NCLEX-PN
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The HCP orders a digitalizing dose of digoxin 225 mcg IV now to be given to a 3-year-old. The pharmacy sends a solution of 500 mcg in 50 mL of D5W. How many mL should the nurse administer?
Correct Answer: 22.5
Rationale: Use a proportion formula: 500 mcg : 50 mL :: 225 mcg : X mL; 500X = 11250; X = 22.5 mL.
Question 2 of 5
The 11-year-old with type 1 DM is learning to use insulin pens for basal-bolus insulin therapy with both a very-long-acting insulin and rapid-acting insulin. Which action by the child should indicate to the nurse that additional teaching is needed?
Correct Answer: C
Rationale: A:
To ensure that the medication is administered with the insulin pens, the pen is held in place for 10 seconds after delivery of the medication. This action is correct. B: Insulin lispro (Humalog) is rapid-acting insulin with an onset of 5 to 10 minutes. This action is correct. C: Insulin glargine (Lantus) is very-long-acting insulin administered once daily and is not used for covering the number of carbohydrates eaten. This action indicates the child needs additional teaching. D: The rapid-acting insulin lispro (Humalog) is not needed if the glucose level is WNL. Turkey does not contain carbohydrates; insulin is administered to cover only the carbohydrates eaten. This action is correct.
Question 3 of 5
The parent of the child brought to the ED states to the nurse, “My child is sweaty and shaky; I think some of my medication is gone.†The parent hands the nurse the medication bottle illustrated. Which action should the nurse take first?
Correct Answer: C
Rationale: A: Initiating an IV access for glucose administration is more time-consuming than giving glucose by the oral route or glucagon (GlucaGen) subcutaneously to a child who is still responsive. B: An oral form of glucose should be administered if the child is responsive and glucagon given only if the child is unresponsive or too uncooperative or upset to take oral glucose. Glucagon stimulates the release of liver glycogen and releases glucose into the circulation. C: The child may have ingested the glipizide (Glucotrol XL), a sustained-released hypoglycemic agent. The child's blood glucose level should be checked first to determine the appropriate treatment. D: Determining the number of tablets taken may delay the child's treatment.
Question 4 of 5
The child is to start on medication therapy for enuresis that has not resolved with behavioral interventions. Which medication should the nurse anticipate being prescribed for the child?
Correct Answer: B
Rationale: A: Lorazepam (Ativan) is a benzodiazepine used to treat anxiety. A side effect is drowsiness, which could impair a child's ability to waken for voiding. B: Desmopressin (DDAVP) is an analog of arginine vasopressin, which acts as an antidiuretic. It promotes resorption of water in the renal tubule or decreases bladder filling. C: Nitrofurantoin (Macrobid) is a urinary tract antiseptic used to treat UTIs and would not be used with enuresis. D: Spironolactone (Aldactone) is a potassium-sparing diuretic that would promote, not inhibit, diuresis.
Question 5 of 5
The 14-year-old who has GERD is receiving lansoprazole. Which response should the nurse expect if lansoprazole is achieving the desired therapeutic effect?
Correct Answer: C
Rationale: A: Lansoprazole would not be expected to change appetite. B: Lansoprazole is not a gastric motility agent. C: Lansoprazole (Prevacid) is a PPI of stomach acid secretion. Decreasing the overall pH allows the gastric mucosa to heal. D: Flatulence is not affected.