1)
Epoetin alfa
a) Epoetin alfa can cause hypertension and does not reduce blood pressure.
b) Epoetin alfa does not inhibit clotting of an AV fistula but can instead cause clot formation.
c) Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce
anemia. Anemia is common in clients who have chronic kidney failure, since erythropoietin is produced
by the kidney.
2) Pain Meds for Peptic Ulcer
a) Ibuprofen is an NSAID that is contraindicated for clients who have peptic ulcer disease because it can
reduce platelet aggregation and increase the risk of gastrointestinal irritation and hemorrhage.
b) Naproxen is an NSAID that is contraindicated for clients who have peptic ulcer disease because it can
reduce platelet aggregation and increase the risk of gastrointestinal irritation and hemorrhage.
c) Aspirin is an NSAID that is contraindicated for clients who have peptic ulcer disease because it can
reduce platelet aggregation and increase the risk of gastrointestinal irritation and hemorrhage.
d) Acetaminophen is an analgesic used for mild to moderate pain. It can be administered to a client who
has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of
gastrointestinal bleeding.
3) Clopidogrel Adverse Effects
a) Clopidogrel is an antithrombotic medication that inhibits platelet aggregation. It is used to prevent
stenosis of coronary stents, myocardial infarctions, and strokes. The nurse should monitor for coffee
ground emesis, black tarry stools, ecchymosis, or any indication of bleeding.
b) Clopidogrel can cause dizziness and headache but does not cause insomnia.
c) Clopidogrel can cause hypertension but does not cause hypotension.
d) Clopidogrel can cause diarrhea but does not cause constipation.
4) Allergy contraindication to Ceftriaxone
a) Clients who have a severe allergy to piperacillin, which is a penicillin, can have a cross sensitivity to
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ceftriaxone, a third-generation cephalosporin. Ceftriaxone is contraindicated for the client who has an
allergy to cephalosporins or a severe allergy to penicillin.
Gentamycin, an aminoglycoside antibiotic.
Clindamycin, an antibiotic that inhibits protein synthesis.
Sulfamethoxazole-trimethoprim, a combination of a sulfonamide and a synthetic anti-infective
medication.
Bupropion is an atypical antidepressant.
Phenelzine is an MAOI antidepressant.
Propylthiouracil blocks thyroid production and is a second-line medication used to treat hyperthyroidism.
Somatropin is a growth hormone prescribed for a client who has a growth hormone deficiency of the
anterior pituitary gland.
Methimazole inhibits thyroid production for a client who has hyperthyroidism.
Hydroxyzine is an antihistamine used to treat mild to moderate anxiety.
Misoprostol is a prostaglandin used to promote ripening of the cervix and induce labor. It is
contraindicated for clients who are experiencing preterm labor.
Dinoprostone is an oxytocic medication used to stimulate uterine contractions for clients who are at term
and to control postpartum hemorrhage. It is contraindicated for clients who are experiencing preterm labor.
Rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color.
The nurse should inform the client that this effect does not cause harm. Rifampin can cause hematuria.
Contraindication to Metoclopramide
a) Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric
emptying. It is contraindicated for a client who has an intestinal obstruction or perforation.
b) It should be used with caution for a client who has hypertension.
18) A client takes chlorpromazine to treat schizophrenia but is displaying a “mask-like” facial expression
and experiencing involuntary movements and tremors. What should the nurse administer?
a) The client is experiencing parkinsonism, which is an adverse effect of the antipsychotic medication
chlorpromazine. Amantadine is an antiparkinsonian medication used to treat the extrapyramidal
manifestations that can occur with chlorpromazine therapy.
19) Adverse effects of Epinephrine
a) Hypertension
b) Hyperglycemia
c) Tachycardia and dysrhythmias
20) Phenazopyridine and ciprofloxacin
a) Phenazopyridine can cause mild gastrointestinal upset. The client can take this medication with meals
to relieve this adverse effect.
b) Phenazopyridine is a urinary tract analgesic used to relieve pain and burning during urination.
Ciprofloxacin is a fluoroquinolone antibiotic that acts by destroying and inhibiting bacteria.
c) The client should drink 2 to 3 L of fluid while taking ciprofloxacin to dilute the urine and flush the urinary
tract.
d) Phenazopyridine is a urinary tract analgesic used to relieve pain and burning during urination. The
medication can cause the client's urine to turn a reddish-orange color. This coloration is an expected
effect of this medication, although it can stain clothing, and does not need to be reported to the
provider.
21) Zolpidem promotes sleep.
a) Zolpidem can cause dizziness and daytime drowsiness. It can cause confusion in the older adult client.
