1.Which statement best describes the pharmacodynamics of insulin?

A. Insulin causes the pancreas to secrete glucose into the bloodstream.

B. Insulin lowers blood glucose by promoting use of glucose in the body cells.

C. Insulin is metabolized by the liver and muscle and excreted in the urine.

D. Insulin is needed to maintain colloidal osmotic pressure in the bloodstream.

2. Which is the most likely expected outcome of administering a drug that antagonizes H1 histamine receptors?

A.  The client will report less wheezing and more energy.

B. The client will report less sneezing and tearing.

C. The client will report that headache is improved.

D. The client will cough less.

3. The healthcare team is attempting to determine cause for a client’s duodenal ulcer. Which factors are not associated with peptic ulcer disease (PUD)?

A. Excessive stress at home

B. Having type A blood

C. Having a parent diagnosed with a peptic ulcer

D. Smoking cigarettes

4. The nurse is educating a client with a history of type 2 diabetes, coronary artery disease, and osteoporosis about their new prescription for rosiglitazone.  What adverse effects will the nurse include in the teaching plan for this client?  (Select all that apply).

A. Increased serum lipids

B. Fatigue

C. Dyspnea

D. Weight gain

E. Edema

5. A patient is brought into the emergency room combative, semi-conscious, and unable to follow commands.  The patient’s finger stick blood glucose level is 53 mg/dL.  Which

A. Helping the client drink a glass of orange juice.

B. Helping the client eat a peanut butter sandwich.

C. Administration of subcutaneous insulin lispro.

D. Administration of intramuscular glucagon.

6. The healthcare provider is reviewing the lab work of a patient with type 2 diabetes that has recently begun treatment with an oral anti-diabetic medication.  The patient’s most recent hemoglobin A1C is 5.9%.  What instruction would the healthcare provider provide based on this finding?

A. “Because you were not fasting this morning, we will need to repeat the lab work.”

B. “Your diabetes is well controlled. No changes are needed for your medication.”

C. “This result indicates that your diabetes is not well controlled and your provider may want to adjust your medication.”

D. “Based on this laboratory result, your provider will probably want you to begin taking insulin.”

7. A patient with type 1 diabetes calls the clinic because they have experienced nausea and vomiting for the past 2 days and are wondering what they should do.  What information will the nurse provide?

A. Increase the amount of fats and protein in the diet until the illness has subsided.

B. Check your blood glucose levels more than normal while ill.

C. You will temporarily need to change to oral antidiabetic therapy.

D. An increase in insulin may be required until well.

8. Drugs that activate beta2-adrenergic receptors:

A. decrease production of viscous secretions.

B. increase labored breathing

C. relax bronchiolar smooth muscle.

D. result in airway diameter narrowing.

9. Rebound congestion is occasionally a problem after use of some drugs for allergic rhinitis. Which preparation is mostly likely to cause this concern?

A. Oral antihistamines

B. Intranasal steroids

C. Oral decongestants

D. Intranasal decongestants

10. The nurse administered 12 units of insulin aspart to the patient with type 1 diabetes at 0700.  Which meal would prevent the client from experiencing hypoglycemia?

A. Bedtime snack

B. Lunch

C. Breakfast

D. Dinner

11. Which medication is a serotonin receptor antagonist?

A. Ondansetron

B. Diphenhydramine

C. Promethazine

D. Dexamethasone

12. A patient with type 1 diabetes received 10 units of isophane, NPH, insulin at 0700.  At what time is the patient most likely to feel the effects of hypoglycemia?

A. 1000

B. 2300

C. 1600

D. 0800

13. A healthcare provider is teaching a patient about their new prescription for repaglinide, a meglitinide.  Which teaching point should be included in the educational plan?

A. “It may take several weeks before you see optimal therapeutic effects.”

B. “This medication is taken once a week through a subcutaneous injection.”

C. “Be sure to take your medication shortly before each meal.”

D. “You will begin by taking this medication once a day before breakfast.”

14. The patient states that they have recently started taking glyburide to control their diabetes.  The nurse knows that glyburide falls into which classification of anti-diabetic medication?

A. Biguanide

B. Sulfonylurea

C. Meglitinide

D. Thiazolidinedione

15. Match the correct side effect to the correct antacid.

Choose from following: Fluid retention / Diarrhea / Kidney stones / Constipation

  1. Calcium carbonate
  2. Sodium bicarbonate
  3. Aluminum hydroxide
  4. Magnesium hydroxide

16. The nurse is instructing a client who has been prescribed bulk-forming laxatives. Which statement by the client indicates understanding of the use of laxatives?

A. “They are indicated for the relief of bowel obstruction.”

B. “They work to increase the frequency and quality of bowel movements.”

C. “I should use them when I have diarrhea caused by an infection.”

D. “I can use them liberally whenever I don’t have regular bowel movements.”

17. A mother is struggling to manage her child’s moderate persistent asthma at home. The mother asks if there are any nonpharmacologic measures she can use. Which strategies are most likely to be effective?

A. Avoiding stimuli such as secondhand smoke, pollutants, and cold air

B. Limiting intake of protein and foods with red and yellow dyes

C. Homeschooling the child and limiting his contact with other children who might have upper respiratory infections

D. Keeping the child’s immunizations up-to-date and wearing a face mask in public

18. A patient will begin an intravenous infusion of insulin due to unstable blood glucose levels.  The nurse understands that which type of insulin will be ordered for the infusion?

A. Aspart

B. Isophane

C. Regular

D. Detemir

19. A patient recently started on incretin therapy to treat their type 2 diabetes.  The nurse would expect to see which medication(s) on the medication administration record?  (Select all that apply).

