NCLEX-PN
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The home care nurse is observing the child with asthma self-administer a dose of albuterol via a metered-dose inhaler with a spacer. Within a short time, the child begins to wheeze loudly. What should the nurse do?
Correct Answer: B
Rationale: A: Reassuring the parent is an inappropriate action; the wheezing is not a normal reaction. There is no indication that this is an initial dose. B: The client's wheezing suggests paradoxical bronchospasms, which can occur with excessive use of adrenergic bronchodilators such as albuterol (Proventil). The medication should be withheld and the HCP notified. C: A paradoxical bronchospasm can occur from excessive use, so the dosage should not be increased. D: Contact with the eyes can cause eye irritation, not wheezing.
Question 2 of 5
The client has an order for an IV piggyback of Ceftriaxone 750 mg in 50 mL D5W to run over 30 minutes. What is the appropriate drip rate?
Correct Answer: A
Rationale: (50 mL / 30 min) × (60 min / 1 hr) = 100 mL/hr
Question 3 of 5
The client is receiving multiple medications for treatment of PD. Which signs and symptoms should the nurse recognize as adverse effects of carbidopa-levodopa?
Correct Answer: D
Rationale: A: Although dystonia is an adverse effect of carbidopa-levodopa, akinesia is a symptom associated with PD. B: Bradykinesia is a symptom associated with PD; agitation is an adverse effect of carbidopa-levodopa. C: Muscle rigidity is a symptom associated with PD; cardiac dysrhythmia is an adverse effect of carbidopa-levodopa. D: Orthostatic hypotension and dry mouth are common adverse effects of carbidopa-levodopa (Sinemet). These can be minimized by slow position changes and sucking on sugarless candy or chewing gum.
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 client is prescribed medications on hospital admission. Four days later the client's serum creatinine level, which was normal at admission, is now 3.7 mg/dL. The nurse should contact the HCP regarding a dosage change for which medication?
Correct Answer: A
Rationale: A: The nurse should contact the HCP regarding ceftriaxone (Rocephin). Ceftriaxone, a third-generation cephalosporin antibiotic, is 33% to 67% excreted in the urine unchanged. Dosage reduction or increased dosing interval is recommended in renal insufficiency because ceftriaxone is nephrotoxic and can further damage the kidneys. B: Insulin glargine (Lantus) is partially metabolized at the site of injection to active insulin metabolites and partially metabolized by the liver, the spleen, the kidney, and muscle tissue; no dose reduction is necessary unless serum glucose levels fluctuate. C: Diltiazem (Cardizem) is mostly metabolized by the liver; no dose reduction is necessary. D: Furosemide (Lasix) is 30% to 40% metabolized by the liver with some nonhepatic metabolism and renal excretion as unchanged medication; no dose reduction is necessary.