NCLEX : Pharmacology
Study concepts, example questions & explanations for NCLEX
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Example Questions
Example Question #31 : Nclex
The pediatric nurse is summoned to a room by the parents of a 2-year-old child. The peripheral IV line has been removed by the patient. When starting a new line, the nurse carefully chooses placement. The nurse should attempt to start the IV __________.
as lateral as possible
as proximal as possible
as ipsilateral as possible
as medial as possible
as distal as possible
as distal as possible
Most peripheral IV's are started in the right or left arm. Distal to the arm would mean closest to the fingertips. When starting an IV, always start looking for potential sites closest to the fingertips and work upwards. If a vein is punctured and becomes unusable, it is possible to move above the previous attempt and start a successful IV.
Example Question #2 : Drug Administration And Distribution
Jane is a 49-year-old woman who has recently had a peripherally inserted central catheter (PICC) placed. The nurse is teaching Jane how to flush her PICC. She knows that the teaching was effective when Jane states which of the following?
"I will use a 30mL syringe or larger to flush my PICC line."
"I will use a 1mL syringe or larger to flush my PICC line."
"I will use a 20mL syringe or larger to flush my PICC line."
"I will use a 3mL syringe or larger to flush my PICC line."
"I will use a 10mL syringe or larger to flush my PICC line."
"I will use a 10mL syringe or larger to flush my PICC line."
One should always use a 10mL syringe or larger to flush a PICC line. Smaller syringes place greater pressure on the line which could result in damage. For example, a 3mL syringe places greater pressure on a PICC line than a 5mL syringe.
Example Question #3 : Drug Administration And Distribution
The pediatric nurse must convince a 4-year-old boy to take his medication. Which phrase is the most acceptable?
"Will you please take your medication for us?"
"Your mother and I need you to take your medicine now."
"If you take your medicine, I will give you a soda pop!"
"If you don't take your medicine now, you will need to take a time-out."
"It is time to take your medicine. It tastes just like candy!"
"Your mother and I need you to take your medicine now."
When convincing a child to take medicine, be straightforward and clear. Try not to offer the child a choice, as they likely won't take it. Stay away from using bribery, punishment, or comparing medicine to candy. Be honest about the taste of the medicine or risk losing the trust of the child.
Example Question #33 : Nclex
When performing a blood transfusion, which of the following procedures should not be adhered to in order to ensure safe delivery of blood product to the patient?
Positively identify the patient identification.
The blood should be administered with isotonic solutions such as lactated Ringers
The tubing should be of a "Y type" to allow for fluid and blood product simultaneous infusion.
Blood must be used within the first 30 minutes of arrival to the unit.
The preferred gauge of the needle should be between 18 to 20 gauge to allow for improved flow
The blood should be administered with isotonic solutions such as lactated Ringers
All are true except for the use of lactated Ringer's this may cause a hemolytic reaction, only normal saline 0.9% is utilized.
Example Question #2 : Drug Administration And Distribution
A nurse is teaching a mother how to administer nystatin to her 2-month-old child in the treatment of oral candidiasis. Which of the following is an appropriate instruction given by the nurse to the mother?
Apply to the mouth using a cotton-tipped applicator
Use a syringe to squirt the medication to the back of the mouth
Rinse the mouth post-administration
Place the medication in the child's bottle
Give the medication before meals
Apply to the mouth using a cotton-tipped applicator
Apply medication to the mouth using a cotton-tipped applicator. Give the medication after meals and avoid rinsing the mouth. The medication should have contact with the mucosa without being washed away. Do not place the medication in a child's bottle, they may refuse to eat due to the bitter taste of the medication. Do not use a syringe to squirt the liquid to the back of the mouth since the child will likely spit it out.
Example Question #34 : Nclex
Which of the following is an appropriate reason to delay antibiotic administration in a stable patient?
A stool sample must be obtained first
The patient is nauseated
A blood type and screen is not up to date
A complete blood count has not been drawn today
Blood cultures must be obtained first
Blood cultures must be obtained first
Obtaining a set of blood cultures before treating a bacterial infection helps to individualize care and reduce antibiotic resistance (using a narrow-spectrum antibiotic doesn't work against so many types of bacteria). By identifying specific bacteria in the blood, a narrow-spectrum antibiotic may be chosen. A physician may prescribe a broad-spectrum antibiotic initially and change treatment later based on the results of the blood cultures.
Example Question #31 : Pharmacology
The nurse is teaching a patient who has just been prescribed antibiotics. The nurse knows that teaching has been effective when the patient states which of the following?
"I can stop taking the antibiotics when I feel better."
"An antibiotic might help prevent me from getting sick in the future."
"I should use a back-up method of birth control if I use oral contraceptives while taking antibiotics."
"My mother was previously prescribed the same antibiotic. I may take some of her leftover pills if my symptoms return."
"An antibiotic will help me get over my case of the flu."
"I should use a back-up method of birth control if I use oral contraceptives while taking antibiotics."
Antibiotics may interfere with the function of oral contraceptives. A woman who is on oral contraceptives must use a back-up method of birth control to prevent pregnancy. Antibiotics should only be taken as prescribed. They should be taken continuously until all pills are gone. It is dangerous to take leftover antibiotics. Antibiotics will not prevent illness and do not work against viruses such as influenza. Misuse of antibiotics may contribute to antibiotic resistance and the rise of antibiotic resistant bacteria.
Example Question #31 : Pharmacology
A client with a history of chronic stable angina takes nitroglycerine when needed for an acute attack. Which of the following is not associated with the administration of nitroglycerine?
The patient may experience orthostatic hypotension
The mechanism of action involves increase in cardiac contractility
The medication relieves pain within 3 minutes and provides relief for up to one hour
To prevent degradation, nitroglycerine should be kept in a closed dark bottle.
Nitroglycerine can be taken sublingually by tablet or metered spray
The mechanism of action involves increase in cardiac contractility
Nitroglycerine is a short acting nitrate. This class of medication works by relaxing arterial and venous smooth muscle promoting vasodilation. This medication does not improve cardiac contractility.
Example Question #1 : Drug Interactions And Biotransformation
A 65-year-old male client is being discharged from the hospital on warfarin therapy for chronic atrial fibrillation. The nurse is aware that the discharge teaching needs to include which of the following instructions?
Alcohol should be limited to no more 1-2 servings on an occasional basis
Increase intake of leafy green vegetables
When having dental procedures there is no need to discontinue warfarin
Warfarin is a medication that does not require monitoring
Use a blade when shaving; avoid electric razors
Alcohol should be limited to no more 1-2 servings on an occasional basis
Warfarin is an anticoagulant, alcohol can increase this effect, so it should be limited or avoided. Leafy greens, contain vitamin K and can reverse the action of warfarin. Warfarin needs monthly monitoring to check client internal normalized ratio (INR). Dental and surgical procedures may require discontinuation temporarily to avoid excess bleeding. Electric razors are preferred.
Example Question #1 : Drug Interactions And Biotransformation
A nurse checks the lithium level of a 28-year-old patient that has been prescribed lithium citrate and sees the level is 1.5 mEq/L, and verifies that the patient has not taken more than the prescribed medication. The nurse advises the client to:
Eat more red meat
Exercise more often
Drink 4 glasses of water a day
Eat salty foods
Eat salty foods
Low sodium diets when taking lithium mood-stabilizing drugs can result in toxicity. The nurse should tell the patient to eat salty foods to increase sodium intake.
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