SAS 1

1. What is pharmacokinetics?
a. The study of biological and therapeutic effects of drugs
b. The study of absorption, distribution, metabolism and excretion of drugs
c. The study of mechanisms of drug action
d. The study of methods of new drug development

2. The interaction of one drug increased by the presence of a second drug is known as:
a. Potentiation
b. Addictive effects
c. Antagonism
d. Synergism

3. Considering the absorption of medications during administration, which of the following routes
would yield the quickest response?
a. Oral Medications
b. Subcutaneous injections
c. Intravenous medications
d. Topical medications

4. Which of the following best defines the process of pharmacokinetics?

a. The effect of medication on the body
b. The effect of the body on medication
c. The study of medications
d. The preparation of medications for administration

5. When performing an assessment about medication drug history should include which of the
following?
a. Complete vital signs
b. Reason for medication
c. Client’s goal therapy
d. Administration of OTC medications

6. When considering the pharmacotherapeutic effects of drugs administered to clients, the nurse
considers which property of most Importance:
a. Efficacy
b. Potency
c. Interaction with other drugs
d. Toxicity

7. Safety of a drug is determined by the degree between which of the following?

a. Therapeutic and toxic doses
b. Potency and efficacy
c. Subtherapeutic and toxic levels
d. Side and adverse effects
8. The nurse is monitoring the therapeutic drug level for a client on vancomycin (Vancocin) and notes that
the level is within the acceptable range. What does this indicate to the nurse? Select all that apply.
a. The drug should cause no toxicities or adverse effects
b. The drug level is appropriate to exert therapeutic effects
c. The dose will not need to be changed for the duration of treatment
d. the nurse will need to continue monitoring because each client response to a drug is unique

9. When a drug is 50% protein bound it means that:

a. 50% of the drug destroys protein
b. A drug not bound to protein is an active drug
c. 50% of the dose is at work
d. Protein must be restricted in the diet

10. When reviewing the patient’s medication regimen, the nurse understands that the interval of
drug dosage is related to what?
a. Half-life
b. Biotransformation
c. Metabolism
d. Therapeutic effect

11. It is important for the nurse to be aware of the four sequential processes of the
pharmacokinetic phase. What are these processes?
a. Distribution, metabolism, excretion, absorption
b. Biotransformation, excretion, absorption, metabolism
c. Absorption, distribution, metabolism, excretion
d. Metabolism, distribution, absorption, excretion

12. The nurse is teaching the client about newly prescribed medication. Which statement made by
the client would indicated the need for further medication education?
a. "the liquid form of the drug will be absorbed faster than the tablets."
b. "If I take more, I'll have a better response"
c. "taking this drug with food will decrease how much gets into my system."
d. "I can consult my health care provider if i experience unexpected adverse effects"

13. The nurse is caring for several clients. Which client will the nurse anticipate is most likely to
experience an alteration in drug metabolism?
a. A 3 day old premature infant
b. A 22 year old pregnant female
c. A 32 year old man with kidney stones
d. A 50 year old executive with hypertension

14. A client is being discharged from the hospital with a nebulizer for self-administration of
inhalation medication. Which statement made by the client indicates to the nurse that the client
education has been successful?
a. "Inhaled medications should only be taken in the morning."
b. "Doses for inhaled medications are larger than those taken orally"
c. "Medicines taken by inhalation produce a very rapid response."
d. "Inhaled drugs are often rendered inactive by hepatic metabolism reaction”
15. The Nurse is caring for a client with hepatitis and resulting in hepatic impairment. The nurse
would expect the duration of action for most medications to:
a. Decrease
b. Improve
c. Be unaffected
d. Increase
 SAS 2

1. The nursery nurse is putting erythromycin ointment in the newborn’s eyes to prevent
infection. She places it in the following area of the eye:
a. Under the eyelid
b. On the cornea.
c. In the lower conjunctival sac
d. By the optic disc.

2. Nursing responsibilities in the assessment phase of the nursing process include which
responsibilities? (Select all that apply.)

a. Identify side effects of drugs that are nonspecific

b. Check peak and trough levels of drugs
c. Advise client to avoid fatty foods prior to ingesting an enteric coated tablet
d. Evaluate client's reaction to drug

3. The nurse is aware of the many factors related to effective health teaching about the
medication. The most essential component of the teaching plan is to do which?
a. Provide written instructions.
b. Establish a trust relationship.
c. Use colorful charts.
d. Review community resources.

4. A medication health teaching plan is tailored to a specific client. Common topics for health
teaching include which? (Select all that apply.)
a. Importance of adherence to the prescribed regimen
b. How to administer medication (s)
c. What side/adverse effects to report to the health care provider
d. Instruction of the client on what foods should be eaten

5. The nurse educator on the unit receives a list of high-alert drugs. Which strategies are
recommended to decrease the risk of errors with these medication? (Select all that apply.)
a. Store medications alphabetically on their usual shelf.
b. Limit access to these drugs.
c. Use special labels.
d. Provide increased information to staff.

6. Nurse is preparing to administer a medication to a 13-year-old client. The nurse follows the six
rights of medication administration for a pediatric client. After checking for the right client, the
right dose, the right drug, the right time and the right route, what is the final item the nurse must
check for this client?
a. Right age
b. Right Label
c. Right Documentation
d. Right strength
7. When performing an assessment about medication, the drug history should include:
a. Complete vital signs
b. Client’s goal of therapy
c. Reason for medication
d. Administration of OTC medications

8. The volume of SC medication must be no more than:

a. 0.5 mL
b. 1.0 mL
c. 1.5 mL
d. 3.0 mL

9. Which of the following muscles is a possible site for IM injections?

a. Outer aspect of the hip
b. Shoulder
c. Vastus gluteus
d. Vastus lateralis

10. When deciding on what time of day to give medications, the nurse pays closest attention to
the client’s habits regarding:
a. Eating
b. Sleeping
c. Elimination
d. Activity

11. Doctor’s Order: Tylenol supp 1 g pr q 6 hr prn temp > 101; Available: Tylenol supp 325 mg
(scored). How many supp will you administer?
a. 2 supp
b. 1 supp
c. 3 supp
d. 5 supp

12. Doctor’s Order: Nafcillin 500 mg po pc; Available: Nafcillin 1 gm tab (scored). How many tab
will you administer per day?
a. 2.5 tabs
b. 2 tabs
c. 1.5 tabs
d. 1 tab

13. Doctor’s Order: Synthroid 75 mcg po daily; Available: Synthroid 0.15 mg tab (scored). How
many tab will you administer?
a. 1 tab
b. 0.5 tab
c. 2 tabs
d. 1.5 tabs

14. Doctor’s Order: Diuril 1.8 mg/kg po tid; Available: Diuril 12.5 mg caps. How many cap will you
administer for each dose to a 31 lb child?
 a. 2 caps
b. 2.5 caps
c. 3 caps
d. 1.5 caps

15. Doctor’s Order: Cleocin Oral Susp 600 mg po qid; Directions for mixing: Add 100 mL of water
and shake vigorously. Each 2.5 mL will contain 100 mg of Cleocin. How many tsp of Cleocin will
you administer?
a. 3 tsp
b. 5 tsp
c. 3.5 tsp
d. 1 tsp
 SAS 3

1. The nurse is administering an anti-infective that is considered to be a bacteriocidal. Before

beginning therapy, the nurse should assess the client for:
a. Any neurologic abnormalities.
b. Cardiac history.
c. Hypersensitivity.
d. Respiratory conditions.

2. The client asks the nurse why the physician didn't prescribe the same antibiotic that he always
takes for an infection. The best response by the nurse would be:
a. "It doesn't matter which antibiotic is taken."
b. "Try this medicine, and if you're not better in 10 days, return to the office."
c. "You don't want to take the same antibiotic all the time."
d. "Bacteria can become resistant to some antibiotics.

3. A nurse is preparing to administer a broad-spectrum antibiotic medication to a client. An

important nursing intervention prior to administration regarding anti-infectives is:
a. Obtaining the culture report before starting any medication.
b. Performing a culture within 24 hours after starting the medication.
c. Performing the culture for evidence before administering the first dose of the anti-infective.
d. Administering medicine, and omitting performing cultures.

4. A client has been on an antibiotic for two weeks for treatment of an ulcer caused by
Helicobacter pylori. The client asks the nurse why a superinfection is caused by this medication.
The nurse responds:
a. "This is a secondary infection due to "Candida."
b. "The infection has developed immunity to the current drug."
c. "The infection has become severe."
d. "The infection has a restricted group of microorganisms."

5. A client has been discharged with a prescription for penicillin. Discharge instructions includes
which of the following?
a. Penicillin can be taken while breastfeeding.
b. The entire prescription must be finished.
c. All penicillin can be taken without regards to eating.
d. Some possible side effects include abdominal pain and diarrhea

6. An antimicrobial medication that has selective toxicity has which characteristic?

a. Ability to transfer DNA coding
b. Ability to suppress bacterial resistance
c. Ability to avoid injuring host cells
d. Ability to act against a specific microbe

7. The development of a new infection as a result of the elimination of normal flora by an antibiotic
is referred to as what?
a. Resistant infection
b. Superinfection
c. Nosocomial infection
d. Allergic reaction

8. A client has been prescribed tetracycline. When providing information regarding this drug, the
nurse would be correct in stating that tetracycline:
a. Is classified as a narrow-spectrum antibiotic.
b. Is used to treat a wide variety of disease processes.
c. Has been identified to be safe during pregnancy.
d. Is contraindicated in children under 8 years of age.

9. Important information to include in the client's education regarding taking aminoglycosides is

that:
a. The drug can cause discoloration of teeth.
b. Fluid intake should be decreased to prevent retention.
c. This drug primarily is given orally, because it is absorbed in the GI tract.
d. A serious side effect is hearing loss.

10. A client has been prescribed ciprofloxacin (Cipro). Important information that the nurse must
know includes:
a. This medicine must be taken on an empty stomach to increase absorption.
b. This medicine is classified as an aminoglycoside and is given for systemic bacterial infections.
c. This medicine should be given with an antacid to increase the absorption and effectiveness of the
medicine.
d. This medicine should not be given with the ordered multivitamin.

11. A nursing intervention for administering sulfamethoxazole-trimethoprim (Bactrim) to a client is

to:
a. Have the client drink a full glass of water with the medicine.
b. Have the client drink a glass of milk.
c. Have the client take the medicine with solid foods.
d. Have the client take the medicine on an empty stomach.

12. This antibiotic can have an adverse effect of dizziness, vertigo, and loss of hearing.
a. Chloramphenicol
b. Aminoglycoside
c. Vancomycin
d. Fluoroquinolones

13. A 60 year old male patient on fourth day of his antibiotic therapy complains of dizziness and
nausea. Which is themost appropriate nursing action?
a. Institute safety precaution and raise side rails.
b. Collaborate with the doctor about antibiotic therapy’s dosage and duration.
c. Provide comfort measures.
d. Instruct client to inform you if symptoms get worse.

