NEW PHARMACOLOGY NCLEX ASSESSMENT QUESTIONS AND

NEW PHARMACOLOGY NCLEX ASSESSMENT QUESTIONS AND

ANSWERS SOLUTION

A nurse is assisting with the care of a client who has myasthenia gravis and is experiencing a cholinergic crisis. Which of the following medications should the nurse expect the RN to administer?

• Bethanechol
• Propranolol
• Atropine
• Epinephrine - ANS IS Atropine

A nurse is caring for a client who has bipolar disorder and a new prescription for lithium.Which of the following laboratory values should the nurse plan to monitor for potential adverse effects?

• Prothrombin time
• Hematocrit
• Sodium
• Potassium - ANS IS Sodium

The nurse should monitor the client's sodium level while the client is taking lithium.When the client's sodium level is low, the kidneys retain lithium, which can cause toxicity. Because polyuria is an adverse effect of lithium in 50% to 70% of clients treated, hyponatremia is a significant risk. The nurse should reinforce teaching with the client about eating consistent amounts of sodium and drinking 2 to 3 L of fluid daily to help prevent lithium toxicity.

A nurse is reinforcing teaching with a client who has a prescription for rosuvastatin to treat high cholesterol levels. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider immediately?

• Muscle weakness
• Headache
• Abdominal pain
• Insomia - ANS IS Muscle weakness

When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding to report is muscle weakness (myalgia) or tenderness because it can be a manifestation of rhabdomyolysis, a rare but potentially fatal adverse effect of HMG-CoA reductase inhibitor (statin) therapy. Rhabdomyolysis is a disintegration of muscle tissue that causes elevations in creatine kinase, potentially impairing renal function

A nurse is reinforcing teaching with a newly licensed nurse regarding safe procedures for medication administration. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

• "I will identify the client by verifying the client's name using the room number."
• "I can administer antibiotics 1 hour before the scheduled time."
• "I will check the label on the client's medication three times before administering it."
• "I will leave the client's medication at the client's bedside." - ANS IS " I will check the

label on the client's medication three times before administering it."

A nurse is collecting data from a client who is receiving morphine to relieve postoperative pain. The client's respiratory rate is 9/min. The nurse should notify the provider and expect a stat prescription for which of the following medications?

• Naloxone
• Glucagon
• Flumazenil
• Protamine - ANS IS Naloxone

Morphine is an opioid analgesic. Naloxone, an opiate antagonist, reverses the effects of opioids, including respiratory depression and sedation. After administering naloxone, the nurse should continue to monitor the client's respiratory function and pain control.

A nurse is reinforcing teaching with a client who has a new prescription for insulin. The client is taking propranolol. The nurse should teach the client to monitor for which of the following findings as a manifestation of hypoglycemia?

• Tachycardia
• Difficulty breathing
• Sleep disturbance
• Hunger - ANS IS Hunger

Propranolol blocks the beta1 receptors, which suppresses the typical early signs of hypoglycemia, such as tachycardia, sweating, and tremors. The nurse should instruct clients who have diabetes mellitus and take propranolol to recognize alternative indications of hypoglycemia, such as hunger and fatigue.

A nurse is reinforcing dietary teaching with a client who is taking furosemide. Which of the following foods should the nurse recommend as the best source of potassium?

• 1 cup of baked potatoes
• 1 cup of fresh blueberries
• 1 cup of fresh watermelon
• 1 cup of raw chopped cabbage - ANS IS 1 cup of baked potatoes

A nurse is reinforcing teaching with a client who has a prescribed isoniazid. Which of the following clients statements indicates an understanding of the teaching?

"I should expect my urine to turn reddish in color." "I will have a skin test to determine when I am no longer contagious." "I should notify my provider if I develop numbness in my feet." "I should expect to take this medication for 6 weeks." - ANS IS " I should notify my provider if I develop numbness in my feet."

The nurse should instruct the client to notify the provider for manifestations of peripheral neuropathy, such as tingling, numbness, burning, or pain in extremities.

