Question 1

A client is admitted with a hypertensive crisis. What medication is commonly used for the rapid reduction of blood pressure in this situation?

Accepted Answer

Answer reason: IV nitroprusside is a potent, short-acting vasodilator used for hypertensive emergencies to rapidly lower blood pressure. The others are oral or slower-acting agents not preferred for immediate reduction.

Question 2

A client with ulcerative colitis is prescribed sulfasalazine. What is the primary therapeutic effect of sulfasalazine?

Accepted Answer

Answer reason: Sulfasalazine is an aminosalicylate used in ulcerative colitis; its primary therapeutic action is anti-inflammatory activity in the colon. It is not mainly an immunosuppressant, antibiotic, or prokinetic.

Question 3

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

Accepted Answer

Answer reason: In acute heart failure exacerbation, the priority is to rapidly reduce fluid overload and pulmonary congestion. Administering diuretics achieves this promptly; the other options are less immediate or not directly indicated.

Question 4

A client is prescribed atropine sulfate. What is the therapeutic effect of atropine sulfate?

Accepted Answer

Answer reason: Atropine is an anticholinergic (muscarinic antagonist) that decreases parasympathetic activity, leading to bronchodilation and reduced secretions. The other options reflect parasympathetic effects, which atropine blocks.

Question 5

A client with heart failure is prescribed a beta-blocker. What is the primary therapeutic effect of beta-blockers in heart failure?

Accepted Answer

Answer reason: Beta-blockers block sympathetic stimulation, slowing the heart rate and decreasing myocardial oxygen demand and workload, which improves outcomes in heart failure.

Question 6

A client is prescribed albuterol for asthma. What is the primary action of albuterol?

Accepted Answer

Answer reason: Albuterol is a short-acting beta2-adrenergic agonist that relaxes bronchial smooth muscle, producing bronchodilation. It is not a leukotriene antagonist, beta blocker, or primary anti-inflammatory agent.

Question 7

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

Accepted Answer

Answer reason: Furosemide is a loop diuretic that inhibits the Na-K-2Cl transporter in the thick ascending limb, blocking sodium (and thus water) reabsorption to cause diuresis. Potassium loss is secondary; it does not inhibit aldosterone or increase sodium reabsorption.

Question 8

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

Accepted Answer

Answer reason: Levothyroxine dosing is titrated based on thyroid function tests (TSH, T4). The primary nursing action is to monitor thyroid function to ensure therapeutic replacement and avoid over- or under-treatment.

Question 9

A client with a history of seizures is prescribed phenytoin. What is the critical laboratory value that the nurse should monitor during phenytoin therapy?

Accepted Answer

Answer reason: Phenytoin has a narrow therapeutic index; serum drug levels (therapeutic ~10–20 mcg/mL) must be monitored to ensure efficacy and avoid toxicity.

Question 10

A client with type 2 diabetes is prescribed glargine insulin. When is the peak action of glargine insulin?

Accepted Answer

Answer reason: Insulin glargine is a long-acting basal insulin with a relatively flat action profile and no pronounced peak.

Question 11

Which drug is administered to treat anaphylaxis?

Accepted Answer

Answer reason: Epinephrine is the first-line medication for anaphylaxis; its alpha and beta agonist effects rapidly reverse bronchospasm, hypotension, and airway edema.

Question 12

A 25 years old para-2 comes to emergency room, after home delivery with heavy bleeding per vagina. After evaluation and emergency resuscitation she diagnosed as a case of uterine atony. What is the appropriate medicine in the management of this case?

Accepted Answer

Answer reason: Uterine atony is the leading cause of postpartum hemorrhage; first-line treatment is a uterotonic such as oxytocin. The other options either relax smooth muscle (salbutamol, magnesium sulfate) or treat hypertension (hydralazine).

Question 13

A 24 years old premigravida comes in labour room for induction for an indication of severe preeclampsia at 39 weeks. Cervix is closed and 3cm long. Which of the following medicine will be given to her for cervical ripening?

Accepted Answer

Answer reason: Misoprostol, a prostaglandin E1 analog, is used for cervical ripening and induction of labor. Ergometrine is for postpartum hemorrhage, methyldopa treats hypertension in pregnancy, and salbutamol is a tocolytic.

Question 14

Which medication is commonly used to treat angina?

