1- A client who is admitted to the medical unit with an acute exacerbation of myasthenia gravis is receiving the anticholinesterase medication, edrophonium chloride. Which assessment finding indicates to the nurse that the medication is effective in treating the myasthenic crisis?

a-Marked improvement in the client’s muscle strength.

b-Increased urinary output and frequency.

c-Elevation of blood pressure and pulse rate.

d-Decreased amplitude of electrical stimulation in the muscle.

2- An adolescent is admitted to the hospital because of a suicide attempt with an overdose of acetaminophen. Which blood values are most important for the nurse to monitor during the first 72 hour following ingestion of this overdose?

a-PH, PC02, HC03

b-White blood count, hemoglobin, hematocrit

c-LDH or LD, SGOT or ALT, SGPT or AST.

d-BUN creatinine, specific gravity

3. Client with hypertension, who has been taking labetalol for two weeks, reports a five pound(2.2 kg) weight gain. Which follow-up assessment is most important for the nurse to obtain?

a- Body temperature.

b- Capillary refill

c- Breath sounds.

d-Muscle strength

4- Prior to administration of the initial dose of the GI agent misoprostol, which information should the nurse the obtain from the client?

a-Currently pregnant.

b-History of glaucoma.

c-Allergy to aspirin.

d-Taking an anti-emetic medication

5-A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa (Epogen) two months ago. Which client finding best indicates that the medication is effective?

a-Takes concurrent iron therapy without adverse effects

b-Hemoglobin level increased to 12 grams/dl (120 mmol/L).

c-Food diary shows increased consumption of iron-rich foods.

d-Reports of increased energy levels and decreased fatigue.

6- A client has been receiving an IV antibiotic for an infection. When the IV infiltrates, the client receives a prescription for the same antibiotic in oral form. The nurse notes that the oral form provides 100% bioavailability. What instruction is important to provide the client?

a-The oral form of the medication will be just as effective as the IV form

b-Since the oral dose will be much higher than the IV dose, be sure to report any side effects.

c-The oral form will be absorbed more quickly than the IV form of the medication.

d-The oral medication must be mixed and administered rapidly for best effect.

7-A female client has a hemoglobin of 9 grams/dL or 90 grams/L (SI) and iron supplements are prescribed. When teaching this client about the administration of iron supplements, how should the nurse instruct her to take the iron tablets?

a-Two hours after breakfast, with a small snack.

b-With a full meal at breakfast, lunch, or dinner.

c-Prior to bedtime, with a glass of low fat milk.

d-Before breakfast, with a glass of orange juice.

8- A client is receiving the antithyroid medication, propylthiouracil (PTU) for hyperthyroidism. Assessment of the client’s vital signs reveal an elevated temperature, and the client reports a sore throat. The nurse palpates swollen glands. In addition to reporting the findings to the healthcare provider, which action by the nurse takes priority?

a-Assess for changes in taste sensation.

b-Observe for signs of hyperthyroidism.

c-Monitor the white blood cell count.

d-Offer warm fluids and saline throat gargle.

9-After receiving the first dose of penicillin the client begins wheezing and has trouble breathing. The nurse notifies the healthcare provider immediately and receives several prescriptions. Which medication prescription should the nurse administer first?

a-Epinephrine injection, USP IV.

b-Albuterol (Ventolin) inhaler.

c-Methylprednisolone (Medrol) IV.

d-Diphenhydramine (Benadryl) IV.

10-A client received succinylcholine (anectine), a depolarizing neuromuscular blocking agent, during surgery. Which assessment finding is most important for the nurse to report the surgeon following surgery?

a-Observable skin flushing.

b-Blood pressure of 114/72.

c-Neck and shoulder pain.

d-ventricular tachycardia

11-Antibiotic-resistant organisms are a major infection control problem. To help minimize the emergence of resistant bacteria, what instruction should the nurse provide to clients?

a-Request a prescription for first line vancomycin for a sore throat.

b-Ask the healthcare provider to prescribe the newest antibiotic when neede.

c-Stop taking prescribed antibiotics when symptoms decrease.

d-Avoid using antibiotics when suffering from colds or the flu.

12-When administering zolpidem (Ambien) to an older client, which computer documentation indicate that the desired outcome has been achieve?

a-Improve ability to concentrate.

b-exhibits fewer emotional outbursts.

c-Sleeps soundly through the night.

d-Decreased episodes of incontinence.

13-A young male athlete tells the nurse that he is concerned because his testicles seem to be shrinking. Which question is most important for the nurse to ask this client?

a-Do you use any type of herbal supplements?

b- Are you taking any type of anabolic steroids?

c-How many hours a day do you spend exercising?

d-Do you perform regular testicular self-examinations?

14-When assessing a female client who has been taking an antipsychotic medication for the past year, the nurse observes that the client demonstrates involuntary foot tapping while both feet are flat on the floor. The nurse plans to report the observation to the healthcare provider. Which additional action should the nurse take?

a-Prepare to initiate seizure precautions for the client’s safety.

b-Assist the client in recognizing her manifestations of anxiety.

c-Advise the client that she has developed tolerance to the medication.

d-Document the finding on the abnormal Involuntary Movement Scale.

15-The home health nurse observes that a female client is using a topical preparation that contains Echinacea to treat a canker sore. Her husband expresses concern regarding the effectiveness and safety of using herbs. How should the nurse respond?

a-Many of the herbal preparations are helpful primarily because of their placebo effect.

b-This product essentially harmless, but also is not very beneficial in treating skin infections.

c-Echinacea seems to be useful in the treatment of some infections, such as canker sores.

d-Topical Echinacea is usually used to soothe burns and can cause damage to the skin.

16-A client tells the home health nurse that he is taking ascorbic acid (vitamin C) 5000 mg PO a day. What action should the nurse implement?

a-Advise the client to avoid dark green vegetables.

b-Teach the client to include citrus fruits in the daily diet.

c-Encourage the client to stand for 30 minutes after administration.

d-Advise the client to take the vitamin in one dose.