22) Medication for HYPOthyroidism.
a) Levothyroxine replaces thyroid hormone for a client who has hypothyroidism. Laboratory values for
hypothyroidism include an increased TSH level and decreased total T3 and T4 levels. Clinical
manifestations for hypothyroidism include fatigue, cold intolerance, and a decreased body temperature
and pulse.
23) Hydrochlorothiazide teaching
a) The client should take hydrochlorothiazide on a regular basis.
b) The client should check his weight daily to monitor for edema.
c) The client should take hydrochlorothiazide with food to reduce gastric distress.
d) The client should take hydrochlorothiazide in the morning to allow for diuresis during the day and
prevent nocturia.
24) Drug that ceases preterm labor (tocolytic medication)
a) Nifedipine is a tocolytic medication that is administered to stop preterm labor.
25) Lactulose to treat cirrhosis
a) Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic
encephalopathy from cirrhosis of the liver.
26) Amitriptyline treats depression. Tests a nurse should perform prior to administering amitriptyline.
a) Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for
cardiovascular effects of amitriptyline; therefore, an ECG should be performed prior to the start of
therapy to obtain a baseline of the client's cardiovascular status.
b) Amitriptyline can cause blurred vision; however, it does not affect hearing.
27) Allopurinol treats Gout.
a) Mild gastrointestinal adverse effects, such as nausea, vomiting, abdominal pain, and diarrhea, can
occur with allopurinol. The nurse should inform the client to take the medication with food to reduce
these effects.
b) Metallic taste is a mild adverse effect of allopurinol. The nurse should inform the client that this can
occur and not to discontinue the medication.
c) Fever can indicate a potentially fatal hypersensitivity reaction. The client should discontinue the
allopurinol and notify the provider if a fever or rash develops.
d) Drowsiness is a mild adverse effect of allopurinol. The nurse should inform the client that this can
occur and not to discontinue the medication.
28) Adverse effects of IV gentamycin.
a) Gentamicin can cause hypokalemia; however, hypoglycemia is not an adverse effect of gentamicin.
b) Proteinuria is a manifestation of nephrotoxicity, an adverse effect of gentamicin. The nurse should
monitor for oliguria and hematuria.
c) Gentamicin can cause apnea at high doses; however, nasal congestion is not an adverse effect of
gentamicin.
d) Gentamicin can cause impaired hearing; however, visual disturbances are not adverse effects of IV
gentamicin. Gentamicin administered by the ophthalmic route can cause eye photosensitivity, redness,
itching, and excess tearing.
29) Gemfibrozil Laboratory Tests
a) Gemfibrozil can decrease WBCs but does not alter platelet count.
b) Gemfibrozil can cause hyperglycemia but does not alter electrolyte levels.
c) Gemfibrozil can cause myopathy but does not alter thyroid function.
d) Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver
toxicity; therefore, the nurse should monitor the client's liver function.
30) Ergotamine
a) Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the
cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood
vessels.
b) It can cause peripheral vasoconstriction and cyanosis to digits.
c) Ergotamine is contraindicated for clients who have anemia or malnutrition.
31) Amphotericin B adverse effects.
a) Amphotericin B is an antifungal medication that can cause hypokalemia.
b) Amphotericin B is an antifungal medication that can cause hypotension.
c) Amphotericin B is an antifungal medication that can cause diarrhea.
d) Amphotericin B is an antifungal medication used to treat severe fungal infections; however, it can
cause nephrotoxicity. The nurse should monitor the client’s creatinine every 3 to 4 days and increase
fluid intake. The dosage of amphotericin B should be reduced if the client’s creatinine is 3.5 mg/dL or
greater.
32) Enalapril adverse effects
a) Enalapril can cause a decrease in Hgb and Hct but does not alter platelets.
b) Enalapril can cause kidney failure but not liver failure or jaundice.
c) Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension and postural
hypotension, especially during the first 3 hr following the initial dosage.
d) Enalapril increases potassium levels and can cause hyperkalemia.
33) After administering sub-q heparin, the nurse should:
a) The nurse should apply firm pressure to the injection site after administration.
b) The nurse should administer heparin using a 25-gauge or smaller needle to decrease the risk of
hemorrhage.
34) Long-term Prednisone therapy adverse effects
a) Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress
fractures.
b) Clients who take prednisone are at risk for hypertension due to sodium and fluid retention.
c) Clients who take prednisone are at risk for weight gain due to water retention.