14. A middle-aged woman came to the ER and complains of ringing in the ears, paresthesias of
the extremities, and erythema of the back. She also noticed that she had decreased urine output.
What history of drug intake should the nurse ask?
a. Oral contraceptive pills (OCPs)
b. Antifungals
c. Vancomycin
d. Trimethoprim-sulfamethoxazole

15. The physician orders penicillin for a patient with streptococcal pharyngitis. The nurse
administers the drug as ordered, and the patient has an allergic reaction. The nurse checks the
medication order sheet and finds that the patient is allergic to penicillin. Legal responsibility for
the error is:
a. Only the nurse’s—she should have checked the allergies before administering the medication.
b. Only the physician’s—she gave the order, the nurse is obligated to follow it.
c. Only the pharmacist’s—he should alert the floor to possible allergic reactions.
d. The pharmacist, physician, and nurse are all liable for the mistake
 SAS 4

1. A patient receiving topical antifungal complains of blisters in her perineum. Which is/are a
possible explanation(s) for this?
a. Fungal infection is not healing.
b. Patient is allergic to the drug.
c. Both A and B
d. None of the above

2. Which of the following will alert the nurse for possible adverse effect in patients receiving long-
term itraconazole therapy?
a. Central obesity
b. Cataract
c. Thickening of the skin
d. Pathologic U wave

3. An eight (8) month old infant is receiving antifungals. Which should be included in the nurse’s
health teaching to the mother?
a. Cover the area of lesions with diaper to prevent additional infection.
b. Make sure area is free from occlusive dressings.
c. Apply more topical cream on draining areas because it is where fungi are most
d. Advise that redness and rashes are negligible side effects of antifungal therapy and should not be a
cause of worry.

4. Which of these antifungals can be used in pregnant women?

a. Fluconazole
b. Nystatin
c. Ketoconazole
d. Amphotericin B

5. Arvic, a 16-year-old student, has acquired systemic fungal infection, he should be treated with:
a. Amphotericin B
b. Miconazole (Monistat IV)
c. Ketoconazole
d. Griseofulvin (Fulvicin)

6. Which of the following must always be present before beginning antifungal therapy?
a. Coagulation profile
b. Confirmed diagnosis
c. Biopsy of infected site
d. Urinalysis

7. A 32-year-old woman presents to her gynecologist with a 4 days history of perineal pruritus and
a non-malodorous, thick, cheesy vaginal discharge. The only medication the woman is taking is
an oral contraceptive. A wet preparation of vaginal secretion shows budding yeast cells and
pseudohyphae. Which of the following drugs, given locally, would be appropriate for this patient?
a. Mebendazole
b. Metronidazole
c. Miconazole
d. Saquinavir

8. The nurse sees a patient in the clinic who has been taking chloroquine for the treatment of
malaria. While the nurse measures vital signs, the patient repeatedly rubs her eyes. When the
nurse questions why, the patient says, "I guess it's time for a trip to the eye doctor. My glasses
don't seem to work very well and I'm having trouble with my vision." What does the nurse suspect
is happening with this patient?
a. Adverse effect of medication
b. Muscles controlling the eye are impacted by malaria
c. Chemical actions of the medication are reducing aqueous humor
d. Malaria infection is damaging optic tissue

9. The nurse is caring for a patient taking antimalarials for prophylaxis while serving in the Peace
Corps in Africa. The patient has taken the medication for 2 months and is continuing to lose
significant weight due to the GI effects of the drug. What recommendations can the nurse make to
reduce GI adverse effects and promote healthy nutrition for this patient (Select all that apply.)
a. Avoid alcohol.
b. Add extra fat to diet for calories.
c. Take the drug immediately after meals.
d. Eat 5 to 6 small meals a day.

10. An instructor is describing the action of primaquine. What would the instructor include?
a. The drug blocks the use of folic acid.
b. It changes the metabolic pathways for reproduction.
c. The drug increases the acidity of plasmodial food vacuoles.
d. It disrupts the mitochondria, killing the gametocytes.

SAS 5

1. Patient X has genital herpes and is using antiviral creams for her condition. Which of the
following is a potential side effect of the medication?
a. Vulvitis
 b. Headache
c. Dizziness
d. Staining of the skin

2. A 15 y/o patient came in for a severe case of respiratory flu and would need drug therapy.
Which of the following drugs should the nurse anticipate to be prescribed?
a. Acyclovir (Zovirax)
b. Amantadine (Symmetrel)
c. Abacavir (Ziagen)
d. Ganciclovir (Cytovene)

3. Which of the following antiviral agents is effective as treatment for H1N1?

a. Zidovudine
b. Acyclovir
c. Oseltamivir
d. Selzentry

4. A student nurse administering acyclovir was asked by the clinical instructor on how the drug
works. The student nurse would be correct by stating that this drug works in which way?
a. Unknown; but it is believed to be shedding the protein coat of the virus.
b. It competes with viral receptors found in the host cells
c. It takes away the necessary substances needed by viruses to form DNA chains
d. Trapping the viruses and disintegrating them directly

5. Which of the following prescribed antiviral should the nurse question for a patient with severe
hypokalemia?
a. Foscarnet
b. Cidofovir
c. Valganciclovir
d. Nevirapine

6. Which enzyme is essential for the maturation of infectious viruses?

a. Reverse transcriptase
b. Protease
c. Nucleosidase
d. CCR5-ase

7. A senior nurse would be correct to advise her colleague to monitor which parameter in patients
receiving cyclosporine and zidovudine at the same time?
a. Skin lesion, temperature, and color
b. Flu-like symptoms
c. Level of consciousness
d. CBC with differential count

8. The only protease inhibitor that is not teratogenic.

a. Darunavir
b. Indinavir
 c. Fosamprenavir
d. Saquinavir

9. Which of the following physical assessment findings will alert the nurse for anthelmintic drug
toxicity in elderly patients?
a. Muscle strength +2
b. Blunt liver edge upon palpation
c. 10 bowel sounds in one minute on right lower quadrant (RLQ) upon auscultation
d. Non-palpable spleen

10. Which drug is indicated for threadworm infections?

a. albendazole
b. ivermectin
c. pyrantel
d. mebendazole
 SAS 6

1. Chemotherapy dosing is usually based on the total body surface. What should the nurse
do before administering chemotherapy?
a. Get the body mass index (BMI).
b. Ask the client about intake and output.
c. Weigh and measure the height of the patient on the day of administration.
d. Ask the client for the height and weight.

2. The nurse is caring for of a client who is receiving a chemotherapy. Which of the following
would be expected as a result of the massive cell destruction that occurred from the
chemotherapy?
a. Leukopenia.
b. Anemia.
c. Thrombocytopenia.
d. Hyperuricemia.

3. Mitomycin (Mutamycin) is prescribed to a client with colorectal cancer. All of which are the
routes of administration, except?
a. Oral
b. Intravenous
c. Intravesical
d. Intraarterial

4. The client with a testicular cancer is being treated with Etoposide (Etopophos). Which of the
following side effect is specifically associated with this medication?
a. Chest pain
b. Edema
c. Alopecia
d. Orthostatic hypotension

5. The clinic nurse provides instructions to a client receiving an antineoplastic medication. When
implementing the plan, the nurse tells the client to?
a. To drink beverages containing alcohol in moderate amount during the evening.
b. To avoid hot foods and high fiber rich foods.
c. To take acetylsalicylic acid as needed for headache.
d. To consult with health care providers before receiving immunization.

6. The nurse is providing teachings to a client receiving cyclophosphamide (Cytoxan). The nurse
tells the client to which of the following?
a. Eat foods rich in potassium.
b. Increase fluid intake to 2-3 liters per day.
c. Take the medication with food.
d. Eat foods rich in purine.

7. The nurse is monitoring a patient receiving an Iv infusion of an antineoplastic medication.

During the infusion, the patient complains of pain and redness at the insertion site. The nurse
should take which actions? Select all that apply.
a. Reinsert the IV at a distal part of the same vein.
 b. Increase the flow rate of the medication.
c. Notify the physician.
d. Apply a heat or ice compress to the site.
e. Administer an antidote as prescribed.

8. The nurse is caring for a client receiving chemotherapy when an anaphylactic reaction occurs
from the medication. The nurse should take which actions? Select all that apply.
a. Stop the medication.
b. Remove the IV line.
c. Administer Oxygen.
d. Administer epinephrine.
e. Positioned the client in a reverse Trendelenburg position.

9. The nurse is caring for a client who is receiving Fluorouracil (Adrucil). Which of the following
symptoms would necessitate the nurse to immediate discontinuation of the medication?
a. Palmar-plantar erythrodysesthesia.
b. Ataxia.
c. Constipation.
d. Insomnia.

10. Nausea and vomiting are frequent adverse effects associated with antineoplastic therapy.
What should the nurse advise clients experiencing these unpleasant adverse effects?
a. Increase intake of dry or high-fiber foods, and foods that have a rough texture.
b. Consider relaxation techniques because these symptoms should improve over time.
c. Use antacids to relieve the irritation to the stomach, which should stop the nausea.
d. Try to maintain hydration and nutrition, which are very important during treatment.
 SAS 7

1. As a well-rounded health care provider, you know that corticosteroid therapy is indicated in all
of the following conditions except:
a. Osteoarthritis
b. Rrheumatoid arthritis
c. Systemic lupus erythematosus
d. Acute spinal cord injury

2. An appropriate nursing diagnosis for clients who are taking NSAIDs and anticoagulants would
be which of the following?
a. Risk for injury related to prolonged bleeding time, inhibition of platelet aggregation, and increased risk
of GI bleeding.
b. Potential for injury related to GI toxicity and decrease in bleeding time.
c. Altered protection related to GI bleeding and increasing platelet aggregation.
d. Risk for injury related to thrombocytosis prolonged prothrombin time.

3. Teaching has been adequate when a client being treated with acetylsalicylic acid states:
a. “I can crush the pills before i swallow them.”
b. “I should take the pills with antacids.”
c. “Taking the pills on an empty stomach will help absorption.”
d. “If the pills smell like vinegar, I should throw them out.”

4. Which of the following groups of clients are most at risk for GI bleeding from the use of
NSAIDs?
a. Clients with dysmenorrhea
b. Clients with headaches
c. Clients with arthritis
d. Clients with renal failure

5. Which of the following NSAIDs is used to prevent thrombosis?

a. Motrin
b. Toradol
c. Aspirin
d. Naproxen

6. To minimize the risk of dyspnea and GI bleeding, OTC ibuprofen is given:

a. IV
b. With orange juice
c. On an empty stomach
d. With meals

7. Nurse Kate is taking care of patients taking ibuprofen. Which of the following should be
included in her assessment and monitoring?
a. Blood pressure and bowel sounds
b. Weight and appetite
c. Muscle strength and range of motion
d. Respiratory rate, depth, and rhythm
8. The nurse is discussing vaccines with the mother of a 4-year-old child who attends a day care
center that requires the DTaP vaccine. The mother, who is pregnant, tells the nurse that she does
not want her child to receive the pertussis vaccine because she has heard that the disease is "not
that serious" in older children. What information will the nurse include when discussing this with
the mother?
a. If she gets the vaccine, both she and her 4 year-old child will be protected.
b. If the 4-year-old child contracts pertussis, it can be passed on to her newborn.
c. The vaccine will not be given to her child while she is pregnant.
d. Vaccinating the 4-year-old will provide passive immunity for her unborn child.

9. A woman who is pregnant tells the nurse she has not had any vaccines but wants to begin so
she can protect her unborn child. Which vaccine(s) may be administered to this patient?
a. Gardasil vaccine
b. Trivalent influenza vaccine
c. MMR vaccine
d. Varivax vaccine

10.A 4-year-old child is receiving amoxicillin (Amoxil) to treat otitis media and is in the clinic for a
well-child checkup on the last day of antibiotic therapy. The provider orders varicella (Varivax);
mumps, measles, and rubella (MMR); inactivated polio (IPV); and diphtheria, tetanus, and acellular
pertussis (DTaP) vaccines to be given. Which action by the nurse is correct?
a. Administer the vaccines as ordered.
b. Discuss giving the MMR vaccine in 4 weeks.
c. Hold all vaccines until 2 weeks after antibiotic therapy.
d. Recommend aspirin for fever and discomfort.

