NCLEX Medical Surgical Drugs

NCLEX Medical Surgical Drugs

A client with heart failure is digitalized (given a loading dose of digoxin) and placed on a maintenance dose of digoxin 0.25 mg by mouth daily. What responses does the nurse expect the client to exhibit when a therapeutic effect of digoxin is achieved?

• Diuresis and decreased pulse rate
• Increased blood pressure and weight loss
• Regular pulse rhythm and stable fluid balance
• Corrected heart murmur and decreased pulse pressure

A hospitalized client is receiving pyridostigmine for control of myasthenia gravis. In the middle of the night, the nurse finds the client weak and barely able to move. Which additional clinical findings support the conclusion that these responses are related to pyridostigmine? Select all that apply.

• Respiratory depression
• Distention of the bladder
• Decreased blood pressure
• Fine tremor of the fingers
• High-pitched gurgling bowel sounds

A client who is receiving hydrochlorothiazide asks what this drug actually does. What information about the drug's therapeutic action will the nurse consider when formulating a response?

• Increases the excretion of sodium
• Increases the glomerular filtration rate
• Decreases the reabsorption of potassium
• Decreases the amount of fluid reabsorption in the loop of Henle

After a short hospitalization for an episode of a transient ischemic attack (TIA) related to hypertension, a client is discharged on a regimen that includes chlorothiazide. What will the nurse instruct the client to do regarding nutrition? Select all that apply.

• Eat more dark green leafy vegetables such as spinach.
• Eat more vitamin-enriched products.
• Return to previous eating habits.
• Increase intake of dairy products.
• Increase intake of beans.

A client is scheduled for a craniotomy to remove a brain tumor. To prevent the development of cerebral edema after surgery, the nurse anticipates the use of drugs from which class?

• Steroids
• Diuretics
• Anticonvulsants
• Antihypertensives

A client with arthritis increases the dose of ibuprofen to abate joint discomfort. After several weeks the client becomes increasingly weak. The client is admitted to the hospital and is diagnosed with severe anemia. What findings does the nurse expect to identify when performing an admission assessment? Select all that apply.

• Melena
• Tachycardia
• Constipation
• Clay-colored stools
• Painful bowel movements

The nurse is providing postoperative care for a client who has received a prescription for nalbuphine for pain. What side effects or adverse reactions does the nurse anticipate after administering this medication? Select all that apply.

• Nausea
• Oliguria
• Sedation
• Dry mouth
• Flushed skin
• Orthostatic hypotension

A nurse is teaching a client who is taking a loop diuretic about foods that are high in potassium. Which foods should the nurse emphasize? Select all that apply.

• Bananas
• Apricots
• Roasted chicken
• Macaroni and cheese
• Baked potatoes with skins

Twenty minutes after the start of an intravenous (IV) vancomycin infusion, the client appears flushed and complains of palpitations. What action should the nurse take?

• Stop the infusion; the client is having an allergic reaction.
• Continue to monitor the client; this is an expected reaction.
• Contact the primary healthcare provider to obtain a prescription to decrease the

infusion rate.

• Contact the primary healthcare provider to obtain a prescription for an antianxiety

medication.

A client is receiving penicillin G and probenecid for syphilis. What rationale should the nurse give for the need to take these two drugs?

• Each drug attacks the organism during different stages of cell multiplication.
• The penicillin treats the syphilis, whereas the probenecid relieves the severe

urethritis.

• Probenecid delays excretion of penicillin, thus maintaining blood levels for longer

periods.

• Probenecid decreases the potential for an allergic reaction to penicillin, which treats

the syphilis.

Which medication requires the nurse to monitor the client for signs of hyperkalemia?

• Furosemide
• Metolazone
• Spironolactone
• Hydrochlorothiazide

A client says, "I take baking soda in water when I get heartburn." The nurse suggests an antacid containing aluminum and magnesium hydroxide instead of baking soda. What is the advantage these antacids have over baking soda?

• They contain little, if any, sodium.
• Absorption by the stomach mucosa is markedly enhanced.
• There is no direct effect on the systemic acid-base balance when taken as directed.
• Fewer side effects, such as diarrhea or constipation, are experienced when they are

used properly.

A healthcare provider prescribes ampicillin for a client with an infection. What information should the nurse include in the teaching plan about this medication?

• Take the ampicillin with meals.
• Store the ampicillin in a light-resistant container.
• Notify the healthcare provider if diarrhea develops.
• Continue the drug until a negative culture is obtained.

An obese client must self-administer insulin at home. The nurse will teach the client to inject insulin at which angle?

• 30-degree angle
• 60-degree angle
• 45-degree angle
• 90-degree angle

For which side effects should a nurse assess a client with cancer who is being treated with chemotherapeutic agents? Select all that apply.

• Diarrhea
• Leukocytosis
• Bleeding tendencies
• Lowered sedimentation rate
• Increased hemoglobin levels

How should a nurse prepare an intravenous piggyback (IVPB) medication for administration to a client receiving an IV infusion? Select all that apply.

• Wear clean gloves to check the IV site.
• Rotate the bag after adding the medication to mix.
• Use 100 mL of fluid to mix the medication.
• Flush the IV insertion site with 2 mL saline.
• Place the IVPB at a lower level than the existing IV.
• Use a sterile technique when preparing the medication.

The healthcare provider prescribes an intravenous medication for a client who has been admitted for a chronic obstructive pulmonary disease exacerbation. When preparing to initiate an intravenous line, the nurse applies the tourniquet to select the site. When should the nurse release the tourniquet?

• After cleaning the insertion site
• As soon as the needle pierces the skin
• When the needle enters the vein
• After the device is secured with tape

A client with human immunodeficiency virus (HIV)-associated Pneumocystis jiroveci pneumonia is to receive pentamidine isethionate intravenously (IV) once daily. The nurse should monitor the client for what adverse effect?

• Hypertension
• Hypokalemia
• Hypoglycemia
• Hypercalcemia

A client with hyperthyroidism is to receive potassium iodide solution before a subtotal thyroidectomy is performed. What action does the nurse include when providing teaching about this drug?

• Decreases the total basal metabolic rate
• Maintains the function of the parathyroids
• Blocks the formation of thyroxine by the thyroid gland
• Decreases the size and vascularity of the thyroid gland

A client with myasthenia gravis improves and is discharged from the hospital. The discharge medications include pyridostigmine bromide 10 mg every 6 hours. The nurse