Practice Questions

1. A patient tells the nurse that he has started to take an over-the-counter antihistamine, diphenhydramine. In teaching about side effects, what is most important for the nurse to tell the patient?

a. To avoid insomnia, do not take this drug at bedtime.

b. Avoid driving a motor vehicle until stabilized on the drug. ✅

c. Nightmares and nervousness are more likely in an adult.

d. Medication may cause excessive secretions.

2. A patient reports a sore throat and has been told it is due to beta-hemolytic streptococcal infection. The nurse anticipates that the patient has which acute condition?

a. Rhinitis

b. Sinusitis

c. Pharyngitis ✅

d. Rhinorrhea

3. A patient is prescribed a decongestant nasal spray that contains oxymetazoline. What will the nurse teach the patient?

a. Take this drug at bedtime because it may cause drowsiness.

b. Directly spray the medication away from the nasal septum and gently sniff. ✅

c. This drug may be used in maintenance treatment for asthma.

d. Limit use of the drug to 3 days to prevent rebound nasal congestion. ✅

4. A patient has been prescribed guaifenesin. The nurse understands that the purpose of the drug is to accomplish what?

a. Treat allergic rhinitis and prevent motion sickness

b. Loosen bronchial secretions so coughing can eliminate them ✅

c. Compete with histamine for receptor sites, thus preventing a histamine response

d. Stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa

5. Beclomethasone has been prescribed for a patient with allergic rhinitis. What should the nurse teach the patient regarding this medication?

a. This medication may be used for an acute attack.

b. An oral form is available if the patient prefers to use it.

c. Avoid large amounts of caffeine intake because an increased heart rate may occur.

d. With continuous use, dryness of the nasal mucosa/lining may occur. ✅

6. The nurse is teaching a patient about diphenhydramine. Which instructions should the nurse include in the patient’s teaching plan? Select all that apply.

a. Take medication on an empty stomach to facilitate absorption.

b. Avoid alcohol and other central nervous system depressants. ✅

c. Notify a health care provider if confusion or hypotension occurs. ✅

d. Use sugarless candy, gum, or ice chips for temporary relief of dry mouth. ✅

e. Avoid handling dangerous equipment or performing dangerous activities until stabilized on the medication. ✅

1. Which drug class ends in “-tidine” and decreases gastric acid secretion?

A) Proton pump inhibitors

B) H₂ receptor antagonists ✅

C) Antacids

D) Anticholinergics

2. What is the main action of Loratadine (Claritin)?

A) Decongestant

B) Antihistamine (H₁ blocker) ✅

C) Expectorant

D) Corticosteroid

3. Which drug suppresses cough by acting on the cough center in the medulla?

A) Dextromethorphan ✅

B) Guaifenesin

C) Albuterol

D) Pseudoephedrine

4. Which laxative works by increasing water in the stool and promoting peristalsis?

A) Bisacodyl (Dulcolax) ✅

B) Docusate sodium (Colace)

C) Polyethylene glycol (MiraLAX)

D) Lubiprostone (Amitiza)

5. Which drug is an expectorant that loosens bronchial secretions?

A) Guaifenesin (Mucinex) ✅

B) Dextromethorphan

C) Diphenhydramine

D) Fluticasone

6. Which antiemetic blocks serotonin receptors in the chemoreceptor trigger zone (CTZ)?

A) Promethazine

B) Ondansetron ✅

C) Scopolamine

D) Dimenhydrinate

7. What is the mechanism of Albuterol?

A) Beta-1 agonist (cardiac)

