NCLEX Medical-Surgical Drugs

NCLEX Medical-Surgical Drugs

A client with Addison disease is receiving cortisone therapy. What complications does the nurse expect if the client abruptly stops the medication? Select all that apply.

• Diplopia
• Dysphagia
• Tachypnea
• Bradycardia
• Hypotension

What should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel?

• Nausea
• Epistaxis
• Chest pain
• Elevated temperature

A client is admitted to the hospital with a diagnosis of an exacerbation of asthma. What should the nurse plan to do to best help this client?

• Determine the client's emotional state.
• Give prescribed drugs to promote bronchiolar dilation.
• Provide education about the impact of a family history.
• Encourage the client to use an incentive spirometer routinely.

A client with terminal cancer is to receive 4 mg of hydromorphone intravenously (IV) every 4 hours as needed for severe breakthrough pain. It is supplied at 10 mg/mL.When the client complains of severe pain, how much solution of hydromorphone should the nurse administer? Record your answer using one decimal place and leading zero if applicable. ___ mL 0.4

A client is diagnosed with acute kidney failure secondary to dehydration. An intravenous (IV) infusion of 50% glucose with regular insulin is prescribed. What does the nurse recognize as the primary purpose of the IV insulin for this client?

• Hyperkalemia
• Increase urinary output
• Prevent respiratory acidosis
• Increase serum calcium levels

A client has increased intracranial pressure resulting from a traumatic brain injury.Assessment findings indicate that the client is unconscious with vital signs of pulse 60 beats/min, respirations 16 breaths/min, and blood pressure 142/64 mm Hg. The nurse reviews the treatment plan and questions which prescription?

• Mannitol
• Dexamethasone
• Chlorpromazine
• Morphine

An intravenous piggyback (IVPB) of cefazolin 500 mg in 50 mL of 5% dextrose in water is to be administered over a 20-minute period. The tubing has a drop factor of 15 drops/mL. At what rate per minute should the nurse regulate the infusion to run? Record your answer using a whole number. Do not include units in your answer. ______ gtt/min 38

A client is scheduled to begin chemotherapy 2 weeks after surgery for colon cancer.What explanation does the nurse give to explain the delay following surgery?

• Chemotherapy interferes with cell growth and delays wound healing.
• Because chemotherapy causes vomiting, it endangers the integrity of the incisional

area.

• Chemotherapy decreases red blood cell production, and the resultant anemia will

add to postoperative fatigue.

• Chemotherapy increases edema in areas distal to the incision by blocking lymph

channels with destroyed lymphocytes.

The nurse is caring for a client with type 1 diabetes. For which signs or symptoms of insulin-induced hypoglycemia should the nurse particularly be observant? Select all that apply.

• Excessive hunger
• Headache
• Diaphoresis
• Excessive thirst
• Deep respirations

A client is admitted to the emergency department in the midst of persistent tonic-clonic seizures (status epilepticus). Diazepam is to be administered immediately. In addition to decreasing central neuronal activity, what other effect does the nurse anticipate?

• Relaxing peripheral muscles
• Slowing cardiac contractions
• Dilating tracheobronchial structures
• Providing amnesia of the convulsive episode

The nurse is caring for a client who is experiencing side effects from high doses of methotrexate. Leucovorin calcium is prescribed and is to be administered immediately after the infusion of methotrexate. What is the best indicator that leucovorin calcium is effective?

• Increased energy
• Decreased nausea
• Decreased white blood cell (WBC) level
• Methotrexate level less than 0.05 micromole

A nurse teaches a client about the dangers of using sodium bicarbonate regularly. What effect of sodium bicarbonate is the nurse trying to prevent?

• Gastric distention
• Metabolic alkalosis
• Chronic constipation
• Cardiac dysrhythmias

A healthcare provider informs a client that midazolam will be administered preoperatively. Later, the client asks the nurse why this medication is given. What primary reason should the nurse consider when formulating a response?

• Reduces pain
• Induces sedation
• Produces amnesia
• Limits oral secretions

A healthcare provider prescribes simvastatin 20 mg daily for elevated cholesterol and triglyceride levels for a female client. Which is most important for the nurse to teach when the client initially takes the medication?

• Take the medication with breakfast.
• Have liver function tests every 6 months.
• Wear sunscreen to prevent photosensitivity reactions.
• Inform the healthcare provider if the client wishes to become pregnant.

A client diagnosed with asthma has received a prescription for an inhaler. The nurse teaches the client how to determine when the inhaler is empty, instructing the client to do what?

• Count the number of doses taken.
• Taste the medication when sprayed into the air.
• Shake the canister.
• Place the canister in water to see if it floats.

A nurse teaches a client about warfarin. Which information is essential for the nurse to include in the education plan?

• Periodic blood testing is necessary.
• Foods do not affect the medication.
• Physical activities should be limited.
• Daily doses should not be interrupted.

A client with anorexia nervosa is admitted to the critical care unit following a period of prolonged starvation. What signs or symptoms indicate to the nurse that the client may have hypokalemia? Select all that apply.

• Muscle weakness
• Metabolic alkalosis
• Cardiac dysrhythmias
• Respiratory rate of 24 or higher
• Serum potassium of 5.5 mEq/L (5.5 mmol/L)

A health care provider prescribes famotidine for a client with dyspepsia. What is important to include about this medication in a teaching program for this client?

• Lowers the stress level
• Neutralizes gastric acidity
• Reduces gastrointestinal peristalsis
• Decreases secretions in the stomach

The health care provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. What is an action of PTU that the nurse will include in teaching?

• Increases the uptake of iodine
• Causes the thyroid gland to atrophy
• Interferes with the synthesis of thyroid hormone
• Decreases the secretion of thyroid-stimulating hormone (TSH)

A client has severe diarrhea, and the health care provider prescribes intravenous fluids, sodium bicarbonate, and an antidiarrheal medication. Which drug does the nurse expect the health care provider to prescribe?

• Psyllium
• Bisacodyl
• Loperamide
• Docusate sodium

A client is waiting for a kidney transplant. What explanation should the nurse include when teaching the client about the transplant?