A nurse is assisting in the care of a client who has oral benzodiazepine toxicity. The client has an IV infusing and is non responsive. Which of the following interventions should the nurse anticipate first? - ANS IS Administering IV flumazenil

Evidence-based practice indicates that the priority action for a client who has benzodiazepine toxicity is to administer IV flumazenil. Flumazenil is a benzodiazepine receptor antagonist used to reverse sedation caused by benzodiazepine toxicity. The IV medication begins working within 1 to 2 min. Therefore, administering flumazenil is the first action the nurse should anticipate.

A nurse is reinforcing teaching with a client who has chronic stable angina and a prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?

• "Replace your bottle of tablets every 3 months for best effectiveness."
• "Place one tablet under the tongue 30 minutes before exercise to prevent angina chest

pain."

• "Call 911 if chest pain is not relieved within 20 minutes of taking nitroglycerin."
• "As soon as chest pain occurs, place one tablet under the tongue." - ANS IS "As soon

as chest pain occurs, place one tablet under the tongue."

The nurse should instruct the client to immediately place one sublingual nitroglycerin tablet under the tongue as soon as chest pain occurs. The tablets begin working in 1 to

• min. Nitroglycerin works by causing vasodilation and decreasing venous return.

Therefore, it can cause orthostatic hypotension and dizziness. The nurse should instruct the client to sit down when experiencing chest pain and to lie down if dizziness occurs.Headache is another adverse effect of nitroglycerin that occurs as a result of vasodilation.

A nurse is collecting data from a client who is scheduled to recei - ANS IS This creatinine level is above the expected reference range for adults of 0.5 to 1.3 mg/dL, indicating impaired kidney function, which increases the risk for nephrotoxicity.Aminoglycoside antibiotics can cause kidney toxicity. Therefore, the nurse should

monitor the client's urinalysis results, as well as BUN and creatinine levels, for manifestations of kidney injury.

A nurse is administering ear drops into an adult client's right ear. Which of the following actions should the nurse take? - ANS IS Instill drops holding the dropper 1 cm (0.4 in) above the ear canal

A nurse is reinforcing teaching with a client who is taking rifampin. Which of the following statements should the nurse make? - ANS IS "You might be unable to wear contact lenses when taking this medication."

The nurse should instruct the client that rifampin can cause body fluids, such as tears and sweat, to turn orange or red. Clients who wear contact lenses might experience permanent staining and should check with an optometrist regarding alternatives.Rifampin is a medication that is commonly used in combination with other antimycobacterial agents to treat pulmonary tuberculosis.

A nurse is administering a varicella immunization to a young adult client who did not receive the immunization as a child. The client asks the nurse if they will need additional doses of the vaccine. Which of the following responses should the nurse make? - ANS IS "You should return for a second dose in 4 to 8 weeks."

The nurse should tell the client that the varicella vaccine requires two doses and they should return for the second dose in 4 to 8 weeks. Ideally, toddlers should receive the first dose of varicella vaccine between 12 and 15 months of age and the second dose at

• to 6 years of age. For adolescents or adults who are not immune to varicella and who

have not been immunized, two doses are required at least 28 days apart.

A nurse is reviewing the medical history of a client who requires ophthalmic medication to treat glaucoma. which of the following factors in the client's history is a contraindication for using beta-adrenergic blocking eye drops to treat this disorder?

• Diabetes Mellitus
• Peptic ulcer disease
• Migraine headaches
• Sinus bradycardia - ANS IS Sinus bradycardia

Beta adrenergic blockers block cardiac beta receptors and can cause atrioventricular heart block and sinus bradycardia.

A nurse is reinforcing with a client who is prescribed an albuterol inhaler, two puffs every 4 hours. Which of the following statements by the client indicates an understanding of the teaching?

• "I will wait 5 seconds in between each puff."
• "I will hold by breath for 10 seconds after inhaling the medication."