NCLEX-PN
NCLEX Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The nurse applies a fentanyl transdermal patch to the client for the first time. Shortly after application, the client is experiencing pain. Which nursing action is most appropriate?
Correct Answer: B
Rationale: A: Removing the patch is unnecessary; effective analgesia may take 12 to 24 hours. B: The nurse should administer a short-acting opioid analgesic. When the first fentanyl (Duragesic) transdermal patch is applied, effective analgesia may take 12 to 24 hours because absorption is slow. C: Transdermal patches should not be rubbed to enhance absorption; it can cause the delivery of the medication to fluctuate. D: It is premature to request a higher dose of fentanyl.
Question 2 of 5
The nurse working on the pediatric unit has scheduled medications to administer at this time. Which assessments should prompt the nurse to conclude that the prescribed medication should be withheld and the HCP immediately notified?
Correct Answer: C
Rationale: A: Dizziness and light-headedness are side effects of hydrocodone with acetaminophen (Vicodin), and the nurse may choose to withhold a scheduled dose. These are not potentially life-threatening or warranting an immediate call to the HCP. B: A rash is a side effect of acetaminophen (Tylenol). However, the rash is not potentially life-threatening or warranting an immediate call to the HCP. C: An adverse effect of clindamycin (Cleocin) is hypotension. A BP of 92/56 mm Hg is low for a 16-year-old. Normal BP for a 16-year-old male is 111/63 mm Hg to 136/90 mm Hg, depending on height percentile. The nurse should compare the previous BP readings with the current one to determine the degree of BP variation and then immediately notify the HCP because the BP can decrease further. D: Tiredness and drowsiness are side effects of phenobarbital (Luminal). However, these are expected. The nurse would not withhold phenobarbital unless there were additional neurological alterations that would warrant contacting the HCP.
Question 3 of 5
Six months after starting disulfiram for treatment of alcoholism, the client has serum laboratory tests completed (see exhibit). Place an X on each serum laboratory result that the nurse should report immediately to the HCP.
Correct Answer: B,C,DE,F
Rationale: Abnormal liver function tests (low albumin, elevated AST, ALT, total bilirubin, ALP) should be reported due to disulfiram's potential liver effects. [Image-based question; X on abnormal LFTs.]
Question 4 of 5
A client receiving drug therapy with furosemide and digitalis requires careful observation and care. In planning care for this client, the nurse should recognize that which of the following electrolyte imbalances is most likely to occur?
Correct Answer: C
Rationale: Furosemide, a diuretic, commonly causes potassium loss, leading to hypokalemia, which can potentiate digitalis toxicity, requiring close monitoring.
Question 5 of 5
The LPN is performing an assessment on a 4-day-old 8-pound, 6-ounce newborn with a head circumference of 33 cm. Given this information, what would the nurse expect the child's chest circumference to be?
Correct Answer: A
Rationale: In newborns, the head circumference should be 2 cm to 3 cm larger than the chest circumference. Note: Due to molding that occurs during the birth process, the head and chest measurement may be nearly equal during the first 48 hours after birth.