NCLEX-RN : NCLEX

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #21 : Pharmacology

The nurse prepares an order of  atropine IM. The label on the available medication reads  atropine per . How many milliliters will the nurse administer? 

Possible Answers:

Correct answer:

Explanation:

Use the concentration of the available medication to find the answer. The ordered dose is  and the concentration proportion is .

Example Question #21 : Pharmacology

You start a patient in the intensive care unit on a drip of phenylephrine, as the patient is persistently hypotensive. You think that this will raise the patient's blood pressure because phenylephrine's primary mechanism of action is which of the following?

Possible Answers:

Alpha-2 adrenergic agonist

Beta-1 adrenergic antagonist

Alpha-1 adrenergic agonist

Beta-2 adrenergic agonist

Beta-1 adrenergic agonist

Correct answer:

Alpha-1 adrenergic agonist

Explanation:

The correct answer is "alpha-1 adrenergic agonist." 

Phenylephrine is frequently administered in the intensive care unit setting for patients with hypotension that is refractory to simple fluid resuscitation. It is a vasopressor, as its mechanism of action is to serve as an alpha-1 adrenergic agonist. 

The other choices are incorrect, as they represent the primary mechanisms of action of a handful of medications other than phenylephrine. 

An example of an alpha-2 adrenergic agonist would be methyldopa.

An example of a beta-1 adrenergic agonist would be dobutamine.

An example of a beta-2 adrenergic agonist would be albuterol.

An example of a beta-1 adrenergic antagonist would be atenolol.

Example Question #22 : Pharmacology

You are the nurse taking care of a patient with asthma. The patient reports using his albuterol inhaler about once a month for wheezing and shortness of breath. Albuterol functions by which of the following mechanisms of action?

Possible Answers:

Alpha-1 adrenergic receptor agonist

Beta-2 adrenergic receptor agonist

Beta-2 adrenergic receptor antagonist

Beta-1 adrenergic receptor agonist

Beta-1 adrenergic receptor antagonist

Correct answer:

Beta-2 adrenergic receptor agonist

Explanation:

The correct answer is "Beta-2 adrenergic receptor agonist."

This question tests your knowledge of the mechanism of action of albuterol, a short-acting medication, frequently used in the treatment of acute asthma flares. Albuterol is an agonist of the Beta-2 adrenergic receptor in the bronchial smooth muscle, which helps to dilate the bronchioles, often providing relief to patients who are suffering from asthma flares, as bronchospasm plays a large role in causing their symptoms. Additional effects of albuterol include increased heart rate, increased insulin release, and vasodilation among others.

An example of a beta-1 adrenergic agonist would be dobutamine.

An example of a beta-1 adrenergic antagonist would be atenolol.

An example of a beta-2 adrenergic antagonist would be butoxamine.

An example of an alpha-1 adrenergic agonist would be phenylephrine.

Example Question #23 : Pharmacology

You are taking care of a patient undergoing chemotherapy for breast cancer and she complains of nausea. Her physician prescribes her ondansetron for nausea relief. What is the mechanism of action of ondansetron?

Possible Answers:

Dopamine D2 receptor antagonist

Dopamine D2 receptor agonist

Serotonin 5HT-3 receptor agonist

Serotonin 5HT-3 receptor partial agonist

Serotonin 5HT-3 receptor antagonist

Correct answer:

Serotonin 5HT-3 receptor antagonist

Explanation:

The correct answer is "Serotonin 5HT-3 receptor antagonist." 

Ondansetron functions by antagonizing the serotonergic 5HT-3 receptors both centrally in the brain and peripherally at vagal nerve endings. It is frequently given as an anti-nausea and anti-emetic agent for patients with cancer undergoing chemotherapy and/or radiation therapy, as well as in post-operative patients, and for patients with gastroenteritis, among other uses. 

Ondansetron is neither a full nor a partial agonist of the 5HT-3 receptors, making those answer choices incorrect.

Metaclopramide, which is another anti-nausea agent, is an anatagonist of the dopamine D2 receptor, but ondansetron is not, so this choice is incorrect. Neither metaclopramide nor ondansetron is an agonist of the dopamine D2 receptor. 

