IV infusion. Long-acting, NPH, and lente are not used for DKA management.

Question 14

An 18-year-old pregnant woman at 30 weeks gestation presents with malodorous vaginal discharge and motile flagellated organisms on wet mount; which antibiotic is the appropriate treatment?

Accepted Answer

Answer reason: Motile flagellated organisms indicate Trichomonas vaginalis; first-line therapy is metronidazole, which is safe in the 2nd and 3rd trimesters. Other options do not treat trichomoniasis or are contraindicated in pregnancy.

Question 15

The nurse notes that a client is receiving ganciclovir sodium; for the treatment of which disorder is this medication most likely prescribed?

Accepted Answer

Answer reason: Ganciclovir is an antiviral used primarily to treat CMV infections, especially CMV retinitis in immunocompromised patients.

Question 16

An 82-year-old client is taking lactulose for hepatic encephalopathy. Which outcome indicates the medication is effective?

Accepted Answer

Answer reason: Lactulose reduces intestinal ammonia absorption, lowering serum ammonia and improving encephalopathy; the best indicator is improved mentation. It typically increases, not decreases, bowel movements.

Question 17

What is the priority drug to be administered by the nurse in a child with diabetic ketoacidosis (DKA)?

Accepted Answer

Answer reason: In DKA the priority medication is insulin, given as regular insulin (typically IV) to stop ketogenesis and lower glucose. NPH is not given IV; dextrose solutions are added later after glucose falls; normal saline is a fluid, not the priority drug.

Question 18

Which drug is administered intramuscularly after delivery of the placenta and membranes to prevent postpartum hemorrhage (PPH)?

Accepted Answer

Answer reason: Active management of the third stage of labor uses oxytocin 10 IU IM to promote uterine contraction and prevent postpartum hemorrhage. The other options are analgesic, antifungal, or opioid analgesic and do not prevent PPH.

Question 19

A client with type 2 diabetes is prescribed metformin. What is the primary action of metformin?

Accepted Answer

Answer reason: Metformin primarily improves peripheral insulin sensitivity and reduces hepatic gluconeogenesis. It does not increase insulin secretion or stimulate hepatic glucose release; decreased intestinal absorption is minimal.

Question 20

A client is prescribed clopidogrel after a coronary artery stent placement. What is the primary purpose of clopidogrel therapy?

Accepted Answer

Answer reason: Clopidogrel is an antiplatelet P2Y12 inhibitor used after stent placement to inhibit platelet aggregation and prevent stent thrombosis; it does not lower blood pressure, cholesterol, or improve contractility.

Question 21

What is acyclovir primarily used to treat?

Accepted Answer

Answer reason: Acyclovir is an antiviral medication effective against herpesviruses, particularly herpes simplex (HSV-1/HSV-2).

Question 22

Which medication is used for fever?

Accepted Answer

Answer reason: Acetaminophen is an antipyretic used to reduce fever; ciprofloxacin and amoxicillin are antibiotics, and cetirizine is an antihistamine.

Question 23

A pregnant woman is hospitalized for treatment of pregnancy induced hypertension in the 3rd trimester. She is receiving magnesium sulfate intravenously. The nurse understands that this medication is used MAINLY to?

Accepted Answer

Answer reason: Magnesium sulfate is used in pregnancy-induced hypertension primarily as a CNS depressant to prevent eclamptic seizures, not to control blood pressure, reduce respirations, or alter uterine blood flow.

Question 24

You are caring for a client with deep vein thrombosis who is on heparin IV. The latest APTT is 50. If the laboratory normal range is 16-24 seconds, you would anticipate?

Accepted Answer

Answer reason: Therapeutic aPTT for heparin is about 1.5–2 times the control. With a normal of 16–24 s, an aPTT of 50 s indicates a therapeutic effect, so the current dose should be maintained.

Question 25

The nurse enters the room of a client diagnosed with COPD. The client's skin is pink, and respirations are 8/minute. The client's oxygen is running at 6L/minute. What should be the nurse's FIRST action?

Accepted Answer

Answer reason: COPD patients may rely on hypoxic drive to breathe. High-flow oxygen can suppress this drive, causing bradypnea (RR 8/min). The priority is to reduce the oxygen flow rate immediately.

Question 26

The nurse is monitoring a client receiving a thrombolitic agent, Alteplase (activasetsissue plasminogen activator) for treatment of a myocardial infarction. What outcome indicates the client is receiving adequate therapy within the first hours of therapy?

