Medication Case Studies Practice Exam (Combined)

Case Study 1: Aspirin by Mouth for CAD

Patient: 68-year-old male with coronary artery disease, prescribed aspirin 81 mg PO daily for antiplatelet effect.

Q1. Highlight the assessment findings that are most concerning for a patient on aspirin:

Q2. Which order should the nurse question?

Q3. Select all teaching points for aspirin:

Q4. Place the following nursing actions in order of priority if the patient develops black, tarry stools and ringing in the ears:

1. --Select--Hold the aspirinNotify the providerAssess for bleeding and vital signsDocument findings
2. --Select--Hold the aspirinNotify the providerAssess for bleeding and vital signsDocument findings
3. --Select--Hold the aspirinNotify the providerAssess for bleeding and vital signsDocument findings
4. --Select--Hold the aspirinNotify the providerAssess for bleeding and vital signsDocument findings

Q5. Matrix: Indicate if each is a common or serious side effect of aspirin:

Side Effect	Common	Serious
Heartburn
GI bleeding
Tinnitus

Q6. Which finding requires immediate provider notification?

Case Study 2: Ibuprofen by Mouth for Arthritic Pain

Patient: 55-year-old female with osteoarthritis, prescribed ibuprofen 400 mg PO every 8 hours as needed for pain.

Q7. Highlight the assessment findings that are most concerning for a patient on ibuprofen:

Q8. Which order should the nurse question?

Q9. Select all teaching points for ibuprofen:

Q10. Place the following nursing actions in order of priority if the patient develops swelling of ankles and black, tarry stools:

1. --Select--Hold the ibuprofenNotify the providerAssess for GI bleeding and edemaDocument findings
2. --Select--Hold the ibuprofenNotify the providerAssess for GI bleeding and edemaDocument findings
3. --Select--Hold the ibuprofenNotify the providerAssess for GI bleeding and edemaDocument findings
4. --Select--Hold the ibuprofenNotify the providerAssess for GI bleeding and edemaDocument findings

Q11. Matrix: Indicate if each is a common or serious side effect of ibuprofen:

Side Effect	Common	Serious
Nausea
GI bleeding
Edema

Q12. Which finding requires immediate provider notification?

Case Study 3: Prednisone by Mouth for Anti-inflammatory Effect

Patient: 40-year-old male with severe asthma exacerbation, prescribed prednisone 40 mg PO daily for 7 days.

Q13. Highlight the assessment findings that are most concerning for a patient on prednisone:

Q14. Which order should the nurse question?

Q15. Select all teaching points for prednisone:

Q16. Place the following nursing actions in order of priority if the patient develops sudden confusion and fever:

1. --Select--Hold the prednisoneNotify the providerAssess for infection and mental statusDocument findings
2. --Select--Hold the prednisoneNotify the providerAssess for infection and mental statusDocument findings
3. --Select--Hold the prednisoneNotify the providerAssess for infection and mental statusDocument findings
4. --Select--Hold the prednisoneNotify the providerAssess for infection and mental statusDocument findings

Q17. Matrix: Indicate if each is a common or serious side effect of prednisone:

Side Effect	Common	Serious
Insomnia
Hyperglycemia
Infection

Q18. Which finding requires immediate provider notification?

Case Study 4: Acetaminophen by Mouth for Pain

Patient: 45-year-old female with osteoarthritis, prescribed acetaminophen 650 mg PO every 6 hours as needed for pain.

Q19. Highlight the assessment findings that are most concerning for a patient on acetaminophen:

Q20. Which order should the nurse question?
Monitor liver function tests
Do not exceed 4 grams per day
Administer with alcohol
Assess for pain relief

Q21. Select all teaching points for acetaminophen:
Do not take more than 4 grams in 24 hours
Avoid alcohol while taking acetaminophen
Report yellowing of skin or eyes
Report right upper quadrant pain

Q22. Place the following nursing actions in order of priority if the patient develops yellowing of the skin and right upper quadrant pain:

1. --Select--Hold the acetaminophenNotify the providerAssess for liver dysfunctionDocument findings
2. --Select--Hold the acetaminophenNotify the providerAssess for liver dysfunctionDocument findings
3. --Select--Hold the acetaminophenNotify the providerAssess for liver dysfunctionDocument findings
4. --Select--Hold the acetaminophenNotify the providerAssess for liver dysfunctionDocument findings

Q23. Matrix: Indicate if each is a common or serious side effect of acetaminophen:

Side Effect	Common	Serious
Nausea
Liver failure
Rash

Q24. Which finding requires immediate provider notification?
Yellowing of skin and right upper quadrant pain
Mild headache
Mild nausea

Case Study 5: Morphine IV for Pain

Patient: 60-year-old male with post-surgical pain, prescribed morphine 2 mg IV every 4 hours as needed for severe pain.

Q25. Highlight the assessment findings that are most concerning for a patient on morphine:

Q26. Which order should the nurse question?
Monitor respiratory status
Administer with benzodiazepines
Assess pain before and after administration
Monitor for constipation

Q27. Select all teaching points for morphine:
Report difficulty breathing
Do not drive or operate machinery
Increase fluid and fiber intake
Report severe itching or rash

Q28. Place the following nursing actions in order of priority if the patient becomes unresponsive with a respiratory rate of 8/min:

1. --Select--Stop the morphine infusionCall for help/activate rapid responseAssess airway and breathingAdminister naloxone if ordered
2. --Select--Stop the morphine infusionCall for help/activate rapid responseAssess airway and breathingAdminister naloxone if ordered
3. --Select--Stop the morphine infusionCall for help/activate rapid responseAssess airway and breathingAdminister naloxone if ordered
4. --Select--Stop the morphine infusionCall for help/activate rapid responseAssess airway and breathingAdminister naloxone if ordered

Q29. Matrix: Indicate if each is a common or serious side effect of morphine:

Side Effect	Common	Serious
Constipation
Respiratory depression
Itching

Q30. Which finding requires immediate provider notification?
Unresponsive with respiratory rate 8/min
Constipation
Mild itching

Case Study 6: Gabapentin by Mouth for Diabetic Neuropathy

Patient: 58-year-old male with diabetic neuropathy, prescribed gabapentin 300 mg PO three times daily.

Q31. Highlight the assessment findings that are most concerning for a patient on gabapentin:

Q32. Which order should the nurse question?
Monitor for sedation and dizziness
Taper dose when discontinuing
Administer with antacids
Monitor for peripheral edema

Q33. Select all teaching points for gabapentin:
Do not stop medication abruptly
Report new or worsening confusion
Report swelling of hands or feet
Use caution when standing up

Q34. Place the following nursing actions in order of priority if the patient develops new confusion and unsteady gait:

1. --Select--Hold the gabapentinNotify the providerAssess mental status and fall riskDocument findings
2. --Select--Hold the gabapentinNotify the providerAssess mental status and fall riskDocument findings
3. --Select--Hold the gabapentinNotify the providerAssess mental status and fall riskDocument findings
4. --Select--Hold the gabapentinNotify the providerAssess mental status and fall riskDocument findings

Q35. Matrix: Indicate if each is a common or serious side effect of gabapentin:

Side Effect	Common	Serious
Drowsiness
Confusion
Peripheral edema

Q36. Which finding requires immediate provider notification?
New confusion and unsteady gait
Mild drowsiness
Mild dizziness