NCLEX RN Quiz with Answer and Rationale 2018, 2019 , 2020, 2021 29th Edition
NCLEX RN Quiz with Answer and Rationale 2018, 2019 , 2020, 2021 29th Edition
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| NCLEX RN Quiz with Answer and Rationale 2018, 2019 , 2020, 2021 29th Edition |
1. A client with narcolepsy has been prescribed dextroamphetamine (Dexedrine). The client complains to the nurse that he no longer sleeps well at night and that he does not want to take the medication any longer. Before making any specific comment, the nurse plans to investigate whether the client takes the medication at which of the following proper time schedules?
A. At least 6 hours before bedtime
B. Two hours before bedtime
C. After dinner each day
D. Just before going to bed
Answer: A. At least 6 hours before bedtime
Rationale: Dextroamphetamine is a central nervous system (CNS) stimulant, which acts by releasing norepinephrine from nerve endings. The client should take the medication at least 6 hours before going to bed at night to prevent disturbances with sleep. Taking the medication at the timeframes indicated in options 2, 3, and 4 will prevent the client from sleeping because of the stimulant properties of the medication.
Test-Taking Strategy: Focus on the name of the medication and recall that it causes CNS stimulation. This medication effect interferes with sleep. Knowing this, you would evaluate each of the options in terms of how far removed the scheduled dose is from the client’s bedtime. Evaluating the question in this way helps you to eliminate each of the incorrect options. Review this medication if you had difficulty with this question.
Level of Cognitive Ability: Analysis
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, pp. 312-313.
2. A client on the nursing unit has an order for dextroamphetamine (Dexedrine) orally daily. The nurse collaborates with the dietitian to limit the amount of which of the following items on the client’s dietary trays?
A. Starch
B. Caffeine
C. Protein
D. Fat
Answer: B. Caffeine
Rationale: Dextroamphetamine is a central nervous system (CNS) stimulant. Caffeine is a stimulant also, and should be limited in the client taking this medication. The client should be taught to limit their own caffeine intake as well.
Test-Taking Strategy: Focus on the name of the medication and recall that it is a CNS stimulant. You would then evaluate each of the options in terms of the additive stimulation provided by the items listed as options. Knowing that caffeine is also a stimulant would help you to choose this as the item to be limited. 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/Implementation
Content Area: Pharmacology
Reference: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 254.
3. A client with Parkinson’s disease has begun therapy with carbidopa/levodopa (Sinemet). The nurse determines that the client understands the action of the medication if the client verbalizes that results may not be apparent for:
A. 24 hours
B. 2 to 3 days
C. 1 week
D. 2 to 3 weeks
Answer: D. 2 to 3 weeks
Rationale: Signs and symptoms of Parkinson’s disease usually begin to resolve within 2 to 3 weeks of starting therapy, although in some clients marked improvement may not be seen for up to 6 months. Clients need to understand this concept to aid in compliance with medication therapy. Options 1, 2, and 3 are incorrect because of the short timeframes.
Test-Taking Strategy: To answer this question, you need to know when the medication begins to produce the expected effects. Remember, signs and symptoms of Parkinson’s disease usually begin to resolve within 2 to 3 weeks of starting therapy. 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. 491.
4. A client is taking trihexyphenidyl (Artane) for the treatment of Parkinson’s disease. The nurse would monitor for which adverse effect of this medication?
A. Urinary incontinence
B. Urinary retention
C. Diarrhea
D. Excessive perspiration
Answer: B. Urinary retention
Rationale: Trihexyphenidyl is an anticholinergic medication. Because of this, it can cause urinary hesitancy and retention, constipation, dry mouth, and decreased sweating as side effects.
Test-Taking Strategy: Recall that this medication has an anticholinergic action. By evaluating each of the options in terms of their consistency with anticholinergic effects, you can eliminate each of the incorrect options. Also, because options 1 and 2 directly oppose each other, you may automatically be drawn to choose between one of them as the correct option. Remember, trihexyphenidyl is an anticholinergic medication that can cause urinary hesitancy and retention. 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. 1080.
5. A client receiving therapy with carbidopa/levodopa (Sinemet) is upset and tells the nurse that his urine has turned a darker color as a result of taking this medication. The client wants to discontinue use of the medication. In formulating a response to the client’s concerns, the nurse interprets that this change is:
A. Indicative of developing toxicity
B. A sign of interaction with another medication
C. A harmless side effect of the medication
D. A result of taking the medication with milk
Answer: C. A harmless side effect of the medication
Rationale: With carbidopa/levodopa therapy, a darkening of the urine or sweat may occur. The client should be reassured that this is a harmless effect of the medication, and its use should be continued. Options 1, 2, and 4 are incorrect interpretations.
Test-Taking Strategy: Use the process of elimination. Eliminate options 1 and 2 first because they are similar. From the remaining options, it is necessary to know that this is a harmless side effect. Review the side effects of this medication if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 167.
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