11.A 48-month-old child is scheduled to receive the following vaccines: MMR, Varivax, IPV, and
DTaP. The child's parents want the child to receive two vaccines today and the other two in 1
week. To accommodate the parents' wishes, the nurse will administer
a. DTaP and Varivax today and the MMR and IPV in 1 week.
b. IPV and MMR today and the Varivax and DTaP in 1 week.
c. MMR and DTaP today and the Varivax and IPV in 1 week.
d. MMR and Varivax today and the DTaP and IPV in 1 week.

12.The nurse is preparing to administer rotavirus vaccine to a 4-month-old infant. The nurse notes
that the infant received Rotarix vaccine at 2 months of age. The nurse will plan to administer
a. Rotarix today.
b. Rotarix today and again at age 6 months.
c. Rota Teq today.
d. Rota Teq today and again at age 6 months.

13.Which is an example of acquired passive immunity?

a. Administration of IgG to an unimmunized person exposed to a disease
b. Administration of an antigen via an immunization
c. Inherent resistance to a disease antigen
d. Immune response to an attenuated virus
14.The parent of a 12-month-old child who has received the MMR, Varivax, and hepatitis A
vaccines calls the clinic to report redness and swelling at the vaccine injection sites and a
temperature of 100.3° F. The nurse will perform which action?
a. Recommend aspirin or an NSAID for pain and fever.
b. Recommend acetaminophen and cold compresses.
c. Report these adverse effects to the Vaccine Adverse Event Reporting System (VAERS).
d. Schedule an appointment in clinic so the provider can evaluate the child.

15.A mother calls the pediatric clinic to ask when her daughter will receive the Varicella vaccine.
Your answer to her question is:
a. at 2, 4, and 6 months
b. at 12 months and 4-6 years
c. at 6 and 12 months
d. at 4 months and 4-6 years
 SAS 8

1. A client diagnosed with schizophrenia is slow to respond and appears to be listening to

unseen others. Which medication should a nurse expect a physician to order to address this type
of symptom?
A. Haloperidol (Haldol) to address the negative symptom
B. Clonazepam (Klonopin) to address the positive symptom
C. Risperidone (Risperdal) to address the positive symptom
D. Clozapine (Clozaril) to address the negative symptom

2. A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol) 50 mg bid,

benztropine (Cogentin) 1mg prn, and zolpidem (Ambien) 10 mg HS. Which client behavior would
warrant the nurse to administer benztropine?
A. Tactile hallucinations
B. Tardive dyskinesia
C. Restlessness and muscle rigidity
D. Reports of hearing disturbing voices

3. A client diagnosed with chronic schizophrenia presents in an emergency department (ED) with
uncontrollable tongue movements, stiff neck, and difficulty swallowing. The nurse would expect
the physician to recognize which condition and implement which treatment?
A. Neuroleptic malignant syndrome and treat by discontinuing antipsychotic medications
B. Agranulocytosis and treat by administration of clozapine (Clozaril)
C. Extrapyramidal symptoms and treat by administration of benztropine (Cogentin)
D. Tardive dyskinesia and treat by discontinuing antipsychotic medications

4. After taking chlorpromazine (Thorazine) for 1 month, a client presents to an emergency

department (ED) with severe muscle rigidity, tachycardia, and a temperature of 105oF (40.5C). The
nurse expects the physician to recognize which condition and implement which treatment?
A. Neuroleptic malignant syndrome and treat by discontinuing Thorazine and administering dantrolene
(Dantrium)
B. Neuroleptic malignant syndrome and treat by increasing Thorazine dosage and administering an
antianxiety medication
C. Dystonia and treat by administering trihexyphenidyl (Artane)
D. Dystonia and treat by administering bromocriptine (Parlodel)

5. A client diagnosed with schizophrenia takes an antipsychotic agent daily. Which assessment
finding should a nurseimmediately report to the client's attending psychiatrist?
A. Respirations of 22 beats/minute
B. Weight gain of 8 pounds in 2 months
C. Temperature of 104F (40C)
D. Excessive salivation

6. An aging client diagnosed with chronic schizophrenia takes an antipsychotic and a beta-
adrenergic blocking agent(propranolol) for hypertension. Understanding the combined side
effects of these drugs, which statement by a nurse is most appropriate?
A. "Make sure you concentrate on taking slow, deep, cleansing breaths."
B. "Watch your diet and try to engage in some regular physical activity."
C. "Rise slowly when you change position from lying to sitting or sitting to standing."
D. "Wear sunscreen and try to avoid midday sun exposure."

7. A client diagnosed with schizophrenia is prescribed clozapine (Clozaril). Which client

symptoms related to the side effects of this medication should prompt a nurse to intervene
immediately?
A. Sore throat, fever, and malaise
B. Akathisia and hypersalivation
C. Akinesia and insomnia
D. Dry mouth and urinary retention

8. If clozapine (Clozaril) therapy is being considered, the nurse should evaluate which laboratory
test to establish a baseline for comparison in order to recognize a potentially life-threatening side
effect?
A. White blood cell count
B. Liver function studies
C. Creatinine clearance
D. Blood urea nitrogen

9. During an admission assessment, a nurse notes that a client diagnosed with schizophrenia has
allergies to penicillin, prochlorperazine (Compazine), and bee stings. Based on this assessment
data, which antipsychotic medication would be contraindicated?
A. Haloperidol (Haldol), because it is used only in elderly patients
B. Clozapine (Clozaril), because of a cross-sensitivity to penicillin
C. Risperidone (Risperdal), because it exacerbates symptoms of depression
D. Thioridazine (Mellaril), because of cross-sensitivity among phenothiazines

10. A newly admitted client has taken thioridazine (Mellaril) for 2 years with good symptom
control. Symptoms exhibited on admission included paranoid delusions and hallucinations. The
nurse should recognize which potential cause for the return of these symptoms?
A. The client has developed tolerance to the antipsychotic medication.
B. The client has not taken the medication with food.
C. The client has not taken the medication as prescribed.
D. The client has combined alcohol with the medication.

11. A client rates anxiety at 8 out of 10 on a scale of 1 to 10, is restless, and has narrowed
perceptions. Which of the following medications would appropriately be prescribed to address
these symptoms? Select all that apply.
A. Chlordiazepoxide (Librium).
B. Clonazepam (Klonopin).
C. Lithium carbonate (lithium).
D. Clozapine (Clozaril).

12. A client diagnosed with generalized anxiety disorder is placed on clonazepam (Klonopin) and
buspirone (BuSpar). Which client statement indicates teaching has been effective?
A. The client verbalizes that the clonazepam (Klonopin) is to be used for long-term therapy in conjunction
with buspirone(BuSpar).
B. The client verbalizes that buspirone (BuSpar) can cause sedation and should be taken at night.
C. The client verbalizes that clonazepam (Klonopin) is to be used short-term until the buspirone (BuSpar)
takes full effect.
D. The client verbalizes that tolerance can result with long-term use of buspirone (BuSpar).

13. In which situation would benzodiazepines be prescribed appropriately?

A. Long-term treatment of posttraumatic stress disorder, convulsive disorder, and alcohol
withdrawal.
B. Short-term treatment of generalized anxiety disorder, alcohol withdrawal, and preoperative sedation.
C. Short-term treatment of obsessive-compulsive disorder, skeletal muscle spasms, and essential
hypertension.
D. Long-term treatment of panic disorder, alcohol dependence, and bipolar affective disorder: manic
episode.

14. A client recently diagnosed with generalized anxiety disorder is prescribed clonazepam
(Klonopin), buspirone (BuSpar),and citalopram (Celexa). Which assessment related to the
concurrent use of these medications is most important?
A. Monitor for signs and symptoms of worsening depression and suicidal ideation.
B. Monitor for changes in mental status, diaphoresis, tachycardia, and tremor.
C. Monitor for hyperpyresis, dystonia, and muscle rigidity.
D. Monitor for spasms of face, legs, and neck and for bizarre facial movements.

15. Which of the following symptoms are seen when a client abruptly stops taking diazepam
(Valium)? Select all that apply.
A. Insomnia.
B. Tremor
C. Delirium
D. Dry mouth
E. Lethargy.
 SAS 9

1. A secondary amine tricyclic antidepressant is prescribed for a patient. The medication will
significantly increase the availability of which neurotransmitter?
a. GABA
b. Glutamate
c. Serotonin
d. Norepinephrine

2. Nortriptyline (Aventyl) was prescribed for a 68-year-old patient diagnosed with depression and
insomnia. Benefits specific to use of nortriptyline would include:
a. Regular bowel movements.
b. Improved sleep pattern.
c. Weight loss.
d. Anhedonia.

3. Priority assessments for a patient beginning amitriptyline (Elavil) include:

a. Nausea, diarrhea, and irritability.
b. Seizures, agranulocytosis, and insomnia.
c. Headache, sexual dysfunction, and weight loss.
d. History of falls, arrhythmias, and blurred vision.

4. A 75-year-old patient with a long history of depression begins amitriptyline (Elavil) 100 mg/day.
The patient also takes a diuretic daily for hypertension. The highest priority nursing diagnosis is
risk for:
a. Falls related to dizziness and orthostatic hypotension.
b. Ineffective thermoregulation related to anhidrosis.
c. Infection related to suppressed white blood cell count.
d. Constipation related to slowed peristalsis.

5. A depressed patient prepares for discharge. The patient is prescribed desipramine (Norpramin)
and will have outpatient visits. The patient reports, "They gave me only a 1-week supply of my
medicine." Select the nurse's best reply.
a. "Federal law limits the amount you may be given at any one time."
b. "It will save you money if the drug doesn't work well for your symptoms."
c. "This is a way of ensuring that you will come in for your follow-up appointment."
d. "Prescribing a small amount of drug addresses our concerns for your continuing safety."

6. Evaluation of a patient's response after 1 week of tricyclic antidepressant therapy would be

expected to show:
a. No change in objective or subjective symptoms.
b. Increased appetite and weight gain.
c. Decreased suicidal ideation.
d. Improved mood and affect.

7. A patient diagnosed with depression who has reported vague suicidal ideation will stay at
home, have close family supervision, and make weekly visits to the health care provider.
Bupropion (Wellbutrin) is prescribed. What is the benefit of bupropion in this scenario?
a. It has antianxiety properties as well as antidepressant effects.
b. It lowers the seizure threshold to a lesser extent than TCAs.
c. There is reduced potential for lethal overdose.
d. It stimulates appetite and weight gain.

8. A patient with depression has taken an SSRI for 1 month. The nurse should use direct
questions to evaluate which potential side effect?
a. Aggressive impulses
b. Sexual dysfunction
c. Paranoid delusions
d. Weight gain

9. A patient prescribed fluoxetine (Prozac) is being changed to tranylcypromine (Parnate). The

nurse schedules a time lapse
between the last dose of fluoxetine and the first dose of tranylcypromine of at least:
a. 7 days.
b. 14 days.
c. 3 weeks.
d. 6 weeks.

10. A patient tells the nurse that he stopped taking sertraline (Zoloft) because the drug made him
impotent. The nurse can be most helpful by saying:
a. "Your doctor wants you to continue taking your medication."
b. "Have you talked with your therapist regarding your feelings about sex?"
c. "Let's talk with your doctor. Changing your medication might be a possibility."
d. "Our priority is to treat your depression. Impotence can be addressed in a few weeks."

