Download Pharmacological and Parenteral Therapies NCLEX RN NCSBN 100 Questions with Verified Answer and more Exams Nursing in PDF only on Docsity!
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Question 1
Pharmacological and Parenteral Therapies NCLEX RN NCSBN 100
Questions with Verified Answers
A nurse is providing care to a female client who is 32-weeks pregnant. The client has been diagnosed with hypertension and will begin prescribed pharmacological treatment. The nurse will clarify which medication if observed in the client’s record?
A
Spironolactone
B
Methyldopa
C
Lisinopril Correct Answer
D
Hydralazine
Question Explanation
Rationale: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension. ACE inhibitors are pregnancy risk category D and are contraindicated during the second and third trimesters of pregnancy. Spironolactone and methyldopa are pregnancy risk category B and have been used routinely and safely during pregnancy. Hydralazine is a pregnancy risk category C, but its use has been proven to be safe during pregnancy.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
A
Question 2
A nurse is preparing to administer plasma to a client with a coagulation disorder. Which identification step will the nurse verify prior to initiating the transfusion?
Cross match
B
Expiration date
C
ABO compatibility Correct Answer
D
Hemoglobin level
Question Explanation
Rationale: Plasma is a blood product that needs to be typed prior to administration to avoid a reaction. Typing determines if the blood product is compatible with the client’s blood type. A cross match for antigens is only required for transfusions containing red blood cells. The expiration date is an important component to check prior to administration. However, this does not identify the client. Plasma does not contain red blood cells, so checking the hemoglobin level is not indicated and does not identify the client.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
question?
A
Continuous infusion of dextrose 5% in 0.9% saline Correct Answer
B
NPH insulin 40 units before meals
C
Labetalol 100 mg orally twice per day Your Answer
D
Ketorolac 15 mg IV push as needed for pain
Question 3
The nurse is preparing to administer newly prescribed intravenous phenytoin to a client. When reviewing the client’s medical record, which prescription should the nurse
A
Involuntary muscle movements Correct Answer
B
Report of increased fatigue
C
Onset of headaches
D
Difficulty with sleep
Question Explanation
Rationale: Metoclopramide is a GI stimulant that is effective in reducing headache, nausea, and vomiting. Metoclopramide can cause a serious movement disorder called tardive dyskinesia (TD). This condition is often irreversible. TD is characterized by involuntary movements of the face, tongue, or extremities. The risk of developing TD is increased with longer treatment and increased dosage. To help prevent TD, this drug shouldn’t be used for longer than 12 weeks. The more common side effects of metoclopramide can include headache, confusion, drowsiness, dizziness, restlessness, and insomnia.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
healthcare provider?
A
Blurred vision
B
Orange-tinged tears
C
Dark amber urine Correct Answer
D
Question 6
The nurse is assessing a client who is taking rifampin for the treatment of tuberculosis. Which finding reported by the client should the nurse immediately report to the
[Date]^5
Diarrhea
Question Explanation
Rationale: Rifampin causes a temporary yellow-orange discoloration of body fluids. Soft contact lenses may be permanently stained. Dark amber urine is an indication of liver dysfunction and should be reported. A major adverse effect of ethambutol, not rifampin, is optic neuritis. Diarrhea is a common side effect of antibiotics and is not the priority in this case.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
Question 7
The nurse is collecting the health history for a client who reports a sudden onset of generalized weakness and fatigue. The nurse notes the client has a new prescription for spironolactone. Which action should the nurse take first?
A
Review the drug formulary for side effects Correct Answer
B
Request the health care provider to stop the medication Your Answer
C
Notify the pharmacist of the findings
D
Document the findings
Question Explanation
Rationale: During medication administration, it is important for the nurse to assess knowledge of drugs, including adverse effects and physiologic factors that affect drug action. Information about specific drugs is available in pharmacology texts and drug reference books. Calling the health care provider may be an option after reviewing the drug formulary. The nurse should notify the pharmacist if the medication is the cause of the symptoms. The nurse will document the findings, but the priority is to review the formulary.
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―Eat plenty of foods that contain calcium such as milk.‖
D
―Choose foods that are high in iron content such as shellfish.‖
Question Explanation
Rationale: Amiloride is a potassium-sparing diuretic used in the treatment of edema, hypertension, and potassium loss caused by other diuretic medications. Amiloride may cause hyperkalemia, so the client should be informed to limit their potassium intake. Sodium, calcium, and iron are not affected by the use of amiloride.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
A
―This medication is used to reduce your risk of seizures.‖ Correct Answer
B
―This medication will raise your blood pressure.‖
C
―This medication might make you urinate more frequently.‖
D
―This medication will be discontinued once your headache subsides.‖
Question Explanation
Rationale: Magnesium sulfate is a medication that is used to prevent seizures for clients with preeclampsia. The medication will not raise blood pressure and has no effect on urination. Magnesium is given continuously and will not be discontinued if the client’s headache subsides.