Accepted Answer

Answer reason: Nitroglycerin is a nitrate that causes venodilation and reduces myocardial oxygen demand, providing rapid relief of angina. Atorvastatin lowers lipids, aspirin is antiplatelet, and digoxin treats heart failure/arrhythmias.

Question 15

What is the antidote for Digoxin toxicity?

Accepted Answer

Answer reason: Digibind (digoxin immune Fab) binds circulating digoxin and reverses toxicity. Naloxone is for opioid overdose, acetylcysteine is for acetaminophen toxicity, and protamine sulfate is for heparin overdose.

Question 16

Which drug is used in the treatment of tuberculosis?

Accepted Answer

Answer reason: Ethambutol is a standard first-line antitubercular drug used in initial TB regimens.

Question 17

Which effect does the nurse expect may occur when using cholinergic agonists?

Accepted Answer

Answer reason: Cholinergic agonists stimulate the parasympathetic system, leading to increased detrusor activity and bladder tone; they cause miosis, bradycardia, and increased secretions rather than pupil dilation, tachycardia, or dry mouth.

Question 18

Protamine sulfate is the antidote for which medication?

Accepted Answer

Answer reason: Protamine sulfate binds and neutralizes heparin, reversing its anticoagulant effect. Warfarin is reversed with vitamin K; beta-blocker toxicity with glucagon; TCA overdose with sodium bicarbonate.

Question 19

What is paracetamol used for?

Accepted Answer

Answer reason: Paracetamol (acetaminophen) is an analgesic and antipyretic used to relieve pain and reduce fever; it is not used for diabetes.

Question 20

The infant is admitted to the unit with Tetralogy of Fallot. The nurse would anticipate an order for which medication?

Accepted Answer

Answer reason: Digoxin is commonly prescribed in infants with congenital heart defects, including Tetralogy of Fallot, to improve myocardial contractility and manage heart failure symptoms. Epinephrine and atropine are used for resuscitation, and aminophylline is a bronchodilator, not indicated for TOF management.

Question 21

The physician has prescribed Cobex (cyanocobalamin) for a client following a gastric resection. Which lab result indicates that the medication is having its intended effect?

Accepted Answer

Answer reason: Cyanocobalamin (vitamin B12) treats B12 deficiency anemia common after gastric resection due to loss of intrinsic factor. Effectiveness is shown by correction of anemia, reflected by a normal hemoglobin level; 14.2 g/dL is normal. Neutrophil, platelet, and eosinophil counts are not specific indicators of B12 therapy effectiveness.

Question 22

A client receiving Vancocin (vancomycin) has a serum level of 20mcg/mL. The nurse knows that the therapeutic range for vancomycin is?

Accepted Answer

Answer reason: Vancomycin’s therapeutic peak serum concentration is approximately 25–40 mcg/mL (trough 5–10 mcg/mL). Therefore, 25–40 mcg/mL is the correct therapeutic range.

Question 23

The mother of a child with chickenpox wants to know if there is a medication that will shorten the course of the illness. Which medication is sometimes used to speed healing of the lesions and shorten the duration of fever and itching?

Accepted Answer

Answer reason: Acyclovir is an antiviral that, when started early in varicella, can reduce lesion healing time and the duration of fever and pruritus. Varivax is for prevention, VZIG is for post-exposure prophylaxis/high-risk patients, and Periactin is an antihistamine that does not shorten the illness.

Question 24

The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?

Accepted Answer

Answer reason: Mannitol is an osmotic diuretic; its direct therapeutic effect is osmotic diuresis, evidenced by increased urine output, which helps lower intracranial pressure. The other findings are not direct indicators of mannitol’s effectiveness.

Question 25

The physician has ordered an IV bolus of Solu-Medrol (methylprednisolone sodium succinate) in normal saline for a client admitted with a spinal cord injury. Solu-Medrol has been shown to be effective in?

Accepted Answer

Answer reason: High-dose methylprednisolone given acutely after spinal cord injury has been shown to improve recovery of motor and sensory function; it does not prevent spasticity, reduce ventilation needs, or treat UTIs.

Question 26

Upon arrival in the nursery, erythromycin eyedrops are applied to the newborn's eyes. The nurse understands that the medication will?

Accepted Answer

Answer reason: Erythromycin ophthalmic prophylaxis prevents ophthalmia neonatorum from gonorrhea/chlamydia, which can cause corneal damage and blindness in newborns. It does not affect light sensitivity, ocular muscles, or accommodation.

