NCLEX Questions-Pharmacology with rationalesStudy online at nurse is caring for a client with hyperparathyroidism and notes that the clients serum calcium level is 13 mgdL. Which medication should the nurse prepare to administer as prescribed to the clien

NCLEX Questions-Pharmacology (with rationales)Study online at https://quizlet.com/_2f6ln21.A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1. Calcium chloride 2. Calcium gluconate 3. Calcitonin (Miacalcin) 4. Large doses of vitamin D3. Calcitonin (Miacalcin)Rationale:The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hy-percalcemia. Calcium gluconate and calci-um chloride are medications used for the treatment of tetany, which occurs as a re-sult of acute hypocalcemia. In hypercal-cemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by in-hibiting bone resorption and lowering the serum calcium concentration.2.Oral iron supplements are pre-scribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the moth-er to administer the iron with which best food item? 1. Milk 2. Water 3. Apple juice 4. Orange juice4. Orange juiceRationale:Vitamin C increases the absorption of iron by the body. The mother should be instruct-ed to administer the medication with a cit-rus 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 toxic-ity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations1. TinnitusRationale: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.4.A client with severe acne is seen in the clinic and the health 1. Vitamin ARationale:1 / 24

NCLEX Questions-Pharmacology (with rationales)Study online at https://quizlet.com/_2f6ln2care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which med-ication? 1. Vitamin A 2. Digoxin (Lanoxin) 3. Furosemide (Lasix) 4. Phenytoin (Dilantin)Isotretinoin is a metabolite of vitamin A and can produce generalized intensifica-tion of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued be-fore isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.5.The nurse is applying a top-ical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the med-ication were being applied to which of the following body ar-eas? 1. Back 2. Axilla 3. Soles of the feet 4. Palms of the hands2. AxillaRationale:Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is es-pecially permeable (scalp, axilla, face, eye-lids, neck, perineum, genitalia), and lower from regions in which permeability is poor (back, palms, soles).6.The health care provider has prescribed silver sulfadi-azine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing informa-tion to the client about the med-ication. Which statement made by the client indicates a lack of understanding about the treat-ments? 1. "The medication is an an-tibacterial."3. "The medication will permanently stain my skin."Rationale:Silver sulfadiazine (Silvadene) is an an-tibacterial that has a broad spectrum of activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is ap-plied directly to the wound to assist in heal-ing. It does not stain the skin.2 / 24

NCLEX Questions-Pharmacology (with rationales)Study online at https://quizlet.com/_2f6ln2 2. "The medication will help heal the burn." 3. "The medication will perma-nently stain my skin." 4. "The medication should be applied directly to the wound."7.The client with metastatic breast cancer is receiving ta-moxifen. The nurse specifically monitors which laboratory val-ue while the client is taking this medication? 1. Glucose level 2. Calcium level 3. Potassium level 4. Prothrombin time2. Calcium levelRationale:Tamoxifen may increase calcium, choles-terol, and triglyceride levels. Before the ini-tiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride lev-els, should be monitored periodically dur-ing 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, hypotonic-ity of muscles, and deep bone and flank pain.8.A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is pre-scribed for the client. The nurse determines that this medica-tion has been prescribed to: 1. Treat thyroid storm. 2. Prevent cardiac irritability. 3. Treat hypocalcemic tetany. 4. Stimulate the release of parathyroid hormone.3. Treat hypocalcemic tetany.Rationale:Hypocalcemia can develop after thyroidec-tomy if the parathyroid glands are acci-dentally 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.9.A client who has been newly diagnosed with diabetes mel-2. Rotate the insulin injection sites system-atically.3 / 24

NCLEX Questions-Pharmacology (with rationales)Study online at https://quizlet.com/_2f6ln2litus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge? 1. Keep insulin vials refrigerat-ed at all times. 2. Rotate the insulin injection sites systematically. 3. Increase the amount of in-sulin before unusual exercise. 4. Monitor the urine acetone level to determine the insulin dosage.Rationale:Insulin dosages should not be adjusted or increased before unusual exercise. If ace-tone is found in the urine, it may possibly indicate the need for additional insulin. To minimize the discomfort associated with in-sulin injections, the insulin should be ad-ministered 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 dai-ly insulin absorption.10.A nurse is reinforcing teach-ing 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, in-dicates the need for further teaching? 1. Withdraws the NPH insulin first 2. Withdraws the regular in-sulin first 3. Injects air into NPH insulin vial first 4. Injects an amount of air equal to the desired dose of in-sulin into the vial1. Withdraws the NPH insulin firstRationale:When preparing a mixture of regular insulin with another insulin preparation, the reg-ular 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 cor-rect actions for preparing NPH and regular insulin.11.Glimepiride (Amaryl) is pre-scribed for a client with di-abetes mellitus. A nurse re-inforces instructions for the client and tells the client to 1. AlcoholRationale:When alcohol is combined with glimepiride (Amaryl), a disulfiram-like reaction may oc-cur. This syndrome includes flushing, pal-4 / 24