Accepted Answer

Answer reason: Effective thrombolysis in acute MI is evidenced by reperfusion, shown by ST-segment returning toward baseline. Cardiac enzymes initially rise after reperfusion, BP reduction is nonspecific, and dysrhythmias may occur with reperfusion.

Question 27

Ondansetron, 8 mg IV given before chemotherapy is to prevent?

Accepted Answer

Answer reason: Ondansetron is a 5-HT3 receptor antagonist used to prevent chemotherapy-induced nausea and vomiting, not dyspnea, weakness, or pain.

Question 28

A client is diagnosed with oral candidiasis. The nurse knows that this condition in AIDS is treated with?

Accepted Answer

Answer reason: Oral candidiasis (thrush) is a fungal infection caused by Candida and is treated with antifungals such as fluconazole. TMP-SMX treats Pneumocystis/toxoplasmosis, acyclovir treats herpes viruses, and zidovudine is an antiretroviral.

Question 29

A client with type 1 diabetes is prescribed regular insulin. When is the peak action of regular insulin?

Accepted Answer

Answer reason: Regular (short-acting) insulin typically peaks about 2–4 hours after dosing; among the provided choices, 1–2 hours is the closest correct timeframe. Thirty minutes is onset, and later times correspond to intermediate-acting insulin.

Question 30

A client is admitted with exacerbation of asthma. What is the priority nursing intervention?

Accepted Answer

Answer reason: In an acute asthma exacerbation the immediate priority is to relieve bronchospasm and improve airflow. Short-acting bronchodilators act quickly; antipyretics and fluid restriction are not indicated, and corticosteroids reduce inflammation but have a slower onset than bronchodilators.

Question 31

A client with chronic kidney disease is prescribed a phosphate binder. What is the purpose of this medication?

Accepted Answer

Answer reason: Phosphate binders bind dietary phosphate in the intestines, reducing its absorption and increasing fecal excretion. They do not increase absorption, do not bind to calcium as their primary action, and are not used to lower potassium.

Question 32

A client is prescribed isosorbide dinitrate for angina. What is the primary action of isosorbide dinitrate?

Accepted Answer

Answer reason: Isosorbide dinitrate is a nitrate that releases nitric oxide, causing vasodilation, especially of venous and coronary arteries, improving coronary blood flow and reducing myocardial oxygen demand.

Question 33

A client is prescribed metoclopramide. What is the therapeutic effect of metoclopramide?

Accepted Answer

Answer reason: Metoclopramide is a prokinetic dopamine D2 antagonist that increases GI motility and accelerates gastric emptying; it does not reduce acid, increase mucus, or inhibit prostaglandins.

Question 34

A client with chronic kidney disease is prescribed epoetin alfa. What is the therapeutic effect of epoetin alfa?

Accepted Answer

Answer reason: Epoetin alfa is recombinant erythropoietin that stimulates erythropoiesis to treat anemia of chronic kidney disease, increasing RBC production.

Question 35

A client is prescribed levothyroxine for hypothyroidism. What is the primary therapeutic effect of levothyroxine?

Accepted Answer

Answer reason: Levothyroxine is synthetic T4 used to treat hypothyroidism; its therapeutic goal is to raise and normalize thyroid hormone levels. The other options describe opposite effects or non-primary outcomes.

Question 36

A client is prescribed enalapril for heart failure. What is the primary action of enalapril?

Accepted Answer

Answer reason: Enalapril is an ACE inhibitor that blocks conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone. That is its primary action.

Question 37

A client is prescribed atorvastatin for hypercholesterolemia. What is the primary action of atorvastatin?

Accepted Answer

Answer reason: Atorvastatin is an HMG-CoA reductase inhibitor (statin) that reduces hepatic cholesterol synthesis, thereby lowering LDL.

Question 38

A client is prescribed ranitidine for peptic ulcer disease. What is the primary action of ranitidine?

Accepted Answer

Answer reason: Ranitidine is an H2 receptor antagonist that blocks histamine H2 receptors on gastric parietal cells, thereby decreasing gastric acid secretion. It does not increase acid, mucus production, or gastric emptying.

Question 39

A client is prescribed metoprolol for hypertension. What is the primary action of metoprolol?

Accepted Answer

Answer reason: Metoprolol is a selective beta-1 adrenergic receptor blocker, decreasing heart rate, contractility, and renin release; its primary action is beta-receptor inhibition, not vasodilation or sodium excretion.

Question 40

A client is prescribed ranitidine (Zantac). What is the primary therapeutic effect of ranitidine?

