NCLEX RN PHARMACOLOGY FINAL EXAM STUDY GUIDE.LATEST UPDATE, Quizzes of Nursing

Download NCLEX RN PHARMACOLOGY FINAL EXAM STUDY GUIDE.LATEST UPDATE and more Quizzes Nursing in PDF only on Docsity! 3 NCLEX RN PHARMACOLOGY - N EUROLOGICAL MEDICATIONS Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease. The nurse monitors the client for side/adverse effects to the medication. Which finding indicates that the client is experiencing an adverse effect? 1. Pruritus 2. Tachycardia 3. Hypertension 4. Impaired voluntary movements 4. Impaired voluntary movements 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 (Tylenol), and acetaminophen overdose is suspected. Which antidote should the nurse anticipate to be prescribed? 1. Pentostatin (Nipent) 2. Auranofin (Ridaura) The home health nurse visits a client who is taking phenytoin (Dilantin) 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? 1. Pregnancy should be avoided while taking phenytoin. 2. The client may stop the medication if it is causing severe gastrointestinal effects. 3. There is the potential of decreased effectiveness of birth control pills while taking phenytoin. 4. There is the increased risk of thrombophlebitis while taking phenytoin and birth control pills together. 3. There is the potential of decreased effectiveness of birth control pills while taking phenytoin. Page 1 of 35 3 3. Fludarabine (Fludara) 4. Acetylcysteine (Mucomyst) 4. Acetylcysteine (Mucomyst) Meperidine hydrochloride (Demerol) has been prescribed for a client to treat pain. Which are side/adverse effects of this medication? Select all that apply. 1. Diarrhea 2. Tremors 3. Drowsiness 4. Hypotension 5. Urinary frequency 6. Increased respiratory rate 2. Tremors 3. Drowsiness 4. Hypotension A client is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. Which finding would be expected as a result of this laboratory result? 1. Hypotension 2. Tachycardia 3. Slurred speech 4. No abnormal finding 3. Slurred speech The client arrives at the emergency department complaining of back spasms. The client states, "I have been taking two to three aspirin every 4 hours for the last week, and it hasn't helped my back." Since aspirin intoxication is suspected, the nurse should assess the client for which manifestation? 1. Tinnitus Page 2 of 35 3 2. "Good oral hygiene is needed, including brushing and flossing." 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? 1. No change in the condition 2. Complaints of muscle spasms 3. An improvement of the weakness 4. A temporary worsening of the condition 4. A temporary worsening of the condition A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken daily for the relief of generalized discomfort. Which laboratory value would indicate toxicity associated with the medication? 1. Sodium level of 140 mEq/L 2. Prothrombin time of 11.8 seconds 3. Direct bilirubin level of 2 mg/dL 4. Platelet count of 400,000 cells/mm3 3. Direct bilirubin level of 2 mg/dL The nurse is caring for a client receiving mannitol (Osmitrol) 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? 1. Discard the vial. 2. Place the vial in warm water. 3. Send the vial back to the pharmacy. 4. Shake the vial to dissolve the crystals. 2. Place the vial in warm water. Page 5 of 35 3 The nurse in a long-term care facility is reviewing the health care provider's (HCP) prescriptions on an assigned client. The nurse notes that the HCP prescribed ropinirole hydrochloride (Requip). The nurse determines that this medication has been prescribed to treat which condition in the client? 1. Depression 2. Diabetes mellitus 3. Coronary artery disease 4. Parkinsonian syndrome 4. Parkinsonian syndrome A client is receiving phenobarbital sodium (Luminal) for the treatment of a seizure disorder. Which finding on the nursing assessment would indicate that the client is experiencing a common side effect of this medication? 1. Drowsiness 2. Hypocalcemia 3. Blurred vision 4. Seizure activity 1. Drowsiness A client with suspected opioid overdose has received a dose of naloxone hydrochloride (Narcan). 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? 1. The client may next become suicidal. 2. These are signs of opioid withdrawal. 3. These effects will last only a few moments. 4. The client may otherwise sign out against medical advice. 2. These are signs of opioid withdrawal. 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 Page 6 of 35 3 not Page 7 of 35 3 1. Increased diuresis 2. Reduced intracranial pressure 3. Increased osmotic pressure of glomerular filtrate 4. Reduced tubular reabsorption of water and solutes The nurse has a prescription to give dexamethasone (Decadron) by the intravenous (IV) route to a client with cerebral edema. How should the nurse prepare this medication? 