NCLEX PN with Answer 75th Edition pdf doc (About Pharmacology)

NCLEX PN with Answer 75th Edition pdf doc (About Pharmacology)

1. A client with rheumatoid arthritis has been taking acetylsalicylic acid (ASA) (aspirin) more frequently than prescribed because the arthritis has been causing more discomfort than usual. The client complains of joint pain and has an elevated temperature. The nurse is concerned about the possibility of aspirin toxicity and asks the client which question that may confirm this suspicion?

A. “Are you having any diarrhea?”
B. “Are you constipated?”
C. “Do you have any ringing in the ears?”
D. “Do you have any double vision?”

Answer: C. “Do you have any ringing in the ears?”

Rationale: Mild intoxication with ASA is called salicylism and is commonly experienced when the daily dosage is more than 4 g. Tinnitus (ringing in the ears) is the most frequent effect noted with intoxication. Options 1, 2, and 4 are unrelated to aspirin toxicity.

Test-Taking Strategy: Note that the question refers to aspirin intoxication. Eliminate options 1 and 2 because they are similar and relate to gastrointestinal symptoms. Knowledge regarding toxicity related to ASA (aspirin) is required to assist in directing you to option C. Remember tinnitus (ringing in the ears) is the most frequent effect noted with intoxication. Review the toxic effects of aspirin if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 88.

2. A nurse administers scopolamine as prescribed to a client in preparation for surgery. The nurse monitors the client for side effects related to the administration of this medication. Which of the following would the nurse determine is an expected side effect of this medication?

A. Increased urinary output in the Foley catheter bag
B. Client complaints of feeling sweaty
C. Client complaints of a dry mouth
D. Pupillary constriction on neurological examination

Answer: C. Client complaints of a dry mouth

Rationale: Scopolamine is an anticholinergic medication that causes the frequent side effects of dry mouth, urinary retention, decreased sweating, and dilation of the pupils. The other options are incorrect.

Test-Taking Strategy: To answer this question accurately, it is necessary to be familiar with this medication and its uses. Recalling that scopolamine is an anticholinergic medication and recalling the effects of anticholinergics will direct you to option 3. Review the action 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: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 962.

3. Sucralfate (Carafate) 1 g four times daily has been prescribed for a client with a diagnosis of gastric ulcer, 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 with my meals and again at bedtime.”
B. “I need to take the medication 1 hour after meals and again at bedtime.”
C. “I need to take the medication every 6 hours around the clock.”
D. “I need to take the medication 1 hour before my meals and at bedtime.”

Answer: D. “I need to take the medication 1 hour before my meals and at bedtime.”

Rationale: This medication is timed to allow it to form a protective coating over the gastric ulcer before food intake stimulates gastric acid production and mechanical irritation. Therefore the medication should be scheduled for administration 1 hour before meals and at bedtime. The other options are incorrect.

Test-Taking Strategy: Use the process of elimination. Focusing on the diagnosis in the question will assist in directing you to option D. It would seem most reasonable that medication should be administered before food with this diagnosis. 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. 994.

4. Psyllium (Metamucil) is prescribed for a client with a cardiac disorder to facilitate defecation and prevent straining with bowel movements. 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 mix the medication with custard.”
B. “I should decrease the amount of fiber in my diet when I take this medication.”
C. “I should mix the medication with a full glass of water.”
D. “I need to decrease my fluid intake following administration of the medication.”

Answer: C. “I should mix the medication with a full glass of water.”

Rationale: Metamucil is a bulk-forming laxative. It should be taken with a full glass of water or juice (not custard), followed by another glass of liquid. This will help prevent impaction of the medication in the stomach or small intestine. Both fiber in the diet and fluid intake should not be decreased unless specifically prescribed by the physician.

Test-Taking Strategy: Focus on the action of the medication and the information identified in the question to assist in eliminating options 2 and D. Recalling that this medication is supplied in a dry form will assist in eliminating option A. Review the 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: Pharmacology
Reference: Hodgson, B., & Kizior, R. (2005). Saunders nursing drug handbook 2005. Philadelphia: W.B. Saunders, p. 908.

Source : NCLEX Questions and answer

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