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Pharmacology NCLEX Questions ScienceMedicineNursing adrianna_lane Save
NCLEX EXAM PREVIEW
110 terms kandykat1012Preview Pharm Quiz Bowl Study Set 134 terms vlee2410Preview APEA- Endocrine Assessment 41 terms adrianna_lanePreview Boyd's 62 terms Kris 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
- 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
- Decreased respirations
- 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.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action?
- Notify the registered nurse.
- Administer pain medication to reduce the discomfort.
- Apply ice and maintain the infusion rate, as prescribed.
- Elevate the extremity of the IV site, and slow the infusion.
- Notify the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV, great care must be taken to prevent the medication from escaping into the tissues surrounding the injection site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then contact the health care provider.
13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed?
- Echocardiography
- Electrocardiography
- Cervical radiography
- Pulmonary function studies
- Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary function studies along with hematological, hepatic, and renal function tests need to be monitored. The nurse needs to monitor lung sounds for dyspnea and crackles, which indicate pulmonary toxicity. The medication needs to be discontinued immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the specific use of this medication.
14.) The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value would the nurse specifically monitor during treatment with this medication?
- Clotting time
- Uric acid level
- Potassium level
- Blood glucose level
- Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can produce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3, and 4 are not specifically related to this medication.
15.) The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
- Alopecia
- Chest pain
- Pulmonary fibrosis
- Orthostatic hypotension
- Orthostatic hypotension
Rationale:
A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is monitored during the infusion. Hair loss occurs with nearly all the antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this medication.
16.) The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse
tells the client:
- To take aspirin (acetylsalicylic acid) as needed for headache
- Drink beverages containing alcohol in moderate amounts each evening
- Consult with health care providers (HCPs) before receiving immunizations
- That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair
- Consult with health care providers (HCPs) before receiving immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without a HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side effects.
17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?
- Diarrhea
- Hair loss
- Chest pain
- Numbness and tingling in the fingers and toes
- Numbness and tingling in the fingers and toes
Rationale:
A side effect specific to vincristine is peripheral neuropathy, which occurs in almost every client. Peripheral neuropathy can be manifested as numbness and tingling in the fingers and toes. Depression of the Achilles tendon reflex may be the first clinical sign indicating peripheral neuropathy. Constipation rather than diarrhea is most likely to occur with this medication, although diarrhea may occur occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest pain is unrelated to this medication.
18.) The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent.The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
- Pancreatitis
- Diabetes mellitus
- Myocardial infarction
- Chronic obstructive pulmonary disease
- Pancreatitis
Rationale:
Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between administration of the doses. The client needs to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not contraindicated with this medication.
19.) Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is
to:
- Increase DNA and RNA synthesis.
- Promote the biosynthesis of nucleic acids.
- Increase estrogen concentration and estrogen response.
- Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.
- Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.
Rationale:
Tamoxifen is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.
20.) The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- Glucose level
- Calcium level
- Potassium level
- Prothrombin time
- Calcium level
Rationale:
Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.
21.) A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply.
- Tinnitus
- Ototoxicity
- Hyperkalemia
- Hypercalcemia
- Nephrotoxicity
- Hypomagnesemia
- Tinnitus
- Ototoxicity
- Nephrotoxicity
- Hypomagnesemia
Rationale:
Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin to reduce the potential for renal toxicity.
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