NCLEX-PN
NCLEX Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The client with CRF receives a sodium polystyrene sulfonate enema. Which finding indicates that the medication is achieving the desired therapeutic effect?
Correct Answer: D
Rationale: A: Although sodium polystyrene sulfonate may be administered as an enema and stool may return, the purpose of the medication is to lower serum potassium levels and not to empty the bowel. B: The client should be encouraged to retain the enema solution for as long as possible so that sodium ions can be exchanged for potassium ions in the intestine, but its retention for this length of time does not indicate its effectiveness in lowering the serum potassium level. C: The client may be constipated prior to receiving the enema, but this is not the purpose of a sodium polystyrene sulfonate enema. D: Sodium polystyrene sulfonate exchanges sodium ions for potassium ions in the intestine and is administered when the client has hyperkalemia. A normal serum potassium level of 4.0 mEq/L indicates that the medication is achieving its desired therapeutic effect.
Question 2 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 3 of 5
The nurse is reviewing the client's medication list illustrated, prepared by the client's daughter. The nurse is most concerned about which finding?
Correct Answer: C
Rationale: A: Missing doses of medication is important to address; however, duplicate medications should be addressed first. B: It is important to address the administration routes, but the duplication of medications is the priority to address. C: Hydrochlorothiazide + captopril (Capozide) is a combination product. The nurse should first determine if the client is taking the combination product along with the individual products due to the potential for overdosing. The client may be clear regarding the dose and the route but may not realize that two medications were replaced with one combination product. D: Drug-drug interactions are important to address and should be addressed, but the duplicate medications are the priority.
Question 4 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 5 of 5
Which of these medications has the least risk of causing tinnitus?
Correct Answer: D
Rationale: Gentamicin, Lasix, and Aspirin are all ototoxic drugs that have a potential side effect of causing tinnitus, a ringing in the ear. Fluoxetine, an SSRI, is not typically associated with tinnitus.