NCLEX-PN
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The HCP prescribes a second antihypertensive medication for the client who has poorly controlled BP on one medication. If prescribed, which medication combination should the nurse question?
Correct Answer: A
Rationale: A: The nurse should question this medication combination. When two medications are used to treat hypertension, each should be from different drug classifications. Atenolol (Tenormin) and metoprolol (Lopressor) are both beta-adrenergic blockers and have the same general mechanism of action. B: Metolazone (Zaroxolyn) is a thiazide-like diuretic, and valsartan (Diovan) is an ARB. C: Captopril (Capoten) is an ACE inhibitor, and furosemide (Lasix) is a loop diuretic. D: Bumetanide (Bumex) is a loop diuretic, and diltiazem (Cardizem) is a calcium channel blocker.
Question 2 of 5
A pregnant client asks how she can prevent getting Group B Strep. What is the LPN's best response?
Correct Answer: B
Rationale: Group B Strep lives in the vagina, rectum, and intestines of about 25% of the female population. It is considered normal flora and is not a sexually transmitted disease. The same woman can test positive in one pregnancy and negative in another, which is why testing is done every pregnancy, usually within 5 weeks of expected delivery. If a woman tests positive for Group B Strep, she will be given antibiotics during delivery to greatly reduce the risk of complications for her and her baby.
Question 3 of 5
The nurse is caring for a group of clients all in need of pain medication. The nurse has determined the most appropriate pain medication for each client based on the client's level of pain. Prioritize the order that the nurse should plan to administer the pain medications, beginning with the most potent analgesic for the client with the most severe pain.
Order the Items
Source Container
Correct Answer: B,D,C,A,E
Rationale: B: Fentanyl 0.1 mg IV bolus per PCA. Fentanyl (Sublimaze), the most potent of the medications, is an opioid narcotic analgesic that binds to opiate receptors in the CNS, altering the response to and perception of pain. A dose of 0.1 to 0.2 mg is equivalent to 10 mg of morphine sulfate. D: Morphine sulfate 4 mg IV. Morphine sulfate is also an opioid analgesic. This dose is IV and would be fast-acting. C: Hydromorphone 5 mg oral. Hydromorphone (Dilaudid), another opioid analgesic, would be next in priority. The oral dosing of this medication would indicate that the client's pain is less severe than the client receiving fentanyl or morphine sulfate. Hydromorphone 7.5 mg oral is an equianalgesic dose to 30 mg of oral morphine or 10 mg parenteral morphine. A: Ketorolac 10 mg oral. Ketorolac (
Toradol) is an NSAID and nonopioid analgesic that inhibits prostaglandin synthesis, producing peripherally mediated analgesia. E: Propoxyphene 65 mg oral. Propoxyphene (Darvon) should be given last. It binds to opiate receptors in the CNS but is used in treating mild to moderate pain. It has analgesic effects similar to acetaminophen's.
Question 4 of 5
One of the major functions of the kidneys in maintaining normal fluid balance is:
Correct Answer: C
Rationale: Major functions of the kidneys in maintaining normal fluid balance include regulation of extracellular fluid and osmolarity by selective retention and excretion of fluids, regulation of pH of the extracellular fluid by retention of hydrogen ions, and excretion of metabolic wastes and toxic substances. ADH is manufactured by the pituitary, and the parathyroid regulates calcium and phosphate balance.
Question 5 of 5
An LPN is taking care of an elderly client who experiences the effects of Sundowner's Syndrome almost every evening. Which of these interventions implemented by the nurse would be the most helpful?
Correct Answer: A
Rationale: A nightlight will help reorient the client to his or her surroundings in the evening and nighttime hours. It is best not to challenge the reality of a client experiencing Sundowner's Syndrome, and sedatives may make the effects of the syndrome worse. Every effort should be made to keep the client's room calm, quiet, and peaceful, so noise should be kept to a minimum.