NCLEX Review Pharmacology {ALREADY GRADED A+ } NEWEST VERSION

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NCLEX Review Pharmacology {ALREADY

GRADED A+ } NEWEST VERSION

• Question: A client with myasthenia gravis has become increasingly weaker. The health

care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis).An injection of edrophonium is administered. Which finding would indicate that the client is in cholinergic crisis?Correct Answer: A temporary worsening of the condition (Note: An edrophonium injection makes the client in cholinergic crisis temporarily worse. An improvement in the weakness indicates myasthenia crisis. Muscle spasms are not associated with this test.)

• Question: The nurse has given medication instructions to a client receiving phenytoin.

Which statement indicates that the client has an adequate understanding of the instructions?Correct Answer: "Good oral hygiene is needed, including brushing and flossing."

• Question: The nurse is caring for a client with chronic back pain. Codeine has been

prescribed for the client. Specific to this medication, which intervention should the nurse include in the plan of care while the client is taking this medication?

Correct Answer: Monitor bowel activity

• Question: A client with trigeminal neuralgia is being treated with carbamazepine, 400 mg

orally daily. Which value indicates that the client is experiencing an adverse effect to the medication?Correct Answer: White blood cell count, 3000 mm³ (3.0 × 10⁹/L) (Note: Adverse effects of carbamazepine appear as blood dyscrasias and cardiovascular disturbances.)

• Question: The client arrives at the emergency department complaining of back spasms.

The client states, "I have been taking 2 to 3 aspirin every 4 hours for the last week, and it hasn't helped my back." Since acetylsalicylic acid intoxication is suspected, the nurse should assess the client for which manifestation?

Correct Answer: Tinnitus

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• Question: A client is taking the prescribed dose of phenytoin to control seizures. Results

of a phenytoin blood level study reveal a level of 35 mcg/mL (140 mcmol/L). Which finding would be expected as a result of this laboratory result?Correct Answer: Slurred speech (Note: The therapeutic phenytoin level is 10 to 20 mcg/mL. At levels >20 mcg/mL, nystagmus occurs. At >30 mcg/mL, ataxia and slurred speech occur.)

• Question: Meperidine has been prescribed for a client to treat pain. Which side and

adverse effects should the nurse monitor for? Select all that apply.

Correct Answer: Tremors; Drowsiness; Hypotension

• Question: The nurse is caring for a client in the emergency department who has been

diagnosed with Bell's palsy. The client has been taking acetaminophen, and acetaminophen overdose is suspected. Which antidote should the nurse prepare for administration if prescribed?

Correct Answer: Acetylcysteine

• Question: The home health nurse visits a client who is taking phenytoin for control of

seizures. During the assessment, the nurse notes that the client is taking birth control pills.Which information should the nurse include in the teaching plan?Correct Answer: There is the potential of decreased effectiveness of birth control pills while taking phenytoin. (Rationale: Phenytoin enhances the rate of estrogen metabolism.)

• Question: Carbidopa-levodopa is prescribed for a client with Parkinson's disease. The

nurse monitors the client for side and adverse effects of the medication. Which finding indicates that the client is experiencing an adverse effect?

Correct Answer: Impaired voluntary movements

• Question: A client with trigeminal neuralgia tells the nurse that acetaminophen is taken

daily for the relief of generalized discomfort. Which laboratory value would indicate toxicity associated with the medication?

Correct Answer: Direct bilirubin level of 2 mg/dL (34 mcmol/L)

• Question: The nurse is caring for a client receiving mannitol via intravenous (IV)

infusion. A vial is sent from the pharmacy, and in preparing the medication the nurse notes that the vial contains crystals. What is the most appropriate nursing action?

Correct Answer: Place the vial in warm water

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• Question: The nurse in a long-term care facility is reviewing the health care provider's

(HCP's) prescriptions on an assigned client. The nurse notes that the HCP prescribed ropinirole hydrochloride. The nurse determines that this medication has been prescribed to treat which condition in the client?

Correct Answer: Parkinsonian syndrome

• Question: A client is receiving phenobarbital sodium. Which finding on the nursing

assessment would indicate that the client is experiencing a common side or adverse effect of this medication?

Correct Answer: Drowsiness

• Question: A client with suspected opioid overdose has received a dose of naloxone

hydrochloride. The client subsequently becomes restless, starts to vomit, and complains of abdominal cramping. The blood pressure increases from 110/72 mm Hg to 160/86 mm Hg. The nurse provides emotional support and reassurance while administering care to the client, knowing which piece of information?

Correct Answer: These are signs of opioid withdrawal

• Question: The nurse is preparing to give a postcraniotomy client medication for

incisional pain. The family asks the nurse why the client is receiving codeine sulfate and not "something stronger." In formulating a response, the nurse incorporates which information about codeine sulfate?Correct Answer: It does not alter respirations or mask neurological signs as do other opioids.

• Question: The nurse is administering medications to a client with trigeminal neuralgia.

The nurse expects that which medication will be prescribed for pain relief?

Correct Answer: Carbamazepine and gabapentin

• Question: The nurse is caring for a client with an exacerbation of multiple sclerosis.

Which medication(s) will the nurse expect to be prescribed to hasten recovery from the exacerbation?

Correct Answer: Methylprednisolone and cyclophosphamide intravenously

19. Question: The nurse is observing a new nursing graduate who is preparing an

intermittent intravenous (IV) infusion of phenytoin for a client with a diagnosis of seizures.Which solution used by the nursing graduate should indicate to the nurse an understanding of proper preparation of this medication?

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Correct Answer: 0.9% sodium chloride

• Question: The nurse has given instructions for taking codeine sulfate to a client with a

severe headache. Which statement by the client indicates the teaching has been effective?

Correct Answer: "I should increase fluid intake."

• Question: A client experiencing spasticity as a result of spinal cord injury has a new

prescription for dantrolene. Before administering the first dose, the nurse checks to see if which baseline study has been done?

Correct Answer: Liver function studies

• Question: The client with a head injury is experiencing signs of increased intracranial

pressure (ICP), and mannitol is prescribed. The nurse administering this medication expects which as intended effects of this medication? Select all that apply.

Correct Answer: Reduced ICP; Increased diuresis; Increased osmotic pressure of

glomerular filtrate; Reduced tubular reabsorption of water and solutes

• Question: The nurse has a prescription to give dexamethasone by the intravenous (IV)

route to a client with cerebral edema. How should the nurse prepare this medication?

Correct Answer: Preparing an undiluted direct injection of the medication

• Question: The nurse who is caring for a client with myasthenia gravis has a prescription

to perform an edrophonium test. After obtaining edrophonium the nurse should be certain that which also is available at the bedside?

Correct Answer: Atropine sulfate

• Question: After review of the client's laboratory values, the nurse notes that a

phenytoin level for a client receiving phenytoin is 7 mcg/mL (27.78 mmol/L). The nurse makes which interpretation regarding this laboratory result?Correct Answer: The level is lower than the expected therapeutic range (Note: Therapeutic medication range of phenytoin is between 10 and 20 mcg/mL (40 to 79 mmol/L).)

• Question: A client with status epilepticus has been prescribed phenytoin to be given by

the intravenous (IV) route. The nurse administering the medication is careful not to exceed which recommended infusion rate?

Correct Answer: 50 mg/min

• Question: A client is scheduled to begin medication therapy with valproic acid. The

nurse looks for the results of which laboratory test(s) before administering the first dose?