B) Beta-2 agonist → bronchodilation ✅

C) Anticholinergic → bronchodilation

D) Corticosteroid → anti-inflammatory

8. Which antidiarrheal slows intestinal motility by acting on opioid receptors?

A) Loperamide ✅

B) Metoclopramide

C) Lactulose

D) Ranitidine

9. Which drug should be taken on an empty stomach, 30 min before meals, to protect ulcers?

A) Sucralfate (Carafate) ✅

B) Omeprazole

C) Famotidine

D) Misoprostol

10. What side effect is common to first-generation antihistamines like Diphenhydramine?

A) Diarrhea

B) Drowsiness ✅

C) Hypertension

D) Bradycardia

1. Which medication is a proton pump inhibitor (PPI) that should be taken before meals to block gastric acid production?

A) Ranitidine

B) Sucralfate

C) Misoprostol

D) Omeprazole ✅

2. What is a major nursing consideration when giving Promethazine (Phenergan) for nausea?

A) Give with food to prevent GI upset

B) Avoid IV use; can cause tissue necrosis ✅

C) Encourage fluids to loosen secretions

D) Take 30 min before meals on an empty stomach

3. Which respiratory drug acts as a corticosteroid and reduces airway inflammation?

A) Albuterol

B) Fluticasone ✅

C) Montelukast

D) Theophylline

4. Which drug class causes dry mouth, blurred vision, and urinary retention as common side effects?

A) Anticholinergics ✅

B) Antihistamines (2nd generation)

C) Proton pump inhibitors

D) Expectorants

5. Which medication prevents motion sickness by blocking acetylcholine at the vestibular nerve?

A) Lorazepam

B) Ondansetron

C) Dimenhydrinate

D) Scopolamine ✅

6. Which bronchodilator has a narrow therapeutic range and risk of toxicity with caffeine or antibiotics?

A) Montelukast

B) Theophylline ✅

C) Fluticasone

D) Dextromethorphan

7. What is the primary use of Misoprostol (Cytotec) in GI pharmacology?

A) Eradicate H. pylori infection

B) Neutralize stomach acid

C) Promote gastric mucus and prevent NSAID-induced ulcers ✅

D) Stop diarrhea by slowing motility

8. Which medication is a leukotriene receptor antagonist used for asthma prophylaxis?

A) Albuterol

B) Montelukast ✅

C) Ipratropium

D) Diphenhydramine

9. Which drug is an antitussive opioid used to suppress nonproductive cough?

A) Guaifenesin

B) Pseudoephedrine

C) Loratadine

D) Codeine ✅

10. A patient on Omeprazole for GERD should be monitored for what long-term risk?

A) Hypertension

B) Bone fractures due to ↓ calcium absorption ✅

C) Tachycardia

D) Constipation

1. A client using an albuterol inhaler reports tremors and palpitations. What is the best nursing action?

A) Reassure the client that these are expected side effects ✅

B) Stop the medication immediately

C) Administer an antihistamine

D) Double the dose interval

2. Which medication should not be used with alcohol or other CNS depressants due to increased sedation?

A) Loratadine

B) Diphenhydramine ✅

C) Montelukast

D) Guaifenesin

3. Which drug neutralizes stomach acid by direct chemical reaction, rather than reducing acid production?

A) Omeprazole

B) Ranitidine

C) Calcium carbonate ✅

D) Misoprostol

4. A nurse instructs a patient using a beclomethasone inhaler to rinse the mouth after each use. This prevents:

A) Gingivitis

B) Oral candidiasis ✅

C) Dental erosion

D) Dry mouth

5. Which laxative is contraindicated in bowel obstruction?

A) Lactulose

B) Docusate sodium

C) Bisacodyl

D) All laxatives ✅

6. The nurse is caring for a patient taking metoclopramide (Reglan). What finding requires immediate intervention?

A) Dry mouth

B) Diarrhea

C) Tremors or lip smacking ✅

D) Drowsiness

7. Which nasal decongestant can raise blood pressure and should be avoided in hypertension?

A) Pseudoephedrine ✅

B) Diphenhydramine

C) Dextromethorphan

D) Cromolyn

8. Which drug protects the stomach lining by stimulating prostaglandin production?

A) Sucralfate

B) Misoprostol ✅

C) Omeprazole

D) Famotidine

9. A patient on theophylline reports insomnia and nausea. The nurse should:

A) Reassure the patient—these are harmless

B) Check serum theophylline level for toxicity ✅

C) Administer caffeine to offset fatigue

D) Stop corticosteroids immediately

10. Which combination is correctly matched with its primary therapeutic effect?

A) Ondansetron – Increases GI motility

B) Montelukast – Prevents asthma attacks ✅

C) Ranitidine – Neutralizes gastric acid

D) Codeine – Loosens bronchial secretions

1. A client with asthma uses albuterol and fluticasone inhalers. Which instruction should the nurse give first?

A) Use fluticasone before albuterol.

B) Take both at the same time.

C) Rinse the mouth after albuterol.

