NCLEX-RN : NCLEX

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #1 : Side Effects

Which of the following antibiotics is potentially ototoxic and may cause irreversible hearing loss? 

Possible Answers:

Doxycycline

Azithromycin

Penicillin 

Gentamicin

Correct answer:

Gentamicin

Explanation:

Gentamicin is an aminoglycoside antibiotic. Most antibiotics in the aminoglycoside class can have significant ototoxic effects. Of these, streptomycin and gentamicin are primarily toxic to the vestubular system, while amikacin, neomycin, dihydrosterptomycin, and kanamicin primarily affect the cochlea. None of the other antibiotics listed are generally associated with ototoxicity.

Example Question #61 : Pharmacology

A 24 year old female presents with a simple urinary tract infection, for which she is prescribed ciprofloxacin. What is the most severe potential side effect of this medication?

Possible Answers:

Kidney failure

Tendon injury or rupture (especially Achilles tendon)

Seizures

Hepatotoxicity

Correct answer:

Tendon injury or rupture (especially Achilles tendon)

Explanation:

Ciprofloxacin has been associated with several cases of tendon injury and rupture, with the typical rupture occuring in the Achilles tendon. Other less severe side effects can include nausea and vomiting, headache, insomnia, and increased sensitivity to caffeine. The other symptoms listed are not generally associated with ciprofloxacin use.

Example Question #61 : Pharmacology

Which of the following antibiotics is strictly contraindicated in pregnancy, in lactating mothers, or in children under 8 years old, due to risk of irreversible teeth staining?

Possible Answers:

Ceftazidime

Clindamycin

Rifaximin

Tetracycline 

Correct answer:

Tetracycline 

Explanation:

Tetracycline antibiotics are strictly contraindicated in pregnancy, in lactating mothers, or in children under 8 years old, due to risk of irreversible teeth staining. The discoloration occurs only in adult teeth that have not broken the gum-line, so adults are not at risk.

Example Question #63 : Pharmacology

A 42 year old man with a history of severe depression who is currently prescribed multiple antidepressants presents with tachycardia, hyperreflexia, sweating, mydriasis, myoclonus. He is confused and mildly agitated. On questioning he admits that he may have taken "one too many" of one or more of his medications. What is the most likely cause of his symptoms?

Possible Answers:

Serotonin syndrome

Hypertensive crisis

Tardive dyskinesia

Extrapyramidal side effects

Correct answer:

Serotonin syndrome

Explanation:

The symptoms this patient are presenting with are consistent with serotonin syndrome, a rapid onset and potentially life-threatening condition of excess circulating serotonin. Symptoms can range from mild to severe, and may include tachycardia, nausea and vomiting, diarrhea, hyperreflexia, sweating, mydriasis, myoclonus, mental status changes, headache, and coma. Serotonin syndrome is generally caused by drug interaction or overdose of drugs that raise circulating serotonin levels, such as selective serotonin reuptake inhibitors (SSRI's) and monoamine oxidase inhibitors (MAOI's). 

Example Question #61 : Nclex

A 63 year old female presents with involuntary grimacing, lip smacking, excessive blinking, and sticking out of the tongue. She also flicks her fingers and her wrists. She states that she has no control over these movements, and that they have gotten progressively worse over the last three years. Her family is worried that she may be experiencing an early form of dementia. Her medical history is significant for depression, for which she has been taking aripiprazole for the last nine years. Which of the following is the most likely cause of her symptoms?

Possible Answers:

Tardive dyskinesia

Worsening depression

Early-onset alzheimer's disease

Serotonin syndrome

Correct answer:

Tardive dyskinesia

Explanation:

The most likely cause of uncontrollable muscle movements in the absence of other systemic symptoms in a patient with a history of antipsychotic drug use is tardive dyskinesia. This is a disorder of rapid involuntary movements, most often in the face or head but also potentially affecting the extremities. It's exact cause is not well understood, but it is theorized to be an issue of sensitization of the D2 dopamine receptors after long-term neuroleptic use. 

Example Question #62 : Pharmacology

 Which of the following is not a common side effects in individuals using selective serotonin reuptake inhibitors (SSRI's)? 

Possible Answers:

Increased risk of bone fracture

Increased risk of suicide in children and adolescents

Low libido

Coronary heart disease

Correct answer:

Coronary heart disease

Explanation:

While SSRI's have been known to cause a variety of adverse effects, including diminished libido, increased risk of suicide in children and adolescents, restlessness, photosensitivity, and increased risk of bone fracture, individuals taking SSRI's are not associated with any increased incidence of coronary heart disease.

Example Question #63 : Pharmacology

Which of the following over-the-counter medications has been associated with hepatotoxicity and liver failure?

Possible Answers:

Acetylsalicylic acid

Acetaminophen

Diphenhydramine

Cetirizine

Correct answer:

Acetaminophen

Explanation:

Acetaminophen has surpassed viral hepatitis as the most common cause of acute hepatic failure in the United States. Hepatotoxicity can occur in doses of 7.5g or up for adults and 150millg/kg of body weight in children aged 1-6. None of the other drugs listed are particularly hepatotoxic.

Example Question #64 : Pharmacology

What is the mechanism of cytotoxicity in acetaminophen-related liver failure?

Possible Answers:

Fibrosis of hepatocytes

Formation of fatty infiltrates

Blockage of bile canaliculi

Depletion of glutathione

Correct answer:

Depletion of glutathione

Explanation:

Acetaminophen depletes glutathione, one of the body's most important antioxidants. The liver is the body's main processing organ for environmental and ingested toxins, and glutathione is the primary molecule the liver uses to rid itself of the harmful biproducts of the detoxification process. When glutathione is severely depleted, such as with acetaminophen overdose, hepatic cells can rapidly necrose, resulting in liver failure and even death. 

Example Question #61 : Pharmacology

An individual taking which of the following medications must be instructed to remain upright for a minimum of thirty minutes after ingestion in order to avoid esophagitis?

Possible Answers:

Finasteride

Paclitaxel

Alendronate

Felodipine

Correct answer:

Alendronate

Explanation:

Alendronate is a bisphosphonate drug used in the treatment of osteoporosis and osteogenesis imperfecta. An individual taking this medication should be instructed to remain upright for a minimum of thirty minutes after ingestion in order to avoid esophagitis. Other gastrointestinal adverse effects of alendronate include esophageal strictures, achalasia, gastric ulcers, and gastritis. None of the other medications listed are associated with esophagitis. 

Example Question #32 : Drug Interactions And Biotransformation

Which of the following is not as side effect associated with beta blockers?

Possible Answers:

All of these are side effects of beta blockers

Weakness

Fatigue

Dizziness 

Correct answer:

All of these are side effects of beta blockers

Explanation:

The most common side effects of beta blockers are fatigue, dizziness, weakness, cold hands or feet, dry mouth, headache, nausea, diarrhea, and shortness of breath.

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