NCLEX-PN
Pharmacological and Parenteral Therapies NCLEX Questions Questions
Extract:
Question 1 of 5
The nurse is administering Phenobarbital 300 mg IV to the child weighing 18 kg who is in status epilepticus. Which actions should the nurse take to safely administer the medication? Select all that apply.
Correct Answer: B,E,F
Rationale: A: This dose of phenobarbital should be administered as an IV-push medication over 10 minutes; administering it over 20 minutes will delay the medication's effects to treat status epilepticus. B: Whenever IV medications are being administered by any route, the site should be evaluated for irritation and extravasation. An extravasation of phenobarbital (Luminal) may cause necrotic tissue changes that necessitate skin grafting. C: Phenobarbital, if diluted, should be mixed with sterile water for injection and not D5W. D: Phenobarbital should be prepared for direct IV administration and not as an IV piggyback because this would delay the child's receiving the medication to terminate the seizure. E: When administering IV medications, identification of medications or solutions that would be incompatible with that medication must occur so that the tubing can be flushed to ensure that crystallization does not occur in the IV tubing. F: Phenobarbital should be administered no faster than 1 mg/kg/min, with a maximum of 30 mg over 1 minute in infants and children.
Question 2 of 5
The nurse is providing instructions to the client taking alprazolam. Which substances should the client be instructed to avoid? Select all that apply.
Correct Answer: A,C,E,F
Rationale: Alcohol, narcotics, antihistamines, and antidepressants can increase CNS side effects when taken with alprazolam (Xanax).
Question 3 of 5
The nurse is discussing the prescribed atypical antipsychotic medication therapy with the client with schizophrenia. What information should the nurse include in this discussion? Select all that apply.
Correct Answer: A,D,E
Rationale: Atypical antipsychotics target hallucinations and emotional responses, require blood glucose monitoring, and may cause increased appetite and weight gain.
Question 4 of 5
The client is placed on lorazepam for short-term treatment of anxiety. Which instruction by the nurse is most important with lorazepam use?
Correct Answer: B
Rationale: Lorazepam (Ativan) is a benzodiazepine anxiolytic and sedative-hypnotic medication. If it is less effective after a few weeks, the client may be developing a tolerance to lorazepam, and the HCP should be notified of this.
Question 5 of 5
Following a THR, the client asks the nurse, “Why am I receiving enoxaparin? With my last hip surgery, I was given a heparin injection.†What is the nurse's best response?
Correct Answer: C
Rationale: A: The cost of enoxaparin is more than twice the cost of the equivalent dose of heparin per injection. Both are available in prefilled syringes for subcutaneous injection. B: Both enoxaparin and heparin increase aPTT, which affects clotting. C: Because enoxaparin is more specific in inhibiting active factor X, the response is more stable, and the effect is two to four times longer than that of heparin. D: Enoxaparin is only administered subcutaneously. Heparin can be administered both subcutaneously and intravenously.