11. A client is to receive a dose of fluphenazine hydrochloride (Prolixin) by intramuscular

injection. What is the most important nursing intervention related to the injection?
a. Massage the site vigorously after injection.
b. Administer the drug using Z-tracking.This document and the information thereon is the property of
c. Avoid rotating the injection sites.
d. Select a 22- to 23-gauge needle.

12. The client has been diagnosed with schizophrenia and is exhibiting a loss of function and
motivation. The nurse recognizes that these symptoms are categorized as:
a. Positive.
b. Paranoiac
c. Negative
d. Incoherent.

13. What is a common side effect for which the nurse must monitor during administration of both
phenothiazine and nonphenothiazine medications?
a. Hypertension
b. Renal failure
c. Increase in number of white blood cells
d. Extrapyramidal symptoms
14. The client with a major depressive disorder taking the selective serotonin reuptake inhibitor
(SSRI) fluoxetine (Prozac) calls the psychiatric clinic and reports feeling confused and restless
and having an elevated temperature. Which action should the psychiatric nurse take?
a. Determine if the client has flulike symptoms
b. Instruct the client to stop taking the SSRI
c. Recommend the client take the medication at night.
d. Explain that these are expected side effects

15. The client diagnosed with depression is prescribed phenelzine (Nardil), a monoamine oxidase
(MAO) inhibitor. Which
statement by the client indicates to the nurse the medication teaching is effective?
a. "I am taking the herb ginseng to help my attention span"
b. "I drink extra fluids, especially coffee and iced tea"
c. "I am eating three well-balanced meals a day"
d. "At a family cookout I had chicken instead of a hotdog"
 SAS 10

1. A nurse is providing instructions to a client is taking Doxapram (Dopram). Which of the

following statements made by the client needs further instructions?
A. “I need to take the medication before meals”.
B. “I need to take the medication at bedtime”.
C. “I need to avoid drinking coffee“.
D. “I will not chew or crush long acting form of the medications”.

2. Narcolepsy can be best explained as:

A. A sudden muscle weakness during exercise
B. Stopping breathing for short intervals during sleep
C. Frequent awakenings during the night
D. An overwhelming wave of sleepiness and falling asleep

3. Older adults who take long-acting sedatives or hypnotics are likely to experience:
A. Hallucinations
B. Ataxia
C. Alertness
D. Dyspnea

4. Which nursing diagnosis is appropriate for a patient who has received a sedative-hypnotic
agent?
A. Alteration in tissue perfusion
B. Fluid volume excess
C. Risk for injury
D. Risk for infection

5. A patient is admitted to the emergency department with an overdose of a barbiturate. The nurse
immediately prepares to administer which of the following from the emergency drug cart?
A. Naloxone HCl (Narcan
B. Activated charcoal
C. Flumazenil (Romazicon)
D. Ipecac syrup

6. During patient teaching, the nurse explains the difference between a sedative and hypnotic by
stating:
A. “Sedatives are much stronger than hypnotic drugs and should only be used for short periods of time.”
B. “Sedative drugs induce sleep, whereas hypnotic drugs induce a state of hypnosis.”
C. “Most drugs produce sedation at low doses and sleep (the hypnotic effect) at higher doses.”
D. “There really is no difference; the terms are used interchangeably.”

7. The patient’s chart notes the administration of dantrolene (Dantrium) immediately

postoperatively. The nurse suspects that the patient experienced:
A. Delirium tremens
B. Malignant hyperthermia
C. A tonic-clonic seizure
D. Respiratory arrest
8. Which of the following is an important nursing action for the administration of a benzodiazepine
as a sedative-hypnotic agent?
A. Use IM dosage forms for longer duration
B. Administer safely with other CNS depressants for insomnia
C. Monitor geriatric patients for the common occurrence of paradoxical reactions.
D. Evaluate for physical dependence that occurs within 48 hours of beginning the drug.

9. Pediatric and geriatric patients often react with more sensitivity to CNS depressants. This type
of sensitivity manifests itself in the development of which type of reaction?
A. Idiopathic
B. Teratogenic
C. Paradoxical
D. Psychogenic

10.Which of the following is an appropriate nursing intervention for patients who are receiving
CNS depressants?
A. Prevent any activity within the hospital setting while on oral muscle relaxants
B. Make sure that the patient knows that sedation should be minimal with these agents.
C. Cardiovascular stimulation, a common side effect, would lead to hypertension
D. Make sure the patient’s call light is close by in case of the need for assistance with activities.

11.Which of the following conditions characterizes rapid eye movement (REM) sleep?
A. Disorientation and disorganized thinking
B. Jerky limb movements and position changes
C. Pulse rate slowed by 5 to 10 beats/minute
D. Highly active brain and physiological activity levels.

12.Abrupt withdrawal of barbiturates can precipitate what medical condition?

A. Ascites
B. Hypertensive crisis
C. Status epilepticus
D. Coma

13. What drug refers to the ability to help patient feel calm and unaware of his environment?
A. Anesthesia
B. Sedatives
C. Hypnotics
D. Anxiolytics

14.What is the most commonly used anxiolytics.

A. Benzodiazepines
B. Diphenhydramine
C. Barbiturates
D. Buspirone

15.Which of the following medical condition(s) can be considered as contraindication(s) to use of

anxiolytics and hypnotics?
A. Psychosis
B. Alcoholic intoxication
C. Acute gastroenteritis
D. Both A and B
 SAS 11

1. A client with chronic pain reports to you, the charge nurse, that the nurse have not been
responding to requests for pain medication. What is your initial action?
A. Check the MARs and nurses’ notes for the past several days.
B. Ask the nurse educator to give an in-service about pain management.
C. Perform a complete pain assessment and history on the client.
D. Have a conference with the nurses responsible for the care of this client.

2. Family members are encouraging your client to “tough it out” rather than run the risk of
becoming addicted to narcotics. The client is stoically abiding by the family’s wishes. Priority
nursing interventions for this client should target which dimension of pain?
A. Sensory
B. Affective
C. Sociocultural
D. Behavioral
E. Cognitive

3. A client with diabetic neuropathy reports a burning, electrical-type in the lower extremities that
is not responding to NSAIDs. You anticipate that the physician will order which adjuvant
medication for this type of pain?
A. Amitriptyline (Elavil)
B. Corticosteroids
C. Methylphenidate (Ritalin)
D. Lorazepam (Ativan)

4. Which client is most likely to receive opioids for extended periods of time?
A. A client with fibromyalgia
B. A client with phantom limb pain
C. A client with progressive pancreatic cancer
D. A client with trigeminal neuralgia

5. In caring for a young child with pain, which assessment tool is the most useful?
A. Simple description pain intensity scale
B. 0-10 numeric pain scale
C. Faces pain-rating scale
D. McGill-Melzack pain questionnaire

6. In applying the principles of pain treatment, what is the first consideration?

A. Treatment is based on client goals.
B. A multidisciplinary approach is needed.
C. The client must be believed about perceptions of own pain.
D. Drug side effects must be prevented and managed.

7. A client appears upset and tearful, but denies pain and refuses pain medication, because “my
sibling is a drug addict and has ruined out lives.” What is the priority intervention for this client?
A. Encourage expression of fears on past experiences.
B. Provide accurate information about use of pain medication.
C. Explain that addiction is unlikely among acute care clients.
D. Seek family assistance in resolving this problem.

8.It is a rare type of seizure that appears sporadically.

A. Febrile seizure
B. Myoclonic seizure
C. Jacksonian seizure
D. Absence seizure

9. Which antiseizure agents is used to treat absence seizures?

A. Hydantoins
B. Benzodiazepines
C. Barbiturates
D. Succinimides

10.A patient on Dilantin began showing bruises and signs of active infection. The nurse would be
right to anticipate that these manifestations give clue to ________________.
A. Drug underdosage
B. Hypersensitivity reactions
C. Cellular toxicity
D. None of the above

11. Which barbiturate is also indicated for management of anxiety?

A. mephobarbital
B. primidone
C. phenobarbital
D. mysoline

12.Benzodiazepines exert their effect primarily on which neurotransmitter?

A. GABA
B. Serotonin
C. Norepinephrine
D. Both A and B

13.The client is prescribed phenytoin (Dilantin), an anticonvulsant, for a seizure disorder. Which
statement indicates the client understands the discharge teaching concerning this medication?
A. "I will brush my teeth after every meal."
B. "I will check my Dilantin level daily."
C. "My urine will turn orange while on Dilantin."
D. "I won't have any seizures while on this medication."

14.The client is admitted to the intensive care department (ICD) experiencing status
epilepticus. Which collaborative intervention should the nurse anticipate?
A. Assess the client's neurological status every hour.
B. Monitor the client's heart rhythm via telemetry.
C. Administer an anticonvulsant medication by intravenous push.
D. Prepare to administer a glucocorticosteroid orally.

15.The client has been newly diagnosed with epilepsy. Which discharge instructions should be
taught to the client? Select
all that apply.
A. Keep a record of seizure activity.
B. Take tub baths only; do not take showers.
C. Avoid over-the-counter medications.
D. Have anticonvulsant medication serum levels checked regularly.
E. Do not drive alone; have someone in the car.
 SAS 12

1. A client with myasthenia gravis has become frequently complaining of weakness and fatigue.
The physician plans to identify whether the client is responding to an overdose of the medication
or a worsening of the disease. A tensilon test is performed. Which of the following would indicate
that the client is experiencing an overdose of the medication?
A. Temporarily worsening of the condition.
B. Improvement of the weakness and fatigue.
C. No change in the condition.
D. Complaints of muscle spasms.

2. The diagnostic work-up of a client hospitalized with complaints of progressive weakness and
fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia
gravis is:
A. Prostigmine (neostigmine)
B. Atropine (atropine sulfate)
C. Didronel (etidronate)
D. Tensilon (edrophonium)

3. Karina a client with myasthenia gravis is to receive immunosuppressive therapy. The nurse
understands that this therapy is effective because it:
A. Promotes the removal of antibodies that impair the transmission of impulses
B. Stimulates the production of acetylcholine at the neuromuscular junction.
C. Decreases the production of autoantibodies that attack the acetylcholine receptors.
D. Inhibits the breakdown of acetylcholine at the neuromuscular junction.

4. Myasthenia gravis is due to ____ receptors being blocked and destroyed by antibodies.
A. Epinephrine
B. Nicotinic
C. Acetylcholine
D. Transient

5. A client with myasthenia gravis has been receiving Neostigmine (Prostigmin). This drug acts
by:
A. Stimulating the cerebral cortex
B. Blocking the action of cholinesterase
C. Replacing deficient neurotransmitters
D. Accelerating transmission along neural swaths

6. The most significant initial nursing observations that need to be made about a client with
myasthenia include:
A. Ability to chew and speak distinctly
B. Degree of anxiety about her diagnosis
C. Ability to smile an to close her eyelids
D. Respiratory exchange and ability to swallow

7. In making a diagnosis of myasthenia gravis Edrophonium HCI (Tensilon) is used. The nurse
knows that this drug will cause a temporary increase in:
A. Muscle strength
B. Symptoms
C. Blood pressure
D. Consciousness

8. A nurse is instructing a client regarding Carbidopa-levodopa (Sinemet) for the treatment of

Parkinson’s disease. The nurse tells the client that which of the following is a side effect of the
medication?
A. Difficulty performing a voluntary movement.
B. Increased blood pressure.
C. Increased heart rate.
D. Itchiness of the skin.

