Transcript Pharmacology and Pathophysiology NCLEX Review I

NCLEX Review I
The nurse is preparing to administer a medication that is
classified as an antihypertensive and knows that this drug
is intended to treat what type of condition?
Bacterial Pneumonia
Peripheral Edema
HTN
Migraine
When assessing a patient who has developed an anaphylactic
reaction, which of the following would the nurse expect to find?
Difficulty Breathing
Decreased Hct
Swollen Lymph Nodes
Swollen Joints
The nurse understands that it is important to educate the pregnant woman
about the importance of taking medication only as prescribed by a
physician while breast feeding. Why is this important for the patient to do?
A woman can become addicted to some
of the medications if the physician has
not prescribed them
The woman may not metabolize the
medication adequately, and the baby
would not receive the correct dose.
Pregnant women do not understand the
importance of not taking any over-thecounter medications.
Many drugs can be passed through the
breast milk, causing ill effects to the
infant.
A parent brings a child to the clinic for an earache. The child receives a prescription for amoxicillin.
The parent calls the clinic the next day and says the child has been taking the medicine and now has
a rash. The nurse should give the parent instructions about which type of response?
Expected Response
Allergic Response
Idiosyncratic Response
Anaphylactic Response
Discharge planning for patients leaving the hospital should include instructions on
the use of Over-The-Counter (OTC) drugs. Which comment by the patient would
demonstrate a good understanding of OTC drugs?
OTC drugs are always safe and will
not cause bad effects.”
OTC drugs have been around for years
and have not been tested by the FDA.”
OTC drugs are different from any drugs
available by prescription and cost less.”
OTC drugs are thought to be safe
when taken as directed.”
A nurse working for a drug company is involved in phase III drug evaluation
studies. Which of the following might the nurse be responsible for during this stage
of drug development?
Working with animals who are given
experimental drugs
Monitoring drug effects in patients who are
selected to participate in a study, who have
the disease that the drug is meant to treat
Administering investigational drugs to
patients
Informing healthy, young volunteer
participants of possible risks that could
occur from taking an experimental drug
Which of the following is a key process with drug
excretion?
Passive Diffusion
Active Transport
Protein Binding
Filtration
A nurse is preparing to administer a subcutaneous injection.
Which gauge needle is the nurse most likely to select?
#22
#25
#20
#18
A patient who has ongoing pain issues has been prescribed meperidine
(Demerol) IM. How should the nurse best administer this medication?
Into the patient's vascular space using
a large-gauge needle
Into the patient shoulder muscle using
a small-gauge needle
Into the patient's buttocks using a
small- to medium-gauge needle
Into the patient's thigh using a largegauge needle
Which of the following is the best method of error
detection?
Manual redundancy system
Bar coding system
Computerized order entry system
Manual order entry system
Your patient underwent abdominal surgery and has been prescribed
morphine to control pain. Morphine, an opioid analgesic, is a central
nervous system (CNS) depressant. Which of the following should be
the priority assessment for your patient?
Peripheral Pulse
Heart Sounds
Bowel Sounds
Respiratory rate and depth
The nurse is preparing to apply testosterone gel (Androgel) to a
male client who has a low testosterone level. What is the nurse's top
priority action before administering this medication?
Shave the patient’s chest
Moisten the skin with water
Put on gloves
Apply to the patient’s scrotum
The nurse is educating a client about what types of foods and drinks
have caffeine in them. What food or drink does the nurse not need to
discuss with the client?
Coffee
Tea
Soda
Fruit Juice (100%)
A man is prescribed ciprofloxacin to treat a sexually
transmitted infection. The nurse will instruct the patient to
complete the entire course of drug
therapy.
reduce the dosage of ciprofloxacin
gradually.
take the drug only in safe and secure
home settings
take the drug through subcutaneous
injection if it tastes bad
The nurse is teaching a client about hypertension. The nurse teaches that
nonpharmacologic methods to decrease blood pressure would include which of the
following?