Accepted Answer

Answer reason: Ranitidine is an H2-receptor antagonist that blocks histamine at parietal cells, reducing gastric acid secretion. It does not stimulate acid or primarily increase motility; ulcer prevention is a result of decreased acid, not the primary effect.

Question 41

A client is prescribed allopurinol for the treatment of gout. What is the primary therapeutic effect of allopurinol?

Accepted Answer

Answer reason: Allopurinol inhibits xanthine oxidase, decreasing uric acid synthesis. It is not a uricosuric agent, does not directly enhance kidney function, and is not primarily an analgesic or anti-inflammatory.

Question 42

A client is prescribed allopurinol for chronic gout. What is the primary action of allopurinol?

Accepted Answer

Answer reason: Allopurinol inhibits xanthine oxidase, decreasing uric acid production to prevent gout attacks; it is not an analgesic, anti-platelet, or primary anti-inflammatory for acute flares.

Question 43

A client is prescribed clopidogrel (Plavix). What is the primary therapeutic effect of clopidogrel?

Accepted Answer

Answer reason: Clopidogrel is an antiplatelet agent that blocks ADP (P2Y12) receptors to inhibit platelet aggregation. It is not an anticoagulant, vasodilator, or lipid-lowering drug.

Question 44

A client is prescribed metoclopramide for nausea and vomiting. What is the primary action of metoclopramide?

Accepted Answer

Answer reason: Metoclopramide is a prokinetic D2 antagonist that increases GI motility, accelerating gastric emptying and helping relieve nausea. It does not increase acid (A); H2 blockers handle histamine receptors (D); serotonin receptor inhibition is not its primary action (C).

Question 45

A client is prescribed atenolol for angina. What is the primary therapeutic effect of atenolol?

Accepted Answer

Answer reason: Atenolol is a beta-1 selective beta-blocker that lowers myocardial oxygen demand by decreasing heart rate and contractility, relieving angina. It does not primarily dilate coronaries, increase BP, or inhibit platelets.

Question 46

A client is prescribed isosorbide dinitrate for angina. What is the primary therapeutic effect of this medication?

Accepted Answer

Answer reason: Isosorbide dinitrate is a nitrate that releases nitric oxide, causing vasodilation (including coronary arteries), improving myocardial oxygen supply and relieving angina. Increased heart rate is a reflex side effect, platelet inhibition is due to antiplatelets, and it does not enhance contractility.

Question 47

A client is admitted with a suspected overdose of benzodiazepines. What is the priority nursing intervention?

Accepted Answer

Answer reason: Naloxone reverses opioids, not benzodiazepines. The specific benzodiazepine antidote is flumazenil (not listed). Among the options, early administration of activated charcoal can reduce benzodiazepine absorption and is the most appropriate priority intervention. Opioid analgesic and antiemetic are not indicated.

Question 48

A client with chronic kidney disease is prescribed sevelamer. What is the therapeutic effect of sevelamer?

Accepted Answer

Answer reason: Sevelamer is a non-calcium phosphate binder used in CKD to treat hyperphosphatemia by binding dietary phosphate in the GI tract, reducing absorption.

Question 49

A client is prescribed levothyroxine for hypothyroidism. What is the primary therapeutic effect of levothyroxine?

Accepted Answer

Answer reason: Levothyroxine is synthetic T4 used to replace deficient thyroid hormone in hypothyroidism; its primary effect is to increase circulating thyroid hormone levels.

Question 50

A client with heart failure is prescribed spironolactone. What is the primary therapeutic effect of this medication?

Accepted Answer

Answer reason: Spironolactone is an aldosterone antagonist. In heart failure, its primary therapeutic effect is blocking aldosterone, which reduces sodium and water retention and adverse remodeling; diuresis is secondary and mild.

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A client is prescribed atorvastatin for hypercholesterolemia. What is the primary therapeutic effect of atorvastatin?

Which clinical manifestation should decrease when nesiritide is effective in a client with acute heart failure and pulmonary edema?

What medication should be readily available prior to the arrival of a patient who attempted suicide by ingesting ethylene glycol?

Which medication should be added to a long-term proton pump inhibitor regimen in a patient with gastroesophageal reflux disease to enhance esophageal motility?

Which of the following signs indicates an expected side effect of intravenous magnesium sulfate?

What is the antidote for an accidental overdose of Atenolol in a 76-year-old male with bradycardia and hypotension?

What is the primary reason for administering mannitol to a patient with increased intracranial pressure (ICP)?