1. Diluting the medication in 500 mL of 5% dextrose 2. Preparing an undiluted direct injection of the medication 3. Diluting the medication in 1 mL of lactated Ringer's solution for direct injection 4. Diluting the medication in 10% dextrose in water and administering it as a direct injection 2. Preparing an undiluted direct injection of the medication The nurse who is caring for a client with myasthenia gravis has a prescription to perform an Enlon (Tensilon) test. After obtaining edrophonium (Enlon), the nurse should be certain that which also is available at the bedside? 1. Atropine sulfate 2. Protamine sulfate 3. Calcium gluconate 4. Magnesium sulfate 1. Atropine sulfate After review of the client's laboratory values, the nurse notes that a phenytoin (Dilantin) level for a client receiving phenytoin (Dilantin) is 7 mcg/mL. The nurse makes which interpretation regarding this laboratory result? 1. The level is within the expected therapeutic range. 2. The level indicates the medication should be stopped. 3. The level is lower than the expected therapeutic range. Page 10 of 35 3 4. The level is higher than the expected therapeutic range. Page 11 of 35 3 3. The level is lower than the expected therapeutic range. A client with status epilepticus has been prescribed phenytoin (Dilantin) to be given by the intravenous (IV) route. The nurse administering the medication is careful not to exceed which recommended infusion rate? 1. 50 mg/min 2. 60 mg/min 3. 100 mg/min 4. 750 mg/min 1. 50 mg/min A client is scheduled to begin medication therapy with valproic acid (Depakene). The nurse looks for the results of which laboratory test(s) before administering the first dose? 1. Liver function tests 2. Renal function tests 3. Pulmonary function test 4. Pancreatic enzyme studies 1. Liver function tests A client is scheduled to begin therapy with carbamazepine (Tegretol). The nurse should assess the results of which test(s) before administering the first dose of this medication to the client? 1. Liver function tests 2. Renal function tests 3. Pancreatic enzyme studies 4. Complete blood cell count 4. Complete blood cell count Dantrolene sodium (Dantrium) has been administered to a client with a spinal cord injury. The nurse determines that the client is experiencing an adverse effect of the medication if which is noted? Page 12 of 35 3 Benztropine mesylate (Cogentin) is prescribed for a client with a diagnosis of Parkinson's disease. What statement by the client indicates that the client needs additional information about the medication? 1. "I will avoid driving if I get drowsy or dizzy." 2. "I'll watch my urinary output and look for signs of constipation." 3. "I will sit in the sun for an hour a day to enhance medication effectiveness." 4. "I will call the health care provider (HCP) if I have difficulty swallowing or if I start vomiting." 3. "I will sit in the sun for an hour a day to enhance medication effectiveness." A client has received a dose of dimenhydrinate (Dramamine). The nurse evaluates the effect of the medication by noting whether the client obtained relief from what symptom? 1. Chills 2. Headache 3. Ringing in the ears 4. Nausea and vomiting 4. Nausea and vomiting A home health nurse visits a client who suffered a back injury. On review of the health care provider's prescriptions, the nurse notes that codeine sulfate has been prescribed for the client, and the nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates an understanding of health measures related to the medication? 1. "The medication is not addicting." 2. "I should watch out for diarrhea as a side effect." 3. "I should increase my fluid intake while taking this medication." 4. "I need to be sure to eat foods that are low in fiber to prevent diarrhea." 3. "I should increase my fluid intake while taking this medication." Phenytoin (Dilantin), 100 mg to be given orally three times daily, has been prescribed to a client for seizure control. The home health nurse visits the client Page 15 of 35 3 and provides instructions regarding the medication. Which statement, if made by the client, would indicate an understanding of the instructions? 1. "I will use a soft toothbrush to brush my teeth." 2. "It's okay to break the capsules to make it easier for me to swallow them." 3. "If I forget to take my medication, I can wait until the next dose and eliminate that dose." 4. "If my throat becomes sore, it's a normal effect of the medication, and it's nothing to be concerned about." 