9. A nurse is giving dietary instructions to a client receiving levodopa. Which of the following food
items should be avoided by the client?
A. Goat yogurt.
B. Whole grain cereal.
C. Asparagus.
D. Apples

10. Biperiden hydrochloride (Akineton) is added to a list of antiparkinsonian medications that an

elderly client is taking. Which of the following instructions made by the nurse that needs further
learning?
A. To avoid smoking, alcohol and caffeine.
B. To use ice chips, candy or gum for dry mouth.
C. Walking in the morning to have a daily source of direct sunlight.
D. Eating foods rich in fiber and increase fluid intake.

11. What is the goal of therapy for Parkinson’s disease?

A. To decrease dopamine and to increase cholinergic neurons
B. To balance dopamine and cholinergic neurons
C. To excite neurons more
D. To inhibit neurons more

12. What is the mainstay of treatment for Parkinson’s?

A. Symmetrel
B. Levodopa
C. Cogentin
D. Parlodel

13. The drug of choice in children with parkinsonian symptom.

A. Levodopa
B. Artane
C. Benadryl
D. Benztropine

14. Which can decrease efficacy of levodopa?

A. Phenytoin
B. Pyridoxine
C. Niacin
D. Both A and B

15. A construction worker for 10 years is about to receive anticholinergics. What should the nurse
consider in handling this patient?
A. Do not give the drug to the patient.
B. Administer it with caution.
C. Discuss it with the doctor and have the order changed.
D. Arrange for a possible increase in the dose.
 SAS 13

1. All of the following are true about dopamine and dobutamine, except:
A. They bind to both alpha- and beta-receptors
B. They can increase heart rate and cause bronchoconstriction
C. Dopamine is the sympathomimetic of choice for shock
D. Administration of these drugs can put patients with peripheral cardiovascular disease into
exacerbation

2. The sympathomimetic found in many OTC cold products.

A. Salmeterol
B. Albuterol
C. Phenylephrine
D. Terbutaline

3. Nurse Jake was doing his usual morning routine care for his patient receiving parenteral
isoproterenol when he noticed a developing extravasation in the site. Which is the best nursing
action for this situation? A. Provide skin care and warm compress because it will subside in 1-2 hours.
B. Explain to the client that it is an expected side effect of the drug.
C. Document and endorse to next nurse on duty because extravasation need long hours of observation
before an appropriate course of nursing actions can be determined.
D. Inject 10 mL of saline with 5 mg of phentolamine to save the area from necrosis.

4. This drug is used to control hypertension and is used as an epidural infusion for patients
suffering from cancer pain.
A. Midodrine
B. Clonidine
C. Albuterol
D. Isoproterenol

5. A pregnant patient on 32 weeks age of gestation came rushing to the emergency complex
because of increased watery discharge and frequent uterine contractions. Upon physical
examination, patient was confirmed to have ruptured of membranes and is in preterm labor.
Which of the additional PE findings will render beta-agonists contraindicated as part of her
management for uterine relaxation?
A. HbA1c of 6
B. Blood pressure of 150/70 mmHg and +3 proteinuria
C. BUN: 10 mg/dL
D. Few to many pus cells in urinalysis

6. Student Nurse Aimee is reviewing for her licensure exam. She would be right to pick which drug
pairing (classification and corresponding example)?
A. Alpha1-selective adrenergic blocking agent: phentolamine
B. Nonselective adrenergic blocking agent: labetalol
C. Nonselective alpha-adrenergic blocking agent: doxazosin
D. Nonselective beta-adrenergic blocking agent: metoprolol

7. Which of the following drugs can improve urine flow in males?

A. Prazosin
 B. Nebivolol
C. Labetalol
D. Amiodarone

8. Nurse Sam is taking care of a patient on carvedilol therapy. Which parameter should he monitor
regularly to assess for possible dose adjustment?
A. Serum sodium level
B. Hemoglobin and hematocrit
C. SGPT
D. BUN

9. Mrs. Smith, a 40-year-old patient, came in due to acute hypertensive episode. Her chart says
she is asthmatic. Which of the following drugs would be safest to give?
A. Nebivolol
B. Timolol
C. Propranolol
D. Atenolol

10. Which of the following drug is used for diagnosis of pheochromocytoma?

A. Amiodarone
B. Phentolamine
C. Tamsulosin
D. Acebutolol

11. Your patient with asthma is taking Theophylline. Which product below should the patient avoid
consuming?
A. Caffeine
B. Dairy
C. Wheat
D. Shellfish

12. Which medication below blocks the function of Leukotriene for the treatment of asthma?*
A. Salmeterol
B. Theophylline
C. Tiotropim
D. Montelukast

13. A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term
management of asthma. You observe the patient taking these medications. Which option below
best describes the correct order in how to take these medications?
A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone.
B. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the Salmeterol.
C. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the Fluticasone.
D. The patient inhales the Fluticasone and immediately inhales the Salmeterol.

14. Epinephrine is used to treat cardiac arrest and status asthmaticus because of which of the
following actions?
A. Increased speed of conduction and gluconeogenesis
B. Bronchodilation and increased heart rate, contractility, and conduction
 C. Increased vasodilation and enhanced myocardial contractility
D. Bronchoconstriction and increased heart rate

15. Your patient is having a sudden and severe anaphylactic reaction to a medication. You
immediately stop the medication and call a rapid response. The patient’s blood pressure is 80/52,
heart rate 120, and oxygen saturation 87%. Audible wheezing is noted along with facial redness
and swelling. As the nurse you know that the first initial treatment for this patient’s condition is?
A. IV Diphenhydramine
B. IV Normal Saline Bolus
C. IM Epinephrine
D. Nebulized Albuterol
 SAS 14

1. The following are true about cholinergic agonists, except:

A. These drugs exert their effect by mobilizing the acetylcholine into their receptors found throughout
the body.
B. Some of their effects include vasodilation, bronchoconstriction, and bladder relaxation.
C. Ophthalmic agents can induce miosis or pupil constriction.
D. Edrophonium is used for diagnosis of myasthenia gravis only.

2. All of the following are direct-acting cholinergic agonists, except:

A. Pilocarpine
B. Neostigmine
C. Carbachol
D. Cevimeline

3. This drug is usually indicated for postoperative and postpartum urinary retention as well as
bladder atony.
A. Carbachol
B. Bethanechol
C. Tacrine
D. Pyridostigmine

4. Which of the following is an indication for withholding indirect-acting cholinergic agonists?

A. Visual acuity of 20/150
B. Blood pressure of 140/90 mmHg
C. GFR of 30 mL/hour
D. Adult heart rate of 55 beats per minute

5. A patient on neostigmine complained of frequent diarrhea and salivation. Which is the best
nursing action for this situation?
A. Educate client about drug therapy to alleviate anxiety as these are expected drug effects.
B. Withhold the dose of the drug and refer to physician.
C. Arrange for increasing the dose of the drug as it is not effective.
D. Document patient response and endorse accordingly for bedside care.

6. Anticholinergic drugs are used

A. To allow the sympathetic system to dominate
B. To block the parasympathetic system, which is commonly hyperactive
C. As the drugs of choice for treating ulcers
D. To stimulate GI activity

7. Atropine and scopolamine work by blocking what receptor(s) in the parasympathetic nervous
system?
A. Nicotinic receptors only
B. Muscarinic and nicotinic receptors
C. Muscarinic receptors only
 D. Adrenergic receptors to allow cholinergic receptors to dominate

8. Which of the following suggestions would the nurse make to help a patient who is receiving an
anticholinergic agent reduce the risks associated with decreased sweating?
A. Covering the head and using sunscreen
B. Ensuring hydration and temperature control
C. Changing position slowly and protecting from the sun
D. Monitoring for difficulty swallowing and breathing

9. Which of the following would the nurse be least likely to include when developing a teaching
plan for a patient who is receiving an anticholinergic agent?
A. Encouraging the patient to void before dosing
B. Setting up a bowel program to deal with constipation
C. Encouraging the patient to use sugarless lozenges to combat dry mouth
D. Performing exercises to increase the heart rate

10. Remembering that anticholinergics block the effects of PNS, the nurse would question an
order for an anticholinergic drug for patients with which of the following conditions?
A. Biliary spasms
B. Bradycardia
C. Glaucoma
D. Asthma

11. The nurse, caring for a client receiving a cholinergic drug, should observe for increased
symptoms of which of the following processes?
A. Hypertension
B. Heart failure
C. Cardiac dysrhythmias
D. Asthma

12. A client diagnosed with Alzheimer's disease is prescribed donzepil (Aricept) for treatment. The
client has a medical history of osteoarthritis and GERD. For what possible complications of this
drug therapy should the nurse assess in the client?
A. Tachycardia
B. Bradycardia
C. Aspiration
D. Muscle pain

13. Pyridostigmine (Mestinon) is prescribed for a client diagnosed with myasthenia gravis. Priority
nursing assessment includes assessing the:
A. Ability to chew and swallow.
B. Vital signs.
C. Urinary status.
D. Bowel motility.

14. The nurse provides preoperative teaching for a client on the side effects of atropine given as a
preoperative medication. The nurse informs the client to expect:
A. Decreased heart rate.
B. Dry mouth.
 C. Sedation.
D. Increased urination

15. Anticholinergic drugs like atropine are given preoperatively to:

A. Minimize the amount of analgesia needed postoperatively.
B. Provide a more rapid induction of anesthesia
C. Decrease the risk of bradycardia during surgery.
D. Induce relaxation prior to induction of anesthesia.

SAS 15
1. Treatment with ADH preparations is associated with adverse effects, including
A. “hangover symptoms” like headache and sweating
B. constipation and paralytic ileus
C. cholecystitis and bile obstruction
D. nocturia and bedwetting

2. Which of the following is true regarding growth hormone (GH) deficiencies?

A. It occurs only in children.
B. It always results in dwarfism.
C. It is treated only in children because GH is usually produced only until puberty.
D. It can occur in adults as well as children.

3. Which of the following drugs can increase the toxicity of bromocriptine?

A. Phenothiazine
B. Opioids Erythromycin
C. Statins

4. This is the most common type of thyroid dysfunction.

A. Cretinism
B. Myxedema coma
C. Hyperthyroidism
D. Hypothyroidism

5. What does thyroid hormones do?

A. stimulate overproduction of TSH
B. increase oxygen consumption
C. increase the heart rate without affecting the respirations
D. retard growth and maturation

6. All of the following should be included in the nursing interventions for patients taking
thyroid hormones, except:
A. consistent administration before breakfast each day
B. monitor cardiac response
C. advise patient to frequently exercise to develop the core
D. provide for temperature control and safety precautions
7. Which of the following is the antithyroid agent of choice for pregnant women.
A. Methimazole
B. PTU
C. Levothyroxine
D. iodine solution

8. Which of the following history data will possibly render strong iodine products
contraindicated for the patient?
A. 35 years old
B. history of blood-tinged sputum for the past three weeks
C. intake of oral anticoagulants
D. both B and C

9. A patient taking calcitriol is also prescribed with a magnesium-containing antacid.

Which of the following should be included in the nurse’s monitoring?
A. Color of stool
B. Signs of bleeding
C. Liver function test
D. Serum electrolyte level

10. Which of the following should be included in patient teaching of patients taking
bisphosphonates?
A. Stay upright 30 minutes after taking the drug.
B. Take drug on empty stomach.
C. Chew drug instead of swallowing.
D. Both B and C

11. Common adverse effects of calcitonin include:

A. Headache
B. Flushing of the face and hands
C. Abdominal tenderness
D. Diarrhea

12. This is a genetically-linked condition with parathyroid dysfunction characterized by

deep bone pain, headaches, and
hearing loss.
A. Tay-Sachs disease
B. Paget’s disease
C. Gaucher disorder
D. Marfan Syndrome

13. Glucocorticoids can reduce inflammation and suppress the immune system by:
A. forming complex reactions needed to reduce inflammation
B. activating more lymphocytes to reduce inflammation
C. inhibiting the localization of phagocytes so immune system can rest
D. all of the above
14. A patient is started on a regimen of prednisone because of a crisis in her ulcerative
colitis. Nursing care of this patient would need to include:
A. immunizations to prevent infections
B. increased calories to deal with metabolic changes
C. fluid restriction to decrease water retention
D. administration of the drug around 8 or 9 AM to mimic normal diurnal rhythm.

