NCLEX-PN
Pharmacological and Parenteral Therapies NCLEX Questions Questions
Extract:
Question 1 of 5
The nurse teaches the client who has lesions that have not healed and are recurring about the newly prescribed medication ganciclovir. The nurse should document that teaching about ganciclovir was completed for the client with which illustrated condition?
Correct Answer: D
Rationale: A: Client A has vitiligo, a skin disorder characterized by the patchy loss of skin pigment. Vitiligo is treated with topical steroids. B: Client B has dried herpes simplex, usually treated with the antiviral medication acyclovir. C: Client C has keloids (hypertrophic scarring), which usually are not treated with medication. D: Ganciclovir (Cytovene) is an antiviral medication used in the treatment of recurrent genital herpes.
Question 2 of 5
The nurse is evaluating the effectiveness of lispro and glargine insulins being administered to the 2-year-old with type 1 DM. Which findings on the serum laboratory report indicate that treatment is effective?
Correct Answer: A, B
Rationale: The treatment goal for children with type 1 DM is blood glucose levels within the normal range (60-105 mg/dL for a 2-year-old). Hgb A1c levels are indicative of the average blood glucose levels over the past 2 to 3 months; normal A1c is 3.9% to 7.7%. Although the other laboratory values are normal, these do not indicate the effectiveness of insulin therapy.
Question 3 of 5
The nurse receives an order to administer phenytoin through the client's J-tube. The order instructs that tube feedings are stopped at least an hour prior to administering the medication and an hour after medication is administered. Which of the following considerations may be a reason to discuss this order with the physician?
Correct Answer: B
Rationale: For a client on a continuous tube-feeding regimen, stopping tube feedings for two hours to administer this medication may compromise the client's nutritional status.
Question 4 of 5
The nurse is preparing to administer IV fluids to the 13-kg child who has dehydration. The daily IV fluid requirement is to administer 1000 mL / 50 mL/kg over 10 kg. How many milliliters per hour should the nurse calculate to administer the IV therapy correctly?
Correct Answer: 48
Rationale: This child weighs 13 kg; the daily requirement is 1000 mL + (50 mL x 3) = 1150 mL/24 hr. The hourly rate is 1150 mL/ 24 hr = 47.9167 mL/hr, rounded to 48 mL/hr.
Question 5 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.