1. "I will use a soft toothbrush to brush my teeth." Dexamethasone (Decadron) intravenously is prescribed for the client with cerebral edema. The nurse prepares the medication for administration and plans to perform which action? 1. Mix the medication in 1000 mL of 5% dextrose. 2. Prepare an undiluted direct injection of the medication. 3. Mix the medication in 100 mL of lactated Ringer's solution. 4. Dilute the medication in lactated Ringer's solution and administer as a direct injection. 2. Prepare an undiluted direct injection of the medication. The nurse has the following prescription for a postcraniotomy client, "dexamethasone (Decadron) 4 mg by the intravenous (IV) route now." How does the nurse administer the medication? 1. IV push over 1 minute 2. IV push over 4 minutes 3. IV piggyback in 50 mL of normal saline over 10 minutes 4. IV piggyback in 50 mL of normal saline over 30 minutes 1. IV push over 1 minute A client is experiencing impotence after taking guanfacine (Tenex). The client states, "I would sooner have a stroke than keep living with the effects of this medication." What is the most appropriate response by the nurse? Page 16 of 35 3 1. "I can understand completely." 2. "You wouldn't really want to have a stroke." 3. "You are concerned about the effects of your medication." 4. "The health care provider should change your prescription." 3. "You are concerned about the effects of your medication." A client with Parkinson's disease has been prescribed benztropine (Cogentin). The nurse should assess for which gastrointestinal (GI) problems as a side effect of this medication? 1. Diarrhea 2. Dry mouth 3. Increased appetite 4. Hyperactive bowel sounds 2. Dry mouth A client has been prescribed cyclobenzaprine (Flexeril) for the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse should withhold the medication and question the prescription if the client has a concurrent prescription for which medication? 1. Furosemide (Lasix) 2. Ibuprofen (Motrin IB) 3. Valproic acid (Depakene) 4. Tranylcypromine (Parnate) 4. Tranylcypromine (Parnate) The nurse has a prescription to administer diazepam (Valium) 5 mg by the intravenous (IV) route to a client. The nurse should administer the medication over a period of at least how long? 1. 15 seconds 2. 30 seconds 3. 1 minute Page 17 of 35 3 A client has a prescription for valproic acid (Depakene) 250 mg once daily. To maximize the client's safety, the nurse should plan to schedule the medication at what time? 1. At bedtime 2. With lunch 3. After breakfast 4. Before breakfast 1. At bedtime A client taking carbamazepine (Tegretol) asks the nurse what to do if a dose is inadvertently missed. The nurse responds that which action should be taken? 1. Withhold until the next scheduled dose. 2. Withhold and call the health care provider (HCP). 3. Take the dose as long as it is not close to the time for the next dose. 4. Withhold until the next scheduled dose, which should then be doubled. 3. Take the dose as long as it is not close to the time for the next dose. The nurse has given medication instructions to a client beginning anticonvulsant therapy with carbamazepine (Tegretol). The nurse determines that the client understands the use of the medication if he or she makes which statement? 1. Use sunscreen when outdoors. 2. Drive a car as long as it is not at night. 3. Keep tissues handy because of excess salivation. 4. Discontinue the medication if fever or sore throat occurs. 1. Use sunscreen when outdoors. A client with vascular headaches is taking ergotamine (Cafergot). The home health nurse should periodically assess him or her for which finding? 1. Hypotension 2. Constipation Page 20 of 35 3 3. Dependent edema 4. Cool, numb fingers and toes 4. Cool, numb fingers and toes The nurse is caring for a client with myasthenia gravis who has received edrophonium (Enlon) by the intravenous route to test for myasthenic crisis. The client asks the nurse how long the improvement in muscle strength will last. The nurse's response is based on the understanding that the effects have a duration of approximately how long? 1. 5 minutes 2. 10 minutes 3. 30 minutes 4. 60 minutes 3. 30 minutes A client with narcolepsy has been prescribed dextroamphetamine (DextroStat). The client complains to the nurse that he cannot sleep well at night and does not want to take the medication any longer. Before making any specific comment, the nurse plans to investigate whether the client takes the medication at which proper time schedule? 1. 