NCLEX-PN
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The client is prescribed medications on hospital admission. Four days later the client's serum creatinine level, which was normal at admission, is now 3.7 mg/dL. The nurse should contact the HCP regarding a dosage change for which medication?
Correct Answer: A
Rationale: A: The nurse should contact the HCP regarding ceftriaxone (Rocephin). Ceftriaxone, a third-generation cephalosporin antibiotic, is 33% to 67% excreted in the urine unchanged. Dosage reduction or increased dosing interval is recommended in renal insufficiency because ceftriaxone is nephrotoxic and can further damage the kidneys. B: Insulin glargine (Lantus) is partially metabolized at the site of injection to active insulin metabolites and partially metabolized by the liver, the spleen, the kidney, and muscle tissue; no dose reduction is necessary unless serum glucose levels fluctuate. C: Diltiazem (Cardizem) is mostly metabolized by the liver; no dose reduction is necessary. D: Furosemide (Lasix) is 30% to 40% metabolized by the liver with some nonhepatic metabolism and renal excretion as unchanged medication; no dose reduction is necessary.
Question 2 of 5
The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
Correct Answer: D
Rationale: The D-dimer test specifically detects fibrin degradation products, indicating DIC's characteristic clotting and fibrinolysis. Other tests are less specific.
Question 3 of 5
For a client with suspected appendicitis, the nurse should expect to find abdominal tenderness in which quadrant?
Correct Answer: C
Rationale: The nurse should expect to find abdominal tenderness in the lower-right quadrant in a client with appendicitis.
Question 4 of 5
The nurse is developing the teaching plan for the client who is started on amitriptyline. Which information is most appropriate to include?
Correct Answer: A
Rationale: Weight gain is often a major concern for clients taking TCAs such as amitriptyline (Elavil). A calorie-controlled diet plan will assist in avoiding weight gain.
Question 5 of 5
The 16-year-old is taking acyclovir. Which statement, if made by the adolescent, should indicate to the nurse that the medication is having the desired therapeutic effect?
Correct Answer: C
Rationale: A: A side effect of acyclovir is a change in the menstrual cycle; however, having a regular menstrual cycle is not the desired therapeutic effect. B: A bad odor from the vagina is a symptom of bacterial vaginosis or trichomoniasis vaginalis, and usually not a symptom of genital herpes simplex. C: Acyclovir (Zovirax), an antiviral medication, is indicated for the treatment of genital herpes simplex virus, shingles, or chicken pox. Labial sores are associated with genital herpes simplex. Improvement of labial sores indicates that acyclovir is having the desired therapeutic effect. D: A green vaginal discharge may be a symptom of Trichomonas, which is treated with metronidazole (Flagyl), an amebicide.