Which of the following medications is the safest to administer to adults needing assistance in falling asleep?

A client is prescribed levothyroxine for hypothyroidism. What is the primary nursing consideration during levothyroxine therapy?

A client is admitted with a suspected overdose of acetaminophen. What intervention is essential in the early management of acetaminophen toxicity?

A client with hypothyroidism asks the nurse if she will still need to take thyroid medication during the pregnancy. The nurse's response is based on the knowledge that?

What medication is anticipated to be ordered for a patient with organophosphate poisoning experiencing muscle tremors, severe drooling, and diaphoresis?

Which type of insulin is prescribed for a client with diabetic ketoacidosis?

An 18-year-old pregnant woman at 30 weeks gestation presents with malodorous vaginal discharge and motile flagellated organisms on wet mount; which antibiotic is the appropriate treatment?

The nurse notes that a client is receiving ganciclovir sodium; for the treatment of which disorder is this medication most likely prescribed?

An 82-year-old client is taking lactulose for hepatic encephalopathy. Which outcome indicates the medication is effective?

What is the priority drug to be administered by the nurse in a child with diabetic ketoacidosis (DKA)?

Which drug is administered intramuscularly after delivery of the placenta and membranes to prevent postpartum hemorrhage (PPH)?

A client with type 2 diabetes is prescribed metformin. What is the primary action of metformin?

A client is prescribed clopidogrel after a coronary artery stent placement. What is the primary purpose of clopidogrel therapy?

What is acyclovir primarily used to treat?

Which medication is used for fever?

A pregnant woman is hospitalized for treatment of pregnancy induced hypertension in the 3rd trimester. She is receiving magnesium sulfate intravenously. The nurse understands that this medication is used MAINLY to?

You are caring for a client with deep vein thrombosis who is on heparin IV. The latest APTT is 50. If the laboratory normal range is 16-24 seconds, you would anticipate?

The nurse enters the room of a client diagnosed with COPD. The client's skin is pink, and respirations are 8/minute. The client's oxygen is running at 6L/minute. What should be the nurse's FIRST action?

The nurse is monitoring a client receiving a thrombolitic agent, Alteplase (activasetsissue plasminogen activator) for treatment of a myocardial infarction. What outcome indicates the client is receiving adequate therapy within the first hours of therapy?

Ondansetron, 8 mg IV given before chemotherapy is to prevent?

A client is diagnosed with oral candidiasis. The nurse knows that this condition in AIDS is treated with?

A client with type 1 diabetes is prescribed regular insulin. When is the peak action of regular insulin?

A client is admitted with exacerbation of asthma. What is the priority nursing intervention?

A client with chronic kidney disease is prescribed a phosphate binder. What is the purpose of this medication?

A client is prescribed isosorbide dinitrate for angina. What is the primary action of isosorbide dinitrate?

A client is prescribed metoclopramide. What is the therapeutic effect of metoclopramide?

A client with chronic kidney disease is prescribed epoetin alfa. What is the therapeutic effect of epoetin alfa?

A client is prescribed levothyroxine for hypothyroidism. What is the primary therapeutic effect of levothyroxine?

A client is prescribed enalapril for heart failure. What is the primary action of enalapril?

A client is prescribed atorvastatin for hypercholesterolemia. What is the primary action of atorvastatin?

A client is prescribed ranitidine for peptic ulcer disease. What is the primary action of ranitidine?

A client is prescribed metoprolol for hypertension. What is the primary action of metoprolol?

A client is prescribed ranitidine (Zantac). What is the primary therapeutic effect of ranitidine?

A client is prescribed allopurinol for the treatment of gout. What is the primary therapeutic effect of allopurinol?

A client is prescribed allopurinol for chronic gout. What is the primary action of allopurinol?

A client is prescribed clopidogrel (Plavix). What is the primary therapeutic effect of clopidogrel?

A client is prescribed metoclopramide for nausea and vomiting. What is the primary action of metoclopramide?

A client is prescribed atenolol for angina. What is the primary therapeutic effect of atenolol?

A client is prescribed isosorbide dinitrate for angina. What is the primary therapeutic effect of this medication?

A client is admitted with a suspected overdose of benzodiazepines. What is the priority nursing intervention?

A client with chronic kidney disease is prescribed sevelamer. What is the therapeutic effect of sevelamer?

A client is prescribed levothyroxine for hypothyroidism. What is the primary therapeutic effect of levothyroxine?

A client with heart failure is prescribed spironolactone. What is the primary therapeutic effect of this medication?

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