2 hours before bedtime 2. After supper each night 3. Just before going to sleep 4. At least 6 hours before bedtime 4. At least 6 hours before bedtime A client on the nursing unit has a prescription for dextroamphetamine (DextroStat) daily. The unit nurse collaborates with the dietitian to limit the amount of which item on the client's dietary trays? 1. Fat 2. Starch 3. Caffeine Page 21 of 35 3 4. Protein 3. Caffeine A client with Parkinson's disease has begun therapy with levodopa. The nurse determines that the client understands the action of the medication if he or she verbalizes that results may not be apparent for how long? 1. 1 week 2. 24 hours 3. 2 to 3 days 4. 2 to 3 weeks 4. 2 to 3 weeks A client is taking trihexyphenidyl hydrochloride for the treatment of Parkinson's disease. The nurse should assess for which adverse effect of this medication? 1. Diarrhea 2. Urinary retention 3. Urinary incontinence 4. Excessive perspiration 2. Urinary retention A client receiving therapy with carbidopa/levodopa (Sinemet) is upset and tells the home health nurse that his urine has turned a darker color since he started taking this medication. The client wants to discontinue its use. In formulating a response to his concerns, the nurse interprets that this change is indicative of which condition? 1. Developing toxicity 2. A harmless side effect of the medication 3. A result of taking the medication with milk 4. A sign of interaction with another medication 2. A harmless side effect of the medication Page 22 of 35 3 3. Decrease in intraocular pressure 4. Interference with DNA production 1. Anticonvulsant effect The health care provider (HCP) writes a prescription for carbamazepine (Tegretol) for a client who was admitted to the hospital. The nurse contacts the HCP to verify the prescription if which condition is noted in the assessment data? 1. Hypertension 2. Tonic-clonic seizures 3. Trigeminal neuralgia 4. Bone marrow depression 4. Bone marrow depression Carbamazepine (Tegretol) has been prescribed for a client. The nurse should tell the client that which blood test will be done periodically while the client is taking this medication? 1. Lipase level 2. Amylase level 3. Ammonia level 4. Complete blood cell (CBC) count 4. Complete blood cell (CBC) count A nurse is transcribing a prescription for antibiotic therapy for a client with bacterial meningitis. The nurse understands that the medication that will be prescribed for the client will have which characteristic? 1. Metabolizes slowly 2. Acts within minutes to hours 3. Crosses the blood-brain barrier 4. Excretes readily and easily in the urine 3. Crosses the blood-brain barrier Page 25 of 35 3 The health care provider is preparing to administer edrophonium (Enlon) to the client with myasthenia gravis. In planning care, the nurse understands which about the administration of edrophonium? Select all that apply. 1. Edrophonium is a long-acting cholinesterase inhibitor. 2. Atropine is used to reverse the effects of edrophonium. 3. If symptoms worsen following administration of edrophonium, the crisis is cholinergic. 4. Edrophonium is used to distinguish between a myasthenic crisis and a cholinergic crisis. 5. An improvement in symptoms following administration of edrophonium indicates worsening of myasthenia gravis. 2. Atropine is used to reverse the effects of edrophonium. 3. If symptoms worsen following administration of edrophonium, the crisis is cholinergic. 4. Edrophonium is used to distinguish between a myasthenic crisis and a cholinergic crisis. 5. An improvement in symptoms following administration of edrophonium indicates worsening of myasthenia gravis. A client has a prescription to receive valproic acid (Depakene) daily. To maximize the client's safety, when is the best time for the nurse to schedule the administration of this medication? 1. After lunch 2. After breakfast 3. Before bedtime 4. Before breakfast 3. Before bedtime The nurse is preparing to ambulate a client with Parkinson's disease who has recently been started on methyldopa (levodopa). Before performing this activity with the client, the nurse should include which most important assessment in the client's plan of care? Page 26 of 35 3 1. History of falls 2. Use of assistive devices 3. Postural (orthostatic) vital signs 4. Degree of exhibited intention tremor 3. Postural (orthostatic) vital signs The nurse is caring for a client with Parkinson's disease who is taking oral benztropine mesylate (Cogentin) daily. What is the priority nursing assessment for the client? 1. Intake and output 2. The prothrombin time 3. The pupillary response 4. The partial thromboplastin time 1. Intake and output A client with a diagnosis of trigeminal neuralgia is started on a regimen of carbamazepine (Tegretol). The nurse provides instructions to the client about the side/adverse effects of the medication. Which client statement indicates an understanding of the side/adverse effects of the medication? 