NCLEX PN Questions with Answers and Strategy 82th Edition

NCLEX PN Questions with Answers and Strategy 82th Edition (Pharmacology Test)

1. Cisplatin (Platinol) is administered to a client with a diagnosis of testicular cancer. The nurse assisting in caring for the client is monitoring for adverse effects related to the medication. Which of the following if noted in the client would indicate an adverse effect related to the administration of this medication?

A. Increased platelet count
B. Diarrhea
C. Tinnitus
D. Elevated white blood cell count

Answer: C. Tinnitus

Rationale: Cisplatin is a medication that kills cells primarily by forming cross-links between and within strands of DNA. Its principle indication for use is to treat testicular cancer. Other indications include carcinomas of the ovary, bladder, head, and neck. It can cause damage to the kidneys. Other adverse effects include neurotoxicity, bone marrow depression, and toxicity to the ear that manifests as tinnitus and high frequency hearing loss. Nausea and vomiting can be severe beginning 1 hour after administration and persisting for 1 to 2 days.

Test-Taking Strategy: Use the process of elimination. Eliminate option 4 first because the white blood cell count is likely to decrease rather than increase. Next eliminate option 1, knowing that the platelet count is likely to decrease rather than increase. From the remaining options, recalling that toxicity to the ear is associated with the use of this medication 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/Evaluation
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 233.

2. Ifosfamide (Ifex) is prescribed for a client with a diagnosis of germ cell cancer of the testes. The nurse assisting in caring for the client would anticipate that which of the following would be prescribed to be administered concurrently during the administration of this antineoplastic medication?

A. Mesna (Mesnex)
B. Cisplatin (Platinol)
C. Prednisone (Deltasone)
D. Melphalan (Alkeran)

Answer: A. Mesna (Mesnex)

Rationale: Ifosfamide is an antineoplastic medication used to treat refractory germ cell cancer of the testes. It is a derivative of cyclophosphamide (Cytoxan). Dose-limiting toxicity of bone marrow depression and hemorrhagic cystitis is minimized by concurrent therapy with mesna and by extensive hydration of at least 2 L of oral or IV fluids daily. Mesna is the antidote specific to this medication.

Test-Taking Strategy: Knowledge regarding the adverse effects related to the administration of ifosfamide is required to answer this question. If you are unfamiliar with these toxic effects and with the antidote associated with the administration of this antineoplastic agent, review this content.

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. 555.

3. A nurse is reinforcing instructions to a client with a diagnosis of scabies regarding the administration of crotamiton (Eurax). Which statement by the client indicates an understanding regarding the application of this medication?

A. “I will apply the application to my entire body and leave on for 24 hours followed by a cleansing bath.”
B. “I will massage the medication into the skin from my chin downward and apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application.”
C. “I should apply the medication to my entire body avoiding the skin folds and creases and wash it off in 12 hours.”
D. “I should apply the medication to my entire body washing it off after 2 hours.”

Answer: B. “I will massage the medication into the skin from my chin downward and apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application.”

Rationale: The client is instructed to massage the medication into the skin of the entire body starting with the chin and working downward. The head and face are treated only if needed. Special attention should be given to skin folds and creases. Contact with eyes, mucous membranes, and any region of inflammation should be avoided. A second application is made 24 hours after the first. A cleansing bath should be taken 48 hours after the second application, and if needed treatment can be repeated in 7 days.

Test-Taking Strategy: Read each option carefully and use the process of elimination. Eliminate options 1 and 4 because of the words “entire body.” Eliminate option 3 because skin folds and creases would not be avoided. Review client teaching points related to this medication if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Safe, Effective Care Environment
Integrated Process: Nursing Process/Evaluation
Content Area: Pharmacology
Reference: Lehne, R. (2004). Pharmacology for nursing care (5th ed.). Philadelphia: W.B. Saunders, p. 1055.

4. A client taking metronidazole (Flagyl) for the treatment of trichomoniasis vaginalis calls the nurse employed in the physician’s office and is concerned because the color of the urine is very dark. Which of the following information would the nurse provide to the client?

A. Report to the clinic to see the physician immediately.
B. Discontinue the medication.
C. The darkening of the urine is a harmless side effect.
D. Increase fluid intake.

Answer: C. The darkening of the urine is a harmless side effect.

Rationale: Metronidazole can produce a variety of untoward effects, but these rarely require termination of treatment. Harmless darkening of the urine may occur, and the client should be forewarned of this effect. The nurse would not instruct the client to discontinue the medication. It is not necessary that the client see the physician. Increasing fluid intake is a good health measure, but will not prevent this side effect from occurring.

Test-Taking Strategy: Focus on the data in the question. Eliminate option 1 because of the word “immediately.” Use general medication guidelines to eliminate option B. From the remaining options, recalling the harmless side effects of this medication will direct you to option C. Review the side 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: Pharmacology
Reference: Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses (6th ed.). St. Louis: Mosby, p. 560.

Source : NCLEX Questions and answer

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