NCLEX Exam Questions with Rationale (Pharmacology) 28th Edition

NCLEX Exam Questions with Rationale (Pharmacology) 28th Edition

NCLEX Exam Questions with Rationale (Pharmacology) 28th Edition

1. A client has an order for valproic acid (Depakene) orally once daily. The nurse plans to:

A. Administer the medication with a carbonated beverage
B. Administer the medication with an antacid
C. Ensure that the medication is administered 2 hours before breakfast only, when the client’s stomach is empty
D. Ensure that the medication is administered at the same time each day

Answer: D. Ensure that the medication is administered at the same time each day

Rationale: Valproic acid is an anticonvulsant, antimanic, and antimigraine medication. It may be administered with or without food. It should not be taken with an antacid or carbonated beverage because these products will affect medication absorption. The medication is administered at the same time each day to maintain therapeutic serum levels.

Test-Taking Strategy: Use general pharmacology guidelines to assist in eliminating options 1 and B. Eliminate option 3 because of the absolute word “only.” Review this medication if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Safe, Effective Care Environment
Integrated Process: Nursing Process/Planning
Content Area: Pharmacology
Reference: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 885.

2. A client taking carbamazepine (Tegretol) asks the nurse what to do if he misses one dose. The nurse responds that the carbamazepine should be:

A. Withheld until the next scheduled dose, which should then be doubled
B. Withheld until the next scheduled dose
C. Taken as long as it is not immediately before the next dose
D. Contact the physician

Answer: C. Taken as long as it is not immediately before the next dose

Rationale: Carbamazepine is an anticonvulsant that should be taken around the clock, precisely as directed. If a dose is omitted, the client should take the dose as soon as it is remembered, as long as it is not immediately before the next dose. The medication should not be double dosed. If more than one dose is omitted, the client should call the physician.

Test-Taking Strategy: Use general medication guidelines to eliminate option 1; medications are not double dosed if one dose is missed. From the remaining options, recalling that the medication is an anticonvulsant will direct you to option C. Review this medication if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Pharmacology
Reference: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 137.

3. A 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 the client agrees to:

A. Drive only during the daytime
B. Use sunscreen when outside
C. Keep tissues handy due to excess salivation that may occur
D. Discontinue the medication if fever or sore throat occurs

Answer: B. Use sunscreen when outside

Rationale: Carbamazepine acts by depressing synaptic transmission in the central nervous system (CNS). Because of this, the client should avoid driving or doing other activities that require mental alertness until the effect on the client is known. The client should use protective clothing and sunscreen to avoid photosensitivity reactions. The medication may cause dry mouth (not excessive salivation), and the client should be instructed to provide good oral hygiene, and use sugarless candy or gum as needed. The medication should not be abruptly discontinued, because it could cause return of seizures or status epilepticus. Fever and sore throat should be reported to the physician (leukopenia).

Test-Taking Strategy: Use the process of elimination. Begin to answer this question by recalling that this is an anticonvulsant medication with CNS depressant properties. This would help to eliminate option 1 first, because driving in general could be hazardous. Option 4 is eliminated next because an anticonvulsant is not discontinued solely as a result of side effects or an infection. Rather, the physician should be called. To choose between the remaining options, remember that carbamazepine causes dry mouth. Review this medication if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
Reference: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 137.

4. A client with vascular headaches is taking ergotamine (Ergostat). The nurse would monitor the client for:

A. Hypotension
B. Dependent edema
C. Constipation
D. Cool, numb fingers and toes

Answer: D. Cool, numb fingers and toes

Rationale: Ergotamine produces vasoconstriction, which suppresses vascular headaches when given at a therapeutic dose range. The nurse monitors for hypertension, cool, numb fingers and toes, muscle pain, and nausea and vomiting. Options 1, 2, and 3 are not associated with this medication.

Test-Taking Strategy: To answer this question, first recall that vascular headaches are due to vasodilatation of the blood vessels in the head. Following this train of thought, you then recall that this medication must cause vasoconstriction. This would help you to eliminate each of the incorrect options. The only side effect consistent with vasoconstriction is option 4, the cool, numb fingers and toes. Review this medication if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 393.

5. A nurse is caring for a client with myasthenia gravis who has received edrophonium (Tensilon) intravenously. 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:
A. 5 minutes
B. 15 minutes
C. 30 minutes
D. 60 minutes

Answer: C. 30 minutes

Rationale: Edrophonium may be given to test for myasthenic crisis. If the client is in myasthenic crisis, muscle strength improves after administration of the medication and lasts for about 30 minutes.

Test-Taking Strategy: This question is difficult to answer as stated without specific knowledge of the medication. You can eliminate options 1 and 2 because they are excessively brief timeframes, but you would need to know that the medication lasts for 30 minutes to choose between options 3 and D. Review the effects of this medication if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology
Reference: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 303.

Source : NCLEX example quiz and answer

Read also:

• Example NCLEX Question with Rationale 27th Edition
• NCLEX Question and Answer with Rationale 2019 / 2020 / 2021 / 2020 / 2023 26th Edition
• NCLEX RN Questions and Answer with Rationale 25th Edition (Child Health)

Thank you for your attention with reading our article NCLEX Exam Questions with Rationale (Pharmacology) 28th Edition. Thanks for your participation, like and share if this is usefull.

Share this post