NCLEX-PN
NCLEX Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
Oral ranitidine 2 mg/kg twice daily is prescribed for the infant weighing 16 lb 8 oz. The medication is supplied as 15 mg/mL. How many milliliters should the nurse instruct the parent to withdraw in the syringe provided with the ranitidine to administer one dose?
Correct Answer: 1
Rationale: Use a proportion formula to calculate the dose. First determine the dose for the child's weight: 16 lb 8 ounces = 16.5 lb/ 2.2 lb/kg = 7.5 kg. Next determine the prescribed dose: 7.5 kg x 2 mg = 15 mg. The medication is supplied in 15 mg per 1 mL. The dose to administer is 1 mL of ranitidine (Zantac).
Question 2 of 5
The HCP prescribes risperidone to manage the hallucinations of the client diagnosed with paranoid schizophrenia. Which client statements reflect a need for further education regarding the medication's side effects? Select all that apply.
Correct Answer: A,B
Rationale: Constipation, not diarrhea, and hypotension, not hypertension, are side effects of risperidone, indicating a need for further education.
Question 3 of 5
The nurse is discharging the child with sickle cell disease who has undergone a splenectomy. The child has an allergy to penicillin. The nurse should anticipate teaching about which prophylactic medication?
Correct Answer: D
Rationale: A: Epoetin (Epogen) stimulates the bone marrow to produce RBCs. In sickle cell disease, increasing the production of sickled RBCs can worsen the condition. B: Amoxicillin (Amoxil) is contraindicated when allergies to penicillin are present. C: Opioids such as morphine sulfate are administered in sickle cell crises or for severe pain; it is usually not given prophylactically. D: The ability to fight infection is decreased following a splenectomy. Daily prophylactic antibiotics are given. Erythromycin ethylsuccinate (E.E.S.) is a macrolide antibiotic and safe to administer when a penicillin allergy exists.
Question 4 of 5
Cyclosporine and methotrexate are prescribed for the client with severe rheumatoid arthritis. What information should the nurse address when teaching the client? Select all that apply.
Correct Answer: B,C,E
Rationale: A: Grapefruit juice should be avoided because it can increase the concentration of cyclosporine. B: Adequate hydration minimizes the risk of adverse effects. C: St. John's wort decreases cyclosporine levels. Echinacea and melatonin interact with cyclosporine to alter immunosuppression. D: Methotrexate and cyclosporine can be taken orally instead of by injection. It is incorrect that both medications are taken weekly. Only methotrexate is taken weekly, whereas cyclosporine is usually taken twice daily. E: Methotrexate and cyclosporine both have immunosuppressive effects.
Question 5 of 5
The client with CRF receives a sodium polystyrene sulfonate enema. Which finding indicates that the medication is achieving the desired therapeutic effect?
Correct Answer: D
Rationale: A: Although sodium polystyrene sulfonate may be administered as an enema and stool may return, the purpose of the medication is to lower serum potassium levels and not to empty the bowel. B: The client should be encouraged to retain the enema solution for as long as possible so that sodium ions can be exchanged for potassium ions in the intestine, but its retention for this length of time does not indicate its effectiveness in lowering the serum potassium level. C: The client may be constipated prior to receiving the enema, but this is not the purpose of a sodium polystyrene sulfonate enema. D: Sodium polystyrene sulfonate exchanges sodium ions for potassium ions in the intestine and is administered when the client has hyperkalemia. A normal serum potassium level of 4.0 mEq/L indicates that the medication is achieving its desired therapeutic effect.