Nclex-Rn Practice Questions-Physıologıcal Integrıty-Pharmacological And Parenteral Therapies Part 4
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Question 1 |
Clients diagnosed with Alzheimer’s disease respond to cholinergic medications. Why do these medications help these clients?
A | Cholinergics increase acetylcholine in the brain. |
B | Parasympathetic stimulation helps the Alzheimer’s client to function at a higher level. |
C | Sympathetic stimulation is inhibited when cholinergic medications are used. |
D | The vasodilation caused by the cholinergics increases the amount of oxygen available. |
Question 2 |
Which statement made by the nurse to the client who is given hydrocodone bitartrate (Vicodin) for pain control indicates knowledge of possible side effects of this medication?
A | It is important that you avoid bananas and green, leafy vegetables while on this medication. |
B | You will need to stay close to a bathroom while taking this medication because it can cause urinary incontinence. |
C | Drink plenty of liquids and increase your intake of high-fiber foods while on this medication. |
D | Report any muscle twitching, muscle cramping, or numbness and tingling that may occur. |
Question 3 |
When meperidine (Demerol) is used too often for chronic pain, a metabolite known as normeperidine can build up in the body. The nurse knows one of the effects of this metabolite is:
A | Hypertension. |
B | Hyperthermia. |
C | Diplopia. |
D | Seizures. |
Question 4 |
A Native American client experiences chronic pain associated with rheumatoid arthritis. The nurse is aware that culture is an important factor in the perception and treatment of pain. Without stereotyping, the nurse knows many Native Americans employ which practice to combat pain?
A | Moxibustion. |
B | Sweat baths. |
C | Yin and yang. |
D | Acupuncture. |
Question 5 |
Within the understanding of pain control, nociceptors present in the body play an important role. What is this role?
A | Nociceptors are nerve endings that have receptors that respond to painful stimuli. |
B | Nociceptors are blocking agents that decrease the amount of pain a client experiences. |
C | Nociceptors are neurotransmitters that increase nerve cell membrane activity. |
D | Nociceptors allow the client experiencing pain to relax. |
Question 6 |
Pain control is an important aspect of client care. Which theory most accurately addresses a client’s pain?
A | Endorphin-releasing theory. |
B | Nociceptor-reversal theory. |
C | Gate-control theory. |
D | Open-door theory. |
Question 7 |
A client uses budesonide (Pulmocort Turbuhaler) twice a day. Why should the nurse give instruction for the client to rinse the mouth out after each use?
A | To aid in the absorption of the medication. |
B | To prevent the development of oral fungal infections. |
C | To decrease the negative taste of medication. |
D | To enhance the effects of the medication. |
Question 8 |
Alpha-adrenergic blocking agents include medications such as doxazosin (Cardura) and prazosin hyrdrochloride (Minipress). The mechanism of action for these medications is to:
A | Inhibit the parasympathetic system. |
B | Stimulate the sympathetic system. |
C | Inhibit the sympathetic system. |
D | Stimulate the parasympathetic system. |
Question 9 |
A medication is said to have inotropic, chronotropic, or dromotropic effects on cardiac tissue. The nurse knows medications that have a chronotropic effect can cause:
A | A change in heart rate. |
B | A change in force of cardiac contraction. |
C | A change in conduction of cardiac impulses. |
D | A change in valvular strength. |
Question 10 |
One of the side effects that can occur in nitrates is a process called reflex tachycardia. What is the mechanism of action that causes this effect?
A | Venoconstriction occurs in the coronary arteries, causing the heart to beat more rapidly in response to the stress it is experiencing. |
B | Oxygen demand on the heart increases and causes the heart to respond with an increasing rate and force of contraction. |
C | Rapid vasodilation causes an increase of blood volume in the venous system, which makes the heart react to a perceived low blood volume. |
D | An increase in venous blood flow to the cardiac tissue causes a parasympathetic response, which increases the heart rate. |
Question 11 |
A client receives rabies immunization after being bitten by a bat. Which statement is correct?
A | Active immunity occurs when the rabies immune globulin helps the body build up antibodies. |
B | Passive immunity from the rabies vaccine provides antibodies to inactivate the virus. |
C | Active immunity takes time to increase and is measured by the antibody titer. |
D | Passive immunity requires the client to promote an immune response within the humoral immune system. |
Question 12 |
A nurse caring for a client with Alzheimer’s disease administers tacrine hydrochloride (Cognex) to the client four times a day. The nurse knows this medication works by binding to:
A | Acetylcholine. |
B | Cholinesterase. |
C | Norepinephrine. |
D | Epinephrine. |
Question 13 |
Cholinergic agents are also known as parasympathomimetics. Why is this type of medication useful in the treatment of glaucoma?
A | Causes miosis. |
B | Increases anhidrosis. |
C | Decreases lacrimation. |
D | Causes mydriasis. |
Question 14 |
The nurse is concerned that an elderly home care client may overdose on prescribed opioid analgesics. Which set of symptoms indicate the classic triad of opiate overdose?
A | Miosis, decreased respiratory rate, and coma. |
B | Diplopia, decreased respiratory rate, and hyperactivity. |
C | Hallucinations, hypertension, and Kussmaul respirations. |
D | Seizures, decreased respiratory rate, and dilated pupils. |
Question 15 |
Which medication provides artificially acquired passive immunity?
A | Diptheria and tetanus toxoid. |
B | Snakebite antivenin. |
C | Haemophilus influenzae type B conjugate vaccine. |
D | Influenza virus vaccine. |
Question 16 |
Warfarin (Coumadin) works by obstructing certain clotting factors in the clotting cascade. Which information is correct regarding this mechanism of action?
