Download RN Pharmacology 2024 Complete Exam Guide – 242 Real NCLEX Questions and Verified Answers and more Exams Nursing in PDF only on Docsity!
RN Pharmacology 2024 Complete Exam Guide –
242 Real NCLEX Questions and Verified Answers
with Rationales | A+ Graded for Nursing Students
Question 1: Transdermal Patch Application A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I will clean the site with an alcohol swab before I apply the patch." B. "I will rotate the application sites weekly." C. "I will apply the patch to an area of skin with no hair." ✅ D. "I will place the new patch on the site of the old patch." Correct Answer: C Rationale: Applying the patch to hairless skin promotes better absorption and ensures secure adhesion. Alcohol can irritate the skin and affect absorption (A is incorrect). Application sites should be rotated daily , not weekly (B is incorrect). Applying a new patch on the same site can cause skin irritation (D is incorrect). Question 2: Trough Level Monitoring A nurse reviewing a client’s medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take? A. Obtain a blood specimen immediately prior to administering the next dose of medication. ✅ B. Verify that the client has been taking the medication for 24 hr before obtaining a blood specimen. C. Ask the client to provide a urine specimen after the next dose of medication. D. Administer the medication, and obtain a blood specimen 30 min later. Correct Answer: A
Rationale: Trough levels are measured just before the next dose to determine the lowest concentration of the drug in the bloodstream. This ensures the medication remains within the therapeutic range. Options B, C, and D do not reflect the appropriate timing or method for trough level testing. Question 3: Legal Responsibilities in Medication Administration A nurse is preparing a client’s medications. Which of the following actions should the nurse take in following legal practice guidelines? (Select all that apply.) A. Maintain skill competency. ✅ B. Determine the dosage. C. Monitor for adverse effects. ✅ D. Safeguard medications. ✅ E. Identify the client’s diagnosis. Correct Answers: A, C, D Rationale: Nurses are legally responsible for maintaining competency (A), monitoring for adverse effects (C), and safeguarding medications (D), especially controlled substances. Determining dosages (B) and diagnosing (E) are outside the nurse’s scope and are the provider’s responsibility. Question 4: Type of Prescription A nurse reviewing a client's health record notes a new prescription for lisinopril 10 mg PO once every day. The nurse should identify this as which of the following types of prescription? A. Single B. Stat C. Routine ✅ D. Standing ✅ Correct Answer: C Rationale: A routine (or standing) prescription is administered on a regular schedule until the provider discontinues it. A single order is for one-time use. A stat order is for immediate administration. A standing order can be protocol-based and used in specific situations.
A. Increased renal secretion B. Increased medication-metabolizing enzymes C. Liver failure D. Peripheral vascular disease E. Concurrent use of medication the same pathway metabolizes - - correct ans- - Answer: C. Liver failure decreases metabolism and thus increases the concentration of a medication. This requires decreasing the dosage. E. When the same pathway metabolizes two medications, they compete for metabolism, thereby increasing the concentration of one or both medications. This requires decreasing the dosage of one or both medications. A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.) A.have the client lie on her side. B.Ask the client to look up at the ceiling. C.Tell the client to blink when the drops enter her eye.
D.Drop the medication into the center of the client's conjunctival sac. E.Instruct the client to close her eye gently after instillation - - correct ans- - B. The client should look upward to keep the drops from falling onto her cornea. D. The nurse should drop the medication into the center of the conjunctival sac to promote distribution. E. The client should close her eye gently to promote distribution of the medication A nurse is admitting a client and completing a preassessment before administering medications. Which of the following data should the nurse include in the preassessment? (Select all that apply.) A.Use of herbal teas B.Daily fluid intake C.Current health status D.Previous surgical history E.Food allergies - - correct ans- - A. The nurse should inquire about the client's use of herbal products, which often contain caffeine, prior to medication
A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero. - - correct ans- - 22 gtt/min A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero. - - correct ans- - 200 mL/hr A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is furosemide oral solution 10 mg/1 mL. how many mL should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.) - - correct ans- - 8 mL A nurse is preparing to administer haloperidol 2 mg PO every 12 hr. The amount available is haloperidol 1 mg/tablet. how many tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero. - - correct ans- - 2 tablets A nurse is preparing to administer amoxicillin 20 mg/kg/day PO to divide equally every 12 hr to a preschooler who weighs 44 lb. The amount available is amoxicillin suspension 250 mg/ mL. how many mL should the nurse administer per dose? (Round the answer
to the nearest whole number. Do not use a trailing zero.) - - correct ans- - 4 mL A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. how many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Do not use a trailing zero. - - correct ans- - 0.8 mL A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen liquid 500 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero. - - correct ans- - 6.5 mL A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero. - - correct ans- - 125 mL/hr A nurse is assessing a client's IV infusion site. Which of the following findings should the nurse identify as an indication of phlebitis? (Select all that apply.) A.Pallor B.Dampness C.Erythema D.Coolness
B.Select the back of the client's hand to insert the IV catheter. C.Distend the veins by using a blood pressure cuff. D.Direct the client to raise his arm above his heart - - correct ans- - C.The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the vein, which can result in a hematoma. A nurse assessing a client's IV catheter insertion site notes a hematoma. Which of the following actions should the nurse take? (Select all that apply.) A.Stop the infusion. B.Apply alcohol to the insertion site. C.Apply warm compresses to the insertion site D.Elevate the client's arm. E.Obtain a specimen for culture at the insertion site - - correct ans- - C. Warm compresses can help promote healing of a hematoma. D. Elevation of the arm helps reduce edema, which can cause pressure and pain and additional bleeding in the area of the hematoma.
