NCLEX-PN
NCLEX Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The client experiencing an acute attack of gouty arthritis is prescribed colchicine 1 mg IV now and then 0.5 mg q6h. Colchicine 0.5 mg/mL in a 2-mL ampule is available. How many milliliters should the nurse administer for the initial dose?
Correct Answer: 2
Rationale: Use a proportion formula; multiply the extremes (outside values) and then the means (inside values), and solve for X. 0.5 mg: 1 mL :: 1 mg: X mL; 0.5X = 1; 1 / 0.5 = 2; X = 2 mL. Colchicine (Colcrys) interferes with the function of WBCs in initiating and perpetuating the inflammatory response to monosodium urate crystals.
Question 2 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 3 of 5
The unresponsive client with DM is admitted to the ED with a serum glucose level of 35 mg/dL. Which medication should the nurse plan to administer?
Correct Answer: D
Rationale: A: Exenatide (Byetta), a synthetic incretin mimetic, is used as an adjunct in type 2 diabetes to decrease blood glucose levels. B: Pramlintide (Symlin) lowers postprandial glucose levels by slowing gastric emptying. C: Miglitol (Glyset), an alpha-glucosidase inhibitor, lowers postprandial serum glucose levels. D: The nurse should plan to administer glucagon (GlucaGen). Glucagon, administered intramuscularly, intravenously, or subcutaneously, is used in unconscious clients with diabetes to reverse severe hypoglycemia from insulin overdose. Normal serum glucose is 70 to 110 mg/dL.
Question 4 of 5
The client with Addison's disease is taking fludrocortisone 100 mcg orally once daily. Which statement made by the client regarding the fludrocortisone therapy requires further teaching by the nurse?
Correct Answer: B
Rationale: A: The client should check with the HCP about getting vaccinations such as influenza; a chronic condition increases the client's risk for other illnesses and complications. B: The client needs further teaching if stating that he or she will stop taking fludrocortisone (Florinef) if his or her blood sugar levels are too high; stopping mineralocorticoid replacement therapy abruptly may lead to addisonian crisis. C: Common adverse effects of fludrocortisone include edema, arrhythmias, and hypertension; stating that he or she should monitor weight, BP, and pulse daily is appropriate. D: Common adverse effects of fludrocortisone include hypokalemia; stating that he or she should consume potassium-rich foods is appropriate.
Question 5 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.