A | Interference with calcium occurs within the clotting cascade. |
B | Increased solubility of vitamin D occurs in the mucosal lining of the stomach. |
C | Decreased functioning of vitamin K occurs within the production sites. |
D | Binding with magnesium occurs in the hepatic cells. |
Question 17 |
Bronchodilators are classified as adrenergic drugs. In addition to this classification, bronchodilators work by stimulating which receptor?
A | Alpha1-adrenergic receptor sites. |
B | Apha2-adrenergic receptor sites. |
C | Beta1-adrenergic receptor sites. |
D | Beta2-adrenergic receptor sites. |
Question 18 |
A client has the following medications ordered: albuterol sulfate (Proventil) inhaler 2 puffs every 4 hours and fluticasone propionate (Flovent) one puff in each nostril twice a day. Which is a true statement regarding the use of these two medications?
A | They should not be used together. |
B | The fluticasone propionate (Flovent) should be used first. |
C | The albuterol sulfate (Proventil) should be used first. |
D | The nurse should ask the pharmacist to combine them into one medication. |
Question 19 |
A 2-year-old client has an order for instillation of antipyrine and benzocaine otic (Auralgan) into the external ear canal. Which action by the nurse is correct?
A | Pull the ear backward and down. |
B | Pull the ear upward and in. |
C | Pull the ear backward and up. |
D | Pull the ear upward and lateral. |
Question 20 |
A client diagnosed with hypertensive crisis develops the following symptoms: headache, muscle twitching, chest pain, nausea, vomiting, and confusion. Which medication should the nurse administer?
A | Dobutamine hydrochloride (Dobutrex). |
B | Sodium nitrite. |
C | Pralodoxime chloride (2-PAM). |
D | Edetate calcium disodium (calcium EDTA). |
Question 21 |
A client experiences an opioid overdose. Which medication antagonizes the effects of opioids?
A | Flumazenil (Romazicon) 0.2 mg IV up to total of 1 mg. |
B | Naloxone (Narcan) 0.4 mg IV up to a total of 10 mg. |
C | Dimercaprol (BAL in Oil) 4 mg / kg IM. |
D | Atropine sulfate (Atropine) 1 to 2 mg IV. |
Question 22 |
A client with a closed head injury requests pain medication for headache. Which medication is most likely contraindicated in this client?
A | Acetaminophen with codeine (Tylenol with codeine #3). |
B | Acetaminophen (Tylenol). |
C | Hydrocodone bitartrate (Vicodin). |
D | Ibuprofen (Motrin). |
Question 23 |
A client is diagnosed with hypovolemia following surgery evidenced by low blood pressure and tachycardia. The physician orders albumin 5% 500 milliliters intravenously. The nurse knows the administration of this medication causes a change in:
A | Hydrostatic pressure. |
B | Colloidal osmotic pressure. |
C | Peripheral capillary pressure. |
D | Central venous pressure. |
Question 24 |
A client has eye ointment instilled in both eyes. Which action should the nurse take immediately after medication administration?
A | Have the client squeeze the eyes shut tightly. |
B | Apply some of the ointment to the eyelid. |
C | Apply gentle pressure to the nasolacrimal duct. |
D | Have the client lie flat for 10 minutes. |
Question 25 |
Prior to instilling nasal medications, it is important for the client to have clear nasal passages. The client can blow the nose to clear the nasal passages. Which client should not perform this preliminary intervention?
A | 55-year-old client recovering from a closed head injury. |
B | 22-year-old client who has a fractured mandible. |
C | 44-year-old client status post myocardial infarction. |
D | 82-year-old client with a history of chronic obstructive pulmonary disease (COPD). |
Question 26 |
An 82-year-old female client is prescribed meperidine (Demerol) to be given every 4 hours as needed for pain. Why should the nurse question this order?
A | The older adult cannot rate his or her pain well, and therefore may overdose on the medication. |
B | The older adult may not excrete metabolites of this medication easily due to the normal aging process. |
C | The older adult always has a decrease in liver function and will not metabolize the medication readily. |
D | The older adult has sensory deprivations and may not tolerate normal side effects of this medication. |
Question 27 |
The nurse notes that a client has a blood pressure of 102/56 mm Hg, pulse of 94 beats/minute, and respiratory rate of 6 breaths/minute. The client is pale, with cyanotic lips and nail beds. The nurse suspects a reaction to medication. Which medication is most likely the cause of these symptoms?
A | Morphine sulfate (morphine). |
B | Nalmefene (Revex). |
C | Acetylsalicylic acid (aspirin). |
D | Methylphenidate hydrochloride (Ritalin). |
Question 28 |
A client who has difficulty rating pain is noted to have the following vital signs. Which of these indicates to the nurse that pain may be present?
A | Blood pressure 124/72 mm Hg. |
B | Pulse 120 beats/minute. |
C | Respiratory rate 8 breaths/minute. |
D | Pulse oximetry 92%. |
Question 29 |
An infant client weighs 18.5 pounds. The physician orders ibuprofen (Motrin) 10 mg/kg. The medication on hand is 100 mg/5 mL. Which is the proper dose of medication for this client?
A | 37 mg. |
B | 84 mg. |
C | 185 mg. |
D | 407 mg. |
Question 30 |
A child client who has vomiting, high fever, and cough is prescribed acetaminophen (Tylenol) 325 mg by suppository. The medication on hand is acetaminophen (Tylenol) 650 mg suppository. Which action should the nurse take to provide the proper dose?
A | Give the child the oral elixir instead. |
B | Break the suppository in half and administer. |
C | Wait for the pharmacy to send a 325-mg suppository. |
D | Contact the physician for a change in dosage order. |
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