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.) A.A client at 8 weeks of gestation who asks for an influenza immunization B.A client who takes prednisone and has a possible fungal infection C.A client who has chronic liver disease and is taking hydrocodone D.A client who has peptic ulcer disease, takes sucralfate, and tells the nurse she has started taking OTC aluminum hydroxide E.A client who has a pr osthetic heart valve, takes warfarin, and reports a suspected pregnancy - - correct ans- - B. Glucocorticoids should not be taken by a client who has a possible systemic fungal infection. The nurse should recognize a contraindication and notify the provider. C. Acetaminophen is contraindicated due to toxicity for a client who has a liver disorder. The nurse should notify the provider,
A."Be sure to limit your potassium intake while taking the medication." B."You should check your blood pressure every 8 hours while taking this medication." C."Your medication dosage will be increased if you develop tachycardia." D."Change positions slowly when you move from sitting to standing." - - correct ans- - D. Orthostatic hypotension is a common adverse effect of antihypertensive medications. The client should move slowly to a sitting or standing position and should be taught to sit or lie down if lightheadedness or dizziness occurs A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client? A.Cardiovascular B.Immune C.Central nervous
D.Gastrointestina - - correct ans- - C. The nurse should realize that extrapyramidal effects are movement disorders that can be caused by a number of central nervous system medications, such as typical antipsychotic medications A nurse is caring for a client who is taking oral oxycodone The client states he is also taking ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings? A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication B.A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication C.An increase in the expected therapeutic effect of both medications D.An increase in expected adverse effects for both medications - - correct ans- - C. These medications work together to increase the pain-relieving effects of both medications. Oxycodone is a narcotic analgesic, and ibuprofen is an NSAID. They work by different mechanisms, but pain is better relieved when they are taken together A nurse is preparing to administer medications to a 4-month-old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply.)
following immunizations may the nurse administer safely to this client? A.Varicella vaccine B.Rubella vaccine C.Inactivated influenza vaccine D.measles vaccine - - correct ans- - C. During influenza season, providers recommend the inactivated influenza vaccine for women who are pregnant A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness? A.Reduced cardiac function B.First-pass effect C.Reduced hepatic function D.Increased gastric motility - - correct ans- - C. Older adults have reduced hepatic function, which can prolong the effects of medications the liver metabolizes. The client probably needs a lower dosage of the hypnotic medication
A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority? A.Administer flumazenil. B.Identify the client's level of orientation. C.Infuse IV fluids. D.Prepare the client for gastric lavage - - correct ans- - B. The first action the nurse should take when using the nursing process is to assess the client. Identifying the client's level of orientation is the priority action. A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? A."I should take the medication on an empty stomach." B."I will follow a low-sodium diet while taking this medication." C."I need to discontinue this medication slowly." D."I should not crush this
C."You should take the medication when needed for obsessive urges." D."monitor for weight gain while taking this medication." - - correct ans- - A. Paroxetine can take 1 to 4 weeks before the client reaches full therapeutic benefit. A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (Select all that apply.) A.Concurrent administration of buspirone B.Administration of a different SSRI C.Use of a mouth guard D.Changing to a different class of antidepressant medication E.Increasing the dose of paroxetine - - correct ans- - A. Concurrent administration of a low dose of buspirone is an effective measure to manage the adverse effects of paroxetine C.Using a mouth guard during sleep can decrease the risk for oral damage resulting from bruxism.
D. Changing to different class of antidepressant medication that does not have the adverse effect of bruxism is an effective measure A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication? A.Orthostatic hypotension B. hearing loss C.Gastrointestinal bleeding D.Weight loss - - correct ans- - A.Orthostatic hypotension is an adverse of effect of mAOIs, including phenelzine. A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.) A.Expect therapeutic effects in 24 to 48 hr. B.Discontinue the medication after a week of improved mood.
