NCLEX-PN
Pharmacological and Parenteral Therapies NCLEX Questions Questions
Extract:
Question 1 of 5
The nurse is concerned that the adolescent may be developing a side effect of methotrexate. Which test or exam results should the nurse review prior to administration?
Correct Answer: C
Rationale: A: Although methotrexate is a folic acid antagonist, it does not alter serum levels. B: Methotrexate has no effect on electrolytes. C: An adverse effect of methotrexate (Trexall) is aplastic anemia; thus, the nurse should review the CBC results before administration. D: Methotrexate has no effect on coagulation.
Question 2 of 5
The 9-year-old with SLE is receiving large doses of prednisolone. Which laboratory finding should the nurse recognize as an untoward effect of the medication?
Correct Answer: B
Rationale: A: The liver is not affected by prednisolone use, so an increased total bilirubin of 4 mg/dL is not related to the use of the drug. Normal total bilirubin in a 9-year-old should be less than 2 mg/dL. B: A WBC count of 18,000/mm3 may indicate an infection, an untoward effect of prednisolone (Omnipred). Prednisolone, a corticosteroid used to reduce inflammation, may increase the risk of infection. The normal WBC in a 9-year-old is 4500-11,100/mm3. C: Prednisolone has been associated with the adverse effect of hypokalemia, but not hyponatremia. Normal serum sodium is 135-145 mEq/L. D: Although corticosteroids may have the effect of increasing blood glucose, a random glucose of 130 mg/dL is not abnormal.
Question 3 of 5
The nurse is assessing the client. Which findings indicate that the client may be experiencing physical changes from long-term use of prednisone? Select all that apply.
Correct Answer: A,C,D
Rationale: A: Weight gain and muscle atrophy are body changes that may occur with long-term glucocorticoid therapy. B: Muscle wasting (not increased muscle mass) is a side effect of prednisone. C: Fragile skin is a possible body change that may occur with long-term glucocorticoid therapy. D: Acne vulgaris may occur with long-term glucocorticoid therapy. E: Hirsutism (not alopecia) is a side effect of prednisone.
Question 4 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 5 of 5
When caring for pediatric clients, the nurse should pay special attention to the psychosocial development stages credited to ?
Correct Answer: B
Rationale: Erik Erikson is credited with the psychosocial development theory and eight stages. The nurse should take these stages into account when caring for pediatric clients to assess their development. Jean Piaget is responsible for cognitive development. Sigmund Freud is responsible for psychosexual development. Robert Peck is responsible for aging theory.