Weight loss and decreased salt intake
Decreased water intake and decreased
potassium intake
Increased exercise activity and fat
intake
Stress reduction techniques and high
fat intake
A patient with a high fever visits the healthcare facility. The physician
prescribes 650 mg of buffered aspirin to be administered for every dose.
How many tablets will the nurse administer to the patient each time if the
drug is available in 325-mg tablets?
0.5
1
2
4
A patient who is admitted with chronic bronchitis has a cough
with copious secretions. Which of the following would be a
high priority nursing diagnosis for this patient?
Risk for injury
Ineffective airway clearance
Ineffective coping
Altered comfort
The nurse is preparing to administer a sulfonamide to a client
when the client states, "I woke up this morning with a lot of
sores in my mouth." What is the nurse's next best action?
I'm going to contact your health care
provider before I administer your
medication."
I wouldn't worry about it. It should get
better in the next day or two."
"I'm sure you have developed these
sores due to the stress of the infection."
Take this dose of medication and let me
know if you develop any more sores."
A patient is taking a nonsteroidal anti-inflammatory agent. Which of the
following instructions should the patient be given in regards to
administration?
Administer the medication with
orange juice
Crush enteric-coated tablets for
impaired swallowing
Administer the medication with food
Administer the medication every other
day
A client should be instructed to take sublingual NTG how
often if he experiences chest pain?
Q1 minute x3
Q3 minutes x5
Q5 minutes x3
Q10 minutes x 3
A client is receiving ciprofloxacin for a urinary tract infection. This drug is
administered IV. During an infusion, the nurse notes fluid leaking into the
tissue around the IV site. What is the best response of the nurse?
D/C the IV
Decrease the IV drip rate
Administer pain medication
Elevate the extremity
A patient has an elevated total serum cholesterol of 260. Which of the following
aspects of patient teaching of lifestyle changes is most important for the patient?
Decrease dietary vegetables
Stop smoking
Increase rest periods
Drink whole milk
A patient is sent home with a prescription for codeine to suppress a cough
and to help with mild discomfort. Which of the following should the nurse
tell this patient to avoid while taking this medication?
green leafy vegetables
alcohol
coffee
chocolate
A patient is prescribed an antitussive agent with codeine.
Which of the following statements by the patient indicates that
your teaching has been effective?
“I will take this medication whenever I
am coughing
This medication will make me anxious
and nervous.”
I will call my physician if I develop
diarrhea when I take it
“This medication will cause
drowsiness, and I will not drive.”
The order for pain management for a 30-year-old patient is: morphine 2 to 3
mg q 5 min until pain relief is adequate. Which medication should the
nurse also have available in case of opioid overdose?
Naloxone (Narcan)
Butorphanol (Stadol)
Morphine (Duramorph)
Hydromorphone (Dilaudid)
You are teaching a client at your clinic about non-pharmacologic
methods of controlling serum cholesterol levels. What lifestyle
change may help increase high-density lipoprotein (HDL) levels?
Quitting smoking
Increasing aerobic exercise
Losing weight
All the above changes may help
increase HDL levels
You are a critical care nurse caring for a patient taking aminoglycosides.
Which of the following should you monitor closely to determine whether
dosage adjustment is required?
Lung Function
Renal Function
Cardiac Function
Intestinal Function
When kanamycin (Kantrex) is administered to a client to treat hepatic coma
which of the following is not part of the nurse's ongoing assessment?
Changes in mentation
Changes in level of consciousness
Changes in ability to swallow
Changes in sputum production
A client is given a prescription for fluticasone/salmeterol (Advair) 250/50
to inhale one puff twice a day, before leaving the hospital after an acute
asthma attack. The nurse completing the client's discharge counseling
should tell the client which of the following?
Take the medication as needed
Advair replaces the need for a rescue
inhaler
Rinse your mouth out after each use
Shake the meter well before using
Ciprofloxacin (Cipro) is contraindicated for which of the
following patients?
Pregnant
Pediatric
Allergy to PCN
Allergy to Sulfa
A patient has received azithromycin (Zithromax) for an infection. What is
essential for the nurse to teach the patient about this medication?
This medication is taken for 5 days,
once a day.
