Example of Hard NCLEX Question 78th Edition - NCLEX Exam Example of Hard NCLEX Question 78th Edition - NCLEX Exam

Example of Hard NCLEX Question 78th Edition

Example of Hard NCLEX Question 78th Edition


Example of Hard NCLEX Question 78th Edition


1. A nurse is collecting data on a client admitted to the hospital with a diagnosis of a respiratory infection unresponsive to oral antibiotics. The nurse discovers that the client has a history of bronchial asthma and has been taking zafirlukast (Accolate). The nurse assists to develop a plan of care for the client and suggests that a priority includes monitoring:

A. Platelet counts
B. Gastric pH
C. Liver function tests
D. Urinary output

Answer: C. Liver function tests

Rationale: Zafirlukast is a leukotriene receptor antagonist that is used in the prophylaxis and chronic treatment of bronchial asthma. It is used with caution in clients with impaired hepatic function. Liver function laboratory values should be obtained as a baseline and should be monitored during administration of the medication. Options 1, 2, and 4 are not specifically related to the use of this medication.

Test-Taking Strategy: Focus on the name of the medication and note the key word priority. Recalling that this medication would affect hepatic function will direct you to the correct option. Review this medication 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: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 1125.



2. A nurse is providing instructions to a client taking ethambutol (Myambutol) about the medication. The nurse instructs the client to contact the physician immediately if which of the following occur?

A. Distressing gastrointestinal effects (GI) side effects
B. Hearing disturbances
C. Orange colored urine
D. Visual disturbances

Answer: D. Visual disturbances

Rationale: Ethambutol causes optic neuritis, which decreases visual acuity and the ability to discriminate between the colors red and green. This poses a potential safety hazard when driving a motor vehicle. The client is taught to report this symptom immediately. The client is also taught to take the medication with food if GI upset occurs. Impaired hearing results from antitubercular therapy with streptomycin. Orange-red discoloration of secretions occurs with rifampin (Rifadin).

Test-Taking Strategy: Use the process of elimination. Option 1 is the least likely symptom to report; rather, it should be managed by taking the medication with food. Thus this option may be eliminated first. To select from the other options, it is necessary to know that this medication causes optic neuritis and causes difficulty with red-green discrimination. If this question was difficult, review antitubercular medications since the incorrect options for this question are typical side effects of other antitubercular medications.

Level of Cognitive Ability: Application
Client Needs: Health Promotion and Maintenance
Integrated Process: Teaching/Learning
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 412.



3. A client with rheumatoid arthritis is told that treatment for the disorder will include the administration of gold therapy. In preparation for the treatment, which of the following medications would the nurse anticipate would be prescribed for the client?

A. Auranofin (Ridaura)
B. Fludarabine (Fludara)
C. Prednisone (Deltasone)
D. Pentostatin (Nipent)

Answer: A. Auranofin (Ridaura)

Rationale: Auranofin is a gold preparation used in rheumatoid arthritis. It is used in the management of rheumatoid arthritis in those individuals with insufficient therapeutic response to nonsteroidal anti-inflammatory drugs (NSAIDs). Fludarabine and pentostatin are antineoplastic agents. Prednisone is a corticosteroid.

Test-Taking Strategy: Use the process of elimination. Option 3 can be easily eliminated knowing that this medication is a corticosteroid. From the remainder of the options, it is necessary to know the classifications of these medications. Review these 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: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 98.



4. Baclofen (Lioresal) is prescribed for a client with a spinal cord injury who is experiencing muscle spasms, and the nurse prepares a list of the associated side effects of the medication and reviews the list with the client. Which side effects if identified by the client indicates a need for further instructions?

A. Photosensitivity
B. Slurred speech
C. Nasal congestion
D. Tremors

Answer: A. Photosensitivity

Rationale: Side effects of baclofen include drowsiness, dizziness, weakness, and nausea. Occasional side effects include headache, paresthesia of the hands and feet, constipation or diarrhea, anorexia, hypotension, confusion, and nasal congestion. Paradoxical central nervous system excitement and restlessness can occur along with slurred speech, tremor, dry mouth, nocturia, and impotence. Photosensitivity is not a side effect of this medication.

Test-Taking Strategy: Note the key words need for further instructions in the stem of the question. These words indicate a false-response question, and that you need to select the incorrect client statement. Eliminate options 2 and 4 first because both are neurological signs. From the remaining options, it is necessary to know that photosensitivity is not an associated side effect of the medication. If you had difficulty with this question, review the side effects related to baclofen.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 108.




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1 Response to "Example of Hard NCLEX Question 78th Edition"

  1. Thank you, it's a good day for me learning NCLEX, i hope i can passing in last year

    ReplyDelete

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