NCLEX-PN
NCLEX Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The client taking tranylcypromine develops a list of possible meal plans. Which meal plans should the nurse identify as safe for the client? Select all that apply.
Correct Answer: B,C,D
Rationale: Meals without tyramine (e.g., pepperoni, raisins, yogurt, sour cream, avocados, beer) are safe for clients taking MAOIs like tranylcypromine.
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
A laboring client is experiencing late decelerations. Which position should she be placed in?
Correct Answer: A
Rationale: The left lateral position promotes blood flow to the placenta.
Question 4 of 5
The nurse is reviewing documentation on four clients prior to administering medications. The nurse should immediately withhold the medication and notify the HCP about which client?
Correct Answer: D
Rationale: Client 4's symptoms of tardive dyskinesia (lip smacking, uncontrolled rhythmic movements) may be irreversible, requiring immediate medication withdrawal and HCP notification.
Question 5 of 5
The client taking paroxetine telephones the mental health clinic nurse and states, “Since I started taking St. John's wort, I have had a high fever and muscle stiffness, and I am sweating a lot.†Which statement is most appropriate?
Correct Answer: D
Rationale: Fever, muscle stiffness (rigidity), and diaphoresis are symptoms of serotonin syndrome, a potentially fatal condition that may occur with concurrent use of St. John's wort and paroxetine (Paxil). The client should be taken to the ED.