Question 10
The nurse is educating a client with preeclampsia about magnesium sulfate. Which statement should the nurse include in the teaching?
Question 11
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
The nurse is providing medication teaching for a client prescribed famotidine for the treatment of gastroesophageal reflux disease (GERD). Which statement by the client indicates an understanding of the teaching?
A
―I will take this medication once a day in the morning.‖
B
―I will no longer have discomfort at night once I begin this medication.‖
C
―This medication will both prevent and treat heartburn.‖ Correct Answer
D
―My treatment will be done in one week.‖
Question Explanation
Rationale: H2 receptor blockers (antagonists) are used to prevent and treat conditions caused by too much acid being produced in the stomach. These conditions include gastric ulcers, duodenal ulcers, and GERD. Famotidine may be prescribed to take twice a day, in the morning and evening, or just once daily in the evening. Duration of treatment varies but is at a minimum two weeks.
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NCLEX: Pharmacological and Parenteral Therapies
A
―I will rinse my mouth with water after using the inhaler.‖ Correct Answer
B
―Disinfectant wipes can be used to clean the spacer.‖
Question 12
The nurse is educating a client on self-administration of a fluticasone inhaler. What statement indicates an understanding of the teaching?
Question 15
contraindications to this method. Acne is a side effect of oral contraceptives but not a contraindication.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
the nurse take prior to administration?
A
Assess the client’s swallowing ability Correct Answer
B
Place the client in the supine position
C
Remove any oxygen delivery devices
D
Place all tablets into a pill cup together
Question Explanation
Rationale: Prior to administration, the client’s swallowing ability should be assessed. If any difficulty swallowing is identified, oral medications should not be administered. When administering oral medications, the client should be placed in a high-Fowler’s position, and oxygen delivery devices should only be removed temporarily if they impede the ability to take the medication (a nasal cannula should not be removed). Oral medications should be administered one at a time rather than all together.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
A nurse is assessing a client diagnosed with diabetic ketoacidosis. The client is on a prescribed regular insulin infusion at 0.1 units/kg/hr. The client appears restless and verbalizes tingling to the extremities. Which action does the nurse perform next?
A
Question 14
The nurse is preparing to administer a client’s oral medications. Which action should
[Date]
Question 16
Check the client’s capillary blood glucose Correct Answer
B
Stop the regular insulin infusion
C
Increase the infusion to 0.15 units/kg/hr
D
Give the client 4 oz of fruit juice
Question Explanation
Rationale: The client is experiencing symptoms of hypoglycemia. Prior to decreasing the dose of the infusion, the nurse should assess the client’s blood glucose level to confirm the hypoglycemia. Prior to stopping the infusion, the nurse needs to assess the client’s blood sugar level and notify the healthcare provider of the results. Increasing the infusion will cause further hypoglycemia. Prior to performing an intervention to correct the hypoglycemia, the nurse needs to assess the blood glucose level first.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
During morning rounds, a healthcare provider informs a client with hypertension that a calcium channel blocker will be added to their treatment regimen. The nurse notes a new prescription for amiloride 10 mg PO daily. Which action does the nurse perform next?
A
Clarify the prescription with the healthcare provider Correct Answer
B
Educate the client on the new prescription
C
Administer the medication with food
D
Assess the client’s blood pressure
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Question 18
A nurse has administered acetaminophen for pain relief to an infant. Based on the client’s development stage, which action is most important to include in the medication administration record?
A
The dose administered based on the client’s weight Correct Answer
B
The client’s pain level after administration of the medication
C
The time the dose was administered to the client
D
The client’s vital signs before the medication was administered Your Answer
Question Explanation
Rationale: The most important action to document in the client’s medical record is the dose administered. The dose of acetaminophen administered to infants is based on weight. Infants should not exceed more than 5 doses of 10-15 mg/kg/dose in a 24-hour period. Documenting the pain level after administration of analgesics, the time the dose was administered, and the latest vital signs should be performed on every client regardless of their developmental stage.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
A
Blood sugar is 115 mg/dl
B
White blood cell count is 11,500 Correct Answer
C
Albumin level is 3.7 g/dl Your Answer
Question 19
The nurse is caring for a client receiving total parenteral nutrition (TPN). The TPN has been infusing 24 hours. Which of the following findings requires intervention?
Question 20
D
Potassium level is 3.6 mmol/l
Question Explanation
Rationale: An increase in WBC count is an indication of infection. Dextrose in TPN increases the risk of infection. Assess for signs and symptoms of infections at the site (redness, tenderness, discharge) and systemically (fever, increased WBC, malaise). The site dressing should be dry and intact. Blood glucose, albumin, and potassium are some of the labs that are monitored while a client is on TPN. The results in this example are expected findings.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
The nurse is caring for a client prescribed warfarin therapy for treatment of persistent atrial fibrillation. Which of the following may potentiate the effect of this medication?