15. Which of the following patient complaint(s) will alert the nurse for possible aldosterone
toxicity?
A. muscle weakness and abdominal fullness
B. BP of 80/60 mmHg
C. parched skin and dry mucous membranes
D. all of the above

SAS 16

1. Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what
this means. What is the best response by the nurse? Select all that apply.
A. “Your alpha cells should be able to secrete insulin, but cannot.”
B. “The exocrine function of your pancreas is to secrete insulin.”
C. “Without insulin, you will develop ketoacidosis (DKA).”
D. “The endocrine function of your pancreas is to secrete insulin.”
E. “It means your pancreas cannot secrete insulin.”

2. Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563.
Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best
evaluation of the nurse reveal? Select all that apply.
A. The nurse could have given the insulin subcutaneously.
B. The nurse should have contacted the physician.
C. The nurse should have used regular insulin (Humulin R).
D. The nurse used the correct insulin.

3. Ben injects his insulin as prescribed, but then gets busy and forgets to eat. What will
the best assessment of the nurse reveal?
A. The client will be very thirsty.
B. The client will complain of nausea.
C. The client will need to urinate.
D. The client will have moist skin.

4. A clinical instructor teaches a class for the public about diabetes mellitus. Which
individual does the nurse assess as
being at highest risk for developing diabetes?
A. The 50-year-old client who does not get any physical exercise
B. The 56-year-old client who drinks three glasses of wine each evening
C. The 42-year-old client who is 50 pounds overweight
D. The 38-year-old client who smokes one pack of cigarettes per day
5. Steven John has type 1 diabetes mellitus and receives insulin. Which laboratory test will
the nurse assess?
A. Potassium
B. AST (aspartate aminotransferase)
C. Serum amylase
D. Sodium

6. Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse
with regard to patient education with this drug? Select all that apply.
A. It stimulates the pancreas to produce more insulin.
B. It must be taken with meals.
C. It decreases sugar production in the liver.
D. It inhibits absorption of carbohydrates.
E. It reduces insulin resistance.

7. Nurse Andy has finished teaching a client with diabetes mellitus how to administer
insulin. He evaluates the learning has occurred when the client makes which statement?
A. “I should check my blood sugar immediately prior to the administration.”
B. “I should provide direct pressure over the site following the injection.”
C. “I should use the abdominal area only for insulin injections.”
D. “I should only use calibrated insulin syringe for the injections.”

8. Genevieve has diabetes type 1 and receives insulin for glycemic control. She tells the
nurse that she likes to have a glass of wine with dinner. What will the best plan of the
nurse for client education include?
A. The alcohol could cause pancreatic disease.
B. The alcohol could cause serious liver disease.
C. The alcohol could predispose you to hypoglycemia.
D. The alcohol could predispose you to hyperglycemia.

9. Dr. Wijangco orders insulin lispro (Humalog) 10 units for Alicia, a client with diabetes
mellitus. When will the nurse administer this medication?
A. When the client is eating
B. Thirty minutes before meals
C. fifteen minutes before meals
D. When the meal trays arrive on the floor

10. Nurse Matt makes a home visit to the client with diabetes mellitus. During the visit,
Nurse Matt notes the client’s additional insulin vials are not refrigerated. What is the best
action by the nurse at this time?
A. Instruct the client to label each vial with the date when opened.
B. Tell the client there is no need to keep additional vials.
C. Have the client place the insulin vials in the refrigerator.
D. Have the client discard the vials.
11. During the morning rounds, Nurse AJ accompanied the physician in every patient’s
room. The physician writes orders for the client with diabetes mellitus. Which order would
the nurse validate with the physician?
A. Use Humalog insulin for sliding scale coverage.
B. Metformin (Glucophage) 1000 mg per day in divided doses.
C. Administer regular insulin 30 minutes prior to meals.
D. Lantus insulin 20U BID.

12. An older woman with diabetes mellitus visits the clinic concerning her condition. Of
which of the following symptoms might an older woman with diabetes mellitus complain?
A. Anorexia
B. Pain intolerance
C. Weight loss
D. Perineal itching

13. Which of the following exerts its effect by inhibiting the enzyme that breaks down
glucose for absorption?
A. Miglitol
B. Metformin
C. Pramlintide
D. Linagliptin

14. This antidiabetic agent works best in patients with insulin resistance.
A. Biguanides
B. Dipeptidyl peptidase-4 inhibitors
C. Thiazolidinediones
D. Meglitinides

15. Which antidiabetic agent works by modulating gastric emptying after a meal to cause a
feeling of fullness?
A. Incretin mimetics
B. Meglitinides
C. Human amylin
D. Biguanides

SAS 17

1. The three primary elements that determine the pressure in the cardiovascular system are heart
rate, stroke volume, and:
A. Baroreceptors
B. Peripheral resistance
C. Renin-Angiotensin-Aldosterone System (RAAS)
D. All of the above

2. Untreated hypertension can result to which of the following:

A. Stroke
B. Renal failure
C. Loss of vision
D. All of the above
3. A student nurse was asked to take the blood pressure of a patient in the emergency room. The
BP reads 140/90 mmHg. She would be correct to say that this BP belongs to ____________
classification.
A. Normal
B. Elevated
C. Stage 1 Hypertension
D. Stage 2 Hypertension

4. Which of the following medications will decrease the therapeutic effects of quinapril (Accupril)?
A. NSAIDs
B. Allopurinol
C. Antacids
D. All of the above

5. A patient receiving nitroprusside begun manifesting headache, distant heart sounds,

imperceptible pulses, and shallow
breathing. The nurse knows that these are signs of?
A. Reflex tachycardia
B. Hypothyroidism
C. Cyanide toxicity
D. Severe alteration of blood pressure

6. The nurse is administering antihypertensive drugs to older adults patients. the nurse knows
which adverse effect is of most concern for these patients?
A. dry mouth
B. hypotension
C. restlessness
D. constipation

7. Which of the following objective data should the nurse consider when determining the
effectiveness of the drug therapy?
A. Blood pressure log notes blood pressure 120/70-134/88 since discharge.
B. Weight loss of six pounds in the past month
C. Frequency of voiding of at least six times per day
D. Absence of edema in lower extremities

8. A client receiving HCTZ 25 mg q.d. and digoxin 0.125 mg q.d. complains of nausea and
vomiting, and of seeing halos around lights. The client's serum digoxin level is 2.5 ng. The
appropriate nursing intervention is to:
A. Administer both drugs as ordered.
B. Document the findings; the lab results are within normal limits.
C. Hold the digoxin and HCTZ.
D. Hold the digoxin, and give HCTZ as ordered.

9. Nitroprusside (Nitropress) is prescribed for a client admitted with a blood pressure of 220/110.
What action by a new
nurse would require intervention by the charge nurse?
A. The nurse inserts a Foley catheter.
B. The nurse documents the IV rate and status of site every 15 minutes.
C. The nurse uses electronic monitoring of blood pressure every hour.
D. The nurse cautions the client to call for assistance before getting out of bed.

10. The nurse reviews the teaching plan with a client receiving nifedipine (Procardia). Which of
the following client indicates understanding?
A. The client avoids taking the drug with grapefruit juice.
B. The client consumes three servings of alcohol daily.
C. The client breaks an enteric-coated tablet for ease of swallowing.
D. The client monitors blood pressure every week.

11. A diuretic is added to the treatment regimen for a client with hypertension. The nurse explains
that diuretics help reduce blood pressure by:
A. Removing serum potassium.
B. Dilating peripheral blood vessels.
C. Reducing sympathetic outflow.
D. Constricting blood vessels.

12. Atenolol (Tenormin) is prescribed for a client with hypertension. The nurse recognizes that a
safe dose for this drug is:
A. Atenolol (Tenormin) 100 mg b.i.d.
B. Atenolol (Tenormin) 150 mg q.d.
C. Atenolol (Tenormin) 50 mg b.i.d.
D. Atenolol (Tenormin) 75 mg b.i.d.

13. Nifedipine (Procardia) 30 mg p.o. is prescribed for a client. The nurse teaches the side effects
and instructs the client
to immediately report:
A. Blood pressure 110/70-114/78 for two successive readings.
B. Dizziness when changing positions.
C. Increased shortness of breath and orthopnea.
D. Weight loss of two pounds per week.

14. The client is taking atenolol (Tenormin) and doxazosin (Cardura). what is the rationale for
combining 2 anti-HT drugs?
A. BP will decrease faster
B. Lower doses of both drugs may be given with fewer adverse effects.
C. There is less daily medication dosing.
D. Combination therapy will treat the patient's other medical conditions.

15. What health teaching should the nurse provide for the client receiving nadolol (Corgard)?
A. Increase fluids & fiber to prevent constipation
B. Report weight gain of 1kg / month or more
C. Immediately stop taking meds if sexual dysfunction occurs.
D. Rise slowly after prolonged periods of sitting or lying down.
 SAS 18

1. Nursing student Annie was assigned in the cardiovascular unit A wherein all the patients have
heart failure. Ms. Annie Is aware that the primary treatment for heart failure (HF) is which of the
following?.
A. Increasing the heart rate so the heart can pump more blood
B. Decreasing the heart rate so the heart can rest
C. Increasing contractility so the heart will be able to pump more blood
D. Decreasing contractility to prevent muscle fatigue

2. Which of the following is the most common cause of heart failure?

A. Hypertension
B. Valvular heart diseases
C. Cardiomyopathy
D. Coronary artery disease (CAD)

3. Digoxin was prescribed to a patient with ventricular tachycardia. What should the nurse do?
A. Administer the drug as ordered.
B. Discuss the order with the doctor.
C. Discontinue other intravenous medications before administering digoxin.
D. Count apical pulse for one full minute before administering.

4. What is the antidote for digoxin intoxication?

A. Diphenhydramine
B. Atropine sulfate
C. Digoxin immune fab (Digibind, DigiFab).
D. Phosphodiesterase inhibitors

5. An infant who is receiving cardiac glycosides has an apical pulse of 80 beats per minute.
Which is the best nursing intervention for this assessment finding?
A. Administer drug as ordered.
B. Withdraw the drug and notify doctor.
C. Assess apical pulse every hour for the next five hours.
D. Decrease drug dose and administer.

6. What signals the novice nurse that intravenous milrinone was combined to furosemide in
management of patients with heart failure?
A. Presence of bubbles
B. Pink discoloration of the solution
C. Formation of precipitates
D. No obvious sign. Solution is clear.

