NCLEX CLINICAL DRUG THERAPY 2025 EXAM

NCLEX CLINICAL DRUG THERAPY 2025 EXAM

QUESTIONS AND CORRECT ANSWERS ALREADY GRADED

A+ LATEST VERSION.

◉39.2 Which of the following oral medications is safe to use in a 60-year-old constipated patient with dysphagia?

• methylcellulose
• psyllium
• mineral oil

D. docusate sodium. Answer: D.

Rationale: Bulk-forming laxatives such as methylcellulose and psyllium are contraindicated for clients with dysphagia because they may cause obstruction. Clients with dysphagia are also not good candidates for bulk-forming laxatives, because they may have decreased fluid intake secondary to their dysphagia. Mineral oil in oral formation is contraindicated for these clients because it may be aspirated leading to a lipid pneumonia. Docusate sodium is the safest choice for this client.

◉39.3 A laxative is contraindicated in a patient:

• with cancer taking daily narcotics for pain control
• complaining of abdominal pain and distention
• scheduled for a colonoscopy

D. with limited mobility due to Parkinson's disease. Answer: B.

Rationale: Laxatives are contraindicated in the presence of undiagnosed abdominal pain and distention, which may indicate acute pathology such as an inflamed organ. In the case of appendicitis, laxatives are contraindicated because they may lead to rupture of the appendix, with contents spilling into the abdominal cavity causing life-threatening peritonitis. Laxatives are appropriate for the cancer client because narcotics are often prescribed and may lead to constipation. Laxatives are usually part of the preparation for a colonoscopy. Laxatives are often needed in clients with decreased activity such as those with Parkinson's disease to stimulate bowel function.

◉39.4 A nurse is caring for a patient preparing to undergo a colonoscopy. Which of the following drugs do health care providers commonly use to enhance bowel cleansing? (Select all that apply.)

• polyethylene glycol-electrolyte solution
• bisacodyl 1 / 3

• psyllium

D. docusate sodium. Answer: A and B.

Rationale: Health care providers commonly give polyethylene glycol-electrolyte solution and bisacodyl to evacuate the colon in preparation for a colonoscopy.

◉39.5 Which of the following mechanism of action is shown by over-the-counter drug magnesium hydroxide (milk of magnesia)?

• increased gastric secretions
• increased osmotic pressure in the intestinal lumen
• binding to diarrhea-causing bacteria for excretion

D. decreased gastrointestinal motility. Answer: B.

Rationale: Magnesium hydroxide increases osmotic pressure in the intestinal lumen and causes water to be retained.

◉41.1 A patient presents with a blood pressure of 162/88 mm Hg, heart rate of 100 bpm, triglycerides of 378 mg/dL, and HDL of 25 mg/dL. Which of the following are characteristics of metabolic syndrome? (Select all that apply.)

• blood pressure of 162/88 mm Hg
• heart rate of 100 bpm
• triglycerides of 378 mg/dL

D. HDL of 25 mg/dL. Answer: A, C, and D.

The characteristics of metabolic syndrome are high low-density lipoprotein (LDL) cholesterol and total cholesterol, low HDL, increased blood pressure, impaired glucose values, and abdominal obesity.

◉41.2 A patient who has just arrived at the emergency department may be suffering from diabetic ketoacidosis. Which of the following would confirm the diagnosis?

• elevated serum potassium
• increased respiratory rate
• increased pH

D. elevated blood glucose level. Answer: D.

In diabetic ketoacidosis, the arterial pH is less than 7.35, plasma bicarbonate is less than 15 mEq/L, blood glucose is usually higher than 250 mg/dL, and ketones are present in the urine.The client also usually has Kussmaul's respirations.

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◉41.3 A patient is taking NPH insulin once daily in the morning. What is the most likely time for a hypoglycemic reaction?

• 1 to 3 hours after administration
• 4 to 12 hours after administration
• 12 to 18 hours after administration
• 18 to 24 hours after administration. Answer: B. The insulin begins to work in 1 to 1½ hours,

and its peak of action occurs in 4 to 12 hours, the most likely time a client will experience hypoglycemia.

◉41.4 A patient with newly diagnosed type 1 diabetes is beginning daily insulin injections. The nurse is preparing to teach the patient about insulin injections. What should the nurse include in the teaching plan?

• Understand that ketones in the urine indicate the need for a decrease in the number of units

of insulin.

• Administer the insulin at the same time every day regardless of meals.
• Rotate the insulin injection sites.

D. Increase the insulin dosage just prior to exercise.. Answer: C.

Lipodystrophy (hypertrophy of subcutaneous tissue at the injection site) can occur when the clients uses the same injection sites. Hypertrophied tissue can affect the amount or degree to which subcutaneous insulin is absorbed and thereby affect blood glucose levels.

◉41.5 When teaching a patient who has recently received a diagnosis of diabetes how to self- administer short-acting and intermediate-acting insulin subcutaneously, which of the following instructions is correct?

• Understand that the order of drawing up the two insulins into the syringe does not matter.
• Draw the short-acting insulin into the syringe first, followed by the intermediate-acting

insulin.

• Draw the intermediate-acting insulin into the syringe first, followed by the short-acting

insulin.

• Give yourself two injections because mixing these insulins together is unsafe.. Answer: B.

The short-acting insulin (clear) should always be drawn up first because the intermediate- acting insulin (cloudy) can inversely affect the short-acting insulin if mixed in the vial.

◉41.6 Which of the following insulins cannot be administered in a continuous subcutaneous insulin infusion pump?

• insulin lispro
• insulin aspart
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