NCLEX-PN
NCLEX Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The client with chronic, stable angina telephones the clinic nurse and reports a headache lasting for several days after taking one dose of isosorbide mononitrate. The client also reports symptoms of orthostatic hypotension and palpitations. Which is the nurse's best action?
Correct Answer: A
Rationale: A: Severe headaches, orthostatic hypotension, and palpitations may be a sign of isosorbide mononitrate (Imdur) toxicity; thus, the client should be evaluated by an HCP. Other signs of toxicity include syncope, dizziness, blurred vision, and light-headedness. B: Isosorbide mononitrate should be taken in the morning to improve blood flow to the heart and prevent angina attacks that can occur due to increased oxygen demand from activity. C: A headache (but not a severe headache) can be treated with or prevented by analgesics taken either before or at the same time as the isosorbide mononitrate. D: Although the headaches will subside over time, the client is experiencing symptoms of isosorbide mononitrate toxicity.
Question 2 of 5
When administering intravenous electrolyte solution, the nurse should take which of the following precautions?
Correct Answer: C
Rationale: Preventing tissue infiltration is important to avoid tissue necrosis.
Choice A is incorrect because hypertonic solutions should be infused cautiously and checked with the RN if there is a concern.
Choice B is incorrect because potassium, mixed in the pharmacy per physician order, is mixed at a concentration no higher than 60 mEq/L.
Question 3 of 5
The 8-year-old child with gastroenteritis is prescribed to receive 500 mL of lactated Ringer's (LR) solution over the next 10 hours. How many milliliters per hour should the nurse administer?
Correct Answer: 50
Rationale: 500 mL / 10 hr = 50 mL/hr
Question 4 of 5
The nurse is preparing to administer Azithromycin, and the pharmacy has provided the drug in a powder form that requires reconstitution connected to a saline piggyback. Which of the following is least concerning when preparing the medication?
Correct Answer: B
Rationale: The brand or trade name is not required to be on the medication label if the generic name is present. The nurse should check that the medication is not expired and that it has been stored according to the storage instructions. If the saline bag is leaking, it may indicate that the container is damaged and the fluid may not be sterile.
Question 5 of 5
The nurse is to administer vancomycin to the client diagnosed with sepsis. The client is to have a peak and trough level completed on this dose of vancomycin. Which action should the nurse initiate first?
Correct Answer: A
Rationale: A: A trough level must be drawn before vancomycin (Vancocin) is administered. This is the first action because if the trough level has not been drawn, it will delay the vancomycin dose and could result in a medication error. B: Checking medication compatibilities is important, but this can be completed while the laboratory is obtaining the trough level. C: Checking C&S report results is important, but this can be completed while the laboratory is obtaining the trough level. D: Calculating the administration rate is important, but this can be completed while the laboratory is obtaining the trough level.