Exam Practice - 2.) Oral iron supplements are prescribed for a ...

HESI Pharmacology Exam Practice NCLEX-PN style study questions 2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item?

• Milk
• Water
• Apple juice
• Orange juice - ANSWER 4. Orange juice

Rationale:

Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice.

3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?

• Tinnitus
• Diarrhea
• Constipation 1 / 4

• Decreased respirations - ANSWER 1. Tinnitus

Rationale:

Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism.

22.) A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication

has been prescribed to:

• Treat thyroid storm.
• Prevent cardiac irritability.
• Treat hypocalcemic tetany.
• Stimulate the release of parathyroid hormone. - ANSWER 3.

Treat hypocalcemic tetany.

Rationale:

Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside.

23.) A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?

• Keep insulin vials refrigerated at all times.
• Rotate the insulin injection sites systematically.
• Increase the amount of insulin before unusual exercise. 2 / 4

• Monitor the urine acetone level to determine the insulin dosage. -

ANSWER 2. Rotate the insulin injection sites systematically.

Rationale:

Insulin dosages should not be adjusted or increased before unusual exercise. If acetone is found in the urine, it may possibly indicate the need for additional insulin. To minimize the discomfort associated with insulin injections, the insulin should be administered at room temperature. Injection sites should be systematically rotated from one area to another. The client should be instructed to give injections in one area, about 1 inch apart, until the whole area has been used and then to change to another site. This prevents dramatic changes in daily insulin absorption.

24.) A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching?

• Withdraws the NPH insulin first
• Withdraws the regular insulin first
• Injects air into NPH insulin vial first
• Injects an amount of air equal to the desired dose of insulin into the vial -

ANSWER 1. Withdraws the NPH insulin first

Rationale:

When preparing a mixture of regular insulin with another insulin preparation, the regular insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of regular insulin with insulin of another type. Options 2, 3, and 4 identify the correct actions for preparing NPH and regular insulin.

25.) A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to: 3 / 4

• Freeze the insulin.
• Refrigerate the insulin.
• Store the insulin in a dark, dry place.
• Keep the insulin at room temperature. - ANSWER 2.

Refrigerate the insulin.

Rationale:

Insulin in unopened vials should be stored under refrigeration until needed. Vials should not be frozen. When stored unopened under refrigeration, insulin can be used up to the expiration date on the vial. Options 1, 3, and 4 are incorrect.

27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?

• Neuralgia
• Insomnia
• Use of nitroglycerin
• Use of multivitamins - ANSWER 3. Use of nitroglycerin

Rationale:

Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus cavernosum of the penis, thus sustaining an erection. Because of the effect of the medication, it is contraindicated with concurrent use of organic nitrates and nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia and insomnia are side effects of the medication.

28.) The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention?

• The medication is administered within 60 minutes before the morning and

evening meal.

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