7. What is the therapeutic level for digoxin?

A. 0.5-2 ng/Ml
B. 1.5-2 ng/mL
C. 0.5-1.5 mg/mL
D. 0.5-2 mg/Ml
.
8. In severe cardiac glycoside toxicity, all of the following should be in the bedside, except
_________.
A. Lidocaine
B. Phenytoin
C. Calcium channel blocker
D. A and B only

9. Type of angina which involves spasm of the blood vessels

A. Stable angina
B. Pre-infarction angina
C. Unstable angina
D. Prinzmetal angina

10. Which instruction should be included in the discharge teaching for a patient with a
transdermal nitroglycerin (Nitro-Dur) patch?
A. "If you get chest pain, apply a second patch next to the first patch."
B. "If you get a headache, remove the patch for 4 hours and then reapply."
C. "Make sure to rub a lotion or cream on the skin before putting on a new patch."
D. "Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder."

11. Contraction and relaxation in each cardiac cycle is controlled by:

A. autonomic nervous system
B. the heart
C. cranial nerves
D. central nervous system

12. All of the following can cause arrhythmia, except:

A. Acidosis
B. respiratory depression
C. hyperkalemia
D. none of the above

13. Verapamil and diltiazem belong to which class of antiarrhythmics?

A. Class IV
B. Class III
C. Class Ia
D. Class II

14. The conduction system of the heart include the following:

A. Sinoatrial node
B. Bundle of Purkinje
C. His Fibers
D. Atriomyocardial node

15. The patient states to the nurse, "My friend said nitroglycerin relieves angina pain by reducing
preload. What is
preload?" Which statement by the nurse explains preload to this patient?
A. "It is the blood return to the heart."
B. "It is the oxygen demand of the heart."
C. "It is the pressure against which the heart must pump."
D. "It is dilation of arteries and veins
 SAS 19

1. Lipid levels of individuals with coronary artery disease (CAD) is usually high. All of the following
are factors of CAD, except:
A. Men
B. Gout
C. Untreated Chlamydia infections
A. None of the above

2. Which assessment finding in a patient taking an HMG-CoA reductase inhibitor will the nurse
act on immediately?
A. Decreased haemoglobin
B. Elevated liver function tests
C. Elevated HDL
D. Elevated LDL

3. A patient is taking pravastatin sodium. Which assessment finding requires immediate action by
the nurse?
A. Headache
B. Slight nausea
C. Muscle pain
D. Fatigue

4. Antihyperlipidemic agent that is used to decrease plasma cholesterol levels.

A. HMG-CoA reductase inhibitors
B. Phosphodiesterase inhibitors
C. Bile acid sequestrants
D. Cholesterol absorption inhibitor

5. A pregnant woman needs a lipid-lowering agent. What would be the best class of lipid-lowering
agent for pregnant
women?
A. HMG-CoA reductase inhibitors

This document and the information thereon is the property of

PHINMA Education (Department of Nursing) 9 of 12
B. Bile acid sequestrants
C. Cholesterol absorption inhibitors
D. Phosphodiesterase inhibitors

6. A patient begins taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports
abdominal discomfort and
constipation. The nurse will provide which instruction to the patient?
A. Increase fluid and slowly increase fiber intake.
B. Stop the medication.
C. Decrease oral fluids
D. Give stool softeners
7. The only statin with outcome data to show effectiveness in decreasing CAD and incidence of
myocardial infarction.
A. atorvastatin (Lipitor)
B. simvastatin (Zocor)
C. pravastatin (Pravachol)
D. fluvastatin (Lescol)

8. Which organ(s) produce(s) clotting factors?

B. Bone marrow
C. Spleen and other lymphoid tissues
D. Liver
E. Both B and C
ANSWER: ________

9. What is the first reaction to a blood vessel injury?

A. Vasodilation and swelling
B. Vasoconstriction
C. Bleeding
D. Blood coagulation

10. Heparin is an anticoagulant. What family of anticoagulant medications does this drug belong
to?
A. Direct thrombin inhibitors
B. Indirect thrombin inhibitors
C. Vitamin K antagonists
D. Factor Xa inhibitors

11. Which statement below BEST describes how Heparin works as an anticoagulant?
A. “It inhibits clotting factors from synthesizing Vitamin K.”
B. “It inactivates the extrinsic pathways of coagulation.”
C. “It prevents Factor Xa from activating prothrombin to fibrinogen.”
D. “It enhances the activation of antihrombin III, which prevents the activation of thrombin and the
conversion of fibrinogen to fibrin.”

12. Which patients below would be at a HIGH risk for developing adverse effects of Heparin drug
therapy? Select all that apply:
A. A 55-year-old male patient who is post-op day 1 from brain surgery.
B. A 45-year-old female patient with a pulmonary embolism.
C. A 36-year-old male patient with active peptic ulcer disease.
D. A 43-year-old female with uncontrolled atrial fibrillation.
A. All of the above.

13. A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the
nurse would ensure what information is gathered correctly before initiating the drip?
A. Vital signs
B. Weight
C. PT/INR level
D. EKG
14. What is the approximate NORMAL level range for an activated partial thromboplastin time
(aPTT)?
A. 20-25 seconds
B. 2-3 seconds
C. 30-40 seconds
D. 60-80 seconds

15. A patient, who is receiving continuous IV Heparin, has an aPTT of 105 seconds. What is your
next nursing action per
protocol?
A. Continue with the infusion because no change is needed based on this aPTT.
B. Increase the drip rate per protocol because the aPTT is too low.
C. Re-draw the aPTT STAT.
D. Hold the infusion for 1 hour and decrease the rate per protocol because the aPTT is too high.
 SAS 20

1. As a nurse you know that Ferrous should not be given with:

A. Dairy products
B. Antacids
C. Tetracyclines
D. All of the above.

2. What do you give with Ferrous sulfate, ferrous fumarate, or ferrous gluconate to help promote
absorption?
A. Vitamin C
B. Vitamin D
C. Vitamin E
D. Vitamin B12

3. The client receives epoetin alfa (Epogen) subcutaneously, and says to the nurse, "My doctor
said I have anemia. Are there little red blood cells in that shot?" What are the best responses by
the nurse?
A. "No, we do not give blood for anemia anymore."
B. "No, this medication stimulates your body to make red blood cells."
C. " Yes, this small amount of red blood cells will stimulate your bone marrow to produce more
cells in the kidney."
D. "No, this medication promotes clotting so you will not lose even more red blood cells."

.
4. The nurse is teaching a class on how red blood cell formation is regulated by the body to a
group of clients who have AIDS. The nurse evaluates that learning has occurred when the clients
make which statements?
A. "Red blood cell formation is regulated through chemicals called colony-stimulating factors that
come from white blood cells."
B. "Red blood cell formation is regulated through messages from the hormone, secretin, which is
located in the kidney."
C. "Red blood cell formation is regulated through specific liver enzymes and a process called
hemochromatosis."
D. "Red blood cell formation is regulated through messages from the hormone erythropoietin."

5. The client receives chemotherapy as therapy for cancer. The physician orders epoetin alfa
(Procrit) subcutaneously. The client asks the nurse if this drug is also chemotherapy. What is the
best response by the nurse?
A. "No, but it works with your chemotherapy to make it more effective."
B. "No, this drug helps to counteract the nausea and vomiting caused by your chemotherapy."
C. "No, it will stimulate your immune system to help you battle the cancer."
D. "No, this drug will help prevent anemia that can be caused by your chemotherapy."
A. All of the above.

6. The client is receiving medication for the treatment of anemia. The nurse has taught the client
about this drug and about anemia. The nurse evaluates that learning has occurred when the
client makes which statement?
A. "My anemia could be caused by blood loss somewhere, but there are other causes too."
B. "My anemia was caused by drinking too many carbonated beverages with caffeine."
C. "There are many causes for anemia; mine was caused by heart failure and fluid overload."
D. "I think my anemia occurred when I started that vegetarian diet."

7. The client had stomach cancer and a surgical removal of his stomach several years ago. The
physician prescribed cyanocobalamin (Nascobal). The client stopped this drug several months
ago. What will the nurse most likely assess in this client?
A. Memory loss, numbness in the limbs, and depression
B. A gradual decrease in red blood cell count
C. Jaundice and tarry stools
D. Low hemoglobin and hematocrit counts

8. What is the only potassium-sparing diuretics that can be used in children?

A. Furosemide
B. Spironolactone
C. Amiloride
D. Triamterene

9. A patient receiving diuretics should alert the nurse if she feels the following:
A. insomnia
B. low-grade fever
C. muscle weakness
D. all of the above

10. A patient admitted for cerebral swelling complained of feeling light-headed and nauseous
while receiving mannitol. What should the nurse do?
A. Document, withdraw, and notify doctor.
B. Decrease mannitol flow.
C. Provide comfort measures.
D. Increase mannitol flow.

11. The physician prescribes the patient a loop diuretic. As the nurse you know that this type of
diuretic causes diuresis by
mainly affecting what structure in the nephron?
A. Distal convoluted tubule
B. Descending limb of the loop of Henle
C. Proximal convoluted tubule
D. Ascending limb of the loop of Henle

12. Loop diuretics are effective with inhibiting sodium reabsorption within the nephron because it
inhibits?
A. the sodium-chloride transporter
B. the effects of aldosterone on the distal convoluted tubule
C. the sodium-potassium-chloride cotransporter
D. the transport of bicarbonate by the proximal convoluted tubule

13. Your patient is ordered a loop diuretic at 1000. Which finding below would require you to hold
the dose and notify the
physician for further orders?
A. Calcium level 9 mg/L
B. Potassium level 1.5 mEq/L
C. Blood pressure 102/78
D. Sodium level 144

14. You’re providing discharge instructions to a patient who will be taking a loop diuretic at home.
Which statement by the
patient demonstrates they did NOT understand the teaching material and requires that you
reinforce some of the
teaching points?
A. “I will eat a diet rich in potatoes, bananas, avocadoes, strawberries, and spinach.”
B. “I will weight myself daily and report to my physician if I gain more than 3 lbs in 1 day.”
C. “I will change position slowly because I can become dizzy easily while taking this medication.”
D. “This medication can cause dehydration, so I will stay hydrated by consuming at least 2 L or
more of fluid per day.”

15. What electrolyte imbalances would the nurse monitor for in the patient who is taking a loop
diuretic? Select all that apply:
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypokalemia
 SAS 21

1. A client is prescribed with Guaifenesin (Mucinex). The nurse determines that the client understands the
proper administration of this medication if the client states that he or she will:
A. Drink extra fluids while taking this medication.
B. Take the medication with meals only.
C. Take an additional dose once fever and cough persist.
D. Limit oral fluid intake.

2. A nurse is about to administer Albuterol (Ventolin HFA) 2 puff and Budesonide (Pulmicort Turbohaler) 2
puff by metered dose inhaler. The nurse plans to administer by?
A. Alternating with a single puff each, starting with albuterol.
B. Alternating with a single puff each, starting with budesonide.
C. Budesonide inhaler first then the albuterol.
D. Albuterol inhaler first then the budesonide

3. A nurse is about to administer Naloxone hydrochloride (Narcan) to a client with known opioid overdose.
Which of the following equipment should be readily available at the bedside?
A. Suction machine.
B. Resuscitative equipment.
C. Nasogastric tube.
D. Dressing tray.

4. A client with a chronic obstructive pulmonary disease is prescribed with Ipratropium (Combivent). Upon
reviewing the medical history of the patient, the nurse questions the prescription if which of the following
is noted?
A. History of smoking.
B. History of allergy to egg.
C. History of allergy to peanut.
D. History of a previous infection.

5. Montelukast (Singulair) is prescribed to a client with asthma. During the medication therapy, which of
the following laboratories should be monitored?
A. Complete blood count (CBC).
B. Sodium and Potassium.
C. Calcium and Platelet count.
D. ALT and AST.