35) Valproic Acid Labs to monitor:
a) PTT is correct. Valproic acid can alter coagulation; therefore, PT and PTT should be monitored.
b) Aspartate aminotransferase (AST) is correct. Valproic acid can cause life-threatening
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hepatotoxicity. The client should have baseline liver function tests (LFTs) before starting this
medication and LFTs should be repeated at regular intervals during therapy.
Alanine aminotransferase (ALT) is correct. ALT is a liver enzyme that is measured as a component
of liver function tests. Levels of the enzyme identify liver damage.
36) Sulfasalazine adverse effects
a) Sulfasalazine can cause a yellow discoloration of the skin and yellow/orange discoloration of the urine.
The nurse should instruct the client to notify the provider if these occur.
b) it can cause bloody diarrhea.
c) Sulfasalazine can cause stomatitis
d) Sulfasalazine can cause headache and peripheral neuropathy.
37) Cromolyn Sodium teaching
a) Cromolyn is a mast cell inhibitor that has a slow onset and is given for prophylactic treatment of
asthma. It is not a rescue medication.
b) Cromolyn administered by inhaler can cause mouth and throat irritation. The client should rinse or
gargle with water after each use.
c) The client should exhale completely, and then breathe in evenly while depressing the canister.
d) A spacer provides a chamber to hold the medication exhaled in suspension. It allows clients who have
difficulty breathing in the entire dose in one inhalation to continue to receive medication in subsequent
breaths.
38) Chlorothiazide adverse effects
a) Chlorothiazide can cause hypercalcemia but does not cause thrombophlebitis.
b) Chlorothiazide can cause hypoactive reflexes.
c) Chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure. It promotes
excretion of water, sodium, and potassium, and can cause hypokalemia. Manifestations of
hypokalemia include muscle weakness, muscle cramps, and dysrhythmias.
d) Chlorothiazide can cause hyperglycemia but does not cause hypoglycemia.
39) Morphine
a) Respiratory depression can occur within 7 min following the administration of IV bolus morphine. The
nurse should monitor the client's respirations and have naloxone available to reverse the effects of the
morphine.
b) IV morphine peaks in 20 min.
c) The nurse should withhold the morphine if the client has a respiratory rate less than 12/min.
d) The nurse should administer morphine via IV bolus slowly over 4 to 5 min to prevent hypotension and
respiratory depression.
40) Filgrastim teaching
a) Filgrastim does not increase erythrocyte production. It can cause anemia.
b) Filgrastim increases neutrophil production. It is given to treat neutropenia and reduce the risk of
infection for clients who are receiving chemotherapy for cancer or who have undergone bone marrow
transplant.
c) Filgrastim does not increase lymphocytes.
d) Filgrastim does not increase thrombocytes.
41) Tamoxifen
a) Tamoxifen is an antiestrogen medication used to treat cancer of the breast in both pre- and
postmenopausal women. It is also used to prevent breast cancer in women who are at an increased
risk.
42) Alendronate to treat Paget’s disease of the bone.
a) The nurse should ambulate the client to a chair and ensure that the client is sitting upright before
administering the alendronate to prevent esophagitis from occurring. The client must also be able to sit
or stand upright for 30 min after taking the medication. The nurse should apply the safety and risk
reduction priority-setting framework. This framework assigns priority to the factor or situation posing
the greatest safety risk to the client. When there are several risks to safety, the one posing the greatest
threat is the highest priority. The nurse should use Maslow’s Hierarchy of Needs, the ABC prioritysetting framework, or nursing knowledge to identify which risk poses the greatest threat to the client.
b) The nurse should administer the medication with water rather than milk since milk and other calciumcontaining substances can decrease the client's absorption of alendronate
c) The nurse should administer the medication before breakfast in the morning since food can reduce the
absorption of alendronate.
43) IV Heparin, patient has an aPTT of 90 seconds. What should a nurse do?
a) An aPTT of 90 seconds is outside the expected reference range of 60 to 80 seconds, which can cause
anticoagulation. The nurse should contact the provider, reduce the infusion rate, and assess the client
for bleeding.
b) Aspirin can inhibit platelet aggregation and is contraindicated for a client who is receiving heparin.
c) An INR is indicated for a client who is receiving warfarin, but it is not indicated for a client who is
receiving heparin.
44) Teaching for a patient with chronic stable angina pectoris and a prescription for Nitroglycerin.
a) The client should first stop all activity and place a tablet under his tongue. Next, he should wait 5 min.
If chest pain is not relieved, he should call 911.
45) Nifedipine, a calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to the
myometrial cells of the uterus.
