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Example of NCLEX Question pdf doc 2019 / 2020 79th Edition (Pharmacology Test for Nurse)
1. Aminophylline (Theophylline) is being administered to a client with acute bronchitis. The nurse planning care for the client understands that the primary action of this medication is to:
A. Promote expectoration
B. Suppress the cough
C. Relax smooth muscles of the bronchial airway
D. Prevent infection
Answer: C. Relax smooth muscles of the bronchial airway
Rationale: Aminophylline is a bronchodilator that directly relaxes the smooth muscles of the bronchial airway. Options 1, 2, and 4 are not direct actions of this medication.
Test-Taking Strategy: Focus on the name of the medication. Recalling that bronchodilator medication names end with the letters “line” will assist in directing you to the correct option. Review the primary action of this medication if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
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. 51.
2. A nurse is providing instructions to a client who will be taking phenytoin (Dilantin) for seizure control. Which statement will the nurse make to the client regarding the administration of this medication?
A. “If you have difficulty swallowing the capsules, open them and mix the contents with applesauce.”
B. “You need to cancel your next dentist visit and plan dentist appointments yearly rather than twice a year.”
C. “If you miss a dose of medication, wait until the next dose and take both doses.”
D. “If a sore throat develops, it is necessary to notify the physician.”
Answer: D. “If a sore throat develops, it is necessary to notify the physician.”
Rationale: Phenytoin it an anticonvulsant. Gingival hyperplasia, bleeding, and swelling and tenderness of the gums can occur with the use of this medication. The client needs to be taught good oral hygiene, gum massage, and the need for regular dentist visits. The client should not miss medication doses because this could precipitate a seizure. Capsules should not be chewed or broken, and they must be swallowed. The client needs to be instructed to report a sore throat, fever, glandular swelling, or any skin reaction because this indicates hematological toxicity. Test-Taking Strategy: Use general medication guidelines in selecting the correct option. Eliminate option 1 recalling that phenytoin capsules should not be broken. Eliminate option 3 because the client needs to be encouraged to take medications on time. Recalling that gingival hyperplasia can occur with the use of this medication or that hematological toxicity can occur will assist in directing you to the correct option from those remaining. Review the side effects related to phenytoin if you had difficulty with this question.
Level of Cognitive Ability: Application
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. 858.
3. A client with a history of seizures is taking phenytoin (Dilantin) for seizure control. The client arrives at the health care clinic, and a serum phenytoin drug level is drawn. The laboratory calls the nurse and reports a result of 10 mcg/mL. The nurse interprets that this value indicates:
A. An inadequate drug level
B. The low end of therapeutic range
C. The high end of therapeutic range
D. A toxic level
Answer: B. The low end of therapeutic range
Rationale: The therapeutic serum drug level range for phenytoin is 10 to 20 mcg/mL. A laboratory result of 10 mcg/mL is at the low end of the therapeutic range.
Test-Taking Strategy: Knowledge regarding the therapeutic serum range of this medication is required to answer the question. A helpful hint may be to remember that the theophylline therapeutic range and the acetaminophen (Tylenol) therapeutic range is the same as the phenytoin therapeutic range. Remembering this may assist you when answering questions related to these three medications. Review this medication if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
Reference: Chernecky, C., & Berger, B. (2004). Laboratory tests and diagnostic procedures (4th ed.). Philadelphia: W.B. Saunders, p. 869.
4. A nurse reviews the laboratory results of a client with trigeminal neuralgia who is being treated with carbamazepine (Tegretol) 400 mg orally daily. The client’s white blood cell (WBC) count is 3000/μL, blood urea nitrogen (BUN) is 15 mg/dl, sodium is 140 mEq/L, and uric acid is 5.0 ng/dl. The nurse would notify the physician that:
A. The BUN is elevated indicating nephrotoxicity
B. The WBC is low indicating a blood dyscrasia
C. The sodium level is low indicating an electrolyte imbalance
D. The uric acid level is elevated indicating the risk for renal calculi
Answer: B. The WBC is low indicating a blood dyscrasia
Rationale: Adverse effects of carbamazepine appear as blood dyscrasias, including aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, cardiovascular disturbances, thrombophlebitis, dysrhythmias, and dermatological effects. Options 1, 3, and 4 are incorrect because the laboratory values identified in the question for these specific tests are within normal range.
Test-Taking Strategy: Use the process of elimination and knowledge regarding normal laboratory values to answer the question. If you are familiar with normal laboratory values, you will easily be able to eliminate options 1, 3, and D. Review the signs of adverse reactions related to this medication 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. 166.
Pagana, K., & Pagana, T. (2003). Mosby’s diagnostic and laboratory test reference (6th ed.). St. Louis: Mosby, p. 940.
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1 Response to "Example of NCLEX Question pdf doc 2019 / 2020 79th Edition"
Thank you, it's a good day for me learning NCLEX, i hope i can passing in last year
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