6. The nurse is giving medication teachings to a client receiving theophylline. The nurse instruct the client
to limit the intake of which of the following?
A. Apple and banana.
B. Yogurt and cheese.
C. Tuna and oysters.
D. Cola and chocolate.
7. A nurse is giving teachings to a client receiving Desloratadine (Clarinex). Which of the following
statements made by the client will need further instructions?
A. “I can eat gum after I drink the medicine”.
B. “I can take the medicine on an empty stomach”.
C. “I should avoid using alcohol”.
D. “I will avoid driving while using this medication”.

8. Antitussives are useful in blocking the cough reflex and preserving the energy associated with
prolonged, nonproductive coughing. Antitussives are best used with the following except:
A. Postoperative patients
B. COPD patients who tire easily
C. Patients with a dry, irritating cough
D. Asthma patients

9. Which of the following pathophysiological mechanisms that occur in the lung parenchyma allows
pneumonia to develop?
A. Atelectasis
B. Bronchiectasis
C. Effusion
D. Inflammation

10. A nurse is giving teachings to a client receiving Desloratadine (Clarinex). Which of the following
statements made by the client will need further instructions?
A. “I can eat gum after I drink the medicine”
B. “I can take the medicine on an empty stomach“
C. “I should avoid using alcohol”
D. “I will avoid driving while using this medication”

11. Nurse Zeke is giving instructions to her client who is taking antihistamine. Which of the following
nurse teachings is appropriate for the client?
A. Expect a relief in 24 hours
B. Be aware that you may have increased saliva
C. Be aware that you may need to take a decongestant
D. Avoid ingesting alcohol

12. Andrew has vertigo, which antihistamine is best for his condition?
A. Terfenadine
B. Guaifenesin
C. Meclizine
D. Hydrocodone

13. Raul, a 20-year-old student, used to buy OTC drugs whenever he feels sick. Which of the following
statements best describes the danger of self-medication with over-the-counter drugs?
 A. Clients are not aware of the action of over-the-counter drugs.
B. Clients are not aware of the side effects of over-the-counter drugs.
C. Clients minimize the effects of over-the-counter drugs because they are available without a
prescription.
D. Clients do not realize the effects of over-the-counter drugs.

14. Which histamine-2 antagonist is associated with the most drug interactions?
A. Prilosec
B. Nizatidine
C. Ranitidine
D. Cimetidine

15. Stephanie will be having her exam in pharmacology tomorrow. She should be aware that antitussive
is indicated to:
A. Encourage removal of secretions through coughing
B. Relieve rhinitis
C. Relieve a dry cough
D. Control a productive cough
 SAS 22

1. A client has been taking Ibuprofen for some quite time and was given Misoprostol (Cytotec). Which of
the following is exhibiting the therapeutic effect of Cytotec?
A. Relief of gastric ulcer.
B. Relief of diarrhea.
C. Relief of vomiting.
D. Relief of constipation.

2. A geriatric patient is prescribed with Cimetidine (Tagamet) for the treatment of heartburn. Which of the
following is the most frequent CNS side effect?
A. Agitation.
B. Drowsiness.
C. Headache.
D. Somnolence

3. A nurse is administering an IV bolus of Cimetidine (Tagamet). Which of the following should the nurse
monitor closely follow the administration?
A. Respiratory rate.
B. Skin turgor.
C. Blood pressure.
D. Temperature.

4. A client has been given Loperamide hydrochloride (Imodium). Which of the following situation is the
medication indicated to?
A. Abdominal pain.
B. Patients with an ileostomy.
C. Bloody Diarrhea.
D. Acute dysentery.

5. A client has been given Ondansetron (Zofran). For which condition should the nurse administer this
medication to the postoperative patient?
A. Vomiting.
B. Incisional pain.
C. Abdominal infection.
D. Atelectasis.

6. A client with a duodenal ulcer is diagnosed with H. pylori infection. The physician prescribed Amoxicillin
(Wymox), Pantoprazole (Prevacid), and Clarithromycin (Biaxin). Which statement made by the nurse
correctly explains the purpose of these medications?
A. “These medicines will minimize acid production and will coat the ulcer”.
B. “These medicines will stop the acid production and will kill the bacteria”.
C. “The ulcer will heal because the medications will kill the bacteria”.
D. “These medicines will control the ulcer and motion sickness”
7. A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its
therapeutic effect if which of the following is stated by the client:
A. Relief of nausea and vomiting.
B. Decrease diarrheal episodes.
C. The absence of constipation.
D. Relief from GERD.

8. A client has been prescribed with Pancrelipase (Pancrease). Which of the following symptoms would
prompt the nurse that the medication is having its therapeutic effect if which of the following is noted?
A. Negative abdominal pain.
B. An absence of constipation.
C. An absence of diarrhea.
D. Reduction of excess fat in feces.

9. A nurse is giving a nothing per orem instructions to a malnourished client with diarrhea and frequent
abdominal pain episodes which is about to receive a Total Parenteral Nutrition. Which statement made by
the nurse is the most appropriate?
A. “It will help in your weight loss”.
B. “It can assure you that you feel better after receiving TPN”.
C. “It will decrease your diarrhea and your bowel can rest”.
D. “It will give you less time in the hospital”.

10. A client is receiving Sulfasalazine (Azulfidine) for the treatment of ulcerative colitis. Which of the
following assessment finding will concern the nurse most?
A. Drowsiness.
B. Decreased urine output.
C. Urine discoloration.
D. Vomiting.

11. A client has been prescribed with Sucralfate (Carafate) for the treatment of gastric ulcer. The nurse
instruct the client that this medication is taken?
A. 1 hour before meals.
B. 1 hour after meals.
C. At the same time with an antacid.
D. Lunch time.

12. Tincture of opium is given to a patient who is having diarrheal episodes. Which of the following is true
regarding this medication?
A. Opium tincture is not a controlled substance.
B. Opium tincture can be used with medications like naltrexone and buprenorphine.
C. Has an unpleasant taste and it can be diluted with 15-30 ml water.
D. increases intestinal motility and peristalsis.

13. A nurse is giving medicine instructions to a client with hemorrhoids who is receiving a Mineral oil.
Which of the following statements made by the client indicates a further teaching?
 A. “I can take it at least 2 hours before bedtime”.
B. “It can interfere with the absorption of the vitamin E that I am taking”.
C. “If I miss a dose of mineral oil liquid, I’ll take it as soon as I remember”.
D. “I can use mineral oil liquid for an extended period to prevent further damage”.

14. A nurse is giving discharge instructions to a client who is receiving a bulk-forming laxative as part of
the home medications. All of which are examples of bulk-forming laxative, except?
A. Docusate Sodium (Colace).
B. Methylcellulose (Citrucel).
C. Polycarbophil (Fibercon).
D. Psyllium (Metamucil).

15. What is the priority nursing intervention for a client receiving an antiemetic?
A. Monitor intake and output.
B. Keep items far away from the bed.
C. Give the client privacy by letting him walking around the room.
D. Keep bed in low position with side rails up.
 SAS 23

1. Nurse Ejay is assigned to a telephone triage. A client called who was stung by a honeybee and is
asking for help. The client reports of pain and localized swelling but has no respiratory distress or other
symptoms of anaphylactic shock. What is the appropriate initial action that the nurse should direct the
client to perform?
A. Removing the stinger by scraping it.
B. Applying a cold compress.
C. Taking an oral antihistamine.
D. Calling emergency number.

2. An osmotic diuretic used in emergency, trauma, critical care, and neurosurgical settings to treat
cerebral edema and to reduce increased intracranial pressure.
A. Mannitol
B. Lidocaine
C. Furosemide
D. Albuterol

3. A client arrives in the emergency unit and reports that a concentrated household cleaner was splashed
in both eyes. Which of the following nursing actions is a priority?
A. Use Restasis (Allergan) drops in the eye.
B. Flush the eye repeatedly using sterile normal saline.
C. Examine the client’s visual acuity.
D. Patch the eye.

4. A 5-year-old client was admitted to the emergency unit due to ingestion of unknown amount of
chewable vitamins for children at an unknown time. Upon assessment, the child is alert and with no
symptoms. Which of the following information should be reported to the physician immediately?
A. The child has been treated multiple times for injuries caused by accidents.
B. The vitamin that was ingested contains iron.
C. The child was nauseated and vomited once at home.
D. The child has been treated several times for toxic substance ingestion

5. Which of the following is a concentrated, high-carbohydrate solution given to treat insulin-induced

hypoglycemia or insulin shock?
A. Dextrose 50%
B. Glocagon
C. Mannitol
D. Sodium bicarbonate

6. Epinephrine is administered to a female patient. The nurse should expect this agent to rapidly affect:
A. Adrenergic receptors.
B. Muscarinic receptors.
C. Cholinergic receptors.
D. Nicotinic receptors.
7. An anxious female client complains of chest tightness, tingling sensations, and palpitations. Deep,
rapid breathing, and carpal spasms are noted. Which of the following priority action should the nurse do
first?
A. Provide oxygen therapy.
B. Notify the physician immediately.
C. Administer anxiolytic medication as ordered.
D. Have the client breathe into a brown paper bag.

8. A nurse is providing discharge instruction to a woman who has been treated for contusions and bruises
due to a domestic violence. What is the priority intervention for this client?
A. Making a referral to a counselor.
B. Making an appointment to follow up on the injuries.
C. Advising the client about contacting the police.
D. Arranging transportation to a safe house.

9. In the work setting, what is the primary responsibility of the nurse in preparation for disaster
management, that includes natural disasters and bioterrorism incidents?
A. Being aware of the signs and symptoms of potential agents of bioterrorism.
B. Making ethical decisions regarding exposing self to potentially lethal substances.
C. Being aware of the agency’s emergency response plan.
D. Being aware of what and how to report to the Centers for Disease Control and Prevention.

10. Early signs and symptoms of local anesthetic toxicity include ALL BUT ONE of the following. Indicate
the exception:
A. Tinnitus
B. Perioral numbness
C. Dizziness
D. Hypertension

11. Which of the following is used to treat significant ventricular dysrhythmias?

A. Lidocaine
B. Mannitol
C. Naloxone
D. Dopamine

12. A patient presents to the emergency department with severe respiratory distress, hives, and edema
after being stung on the face by a bee. Which are accurate nursing assessments of the situation?
A. Hypotension and bronchospasm will progress rapidly if treatment is delayed.
B. The patient is suffering from anaphylactic shock.
C. Epinephrine and diphenhydramine are the drugs of choice as first-line agents.
D. Prompt treatment with drug therapy will prevent this syndrome from occurring again.

13. Which finding indicates that administration of glucagon has been effective? The patient experiences
A. an improvement in level of consciousness.
 B. an elevation in respiratory rate.
C. suppression of heart rate.
D. reduction in blood pressure.

14. A patient is experiencing both atrial and ventricular dysrhythmias. The nurse anticipates
administration of which medication?
A. Adenosine
B. Amiodarone
C. Atropine
D. Epinephrine

15. A dopamine infusion was started in a patient's antecubital vein during resuscitation after cardiac
arrest. The electronic infusion device is now sounding an alert for an occlusion. What is the most
important immediate concern for the nurse?
A. Infiltration with phentolamine will be necessary if there is extravasation
B. An interruption in the infusion can produce hypotension in the patient.
C. The device will need to be reported to the hospital's clinical engineering department for service
D. The patient could develop hypertension as a result of the alarm.