Free 1000 NCLEX PN Practice Questions 56th Edition

Free 1000 NCLEX PN Practice Questions 56th Edition

1. A client is receiving somatropin (Humatrope). The nurse tells the client about the importance of follow-up laboratory studies knowing that which of the following studies would be most significant to monitor during therapy with this medication?

A. Amylase
B. Lipase
C. Blood urea nitrogen (BUN)
D. Thyroid stimulating hormone (TSH)

Answer: D. Thyroid stimulating hormone (TSH)

Rationale: An adverse reaction to somatropin is hypothyroidism. Thyroid function is monitored throughout therapy. Options 1 and 2 would evaluate pancreatic function, and option 3 evaluates renal function.

Test-Taking Strategy: Use the process of elimination. Eliminate options 1 and 2 first because both evaluate pancreatic function and therefore are similar. Next eliminate option 3 because it evaluates renal function. Also, recalling that somatropin is a growth hormone will direct you to option D. Review 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. 791.

2. A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. Following diagnostic studies, diabetes insipidus in diagnosed. Lypressin (Diapid) is prescribed for the client. The nurse reinforces instructions to the client and tells the client that the medication is prescribed to:

A. Relieve the headaches
B. Increase water reabsorption
C. Decrease production of antidiuretic hormone
D. Stimulate the production of aldosterone

Answer: B. Increase water reabsorption

Rationale: Lypressin is an antidiuretic hormone used in the treatment of diabetes insipidus. It promotes renal conservation of water by acting on the collecting ducts of the kidney to increase their permeability to water, which results in increased water reabsorption.

Test-Taking Strategy: Note the diagnosis identified in the question. Recalling the pathophysiology associated with the disorder will assist in directing you to the correct option. Review the action of lypressin if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology
Reference: McKenry, L., & Salerno, E. (2003). Mosby’s pharmacology in nursing (21st ed.). St. Louis: Mosby, pp. 832-833.

3. An adult client with hypothyroidism is admitted to the hospital. When reviewing the client’s health record, the nurse notes that the client is taking a maintenance dose of levothyroxine (Synthroid). The nurse checks the dosage that the client is taking knowing that the normal adult maintenance dose of this medication is:

A. 0.025 to 0.05 mg daily
B. 0.075 to 0.1 mg daily
C. 0.05 to 0.075 mg daily
D. 0.1 to 0.2 mg daily

Answer: D. 0.1 to 0.2 mg daily

Rationale: The normal maintenance dose of levothyroxine in an adult is 0.1 to 0.2 mg daily. The maintenance dose for infants 0 to 6 months is 0.025 to 0.05 mg daily, for children 1 to 5 years is 0.075 to 0.1 mg daily, and for children 6 to 12 months is 0.05 to 0.075 mg daily.

Test-Taking Strategy: Knowledge regarding the normal adult dosage of levothyroxine is required to answer the question. Review 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: Mosby’s 2005 drug consult for nurses (2005). St. Louis: Mosby, p. 1166.

4. A client is diagnosed with hypothyroidism and levothyroxine (Synthroid) is prescribed. The nurse notes that the client is presently taking warfarin sodium (Coumadin) and anticipates that the physician will prescribe which of the following?

A. An increased dosage of warfarin sodium
B. A decreased dosage of warfarin sodium
C. An increased dosage of levothyroxine
D. A decreased dosage of levothyroxine

Answer: B. A decreased dosage of warfarin sodium

Rationale: Levothyroxine accelerates the degradation of vitamin K dependent clotting factors. As a result, effects of warfarin sodium are enhanced. If thyroid hormone replacement therapy is instituted in a client who has been taking warfarin sodium, the dosage of warfarin sodium should be reduced.

Test-Taking Strategy: Knowledge regarding the medication interactions that can occur with levothyroxine is required to answer the question. Remember, levothyroxine accelerates the degradation of vitamin K dependent clotting factors. Review these interactions if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Pharmacology
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 623.

Source : NCLEX example quiz and answer

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