Blog about quiz / question and answer NCLEX (National Council Licensure Examination) For Nursing Student, Example Question NCLEX RN and NCLEX PN. Exam for Nurse
1. A client receiving theophylline (Theo-Dur) is due to have a theophylline level drawn. The nurse questions the client to assure that the client has not ingested which of the following substances before the blood test?
A. Analgesics
B. Narcotics
C. Glucose
D. Chocolate
Answer: D. Chocolate
Rationale: Theophylline is a xanthine bronchodilator. Before drawing a serum level of the medication, the client should avoid taking in foods or beverages that contain xanthine, such as colas, coffee, or chocolate.
Test-Taking Strategy: Specific knowledge regarding this medication is required to answer this question. Remember, the client needs to avoid foods or beverages that contain xanthine. 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. 53.
2. A nurse has observed a client self-administer a dose of metaproterenol sulfate (Alupent) via metered dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse interprets that this is due to:
A. Insufficient dosage of the medication, which needs to be increased
B. Probable interaction of this medication with an over-the-counter cold remedy
C. Tolerance to the medication, indicating a need for a stronger type of bronchodilator
D. Bronchospasm, which must be reported to the physician
Answer: D. Bronchospasm, which must be reported to the physician
Rationale: The client taking a bronchodilator may experience bronchospasm, which is evidenced by the client’s wheezing. This can occur with excessive use of inhalers. Further medication should be withheld, and the physician should be notified. Options 1, 2, and 3 are incorrect interpretations.
Test-Taking Strategy: Use the process of elimination. Eliminate option 1 first, because the client began wheezing after the medication was administered. Option 3 may be eliminated next, because tolerance does not generally occur. From the remaining options, recalling that wheezing is associated with bronchospasm will direct you to option D. Review the adverse effects of inhaled medications if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
References: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 682.
McKenry, L., & Salerno, E. (2003). Mosby’s pharmacology in nursing (21st ed.). St. Louis: Mosby, p. 717.
3. A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is currently being weaned to triamcinolone acetonide (Azmacort) by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change if the client states to report:
A. Blurred vision, headache, and insomnia
B. Chills, itching, and generalized rash
C. Anorexia, nausea, weakness, and fatigue
D. Chills and fever
Answer: C. Anorexia, nausea, weakness, and fatigue
Rationale: The client undergoing change from oral to inhalation glucocorticoids could experience signs of adrenal insufficiency. The nurse teaches the client to report anorexia, nausea, weakness, and fatigue. Other signs, which are objective in nature, include hypotension and hypoglycemia.
Test-Taking Strategy: To answer this question accurately, it is necessary to know that tapering could result in adrenal insufficiency, and then you must know what those typical signs and symptoms are. Because option 4 seems most compatible with infection, eliminate that option first. Option 1 implies central nervous system involvement, so that may be eliminated next. From the remaining options, choose option 3 because option 2 seems to resemble a hypersensitivity reaction. Review the adverse effects of glucocorticoids 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: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 1075.
4. A nurse notes that the serum theophylline level of a client taking theophylline (Theo-Dur) is 15 mcg/mL. The nurse interprets this result as:
A. Below the therapeutic range
B. In the middle of the therapeutic range
C. At the top of the therapeutic range
D. In excess of the therapeutic range
Answer: B. In the middle of the therapeutic range
Rationale: The normal therapeutic range for theophylline levels is 10 to 20 mcg/mL. A level above 20 mcg/mL is considered toxic. The value of 15 mcg/mL places the client in the middle of the therapeutic range.
Test-Taking Strategy: Specific knowledge regarding the therapeutic theophylline level is required to answer this question. Remember, the normal therapeutic range for theophylline levels is 10 to 20 mcg/mL. Review this medication and the therapeutic range for the theophylline level if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 53.
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