1. "I will report a fever or sore throat to my health care provider." 2. "I must brush my teeth frequently to avoid damage to my gums." 3. "If I notice ringing in my ears that doesn't stop, I'll seek medical attention." 4. "If I notice a pink color to my urine, I will stop the medication and call my health care provider (HCP)." 1. "I will report a fever or sore throat to my health care provider." A home care nurse visits a client at home. Clonazepam (Klonopin) has been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates that further teaching is necessary? 1. "My drowsiness will decrease over time with continued treatment." 2. "I should take my medicine with food to avoid any stomach problems." Page 27 of 35 3 4. Urinary retention 4. Urinary retention The nurse is caring for a client receiving morphine sulfate for pain. Because this medication has been prescribed for this client, which nursing action should be included in the plan of care? 1. Encourage fluids. 2. Monitor the client's temperature. 3. Maintain the client in a supine position. 4. Encourage the client to cough and deep breathe. 4. Encourage the client to cough and deep breathe. A nurse is caring for a client who has been taking hydrocodone for the last 3 months. Which side/adverse effects of this medication should the nurse assess the client for? 1. Tachycardia and hypertension 2. Diarrhea and abdominal cramping 3. Psychological and physical dependence 4. Increased respiratory rate and bronchospasm 3. Psychological and physical dependence A nurse is reviewing the results of a test on a sample drawn from a child who is receiving carbamazepine (Tegretol) for the control of seizures. The results indicate a serum carbamazepine level of 10 mcg/mL. The nurse analyzes the results and anticipates that the health care provider (HCP) will note which prescription? 1. Discontinuation of the medication 2. An increased dose of the medication 3. A decreased dose of the medication 4. Continuation of the presently prescribed dosage 4. Continuation of the presently prescribed dosage Page 30 of 35 3 The nurse is caring for a client who underwent an open reduction internal fixation to the right hip. When administering opioid analgesics for pain, the nurse should instruct the client that which are side/adverse effects of opioid analgesics? Select all that apply. 1. Sedation 2. Diarrhea 3. Constipation 4. Increased pain level 5. Respiratory depression 1. Sedation 3. Constipation 5. Respiratory depression A nurse should question a prescription for which medication in the client concurrently receiving tramadol (Ultram)? 1. β-Blockers 2. Histamine 2 antagonists 3. Calcium channel blockers 4. Monoamine oxidase inhibitors (MAOIs) 4. Monoamine oxidase inhibitors (MAOIs) Sumatriptan (Imitrex) is prescribed for a client. Based in this prescription, the nurse suspects that the client has which condition? 1. Sinus headache 2. Simple headache 3. Migraine headache 4. Episodic headache 3. Migraine headache Page 31 of 35 3 A nurse preparing to administer carbamazepine (Tegretol) notices each of the following items on the client's breakfast tray. Which item should be a cause for concern and should be removed from the tray? 1. Carton of milk 2. Scrambled eggs 3. Grapefruit juice 4. Toast with honey 3. Grapefruit juice The nurse is told that the result of a serum carbamazepine (Tegretol) level for a child who is receiving the medication for the control of seizures is 10 mcg/mL. Based on this laboratory result, the nurse anticipates that the health care provider (HCP) will document which prescription? 1. Discontinuation of the medication 2. A decrease of the dosage of the medication 3. An increase of the dosage of the medication 4. Continuation of the presently prescribed dosage 4. Continuation of the presently prescribed dosage A client reports frequent use of acetaminophen (Tylenol) for relief of headaches and other discomforts. The nurse should evaluate which diagnostic data to determine if the client is at risk for toxicity? 1. Chest x-ray 2. The electrocardiogram 3. The liver function studies 4. The upper gastrointestinal x-ray results 3. The liver function studies The nurse is assisting in the care of a client who is being evaluated for possible myasthenia gravis. The health care provider gives a test dose of edrophonium (Enlon). Evaluation of the results indicates that the test is positive. Which would be the expected response noted by the nurse? Page 32 of 35