Nursing NCLEX Quiz with Answer and Rationale (Respiratory & Pharmacology) 19th Edition

Nursing NCLEX Quiz with Answer and Rationale (Respiratory & Pharmacology) 19th Edition

1. A client who has fallen from a roof and fractured his ribs has the following arterial blood gas results: pH 7.42, PaCO2 32 mm Hg, PaO2 89 mm Hg, HCO3− level 22 mEq/L. The nurse interprets that the client’s blood gases indicate which of the following?

A. Normal results
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory alkalosis

Answer: D. Respiratory alkalosis

Rationale: The client has respiratory alkalosis. Normal ranges are pH 7.35 to 7.45, PaCO2 35 to 45, and bicarbonate level 22 to 26 mEq/L. With acidosis, the pH would be less than 7.35; with alkalosis, the pH would be greater than 7.4D. Carbon dioxide levels would be elevated in respiratory acidosis. Bicarbonate levels would be low if metabolic acidosis was present.

Test-Taking Strategy: Specific knowledge related to arterial blood gas (ABG) analysis is needed to answer this question correctly. Recalling that with alkalosis the pH would be greater than 7.45 will direct you to option D. Review the procedure for analyzing ABGs if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Adult Health/Respiratory
Reference: Chernecky, C., & Berger, B. (2004). Laboratory tests and diagnostic procedures (4th ed.). Philadelphia: W.B. Saunders, p. 245.

2. A transcutaneous electrical nerve stimulation (TENS) unit is prescribed for a client with pain, and the nurse provides information to the client about the TENS unit. Which statement by the client indicates the need for further information?

A. “Electrodes are attached to the skin.”
B. “The unit relieves pain.”
C. “The unit will reduce the need for analgesics.”
D. “Needles are inserted in the subcutaneous tissue to stimulate the nerve.”

Answer: D. “Needles are inserted in the subcutaneous tissue to stimulate the nerve.”

Rationale: The TENS unit is a portable unit, and the client controls the system for relieving pain and reducing the need for analgesics. It is attached to the skin of the body by electrodes. Needles are not used.

Test-Taking Strategy: Note the key words need for further information. These words indicate a false response question and that you need to select the incorrect client statement. Noting the word “needles” in option 4 will direct you to this option. Review the concepts related to the TENS unit if you had difficulty with this question.

Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Pharmacology
Reference: deWit, S. (2005). Fundamental concepts and skills for nursing. Philadelphia: W.B. Saunders, pp. 589-590.

3. A nurse is employed in a long-term care facility. Diclofenac (Voltaren) is prescribed for the client with osteoarthritis. Which of the following medications, if noted on the client’s record, would alert the nurse to consult with the physician?

A. Warfarin sodium (Coumadin)
B. Mesoridazine besylate (Serentil)
C. Primidone (Mysoline)
D. Trifluoperazine hydrochloride (Stelazine)

Answer: A. Warfarin sodium (Coumadin)

Rationale: Diclofenac is a nonsteroidal antiinflammatory (NSAID) drug. Interactions may occur with anticoagulants. The nurse should consult with the physician regarding a potential medication interaction. Mesoridazine besylate is an antipsychotic medication. Primidone is an anticonvulsant, and trifluoperazine hydrochloride is an antipsychotic. These medications are not contraindicated when administering diclofenac.

Test-Taking Strategy: Knowledge regarding the contraindications associated with the administration of this medication is required to answer this question. Remember, diclofenac is contraindicated with warfarin sodium. Review this medication if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Safe, Effective Care Environment
Integrated Process: Nursing Process/Data Collection
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 200D. Philadelphia: W. B. Saunders, p. 317.

4. A client is receiving a maintenance dose of oral dantrolene sodium (Dantrium) for the treatment of spasticity. The nurse reviews the medication record expecting that which of the following doses would be prescribed?

A. 50 mg daily
B. 100 mg daily
C. 100 mg twice daily
D. 200 mg four times daily

Answer: C. 100 mg twice daily

Rationale: For treatment of spasticity, dantrolene is administered orally. The initial dose in adults is 25 mg once daily. The usual maintenance dosage is 100 mg 2 to 4 times daily. If beneficial effects do not develop within 45 days, dantrolene therapy should be discontinued.

Test-Taking Strategy: Knowledge of the adult oral dose of this medication is required to answer this question. If you are unfamiliar with this maintenance dosage, review this medication.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 200D. Philadelphia: W. B. Saunders, p. 285.

5. A physician is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The medication is going to be administered intrathecally (within the spinal column). Which of the following medications would the nurse expect to be prescribed and administered by this route?

A. Cyclobenzaprine hydrochloride (Flexeril)
B. Chlorzoxazone (Paraflex)
C. Dantrolene sodium (Dantrium)
D. Baclofen (Lioresal)

Answer: D. Baclofen (Lioresal)

Rationale: Baclofen is the only skeletal muscle relaxant that can be administered intrathecally within the spinal column.

Test-Taking Strategy: Knowledge regarding intrathecal administration of muscle relaxants is required to answer this question. If you are unfamiliar with this form of therapy, review this content.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Pharmacology
References:
Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 200D. Philadelphia: W. B. Saunders, p. 107.
Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 210.

Source : NCLEX example quiz and answer

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