Question 27

A client in labor has been given epidural anesthesia with Marcaine (bupivacaine). To reverse the hypotension associated with epidural anesthesia, the nurse should have which medication available?

Accepted Answer

Answer reason: Epidural anesthesia can cause sympathetic blockade leading to vasodilation and hypotension. A vasopressor is indicated; epinephrine increases vascular tone and blood pressure. The other options are reversal agents for opioids or benzodiazepines, or an inotrope not preferred for this cause of hypotension.

Question 28

A 4-year-old is admitted to the hospital for treatment of Kawasaki's disease. The medication commonly prescribed for the treatment of Kawasaki's disease is?

Accepted Answer

Answer reason: Kawasaki disease is treated with IVIG and high-dose aspirin, followed by low-dose aspirin to reduce inflammation and prevent coronary thrombosis. The other options are not standard therapy (diphenhydramine is an antihistamine, ampicillin is an antibiotic, interferon beta is for multiple sclerosis).

Question 29

The physician has ordered Pyridium (phenazopyridine) for a client with urinary urgency. The nurse should tell the client that?

Accepted Answer

Answer reason: Phenazopyridine is a urinary tract analgesic that commonly turns urine a red-orange color; it does not change output or cause an ammonia odor.

Question 30

A client having a colonoscopy is medicated with Versed (midazolam). The nurse recognizes that the client?

Accepted Answer

Answer reason: Midazolam (Versed) provides conscious sedation with anterograde amnesia; patients typically do not remember events during the procedure. It does not cause retrograde amnesia.

Question 31

A client with AIDS-related cytomegalovirus is started on Cytovene (ganciclovir). The nurse should tell the client that the medication will be needed?

Accepted Answer

Answer reason: In AIDS, CMV often requires chronic suppressive therapy because antivirals like ganciclovir control but do not eradicate the virus; maintenance is typically lifelong while immunosuppression persists.

Question 32

The physician has ordered Activase (alteplase) for a client admitted with a myocardial infarction. The desired effect of Activase is?

Accepted Answer

Answer reason: Alteplase (tPA) is a thrombolytic that converts plasminogen to plasmin, lysing fibrin and dissolving the thrombus; it does not stabilize clots or specifically prevent CHF.

Question 33

The physician has ordered injections of Neumega (oprelvekin) for a client receiving chemotherapy for prostate cancer. Which finding suggests that the medication is having its desired effect?

Accepted Answer

Answer reason: Oprelvekin (Neumega) is an interleukin-11 that stimulates megakaryocyte maturation and increases platelet counts to prevent or treat chemotherapy-induced thrombocytopenia. A platelet count of 250,000/mm3 indicates the desired therapeutic effect. The other values reflect RBCs, hematocrit, or neutrophils, which are not the primary targets.

Question 34

The physician has prescribed Cyclogel (cyclopentolate hydrochloride) drops for a client following a scleral buckling. The nurse knows that the purpose of the medication is to?

Accepted Answer

Answer reason: Cyclopentolate is an anticholinergic cycloplegic that paralyzes the ciliary muscle, resting accommodation and reducing ciliary spasm pain. It is not an antibiotic, does not constrict the pupil, and does not reduce aqueous humor production.

Question 35

What is the recommended course duration of isoniazid for tuberculosis treatment?

Accepted Answer

Answer reason: Standard first-line therapy for drug-susceptible pulmonary TB includes isoniazid for a total of 6 months (2-month intensive phase with RIPE followed by 4 months of INH + rifampin).

Question 36

Which medication is commonly used for cervical ripening before labor induction?

Accepted Answer

Answer reason: Misoprostol (a prostaglandin E1 analog) is used to ripen the cervix prior to labor induction. Oxytocin induces/augments contractions, Methergine treats postpartum hemorrhage, and Terbutaline is a tocolytic.

Question 37

Which drug is recommended to be given during diarrhea?

Accepted Answer

Answer reason: Zinc supplementation for 10–14 days is recommended, especially in children, as it reduces duration and severity of acute diarrhea. Routine antibiotics like cotrimoxazole, nalidixic acid, or cefixime are not indicated unless there is specific bacterial dysentery or cholera.

Question 38

What condition are fluoxetine capsules primarily used to treat?