D) Use albuterol first, then fluticasone. ✅

2. A patient receiving ondansetron for postoperative nausea reports a severe headache. What should the nurse do?

A) Document the finding; this is a common side effect. ✅

B) Stop the medication immediately.

C) Give acetaminophen as ordered for headache relief.

D) Call the provider and request a serotonin test.

3. A client taking theophylline shows restlessness, tachycardia, and nausea. Which priority action should the nurse take?

A) Reassure the patient; these are mild effects.

B) Hold the dose and notify the provider. ✅

C) Encourage fluids and deep breathing.

D) Administer an antacid.

4. A nurse teaches a client prescribed misoprostol for prevention of gastric ulcers. Which statement shows correct understanding?

A) “I will take this drug to help my constipation.”

B) “I must not take this drug if I’m pregnant.” ✅

C) “I’ll take it with magnesium antacids for best results.”

D) “This medicine blocks histamine to reduce acid.”

5. A client with hypertension and nasal congestion buys pseudoephedrine OTC. What teaching is most important?

A) “This drug may cause drowsiness.”

B) “You can use this as long as symptoms last.”

C) “Monitor your blood pressure; it may rise.” ✅

D) “Expect your nasal discharge to turn green.”

6. Which client finding would make the nurse hold promethazine and notify the provider?

A) Mild dizziness after the dose

B) Dry mouth and drowsiness

C) Nausea persisting after 30 minutes

D) Burning at IV site during administration ✅

7. A nurse is about to give lactulose to a client with hepatic encephalopathy. What indicates the medication is effective?

A) Serum potassium is normal.

B) The client has regular formed stools.

C) The client is more alert and oriented. ✅

D) Ammonia levels are increased.

8. A patient taking omeprazole daily reports bone pain. Which assessment should the nurse prioritize?

A) Signs of hypocalcemia or fractures ✅

B) Evidence of GI bleeding

C) Serum amylase level

D) Lung auscultation

9. A client using a scopolamine patch for motion sickness calls the nurse complaining of dry mouth and blurry vision. What is the best response?

A) “Remove the patch immediately; this is toxicity.”

B) “Those are expected effects; increase oral fluids.” ✅

C) “Apply a second patch to balance the dose.”

D) “Call your doctor for an urgent visit.”

10. A nurse gives diphenhydramine to an older adult for allergies. Which outcome requires the most immediate follow-up?

A) Mild drowsiness after dosing

B) Reports of dry mouth

C) New onset confusion or urinary retention ✅

D) Reduced nasal drainage

1️⃣ SATA

The nurse is teaching a client about omeprazole. Which statements show correct understanding? (Select all that apply.)

A) “I’ll take it before breakfast.” ✅

B) “I can crush the capsule if it’s hard to swallow.”

C) “This medicine helps reduce acid by blocking the proton pump.” ✅

D) “Long-term use may increase my risk for fractures.” ✅

E) “It works immediately to relieve heartburn like Tums.”

2️⃣ Priority

A client taking theophylline presents with nausea, insomnia, and irregular heartbeat. What is the nurse’s first action?

A) Hold the next dose and notify the provider. ✅

B) Administer an antiemetic.

C) Encourage fluids.

D) Document and continue the medication.

3️⃣ SATA

Which of the following are expected adverse effects of first-generation antihistamines like diphenhydramine?

A) Drowsiness ✅

B) Diarrhea

C) Dry mouth ✅

D) Urinary retention ✅

E) Hypertension

4️⃣ Clinical Judgment

A client receiving ondansetron reports dizziness and irregular heartbeat. What is the nurse’s priority assessment?

A) Check blood glucose.

B) Monitor ECG for QT prolongation. ✅

C) Assess for dehydration.

D) Ask about caffeine intake.

5️⃣ SATA

Which teaching points should the nurse include for a client using a metered-dose albuterol inhaler? (Select all that apply.)

A) “Shake the inhaler before each use.” ✅

B) “Exhale completely before pressing the canister.” ✅

C) “Hold your breath for 5–10 seconds after inhaling.” ✅

D) “Rinse your mouth immediately after use.”

E) “Use it regularly even when you’re not short of breath.”

6️⃣ Priority

A patient with chronic constipation is ordered lactulose. Which outcome best indicates the drug is effective?

A) The patient reports soft stools 2–3 times per day. ✅

B) Abdominal distension increases.

C) Serum potassium rises.

D) The patient reports improved sleep.

