NCLEX PN Questions with Answer 74th Edition (About Pharmacology)

NCLEX PN Questions with Answer 74th Edition (About Pharmacology)

1. A postpartum nurse is caring for a client following a cesarean birth who received epidural analgesia. The client is lethargic and is exhibiting signs of respiratory depression. The nurse suspects that the respiratory depression is due to the epidural analgesia. The nurse notifies the registered nurse immediately and prepares the client for the administration of:

A. Betamethasone (Celestone)
B. Morphine sulfate
C. Meperidine hydrochloride (Demerol)
D. Naloxone (Narcan)

Answer: D. Naloxone (Narcan)

Rationale: Narcotics are used for epidural analgesia. An adverse reaction of epidural analgesia is a delayed respiratory depression. Respirations are monitored for 24 hours after administration of epidural analgesia. Naloxone is a narcotic antagonist, which reverses the effects of narcotics and is given if respirations fall below 6 to 8 per minute. Morphine sulfate and meperidine hydrochloride are narcotics and are contraindicated because no other narcotics are to be administered during the first 24 hours. Betamethasone is a corticosteroid administered to enhance fetal lung maturity.

Test-Taking Strategy: Use the process of elimination. Eliminate options 2 and 4 first because they are similar and are both narcotics. Focusing on the medication name in option 1 and recalling that medication names that end with the letters “sone” are corticosteroids will assist in eliminating this option. Review the purpose and actions of the medications presented in the options 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. 749.

2. A nurse is assisting in caring for a client who is receiving amphotericin B (Fungizone) intravenously (IV) to treat disseminated candidiasis. The nurse reviews the plan of care and implements which of the following during the administration of the medication?

A. Monitors for hypothermia
B. Monitors for hyperglycemia
C. Monitors urinary output
D. Monitors blood pressure

Answer: C. Monitors urinary output

Rationale: Amphotericin B is a toxic medication, which can produce symptoms during administration, such as chills, fever, headache, vomiting, and impaired renal function. The medication is also very irritating to the IV site, commonly causing thrombophlebitis. The nurse administering this medication watches for all of these problems. Options 1, 2, and 4 are not specifically related to the administration of this medication.

Test-Taking Strategy: Knowledge of this potent medication is necessary to answer this question accurately. Recalling that the medication can be toxic to the kidneys directs you to option C. Review nursing care related to the administration of this medication if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 65.

3. A nursing student is assigned to care for a 30-week-gestation woman who is admitted to the maternity unit in preterm labor. Betamethasone (Celestone) is prescribed to be administered to the mother. The nursing instructor asks the student about the purpose of the medication. Which statement by the student indicates an understanding of the purpose of this medication?

A. “This medication will stop the premature uterine contractions.”
B. “This medication will delay delivery.”
C. “This medication will promote fetal lung maturity.”
D. “This medication will prevent membrane rupture.”

Answer: C. “This medication will promote fetal lung maturity.”

Rationale: Betamethasone, an anti-inflammatory corticosteroid, is given to increase the surfactant level and increase fetal lung maturity, reducing the incidence of respiratory distress syndrome of the newborn. Surfactant production does not become stable until after 32-weeks of gestation, and if adequate amounts of surfactant are not present in the lungs, respiratory distress and death is a possible consequence. Delivery of the baby needs to be delayed for at least 48 hours after administration of betamethasone to allow time for the lungs to mature. Options 1, 2, and 4 are incorrect.

Test-Taking Strategy: Use the process of elimination. Eliminate options 1 and 2 first because they are similar and both relate to stopping labor. Knowing that respiratory distress syndrome of the newborn caused by immature lungs is a major problem of prematurity, and therefore a major concern, will assist in directing you to the correct option from the remaining options. Review the purpose of this medication if you had difficulty with this question.
Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Pharmacology
Reference: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 97.

4. A nurse is providing instructions to a mother regarding the administration of eardrops to her infant. The nurse observes the mother administer the drops and determines that the mother is performing the procedure correctly if the mother:

A. Pulls up and back on the auricle and directs the solution toward the wall of the ear canal
B. Pulls down and back on the auricle and directs the solution onto the eardrum
C. Pulls down and back on the earlobe and directs the solution toward the wall of the canal
D. Pulls up and back on the earlobe and directs the solution toward the wall of the canal

Answer: C. Pulls down and back on the earlobe and directs the solution toward the wall of the canal

Rationale: The infant should be turned on the side with the affected ear uppermost. With the nondominant hand, the mother pulls down and back on the earlobe while resting the wrist of the dominant hand on the infant’s head. The medication is administered by aiming it at the wall of the canal rather than directly onto the eardrum. The infant should be held or positioned with the affected ear uppermost for 10 to 15 minutes to retain the solution. In the adult, the auricle is pulled up and back to straighten the auditory canal.

Test-Taking Strategy: Use the process of elimination. Option 1 is eliminated because it is the adult procedure. Basic safety principles related to the administration of ear medications should assist in eliminating option B. Visualizing the procedures identified in the remaining options will assist in directing you to the correct option. It would be difficult to pull up and back on an earlobe therefore eliminate option D. Review the procedure for administering ear medications in an infant and adult 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: deWit, S. (2005). Fundamental concepts and skills for nursing. Philadelphia: W.B. Saunders, p. 652.

Source : NCLEX Questions and answer

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