46) Administering oxytocin to a client who is 41 weeks and is having ineffective labor.
a) Oxytocin is administered via IV infusion when used for labor induction. Some other medications used
for cervical ripening prior to oxytocin administration (dinoprostone and misoprostol) are administered
vaginally. Oxytocin can be administered IM to decrease postpartum bleeding.
b) The client's blood pressure and pulse should be continually monitored during labor induction with
oxytocin.
c) The goal during oxytocin therapy is for the client to experience contractions that last from 45 to 60
seconds. If prolonged contractions occur, administration should be stopped.
d) Effective uterine contractions should occur every 2 to 3 min.
47) Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients, especially, are
at risk for central nervous system depression even with low doses of benzodiazepines. Clients who are 50
years or older can have a more profound and prolonged sedation than younger clients. Lorazepam is a
benzodiazepine with antiseizure effects.
48) Lithium Teaching
a) NSAIDs, such as naproxen and ibuprofen, increase renal reabsorption of sodium and lithium, which
causes an increase in lithium levels and possible toxicity. Acetylsalicylic acid and sulindac are NSAIDS
that do not affect lithium levels.
b) When sodium levels are low, lithium excretion by the kidneys is increased. Therefore, eating foods with
larger amounts of sodium reduces, rather than increases, the risk for lithium toxicity. Increased sodium
intake can lead to excretion of lithium and a decrease in the lithium level. It is important for clients to
eat normal and consistent amounts of sodium to maintain lithium levels.
c) Vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is retained
by the kidneys and the risk for lithium toxicity increases.
d) Diuretics decrease kidney excretion of lithium, which causes lithium levels to rise and increases the
potential for toxicity.
49) Spironolactone teaching.
a) Spironolactone is a potassium-sparing diuretic. Clients taking potassium-sparing diuretics should limit
their intake of foods high in potassium due to the risk of hyperkalemia.
b) Spironolactone is a potassium-sparing diuretic. Clients who are taking potassium-sparing diuretics
should not use salt substitutes because they contain potassium and place the client at risk for
hyperkalemia.
c) Drinking large amounts of water can cause dilutional hyponatremia, which is dangerous when taking
spirolactone since electrolyte imbalances, including hyponatremia, are common.
d) Spironolactone, which is derived from steroids, can cause adverse endocrine effects, such as
gynecomastia, impotence in men and irregular menses and hirsutism in women. The nurse should
instruct the client that these changes can occur.
50) Theophylline teaching
a) Theophylline is a xanthine derivative bronchodilator. An early manifestation of toxicity is CNS
stimulation, often seen as tremors. Seizures can occur if blood levels continue to rise.
b) Diarrhea, rather than constipation, is a manifestation of theophylline toxicity.
c) Theophylline is a CNS stimulant. An increase in the blood level of theophylline causes restlessness
and irritability, but not fatigue. Lethargy is more indicative of CNS depression.
d) Theophylline is a CNS stimulant. An increase in the blood level of theophylline causes restlessness
and irritability, but not fatigue. Lethargy is more indicative of CNS depression.
51) Furosemide teaching.
a) Loop diuretics, such as furosemide, can cause ototoxicity. The client should be taught to notify the
provider if tinnitus, a full feeling in the ears, or hearing loss occurs.
b) Headaches are not an adverse effect of furosemide. Headaches can occur in a client who has fluid
overload, which furosemide might be prescribed to treat.
52) Contraindications of Diltiazem.
a) Diltiazem can be a treatment option for essential hypertension. This medication will lower blood
pressure and is contraindicated for a client who is hypotensive. The nurse should teach the client to
self-monitor blood pressure and keep a record of the readings.
b) Diltiazem and other calcium channel blockers are contraindicated for use in certain conditions where
bradycardia is present, such as second- or third-degree heart block. It is used to treat
tachydysrhythmia, such as atrial flutter and fibrillation and supraventricular tachycardia.
c) A decreased level of consciousness is not a contraindication to diltiazem use.
d) Diltiazem does not interact with diuretics, and a history of diuretic use is not a contraindication for
diltiazem administration.
53) Oral Hydroxyzine teaching.
a) Hydroxyzine, an H1 receptor antagonist, is sometimes used to treat anxiety. Anxiety is not an expected
adverse effect of the medication.
b) Hydroxyzine has antiemetic properties, thereby reducing the occurrence of nausea and vomiting.
c) Hydroxyzine has anticholinergic properties. Dry mouth is a common adverse effect of this medication.
The nurse should instruct the client to take sips of water or suck hard candies to minimize this effect.
54)