NCLEX-PN
NCLEX-PN Quizlet 2023 Questions
Extract:
Question 1 of 5
A client needs to rapidly achieve a therapeutic plasma drug concentration of a medication. Rather than wait for steady state to be achieved, the physician might order:
Correct Answer: B
Rationale:
To rapidly achieve a therapeutic plasma drug concentration, a loading or priming dose is ordered. This dose quickly establishes the desired drug level. It is calculated by multiplying the volume of distribution by the desired plasma drug concentration. A maintenance dose, like choice A, is used to maintain the therapeutic level after the loading dose. Waiting for steady state without a loading dose would take five drug half-lives.
Choice C, a medication with no first-pass effect, does not directly address the need for rapid attainment of therapeutic levels. While intravenous administration (choice
D) offers excellent bioavailability, a single dose by this route may not achieve the desired therapeutic plasma concentration as rapidly as a loading dose.
Question 2 of 5
A client has been taking a drug (Drug A) that is highly metabolized by the cytochrome P-450 system. He has been on this medication for 6 months. At this time, he is started on a second medication (Drug B) that is an inducer of the cytochrome P-450 system. You should monitor this client for:
Correct Answer: C
Rationale: When a client is taking a drug (Drug
A) metabolized by the cytochrome P-450 system and is then started on another drug (Drug
B) that induces this system, the metabolism of Drug A is increased. This results in decreased therapeutic effects of Drug A as it is broken down more rapidly. Monitoring is required to address potential reduced efficacy. The therapeutic effect of Drug A is diminished, not enhanced. Inducing the cytochrome P-450 system does not directly increase the adverse effects of Drug B. Although Drug B is an inducer, its therapeutic effects are not decreased as it is not metabolized faster.
Question 3 of 5
High uric acid levels can develop in clients who are receiving chemotherapy. This can be caused by:
Correct Answer: B
Rationale: The correct answer is 'rapid cell catabolism.' During chemotherapy, rapid cell destruction occurs, leading to an increase in uric acid levels as a byproduct of cell breakdown. High uric acid levels are primarily a result of the rapid breakdown of cells during chemotherapy, not due to the kidneys' inability to excrete drug metabolites (
Choice
A). The prophylactic antibiotics given concurrently do not directly cause high uric acid levels (
Choice
C). The altered blood pH from the acidic nature of the drugs (
Choice
D) is not a direct cause of elevated uric acid levels; the main mechanism is the rapid cell catabolism that occurs during chemotherapy.
Question 4 of 5
In the treatment of symptomatic bradycardia, which medication is most commonly recognized?
Correct Answer: D
Rationale: Atropine is the medication most commonly recognized for the treatment of symptomatic bradycardia because it increases the rate of conduction in the AV node, helping to alleviate bradycardia. Questran is a medication used to lower cholesterol levels and is not indicated for bradycardia. Digitalis, such as Digoxin, is used for heart failure and atrial fibrillation but not typically for bradycardia. Nitroglycerin is primarily used for angina and not bradycardia.
Question 5 of 5
A client has been diagnosed with Disseminated Intravascular Coagulation (DIC) and transferred to the medical intensive care unit (ICU) following an acute bleeding episode. In the ICU, continuous Heparin drip therapy is initiated. Which of the following assessment findings indicates a positive response to Heparin therapy?
Correct Answer: B
Rationale: Effective Heparin therapy should halt the process of intravascular coagulation, leading to increased availability of fibrinogen. Heparin interferes with thrombin-induced conversion of fibrinogen to fibrin.
Therefore, an increased fibrinogen level indicates a positive response to Heparin therapy. While increased platelet count and decreased bleeding are positive outcomes, the specific indicator for Heparin therapy response is the increase in fibrinogen level. Decreased fibrin split products would also be a positive response, but an increase in fibrinogen directly reflects the impact of Heparin therapy.