A. Exenatide

B. Sitagliptin

C. Linagliptin

D. Nateglinide

E. Liraglutide

20. The healthcare provider is teaching a patient newly diagnosed with type 2 diabetes about the adverse effects of biguanides.  What will the healthcare provider identify as a common adverse effect of this medication class?

A. Sinusitis

B. Fluid retention

C. Diarrhea

D. Hypoglycemia


1. The nurse is reviewing the medication administration records for the patients under their care.  Which patient would the nurse be most concerned about when receiving a new order for an ACE inhibitor?

A. Older adult with hyperlipidemia

B. Pregnant woman

C. Woman with type 2 diabetes

D. Man with glaucoma

2. Which medication class is considered a first-line treatment for hyperlipidemia?

A. HMG-CoA reductase inhibitors

B. Bile acid sequestrants

C. Fibric acids

D. Niacin

3. A patient recently started on a angiotensin receptor blocker (ARB) to treat their hypertension.  The nurse would expect to see which medication on the medication administration record?

A. Lisinopril

B. Lovastatin

C. Labetalol

D. Losartan

4. A client begins taking an ACE inhibitor and complains of a dry cough.  What should the nurse tell the client about this symptom?

A. It occurs frequently in those taking the medication but will subside over time.

B. It indicates that a serious side effect has occurred.

C. It may be uncomfortable enough that the medication will need to be discontinued.

D. It is a common side effect that occurs in almost all patients taking the medication.

5. The nurse is caring for a client who received intravenous hydralazine for hypertensive urgency.  The nurse will monitor the client for what adverse effect?

A. Hypoglycemia

B. Metabolic acidosis

C. Increased liver enzymes

D. Tachycardia

6. What medication class is considered a first-line treatment for heart failure?

A. Cardiac glycosides

B. ACE inhibitors

C. Potassium channel blockers

D. Calcium channel blockers

7. The patient has been prescribed a cardiac glycoside for the treatment of their stage C heart failure.  The nurse expects to see what medication on the medication administration record (MAR)?

A. Digoxin

B. Milrinone

C. Valsartan

D. Captopril

8. Which plasma lipoprotein level is most concerning which considering the risk of coronary atherosclerosis?  Elevated:

A. very-low-density lipoprotein.

B. low-density lipoprotein.

C. very-high-density lipoprotein.

D. high-density lipoprotein.

9. A patient is taking a vasodilator that relaxes smooth muscles in veins.  To help minimize adverse effects, the nurse should provide what education?

A. Encourage the patient to increase fluid intake.

B. Teach the patient about the possibility of bradycardia.

C. Tell the patient to report shortness of breath.

D. Caution the patient not to get up abruptly.

10. A nurse is instructing a client receiving a cholesterol-lowering agent.  Which information should the nurse include in the patient education?

A. Continue your exercise program to increase your HDL serum levels.

B. If you miss a dose, double your next dose to maintain therapeutic blood levels.

C. Stop taking the medication if you experience constipation.

D. This medication will replace the other interventions you have been trying.

11. A nurse is instructing a client receiving a cholesterol-lowering agent.  Which information should the nurse include in the patient education?

A. Continue your exercise program to increase your HDL serum levels.

B. If you miss a dose, double your next dose to maintain therapeutic blood levels.

C. Stop taking the medication if you experience constipation.

D. This medication will replace the other interventions you have been trying.

12. The nurse anticipates that which treatment will be added to the plan of care for a patient that has progressed to stage D heart failure?

A. Lifestyle modifications

B. Oral digoxin

C. Intravenous dopamine

D. Oral metoprolol

13. If a medication has a prodysrhythmic effect, then the nurse must monitor the client for which outcome?

A. New dysrhythmias.

B. Decreased heart rate.

C. Decrease in dysrhythmias.

D. Reduced blood pressure.

14. The nurse is assessing a client who has been taking amiodarone for six months.  The nurse will monitor the client for what adverse effect?

A. Dysphagia

B. Photophobia

C. Tachycardia

D. Urinary retention

15. The nurse is caring for an African American male recently diagnosed with hypertension.  The nurse anticipates the client will begin taking which medication for his condition?

A. Lisinopril

B. Metoprolol

C. Furosemide

D. Amlodipine

16. Which medications are used for a client who is experiencing an acute myocardial infarction (MI)?  (Select all that apply).

A. Warfarin

B. Furosemide

C. Aspirin

D. Morphine

E. Nitroglycerin

17. Patients taking niacin to treat hyperlipidemia should be educated about what common adverse effect?

A. Fishy taste

B. Flushing

C. Muscle pain

D. Constipation

18. A patient is currently taking a statin for hyperlipidemia.  The nurse is concerned about an increased risk of myopathy and rhabdomyolysis when what other medication is

A. Ibuprofen

B. Furosemide

C. Gemfibrozil

D. Metoprolol

19. When caring for a patient taking a beta blocker, the nurse will monitor for which common adverse effects?  (Select all that apply).

A. Fatigue

B. Bradycardia

C. Dizziness

D. Hyperglycemia

E. Dry cough

20. The nurse is providing education for a client newly diagnosed with angina.  What education will the nurse include in the teaching plan regarding treatment of this condition?

A. When experiencing chest pain, take one dose of your beta blocker.

B. If your chest pain is not relieved after three doses of nitroglycerin, drive to the closest emergency room.

C. Your transdermal isosorbide dinitrate patch can be used to stop an episode of chest pain.

D. When taking nitroglycerin, headache and dizziness can occur.

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