NCLEX-PN
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The nurse completed teaching for the client who will be receiving TPN at home. Which client statement indicates that further teaching is needed?
Correct Answer: D
Rationale: A: Several total nutrient solution bags are kept on hand and require refrigeration. B: A telephone is necessary for contacting home health personnel, arranging for supply deliveries, and calling emergency services. C: The TPN is delivered through an infusion pump, which can limit the client's mobility. D: The central catheter lumen is capped with a needleless port. The IV infusion tubing is connected to the insertion site cap and not removed to administer the TPN solution. Caps are changed every 3 to 7 days during dressing changes, with the client in a flat position. An air embolus can occur if the cap is removed while the client is in a sitting position.
Question 2 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.
Question 3 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 4 of 5
The nurse observes that the client being treated with antipsychotics is unsteady while standing and walking and that the client's hands are trembling slightly. What should the nurse do?
Correct Answer: A
Rationale: The client is experiencing extrapyramidal symptoms (EPS) of pseudoparkinsonism, requiring an antiparkinsonian agent like trihexyphenidyl.
Question 5 of 5
A 37-year-old female client asks the nurse about contraception options, and says she would like to ask her doctor for a prescription for an oral contraception pill. Which of the following statements would indicate that oral contraception is appropriate for this client?
Correct Answer: B
Rationale: The client's statement about medication diligence shows that this client could be compliant with a daily oral contraceptive. Contraindications to oral contraception include breast cancer, a history of deep vein thrombosis, and smoking if over age 35.