7️⃣ SATA

The nurse teaches a client starting ranitidine. Which instructions are appropriate?

A) “This medicine neutralizes acid immediately.”

B) “Stop the drug once you feel better.”

C) “Avoid smoking; it reduces the drug’s effectiveness.” ✅

D) “Take it at bedtime if you have nighttime symptoms.” ✅

E) “It works by blocking histamine receptors in the stomach.” ✅

8️⃣ Priority

After giving promethazine IM for nausea, which finding requires immediate nursing intervention?

A) Drowsiness

B) Dry mouth

C) Pain and burning at the injection site ✅

D) Mild dizziness

9️⃣ SATA

Which instructions should be given to a client prescribed fluticasone inhaler? (Select all that apply.)

A) “Rinse your mouth after each use.” ✅

B) “Use this for quick relief during an asthma attack.” ✅

C) “Stop the inhaler abruptly when symptoms improve.”

D) “This drug helps prevent inflammation.” ✅

E) “Report white patches in your mouth.” ✅

🔟 Clinical Reasoning

A client using codeine cough syrup becomes increasingly drowsy with shallow respirations. What should the nurse do first?

A) Place the patient on NPO status.

B) Give caffeine to stimulate breathing.

C) Administer naloxone per protocol. ✅

D) Reassess in 15 minutes.

Explanation: Codeine = opioid → respiratory depression → naloxone (opioid antagonist) is the antidote. Act immediately before reassessing.

1️⃣

A client with GERD is prescribed omeprazole and sucralfate. Which instruction is most important?

A) Take omeprazole in the morning and sucralfate 30 min before meals. ✅

B) Take both medications together before breakfast.

C) Take sucralfate only if heartburn occurs.

D) Stop omeprazole once symptoms improve.

2️⃣

A client with COPD takes albuterol and theophylline. Which finding requires immediate follow-up?

A) Mild tremor after using the inhaler

B) Heart rate of 110 bpm

C) Restlessness and vomiting ✅

D) Dry mouth and thirst

3️⃣

A patient on long-term corticosteroid inhaler therapy reports white patches inside the mouth. What should the nurse do?

A) Document as normal.

B) Advise the patient to rinse the mouth and notify the provider. ✅

C) Instruct to brush teeth more often only.

D) Stop the inhaler for three days.

4️⃣

A client receiving metoclopramide for nausea begins exhibiting facial twitching and lip smacking. What is the nurse’s priority?

A) Continue therapy and observe for worsening symptoms.

B) Document as mild anxiety.

C) Hold the dose and notify the provider immediately. ✅

D) Give diphenhydramine to stop the twitching and continue treatment.

5️⃣

A patient on ranitidine and warfarin reports gum bleeding and dark stools. Which action comes first?

A) Assess for occult blood in stool.

B) Hold ranitidine.

C) Check INR level and notify provider. ✅

D) Give vitamin K.

6️⃣

A nurse cares for a client taking codeine for cough and ondansetron for nausea. Which combined effect is most concerning?

A) Constipation and sedation ✅

B) Diarrhea and insomnia

C) Tachycardia and tremor

D) Dry mouth and cough suppression

7️⃣

A client with chronic bronchitis uses ipratropium and albuterol inhalers. Which statement shows correct understanding?

A) “I’ll use ipratropium first to open my airways.”

B) “I’ll alternate them every other day.”

C) “I’ll use albuterol first, then ipratropium five minutes later.” ✅

D) “I can skip albuterol if I use ipratropium.”

8️⃣

The nurse teaches about bisacodyl. Which instruction must be emphasized?

A) “Use only short-term; long-term use may cause dependence.”✅

B) “Take daily after meals for regularity.”

C) “Expect black stools from this medicine.”

D) “It works best with antacids.”

9️⃣

A client prescribed montelukast for asthma makes which statement that shows further teaching is needed?

A) “I’ll take it every evening, even if I feel fine.”

B) “I’ll use this if I have sudden shortness of breath.” ✅

C) “This helps prevent swelling in my airways.”

D) “I should report mood or behavior changes.”

🔟

A patient on high-dose prednisone reports new ankle swelling and weight gain. What should the nurse do first?

A) Restrict potassium intake.

B) Encourage extra salt in diet.

C) Document findings as expected.

D) Check blood pressure and assess for fluid retention. ✅