Accepted Answer

Answer reason: Fluoxetine is an SSRI antidepressant indicated primarily for major depressive disorder, not for hypertension, angina, or cancer.

Question 39

In which step of the nursing process would the nurse ask a patient if the medication she administered relieved his pain?

Accepted Answer

Answer reason: Determining whether a medication relieved pain is evaluating the effectiveness of an intervention, which is the Evaluation step of the nursing process.

Question 40

A client with leukemia is receiving Trimetrexate. After reviewing the client's chart, the physician orders Wellcovorin (leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to?

Accepted Answer

Answer reason: Leucovorin (folinic acid) is used as a rescue agent with folate antagonists like trimetrexate to reverse toxicity and protect normal tissues from damage.

Question 41

A client with a missed abortion at 29 weeks gestation is admitted to the hospital. The client will most likely be treated with?

Accepted Answer

Answer reason: For fetal demise/missed abortion in the late second or third trimester, induction of labor is indicated. Dinoprostone (PGE2) is used to ripen the cervix and induce uterine contractions. Magnesium sulfate and calcium gluconate are for seizure prophylaxis/toxicity management, and bromocriptine suppresses lactation.

Question 42

A client with preeclampsia has been receiving an infusion containing magnesium sulfate for a blood pressure that is 160/80; deep tendon reflexes are 1 plus, and the urinary output for the past hour is 100 mL. The nurse should?

Accepted Answer

Answer reason: No signs of magnesium toxicity are present: urine output is adequate (100 mL/h) and reflexes, though 1+, are present. Antidote or stopping/slowing the infusion is not indicated; continue therapy and monitor.

Question 43

The client with varicella will most likely have an order for which category of medication?

Accepted Answer

Answer reason: Varicella is caused by varicella-zoster virus; treatment commonly includes antiviral agents (e.g., acyclovir). Antibiotics are for bacterial infections, antipyretics provide symptomatic relief only, and anticoagulants are unrelated.

Question 44

A client is admitted complaining of chest pain. Which of the following drug orders should the nurse question?

Accepted Answer

Answer reason: Ampicillin is an antibiotic and not indicated for acute chest pain/angina. Nitroglycerin, beta-blockers (propranolol), and calcium channel blockers (verapamil) are appropriate antianginal agents.

Question 45

A client who has glaucoma is to have miotic eyedrops instilled in both eyes. The nurse knows that the purpose of the medication is to?

Accepted Answer

Answer reason: Miotic eye drops (e.g., pilocarpine) cause pupillary constriction, which increases aqueous humor outflow and helps lower intraocular pressure in glaucoma.

Question 46

The physician has prescribed NPH insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs?

Accepted Answer

Answer reason: NPH is an intermediate-acting insulin that peaks about 6–12 hours after a morning dose, so hypoglycemia risk is greatest mid-afternoon; planning a 3 PM snack shows understanding of the peak.

Question 47

A client with pneumacystis carini pneumonia is receiving Methotrexate. The rationale for administering leucovorin calcium to a client receiving Methotrexate is to?

Accepted Answer

Answer reason: Leucovorin (folinic acid) is given as a rescue agent with methotrexate to replenish reduced folate in normal cells and counteract methotrexate’s toxic effects, thereby reversing toxicity. It does not treat anemia, increase WBCs, or provide synergy.

Question 48

A client on the postpartum unit has a proctoepsiotomy. The nurse should anticipate administering which medication?

Accepted Answer

Answer reason: After a proctoepsiotomy, rectal medications are avoided to protect sutures. An oral stool softener like docusate prevents constipation and straining. Methylergonovine treats uterine atony; bromocriptine suppresses lactation; a Dulcolax suppository is contraindicated.

Question 49

The physician has ordered an injection of RhoGam for a client with blood type A negative. The nurse understands that RhoGam is given to?

Accepted Answer

Answer reason: Rho(D) immune globulin binds fetal Rh-positive erythrocytes in an Rh-negative client, preventing maternal sensitization and subsequent Rh antibody formation; it does not remove existing antibodies or change Rh type.

Question 50

The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use?

Accepted Answer

Answer reason: Cataract extraction requires pupillary dilation; mydriatics are used preoperatively to facilitate lens removal. Miotics (e.g., Timoptic for glaucoma), corneal laser reshaping (LASIK), and silicone oil (retinal detachment) are not used for cataract surgery.

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