ANSWERSRATIONALES - the client, knowing that which finding indicate...

NCLEX-RN Pharm ANSWERS&RATIONALES

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NCLEX-RN Pharm ANSWERS&RATIONALES

Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this med?

• tinnitus
• diarrhea
• constipation

4. decreased respirations - CORRECT ANSWER IS 1 - rationale: Salicylic acid is

absorbed readily through the skin and systemic toxicity (salicylism) can result.Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances.

The health education nurse provides instructions to a group of clients regarding measures that will assist in preventing skin cancer. Which instructions should the nurse provide? Select all that apply.

• Sunscreen should be applied every 8hrs.
• Use sunscreen when participating in outdoor activities.
• Wear a hat, opaque clothing, and sunglasses when in the sun.
• Avoid sun exposure in the late afternoon and early evening hours.
• Examine your body monthly for any lesions that may be suspicious. - CORRECT

ANSWER IS 2, 3, 5. Instruct client to avoid sun between hours of 10am-4pm.Sunscreen, a hat, opaque clothing, and sunglasses should be worn for outdoor activities. Inspect skin monthly for evidence of precancerous lesions. Sunscreens should be reapplied every 2-3hrs, and after swimming or sweating, otherwise protection is reduced.

Mafenide acetate (Sulfamylon) is prescribed for a client with a burn injury. When applying the medication, the client complains of local discomfort and burning. The nurse should take which most appropriate action?

• Discontinue medication.
• Notify the health care provider.
• Inform the client that this is expected.
• Apply a thinner film than prescribed to the burn site. - CORRECT ANSWER IS 3.

Mafenide acetate is bacteriostatic for gram-neg and gram-pos organisms and is used to treat burns to reduce the bacteria present in avascular tissues. Inform client that med will cause local discomfort and burning and this is a normal reaction.

A burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of the injury. The nurse monitors the client, knowing which finding indicates that a systemic effect has occurred?

NCLEX-RN Pharm ANSWERS&RATIONALES

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• hyperventilation
• local rash at the burn site
• elevated blood pressure
• local pain at burn site - CORRECT ANSWER IS 1. Mafenide acetate can suppress

renal excretion of acid, thereby causing acidosis. Monitor clients for signs of acid-base imbalance (hyperventilation). If this occurs med will be discontinued for 1-2 days. 2 and

• describe local rather than systemic effects. An elevated BP may be expected from the

pain that occurs with burn injury.

Isoretinoin (Amnesteem or Claravis) is prescribed for a client with severe acne. Before the admin of this med, the nurse anticipates that which lab test will be prescribed?

• platelet count
• triglyceride level
• complete blood count
• wbc count - CORRECT ANSWER IS 2. Isoretinoin can elevate triglyceride levels.

Measure before treatment and periodically thereafter.

A client with severe acne is seen in the clinic and the HCP prescribed isoretinoin (Amnesteem or Claravis). The nurse reviews the client's medication record and would contact the HCP if the client is taking which medication?

• vit A
• digoxin (Lanoxin)
• furosemide (Lasix)
• phenytoin (Dilantin) - CORRECT ANSWER IS 1. isoretinoin is a metabolite of vit a

and can produce generalized intensification of isoretinoin toxicity.

The nurse is applying a topical corticosteroid to a client with eczema. Nurse should monitor for the potential for increased systemic absorption of the med if the med is being applied to which body region?

• back
• axilla
• soles of the feet
• palms of the hands - CORRECT ANSWER IS 2. Absorption rate is higher from

regions where skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia) and lower from regions where permeability is poor (back, palms, soles).

Clinic nurse is performing an admission assessment and notes client is taking azelaic acid (Azelex). Because of the medication prescription, nurse suspects that client is being treated for which condition?

• acne
• eczema
• hair loss

NCLEX-RN Pharm ANSWERS&RATIONALES

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• herpes simplex - CORRECT ANSWER IS 1. Azelaic acid is a topical medication used

to treat mild to moderate acne. Works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes.

Silver sulfadiazine (Silvadene, Thermazne, SSD cream) is prescribed for a client with a partial-thickness burn and the nurse provides teaching about the med. Which statement from the client indicates a need for further teaching about the treatments?

• the medication is an antibacterial
• the medication will help heal the burn
• the medication will permanently stain my skin
• the medication should be applied directly to the wound - CORRECT ANSWER IS 3.

Silvadene is a broad spectrum antibacterial that has activity against gram+ and gram- and yeasts. It applied directly to the wound to assist in healing. It does not stain the skin.

The camp nurse asks children preparing to swim in the lake if they have applied sunscreen. Nurse reminds children that sunscreens are most effective when applied at which times?

• immediately before swimming
• 5 min before exposure to sun
• immediately before exposure to the sun
• at least 30 min before exposure to the sun - CORRECT ANSWER IS 4. Apply at least

30 min before exposure to sun so that sunscreen can penetrate skin. Reapply after swimming or sweating.

Chemo dosage is frequently based on total body surface area (BSA), so it's important for the nurse to perform which assessment prior to admin'ing the chemo?

• measure client's abdom girth
• calculate client's body mass index (BMI)
• ask the client about his or her weight and height
• measure client's current weight and height - CORRECT ANSWER IS 4. To calculate

BSA requires a current and accurate height and weight - prior to each med admin.Asking client may lead to inaccuracies.

A client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse is caring for the client anticipates that which diagnostic study will be prescribed?

• echocardiography
• electrocardiography
• cervical radiography
• pulmonary function studies - CORRECT ANSWER IS 4. Bleomycin is an

antineoplastic med that can cause interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmon function studies along with hematological, hepatic, and

NCLEX-RN Pharm ANSWERS&RATIONALES

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renal function tests need to be monitored. Monitor lung sounds for dyspnea and crackles, indicative of pulmonary toxicity. The med needs to be discontinued if pulmon toxicity occurs.

A client with acute myelocytic leukemia is being treated with busulfan (Myleran, Busulfex). Which lab value would the nurse specifically monitor during treatment with this med?

• clotting time
• uric acid level
• potassium level
• blood glucose level - CORRECT ANSWER IS 2. Busulfam can cause increase in uric

acid level. Hyperuricemia can produce uric acid neuropathy, renal stones, and acute kidney injury.

Client with small cell lung cancer is being treated with etoposide (Toposar). Nurse monitors client during admin, knowing that which adverse effect is specifically associated with this med?

• alopecia
• chest pain
• pulmonary fibrosis
• orthostatic hypotension - CORRECT ANSWER IS 4. Adverse effect specific to

etoposide is orthostatic hypotension. Etoposide should be admin'd slowly over 30-60 mins and client's BP should be monitored during infusion.

Clinic nurse preps a teaching plan for client receiving an antineoplastic med. When implementing plan, the nurse should make which statement to the client?

• You can take aspirin as needed for a headache.
• You can drink beverages containing alcohol in moderate amounts each evening.
• You need to consult with the HCP before receiving immunizations.
• It is fine to receive a flu vaccine at the local health fair without HCP approval bc the

flu is so contagious. - CORRECT ANSWER IS 3. Antineoplastic meds lower resistance of the body so clients must be instructed not to receive immunizations without HCP's approval. Also avoid contact with w/ individuals who have recently received a live virus vaccine.

Client with ovarian cancer is being treated with vincristine (Vincasar). The nurse monitors the client, knowing that which manifestations indicates an adverse effect specific to this med?

• diarrhea
• hair loss
• chest pain