NCLEX PN Questions pdf 84th Edition

NCLEX PN Questions pdf 84th Edition

1. A nurse is assigned to care for a client with herpes simplex virus (HSV) who is receiving acyclovir (Zovirax). The nurse is monitoring for adverse effects of the medication. Which of the following laboratory results would the nurse specifically monitor to identify an adverse effect associated with the use of this medication?

A. White blood cell count
B. Red blood cell count
C. Blood urea nitrogen (BUN)
D. Platelet count

Answer: C. Blood urea nitrogen (BUN)

Rationale: The most common reaction related to the administration of this medication is phlebitis and inflammation at the intravenous site of infusion. Reversible nephrotoxicity manifested as elevations in serum creatinine and blood urea nitrogen also occurs in some clients. The cause of nephrotoxicity is the deposition of acyclovir in the renal tubules. The risk of renal injury is increased by dehydration and by the use of other nephrotoxic medications.

Test-Taking Strategy: Use of the process of elimination and knowledge regarding the adverse effects related to the administration of this medication are required to answer this question. Knowing that nephrotoxicity is an adverse effect will direct you to option 3. Review the adverse effects of acyclovir 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: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 12.

2. A nurse is preparing to administer ribavirin (Vibrazole) to a child with respiratory syncytial virus (RSV). The pharmacy dispenses the medication as a powder. The nurse prepares to administer the medication by:

A. Mixing the medication in formula and administering it orally to the child
B. Mixing the medication in sterile saline and administering it by subcutaneous injection
C. Mixing the medication in sterile water and administering it by intramuscular injection
D. Aerosol administration

Answer: D. Aerosol administration

Rationale: Ribavirin is active against (RSV), influenza virus types A and B, and herpes simplex virus. It is administered by oral inhalation, and the medication is absorbed from the lungs and achieves high concentrations in respiratory tract secretions and erythrocytes. It is not administered orally, subcutaneously, or intramuscularly.

Test-Taking Strategy: Knowledge regarding the administration of this medication is required to answer this question. Remember that this medication is administered by aerosol administration. Review the procedure for administering this medication if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Planning
Content Area: Pharmacology
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 979.

3. A pilocarpine ocular system (Ocusert Pilo-20) system is prescribed for the client with glaucoma. The nurse provides instructions to the client regarding the medication. Which statement by the client indicates an understanding of the use of this medication?

A. “I should apply ½ inch into my eye at bedtime.”
B. “I should check my eye each morning to make sure that the medication system is in place.”
C. “I should apply 1 drop of the solution four times a day.”
D. “I need to replace the ocular system every 48 hours.”

Answer: B. “I should check my eye each morning to make sure that the medication system is in place.”

Rationale: The pilocarpine ocular system consists of a bilayered membrane surrounding a reservoir of pilocarpine solution. The tiny unit is placed in the conjunctival sac after which pilocarpine is slowly released. A replacement unit should be installed once a week. Since the unit may fall out during sleep, clients are advised to check each morning for its presence.

Test-Taking Strategy: Knowledge regarding the pilocarpine ocular system is required to answer this question. Knowing that the system remains in the eye for a period of 1 week will assist in directing you to the correct option. If you had difficulty with this question, review this treatment for glaucoma.

Level of Cognitive Ability: Analysis
Client Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process/Evaluation
Content Area: Adult Health/Eye
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 1102.

4. Latanoprost (Xalatan) drops are prescribed for the client with glaucoma. The client returns to the health care clinic for evaluation. Which of the following findings if noted in the client indicate a side effect associated with the use of these eye drops?

A. Periorbital edema
B. Brown pigmentation of the iris
C. Elevated blood pressure
D. Cardiac dysrhythmias

Answer: B. Brown pigmentation of the iris

Rationale: Latanoprost is a topical medication used to lower intraocular pressure in clients with open angle glaucoma and ocular hypertension. The most significant side effect is heightened brown pigmentation of the iris. Other side effects include blurred vision, burning, stinging, conjunctival hyperemia, and punctate keratopathy. The heightened pigmentation stops progressing when the medication is discontinued, but does not regress. Options 1, 3, and 4 are inaccurate and not associated side effects of the medication.

Test-Taking Strategy: Knowledge regarding the effects of this medication is required to answer this question. Remember that the most significant side effect of this medication is heightened brown pigmentation of the iris. Review these side effects 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/Eye
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 1101.

Source : NCLEX Questions and answer

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