Free NCLEX PN Questions with Answers and Strategy pdf 83th Edition

Free NCLEX PN Questions with Answers and Strategy pdf 83th Edition 9 (Adult Health/Immune)

1. A client with acquired immunodeficiency syndrome (AIDS) is taking zidovudine (Retrovir) 200 mg orally three times daily. The client reports to the health care clinic for follow-up blood studies, and the results of the blood studies indicate severe neutropenia. Which of the following would the nurse anticipate to be prescribed for the client?
A. Reduction in the medication dosage
B. Discontinuation of the medication
C. The administration of prednisone (Deltasone) concurrent with the therapy
D. Administration of epoetin alfa (Epogen)

Answer: B. Discontinuation of the medication

Rationale: Hematological monitoring should be done every 2 weeks in the client taking zidovudine. If severe anemia or severe neutropenia develops, treatment should be discontinued until there is evidence of bone marrow recovery. If anemia or neutropenia is mild, a reduction in dosage may be sufficient. The administration of prednisone may further alter the immune function. Epoetin alfa is given to clients experiencing anemia.

Test-Taking Strategy: Knowledge regarding the adverse effects related to the administration of zidovudine is required to answer this question. Focus on the key words “severe neutropenia” to assist in directing you to the correct option. Review the adverse effects of 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: Adult Health/Immune
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, pp. 988, 1018.

2. A client with acquired immunodeficiency syndrome is taking didanosine (Videx). The client calls the nurse at the physician’s office and reports nausea, vomiting, and abdominal pain. Which of the following instructions would the nurse provide to the client?

A. “This is an expected side effect of the medication.”
B. “Come to the office to be seen by the physician.”
C. “Take crackers and milk with the administration of the medication.”
D. “Decrease the dose of the medication until the next physician’s visit.”

Answer: B. “Come to the office to be seen by the physician.”

Rationale: Pancreatitis, which can be fatal, is the major dose-limiting toxicity associated with the administration of didanosine. Clients should be monitored for indications of pancreatitis, which include increased serum amylase in association with increased serum triglycerides, decreased serum calcium, and nausea, vomiting, or abdominal pain. If evolving pancreatitis is diagnosed, the medication should be discontinued. The client should be seen by the physician.

Test-Taking Strategy: Focus on the data in the question. Recalling that nausea, vomiting, and abdominal pain are signs of pancreatitis and that pancreatitis is associated with the use of this medication should direct you to the correct option. Review the adverse effects of this medication if you had difficulty with this question.
Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Adult Health/Immune
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 1018.

3. A client with acquired immunodeficiency syndrome reports to the clinic for a follow-up examination. The client is taking zalcitabine (Hivid). Which of the following questions would the nurse ask to determine the presence of an adverse effect associated with the use of this medication?

A. “Are you having any diarrhea?”
B. “Do you have any numbness or burning sensations in your arms or legs?”
C. “Are you having any ringing in you ears?”
D. “Do you have any burning on urination?”

Answer: B. “Do you have any numbness or burning sensations in your arms or legs?”

Rationale: Peripheral neuropathy is an adverse effect associated with the use of zalcitabine. It manifests initially as numbness and burning sensations in the extremities. These symptoms may progress to sharp shooting pain and severe continuous burning if the medication is not discontinued. The pain of severe neuropathy requires narcotic analgesics for control. Clients should be informed about the early symptoms of neuropathy and instructed to report them immediately. Neuropathy will reverse slowly if the medication is withdrawn early, but may become irreversible if the medication is continued. Options 1, 3, and 4 are unrelated to the adverse effects associated with the use of this medication.

Test-Taking Strategy: Knowledge regarding the adverse effects associated with the use of zalcitabine is required to answer this question. Recalling that peripheral neuropathy is an adverse effect will direct you to option B. Review the adverse effects of this medication if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Adult Health/Immune
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 1018.

4. Indinavir (Crixivan) is prescribed for a client with human immunodeficiency virus (HIV). The nurse has provided instructions to the client regarding the administration of the medication. Which of the following if stated by the client indicates an adequate understanding of the use of this medication?

A. “I need to take the medication with my large meal of the day.”
B. “I need to store the medication in the refrigerator.”
C. “I need to take the medication with water but on an empty stomach.”
D. “I need to take the medication with a high-fat snack.”

Answer: C. “I need to take the medication with water but on an empty stomach.”

Rationale: To maximize absorption, the medication should be administered with water on an empty stomach. The medication can be taken 1 hour before a meal or 2 hours after a meal, or it can be administered with skim milk, coffee, tea, or a low-fat meal, such as corn flakes with skin milk and sugar. It is not to be administered with a large meal. The medication should be stored at room temperature and protected from moisture because moisture can degrade the medication.

Test-Taking Strategy: Use the process of elimination. Options 1 and 4 can be eliminated first because they are similar. From the remaining options, it is necessary to know that this medication is stored at room temperature. Review client teaching points 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: Adult Health/Immune
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 1020.

Source : NCLEX Questions and answer

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