NCLEX-PN
NCLEX Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
A serious complication of a total hip replacement is displacement of the prosthesis. What is the primary sign of displacement?
Correct Answer: A
Rationale: Pain on movement and weight bearing indicates pressure on the nerves or muscles caused by the dislocation. Other symptoms of dislocation include an inability to bear weight and a shortening of the affected leg. Edema is not a primary sign of displacement.
Question 2 of 5
The client is admitted to the ED with tachypnea, tachycardia, and hypotension. The client has been taking theophylline for treatment of asthma and erythromycin for an upper respiratory tract infection. Which conclusion and action taken by the nurse is correct?
Correct Answer: C
Rationale: A: Symptoms of an asthma attack would include wheezing and other signs of air hunger. B: Additional signs would need to be present to suspect septicemia, such as an elevated temperature and skin flushing. C: Tachypnea, tachycardia, and hypotension are signs of theophylline (Theo-Dur) toxicity. These occur because macrolide antibiotics such as erythromycin inhibit the metabolism of theophylline. Obtaining an order for a theophylline level will expedite the client's treatment. D: Symptoms could suggest an allergic reaction, but epinephrine would be ordered, not diphenhydramine.
Question 3 of 5
The client's dose of mirtazapine was increased from 15 to 30 mg at bedtime two days ago. When the nurse is preparing to administer mirtazapine, the client reports having insomnia, irritability, and panic attacks. What should the nurse do next?
Correct Answer: A
Rationale: Mirtazapine (Remeron) is an antidepressant. Adverse effects include insomnia, irritability, panic attacks, and suicidal ideation. A change in medication may be needed rather than a dosage increase.
Question 4 of 5
The nurse is reviewing documentation on four clients prior to administering medications. The nurse should immediately withhold the medication and notify the HCP about which client?
Correct Answer: D
Rationale: Client 4's symptoms of tardive dyskinesia (lip smacking, uncontrolled rhythmic movements) may be irreversible, requiring immediate medication withdrawal and HCP notification.
Question 5 of 5
The client calls a clinic 2 weeks after taking oral carbidopa-levodopa, stating that the medication has been ineffective in controlling the symptoms of PD. What nursing action is most important?
Correct Answer: C
Rationale: A: Reviewing the method for taking carbidopa-levodopa, including foods to avoid, may be important, but option C is most important. More information is needed to determine whether the client is taking it correctly. B: A dosage change is unnecessary because it has been only two weeks since the client started carbidopa-levodopa. C: With oral administration of carbidopa-levodopa (Sinemet), it usually takes 1 to 2 months before an effect is noted, although in some cases it may require up to 6 months. D: A high-protein diet can slow or prevent absorption of carbidopa-levodopa. Vitamin B6 increases the action of decarboxylases that destroy levodopa in the body's periphery, reducing the effects of carbidopa-levodopa. Foods high in pyridoxine should be avoided.