Finish the full 10-day prescription of
this medication
Take this medication every 12 hours
daily
This medication cannot be taken with
food
Aminoglycosides are poorly absorbed from the GI tract;
they are useful in treating which of the following?
Prevention of abdominal infection
from bowel surgery
Pseudomembranous colitis
Ulcerative colitis
Crohn's disease
Decongestants should be used cautiously in clients with
which of the following?
Glaucoma
Hypotension
Hypothyroidism
Arthritis
Penicillins are not utilized in the treatment of which of
the following bacterial infections?
Meningitis
Syphilis
URI
Osteomyelitis
If a client taking metoprolol (Lopressor) 50 mg one tablet
twice daily begins taking pseudoephedrine (Sudafed)
over the counter, which of the following might occur?
Hyperglycemic Episode
Hypertensive Episode
Rebound Congestion
Tachycardia Episode
Daptomycin (Cubicin) can be used to treat which of the following?
Gram-positive bacteria
Gram-negative bacteria
Both gram-positive and gram-negative
bacteria
Neither gram-positive or gramnegative bacteria
Unlike penicillin, most cephalosporins can be taken with food to prevent
gastric upset. Which of the following is the only cephalosporin that the
nurse would advise NOT to take with food?
cefazolin
cephalexin
ceftibuten
cefprozil
A patient is receiving warfarin. Which of the following would
the nurse monitor to determine the effectiveness of therapy?
PT / INR
PTT
Vitamin K level
Platelet Level
Xanthine derivatives elicit their effect by which of the
following mechanisms?
Stimulation of beta-adrenergic
receptors
Reduction of airway hyperresponsiveness
Stimulation of the central nervous
system
Stabilization of mast cell membranes
A patient is observed to have a sudden and significant drop in BP,
erythema of the neck and back, fever, chills and paresthesia. You
identify this emergency as a toxic effect of what medication?
PCN
Bactrim
Tetracycline
Vancomycin
A patient who is 4 days postoperative following abdominal surgery develops a
fever. Upon assessment the incision appears infected. An x-ray reveals infection and
a big abscess in the abdominal cavity. Which anti-infective would be the treatment
of choice for this patient?
Cipro
Levaquin
PCN
Meropenem
Which of the following is a beta blocker?
Inderal
Coreg
Vasotec
Norvasc
Your patient’s telemetry monitor
alarms and you see the following
rhythm. You assess your patient
who is without respirations or a
pulse. Your priority action is to:
Initiate an IV and administer
epinephrine 1 mg immediately
Shock the patient at 200 Joules
immediately using a biphasic defibrillator
Initiate the BLS algorithm
Which of the following is sinus tachycardia?
What is your priority
action with a patient with
this rhythm complaining of
chest pain and SOB?
Administer Oxygen via NRB
Initiate IV and prepare for
cardioversion
Have patient perform vagal
maneuvers
Administer NTG 0.4mg SL stat
A patient comes to the ED with an acute exacerbation of asthma. You
anticipate which of the following medications to be administered initially?
Albuterol / Atrovent Nebulizer
Prednisone
Advair
Symbicort
Your PCT obtains vitals on your patient: 135/60, 14, 57,
97%RA, 2/10 chest pain. Which medication will you hold?
NTG 0.4 mg SL
Simvastatin 10 mg PO
Metoprolol 25mg PO
Zantac 75mg PO
You receive a patient in the ED who is having an allergic reaction to
a medication. Which of the following signify anaphylactic shock?
BP 90/58, HR 130, RR 14, Temp 99.5,
O2 92%
BP 105/65, HR 75, RR 10, Temp 96.8,
O2 91 %
BP 200/105, HR 115, RR 30, Temp 100,
O2 90%
BP 120/80, HR 150, RR 22, Temp 98.5,
O2 92%
Mast cells are associated with what biological chemical
associated with allergic reactions?
Leukotriene
Histamine
Endorphins
Dopamine
A mother asks you how much amoxicillin to give her child. She states that the
pharmacist told her 15 ml. She asks how many teaspoons or tablespoons it is. Your
reply is:
2 tsp
1 tbsp
2 tbsp
1 tsp