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NCLEX PN Quiz and Answer (Pharmacology) 76th Edition pdf doc
1. Metoclopramide (Reglan) four times daily has been prescribed for a client with reflux esophagitis, and the nurse provides instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?
A. “I need to take the medication 1 hour after each meal and at bedtime.”
B. “I need to take the medication with every meal and at bedtime.”
C. “I need to take the medication 30 minutes before meals and at bedtime.”
D. “I need to take the medication every 6 hours spaced evenly around the clock.”
Answer: C. “I need to take the medication 30 minutes before meals and at bedtime.”
Rationale: Metoclopramide stimulates activity of the upper gastrointestinal tract. The client should be taught to take this medication 30 minutes before meals and at bedtime. This allows the medication time to begin working before the client takes in food, which requires digestion and movement. Options 1, 2, and 4 are incorrect.
Test-Taking Strategy: Use the process of elimination and focus on the client’s diagnosis. Remember that if the medication is used to treat reflux esophagitis, it must be taken before meals. 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. 699.
2. A nurse is assisting in preparing a plan of care for a client who will be receiving an infusion of ritodrine (Yutopar) to prevent premature delivery. Which of the following does the nurse suggest to include in the plan of care for the client?
A. Monitor for fluid volume excess
B. Monitor for fluid volume deficit
C. Monitor for hypoglycemia
D. Monitor for hypertension
Answer: A. Monitor for fluid volume excess
Rationale: Intravenous ritodrine can cause pulmonary edema in some clients. The client should be monitored for fluid overload. If pulmonary edema develops, the infusion should be discontinued and standard treatment implemented. The client is also at risk for hypotension and hyperglycemia during infusion of this medication.
Test-Taking Strategy: Knowledge regarding the adverse effects associated with ritodrine is required to answer this question. Noting that options 1 and 2 are opposite problems may indicate that one of these options is correct. Remember intravenous ritodrine can cause pulmonary edema in some clients. Review 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: Pharmacology
Reference: McKenry, L., & Salerno, E. (2003). Mosby’s pharmacology in nursing (21st ed.). St. Louis: Mosby, p. 912.
3. A client is scheduled for an intravenous pyelogram and has been instructed to take liquid magnesium citrate on the day before the scheduled procedure. The client asks the nurse about the administration procedure for this medication. Which of the following instructions will the nurse provide to the client?
A. “Take the medication on ice.”
B. “Take the medication with apple juice only.”
C. “Take the medication with a full glass of water.”
D. “Take the medication at room temperature.”
Answer: A. “Take the medication on ice.”
Rationale: Magnesium citrate is available as an oral solution. It is used commonly as a laxative before or following certain diagnostic studies. It should be served on ice and should not be allowed to stand for prolonged periods. This would reduce the carbonation and make the solution even less palatable.
Test-Taking Strategy: Use the process of elimination. Eliminate options 2 and 3 first noting that liquid magnesium citrate is prescribed, and adding additional liquid will make it difficult to consume. From the remaining options, it is necessary to know that it should be given cold rather than at room temperature to enhance palatability. Review 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
References: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 660.
McKenry, L., & Salerno, E. (2003). Mosby’s pharmacology in nursing (21st ed.). St. Louis: Mosby, p. 218.
4. A nurse is reviewing the laboratory results of a client receiving chemotherapy. The nurse prepares to initiate neutropenic precautions when the nurse notes which of the following laboratory results?
A. A white blood cell (WBC) count of 2000/μL
B. A platelet count of 100,000 cells/μL
C. A clotting time of 10 minutes
D. An ammonia level of 20 mcg/dl
Answer: A. A white blood cell (WBC) count of 2000/μL
Rationale: The normal WBC is 5000 to 10,000/μL. When the WBC count drops, neutropenic precautions need to be implemented. This includes protective isolation measures to protect the client from infection. Bleeding precautions need to be initiated when the platelet count drops. Bleeding precautions include avoiding all trauma, such as rectal temperatures or injections. The normal platelet count is 150,000 to 450,000 cells/μL. The normal clotting time is 8 to 15 minutes. The normal ammonia value is 15 to 45 mcg/dl.
Test-Taking Strategy: Knowledge regarding normal laboratory values and the significance of the specific laboratory tests is required to answer the question. Options 3 and 4 identify normal laboratory values. To select between the remaining options, correlate a low WBC count with the need for neutropenic precaution and a low platelet count with the need for bleeding precautions. Review neutropenic precautions if you had difficulty with this question.
Level of Cognitive Ability: Analysis
Client Needs: Safe, Effective Care Environment
Integrated Process: Nursing Process/Planning
Content Area: Pharmacology
References: deWit, S. (2005). Fundamental concepts and skills for nursing. Philadelphia: W.B. Saunders, p. 392.
Christensen, B., & Kockrow, E. (2003). Adult health nursing (4th ed.). St. Louis: Mosby, p. 253
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