Example Question #24 : General Concepts

You are a nurse at a gastroenterology practice and your patient is being started on ranitidine for gastroesophageal reflux disease (GERD). Which of the following describes the mechanism of action of ranitidine? 

Possible Answers:

Beta-2 adrenergic receptor agonist

Histamine-1 receptor antagonist

Direct acid neutralization 

Proton pump inhibitor

Histamine-2 receptor antagonist

Correct answer:

Histamine-2 receptor antagonist

Explanation:

The correct answer is "Histamine-2 receptor antagonist."

This question tests your knowledge of the mechanism of action of the commonly prescribed antacid medication, ranitidine. Ranitidine functions by antagonizing the histamine-2 receptors within the parietal cells (acid-producing cells) of the stomach. This helps to reduce acid production, which can provide symptomatic relief to patients who suffer from epigastric burning, discomfort, and pain due to gastroesophageal reflux disease and peptic ulcer disease, among other conditions.

An example of a histamine-1 receptor antagonist would be diphenhydramine.

An example of a beta-2 adrenergic receptor agonist would be albuterol.

An example of a proton pump inhibitor would be omeprazole.

An example of a direct acid neutralizer would be calcium carbonate.

Example Question #1 : Drug Administration And Distribution

Ethel is an 80-year-old woman who was admitted for dehydration. The nurse reports that she is not making  of urine and the physician orders a bolus of 250ml to be infused within 30 minutes. What is the correct drip rate for Ethel's infusion?

Possible Answers:

Correct answer:

Explanation:

The minimum urine requirement per hour for most adults is . Based on a low finding, the physician may decide Ethel needs fluid replacement. 

Calculate drip rate in minutes using the following formula: 

Ethel's equation looks as follows:

Example Question #1 : Drug Administration And Distribution

Which of the following is the preferred location of intramuscular (IM) injection in infants?

Possible Answers:

Rectus femoris

Deltoid

Dorsogluteal region

Vastus lateralis

Biceps brachii

Correct answer:

Vastus lateralis

Explanation:

The vastus lateralis is the preferred site of injection in infants. Rectus femoris injections may be preformed as a second choice. The dorsogluteal site should not be used in infants as the muscle is not developed and there is risk associated with the location of the sciatic nerve. Deltoid injections may be given to older children when the muscle becomes larger. 

Example Question #1 : Drug Administration And Distribution

The nurse is preparing to administer an intramuscular (IM) injection to a 4.8 pound infant. The nurse should position the needle at which angle? 

Possible Answers:

90 degrees

30 degrees

45 degrees

15 degrees

60 degrees

Correct answer:

45 degrees

Explanation:

The preferred angle for intramuscular (IM) injections is 90 degrees. However, very small infants may require that the injection be given at a 45 degree angle. Based on patient condition, it is the nurse's responsibility to assess the needs of the patient and adjust care as appropriate.

Example Question #21 : General Concepts

The new pediatric nurse has just given a suppository to a 5-year-old boy. He has a bowel movement 7 minutes post administration. Which action should the nurse take next? 

Possible Answers:

Give an additional half of the prescribed dose

Inform the physician that the child has had a bowel movement

Examine the stool for the suppository

Consult pharmacy

Give another full dose of the suppository

Correct answer:

Examine the stool for the suppository

Explanation:

First, examine the stool for the suppository. Based on the findings, inform the physician. If the suppository was fully present in the stool, the physician may want to prescribe another dose. If not, he may choose to re-order half of the prescribed dose or none at all.  

Example Question #1 : Drug Administration And Distribution

The geriatric nurse is administering nightly medications to a 65-year-old woman with dysphagia. The patient is able to swallow crushed medications with thickened liquids. Which of the following medications should the nurse not crush? 

Possible Answers:

Potassium chloride

Acetaminophen

Sertraline HCl

Multivitamins

Pantoprazole ER

Correct answer:

Pantoprazole ER

Explanation:

Pantoprazole ER should not be crushed. "ER" is an abbreviation for extended release. Extended release medications dissolve over a delayed period of time. Crushing the medication results in a faster rate of absorption by body tissues due to disruption of the coating that allows it's extended release.

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