NCLEX-PN
Pharmacological and Parenteral Therapies NCLEX Questions Questions
Extract:
Question 1 of 5
The client is receiving fludrocortisone for treatment of adrenocortical insufficiency. The nurse is evaluating the client's serum laboratory values for adverse effects of the medication. Place an X in the column indicated for the laboratory values that the nurse should specifically review to evaluate the adverse effects of fludrocortisone. Select all that apply.
Correct Answer: A,C,D,F
Rationale: Adverse effects of fludrocortisone (Florinef) include hyperglycemia, hypokalemia, hypocalcemia, and thrombocytopenia. The nurse should review serum glucose, potassium, calcium, and platelet counts. Thyroid hormones of TSH and free T4, although abnormal, are unaffected by fludrocortisone administration.
Question 2 of 5
The client is taking metolazone and diltiazem for treatment of hypertension. Which statement made by the client to the nurse indicates further teaching is needed?
Correct Answer: C
Rationale: A: Consuming foods daily that are high in potassium is recommended. Thiazide diuretics such as metolazone (Zaroxolyn) can result in hypokalemia. B: The diuretic metolazone (Zaroxolyn) should not be taken at bedtime to avoid nocturia and the subsequent loss of sleep. C: The client should not consume grapefruit juice because it inhibits the metabolism of diltiazem (Cardizem) and can cause toxicity. This client statement indicates the need for further teaching. D: NSAIDs such as ibuprofen (Advil, Motrin) can decrease the diuretic and antihypertensive effects of thiazide diuretics.
Question 3 of 5
The nurse notes from the child's MAR illustrated that the child is to receive the first dose of a newly prescribed medication at 0800 hours. The drug reference book recommends an initial pediatric dose of lamotrigine of 0.6 mg/kg/day in two divided doses for the first 2 weeks. Which action by the nurse is most appropriate?
Correct Answer: B
Rationale: A: Although the medication is written on the MAR, an error still exists in the dose, and the medication should not be administered. B: The nurse should notify the HCP. The child weighs 30 kg; the recommended initial daily dose of lamotrigine (Lamictal) for this child would be 18 mg (0.6 x 30 = 18 mg). If given 18 mg bid, the child would receive a daily dose of 36 mg, twice the recommended initial pediatric dose. C: The child has a new-onset seizure disorder; it is unlikely that the child was taking this medication prior to hospitalization. D: Consulting the pharmacist is unnecessary; the nurse still needs to seek clarification from the HCP.
Question 4 of 5
The LPN is about to give 100 mg Lopressor (metoprolol) to a client. Before administering the drug, he takes the patient's vitals, which are as follows: Pulse: 58, Blood Pressure: 90/62, Respirations: 18/minute. What action should the LPN take?
Correct Answer: D
Rationale: Lopressor is given to treat hypertension, and a pulse of 58 and a blood pressure of 90/62 are considered low.
To prevent the client from bottoming out, the drug should be held and the findings reported to the RN, who should consult with the attending physician. LPNs should never adjust client dosing, as that is outside of their scope of practice.
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.