NCLEX-PN
Pharmacological and Parenteral Therapies NCLEX Questions Questions
Extract:
Question 1 of 5
The 5-year-old is receiving an IV infusion of D5 with 0.45 NaCl at 100 mL/hr. Which assessment findings suggest excessive parenteral fluid intake? Select all that apply.
Correct Answer: A,B,D
Rationale: A: Dyspnea indicates fluid volume overload and occurs from fluid rapidly shifting between the intracellular and extracellular compartments. B: Lethargy and change in level of consciousness can occur from fluid shifting in brain cells. C: Gastric distention can occur from excessive oral (not IV) fluid intake or infection. D: Crackles indicate fluid volume overload and occur from fluid rapidly shifting into the alveoli. E: An elevated temperature is a sign of fluid volume deficit, not excess.
Question 2 of 5
The client with tonsillar cancer is receiving filgrastim. Prior to administering the next dose of filgrastim, the nurse notes that the client's absolute neutrophil count is 11,000/mm3. What is the nurse's best action?
Correct Answer: C
Rationale: A: Unnecessary doses can cause leukocytosis (WBCs above 100,000/mm3), an adverse effect of filgrastim. B: A normal neutrophil count is greater than 2000/mm3. Neutropenic precautions and protective wear are unnecessary because the filgrastim has been effective in increasing the neutrophil count. C: Filgrastim (Neupogen) is a granulocyte colony-stimulating factor for treatment of neutropenia. Filgrastim is usually discontinued when the absolute neutrophil count reaches 10,000/mm3. D: A high-efficiency particulate air (HEP
A) or N95 mask rather than a regular mask should be worn if the client is severely neutropenic (less than 100/mm3).
Question 3 of 5
At discharge, the nurse documents that the client taking lithium has an accurate understanding of self-care. On which client statement should the nurse base this judgment?
Correct Answer: D
Rationale: The client must consume adequate dietary sodium and 2500 to 3000 mL of fluid per day to prevent dehydration leading to lithium toxicity.
Question 4 of 5
The nurse is teaching the 14-year-old who is being given captopril for the first time. Which explanation would be most appropriate?
Correct Answer: D
Rationale: A: Captopril does not have any effect on asthma. B: While HR may slow in response to lowered BP, this is not the desired effect for which captopril is given. C: Captopril does not have any effect on blood sugar. D: Captopril (Capoten) is an ACE inhibitor and is indicated for the treatment of hypertension in children.
Question 5 of 5
The 30-year-old has been taking olanzapine for the past 5 years for the treatment of schizophrenia. The client, who has a positive family history of DM, is now overweight but is not showing signs of hyperglycemia. When the client asks about the next steps for treatment, how should the nurse respond?
Correct Answer: C
Rationale: Due to the risk of hyperglycemia with olanzapine (Zyprexa), blood glucose testing is needed to determine if medication therapy is indicated.