NCLEX-PN
NCLEX Pharmacological and Parenteral Therapies Questions
Extract:
Question 1 of 5
The nurse is teaching the parent of the 3-year-old being treated with vincristine sulfate for Wilms' tumor. The nurse should inform the parents to immediately notify the HCP of which most significant adverse effect?
Correct Answer: C
Rationale: A: Both diarrhea and severe constipation are adverse effects of vincristine, and prophylactic treatment is implemented at the beginning of therapy to decrease the potential of these occurring. B: Hair loss is a common adverse reaction to the medication and is reversible. C: Dysphagia and paresthesia are CNS adverse effects from vincristine sulfate (Oncovin). The nurse should teach the parent to notify the HCP immediately if these occur. D: Three-year-olds may not show signs or symptoms of depression. If present, the signs and symptoms should be distinguished as being associated with the neoplastic disease itself or as side effects of the medication.
Question 2 of 5
The client's dose of mirtazapine was increased from 15 to 30 mg at bedtime two days ago. When the nurse is preparing to administer mirtazapine, the client reports having insomnia, irritability, and panic attacks. What should the nurse do next?
Correct Answer: A
Rationale: Mirtazapine (Remeron) is an antidepressant. Adverse effects include insomnia, irritability, panic attacks, and suicidal ideation. A change in medication may be needed rather than a dosage increase.
Question 3 of 5
The client taking paroxetine telephones the mental health clinic nurse and states, “Since I started taking St. John's wort, I have had a high fever and muscle stiffness, and I am sweating a lot.†Which statement is most appropriate?
Correct Answer: D
Rationale: Fever, muscle stiffness (rigidity), and diaphoresis are symptoms of serotonin syndrome, a potentially fatal condition that may occur with concurrent use of St. John's wort and paroxetine (Paxil). The client should be taken to the ED.
Question 4 of 5
The nurse is teaching the client newly started on propranolol for acute situational anxiety disorder. In addition to treating the client's anxiety, the nurse should inform the client that propranolol's use is effective in treating which associated problem?
Correct Answer: B
Rationale: Propranolol (Inderal), a beta blocker, has been shown to be effective in ameliorating the somatic symptoms of anxiety such as hand tremor.
Question 5 of 5
The new nurse describes the action of TCAs as relieving symptoms of depression by inhibiting neuronal uptake of the neurotransmitters serotonin and norepinephrine. Place an X on the labeled site where the new nurse is stating that inhibition takes place.
Correct Answer: B
Rationale: Neuronal uptake of neurotransmitters occurs at the receptor sites on the postsynaptic neuron. [Image-based question; X placed on postsynaptic receptor sites.]