A
St. John’s wort Your Answer
B
Estrogen
C
Vitamin K
D
Green tea Correct Answer
Question Explanation
Rationale: Warfarin, an anticoagulant agent used to prevent thrombosis and risk of stroke in clients with atrial fibrillation, is associated with many drug and food interactions. Careful assessment with a pharmacist/formulary is recommended to avoid potential complications. Green tea can potentiate the effect of warfarin and increase
Question 1
A nurse is reviewing a client’s medical history. The client has been newly diagnosed with hypertension and has been prescribed oral losartan as treatment. The nurse will clarify the use of losartan if which comorbidity is noted in the client’s medical record?
A
Renal stenosis Correct Answer (Blank)
B
Hyperlipidemia
C
Atrial fibrillation
D
Diabetes
Question Explanation
Rationale: Losartan is an angiotensin II receptor blocker used in the treatment of hypertension. Losartan is contraindicated in clients with renal stenosis due to the risk of kidney injury. Hyperlipidemia, atrial fibrillation, and diabetes are not known to be contraindicated in the use of losartan.
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NCLEX: Pharmacological and Parenteral Therapies
A
Check the client’s wristband against the blood component Correct Answer (Blank)
B
Verify the blood component independently against the provider’s prescription
C
Match the blood component to the client’s consent form
Question 2
A nurse is preparing to initiate a blood transfusion on a client with anemia. Which step will the nurse perform to prevent a transfusion error?
[Date]
Question 3
D
Place a blood component identification label in the client’s medical record
Question Explanation
Rationale: One of the verification steps before a transfusion is to match the client to the blood component. Checking the client’s wristband against the blood component verifies the correct client is receiving the transfusion. The verification should be between two people or one person accompanied by automated identification technology such as a bar code. The consent form verifies the client agreed to the transfusion. However, this does not prevent a misidentification error. Placing an identification label in the client’s medical record verifies the transfusion occurred but does not prevent a transfusion error.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
The nurse is monitoring a client who received a first dose of intravenous ampicillin. Which finding should indicate to the nurse that the client may be experiencing an allergic reaction?
A
Abdominal pain
B
Increase in blood pressure
C
Hypotensive bowel sounds
D
Hives on the extremities Correct Answer (Blank)
Question Explanation
Rationale: If the client experiences an allergic reaction to medications they may display systemic signs such as hives, pruritus, dyspnea, etc. Abdominal pain, hypertension, and hyperactive bowel sounds do not indicate an allergic reaction.
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Headache
C
Palpitations Correct Answer (Blank)
D
Muscle aches
Question Explanation
Rationale: Side effects of albuterol include nervousness, shakiness, headache, throat irritation, and muscle aches. Muscle tremor is the most frequent adverse effect. The main risks with adrenergic bronchodilators, particularly in older adults, are excessive cardiac and central nervous system (CNS) stimulation. Symptoms of cardiac stimulation include angina, tachycardia, and palpitations. Symptoms of central nervous system (CNS) stimulation consist of agitation, anxiety, insomnia, seizures, and tremors. Other reported effects may include serious dysrhythmias and cardiac arrest.
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NCLEX: Pharmacological and Parenteral Therapies
Question 6
The nurse is assessing a client with tuberculosis who has been taking prescribed pyrazinamide. Which finding reported by the client should the nurse immediately report to the healthcare provider?
A
Joint pain Correct Answer (Blank)
B
Fatigue
C
Nausea
D
Decreased appetite
Question 7
Question Explanation
Rationale: Joint pain is a symptom of gout, which is a side effect of pyrazinamide. While fatigue, nausea, and loss of appetite are common side effects of the drug, the joint pain is the priority.
Concepts tested
NCLEX: Pharmacological and Parenteral Therapies
The nurse is preparing to administer prescribed digoxin to client with atrial fibrillation. The nurse notes the packaging for the medication is provided in a different route than prescribed. Which action should the nurse take?
A
Administer the medication as ordered
B
Consult the pharmacist regarding the error Correct Answer (Blank)
C
Alert the charge nurse to the medication error
D
Contact the health care provider
Question Explanation
Rationale: Careful consultation with a pharmacist regarding the error is the most appropriate action for the nurse to take if an error occurs when the pharmacy dispenses the medication. The medication as provided by the pharmacy is incorrect and cannot be administered. The charge nurse may be alerted, but the pharmacy can correct the error.
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NCLEX: Pharmacological and Parenteral Therapies
medication?
Question 8
A nurse has administered sublingual nitroglycerin to a client in the emergency department. Which clinical finding indicates an adverse response to the
