Learning NCEX PN Questions of the Day 53th Edition

Learning NCEX PN Questions of the Day 53th Edition

Learning NCEX PN Questions of the Day 53th Edition

1. A nurse has administered a dose of salmeterol (Serevent) to a client. Following administration, the client develops a generalized rash, urticaria, and swelling of the eyelids. The nurse would:

A. Notify the registered nurse immediately
B. Encourage the client to quickly consume fluids
C. Apply a lanolin-based cream to the rash
D. Check the client’s vision with a Snellen chart

Answer: A. Notify the registered nurse immediately

Rationale: Hypersensitivity reaction can occur in clients taking epinephrine, isoproterenol, or salmeterol. Signs and symptoms include rash, urticaria, and swelling of the face, lips, or eyelids. The nurse would notify the registered nurse immediately, who would then contact the physician. The other options are incorrect.

Test-Taking Strategy: Use the process of elimination. Specific medication knowledge is not even necessarily needed to answer this question. Recognizing that the signs and symptoms listed in the question are typical of a hypersensitivity reaction allows you to eliminate options 3 and 4 first. From the remaining options, recalling that the client needs treatment with an antihistamine or epinephrine, not oral fluids, will direct you to option A. Review the signs of a hypersensitivity reaction 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: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 772.

2. An oral hypoglycemic medication, a sulfonylurea, is prescribed for a client with type 2 diabetes mellitus. The nurse plans to administer the medication knowing that the primary action of this medication is which of the following?

A. Decrease glucose production by the liver
B. Inhibit carbohydrate digestion
C. Promote insulin secretion by the pancreas
D. Decrease insulin resistance

Answer: C. Promote insulin secretion by the pancreas

Rationale: Sulfonylureas promote insulin secretion by the pancreas and may also increase tissue response to insulin. Alpha-glucosidase inhibitors inhibit carbohydrate digestion. Biguanides decrease glucose production by the liver. Thiazolidinediones decrease insulin resistance.

Test-Taking Strategy: Knowledge regarding the specific action of sulfonylureas is required to answer this question. Remember, sulfonylureas promote insulin secretion by the pancreas. Review this classification of medications 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: McKenry, L., & Salerno, E. (2003). Mosby’s pharmacology in nursing (21st ed.). St. Louis: Mosby, pp. 1006-1007.

3. A nurse is assisting in caring for a client admitted to the emergency room with diabetic ketoacidosis. The nurse anticipates that the physician will prescribe which type of insulin for intravenous administration to treat this disorder?

A. NPH
B. Regular
C. Lente
D. Ultralente

Answer: B. Regular

Rationale: Only regular insulin can be administered by the intravenous route. Also, it is the only type of insulin that may be administered by the intramuscular route.

Test-Taking Strategy: Remember that regular insulin is the only type of insulin that can be administered by the intravenous route. Review the treatment for diabetic ketoacidosis 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: Christensen, B., & Kockrow, E. (2003). Adult health nursing (4th ed.). St. Louis: Mosby, p. 488.

4. A nurse is asked to prefill syringes containing NPH and regular insulin for a diabetic client who has difficulty with seeing and accurately preparing dosages. Considering the stability of insulin, how many prefilled syringes will the nurse prepare for the client?

A. Three-day supply
B. Five-day supply
C. Seven-day supply
D. One-month supply

Answer: C. Seven-day supply

Rationale: Mixtures of insulin in prefilled syringes should be stored in a refrigerator, where they will be stable for at least 1 week. The syringe should be stored vertically with the needle pointing up to avoid clogging the needle. Before administration, the syringe should be agitated gently to resuspend the insulin.

Test-Taking Strategy: Knowledge regarding the stability of insulin is required to answer the question. Remember, mixtures of insulin in prefilled syringes will be stable for at least 1 week. Review this medication if you are unfamiliar with the principles related to prefilling insulin syringes.

Level of Cognitive Ability: Application
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 604.

Source : NCLEX example quiz and answer

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