NCLEX Pharmacological and Parenteral Therapies

NCLEX Pharmacological and Parenteral Therapies Related

Review NCLEX Pharmacological and Parenteral Therapies related questions and content

The nurse working on the pediatric unit has scheduled medications to administer at this time. Which assessments should prompt the nurse to conclude that the prescribed medication should be withheld and the HCP immediately notified?

  • A. Oral hydrocodone with acetaminophen to the 10-year-old with burn injuries who is feeling dizzy and light-headed
  • B. Oral acetaminophen to the 6-month-old with a fever of 102°F (38.9°C) from an infection who has developed a rash
  • C. Clindamycin IV to the 16-year-old male with aspiration pneumonia from near-drowning who has a BP of 92/56 mm Hg
  • D. Phenobarbital IV to the 5-year-old with intermittent seizures who states feeling tired and appears to be drowsy
Correct Answer: C

Rationale: A: Dizziness and light-headedness are side effects of hydrocodone with acetaminophen (Vicodin), and the nurse may choose to withhold a scheduled dose. These are not potentially life-threatening or warranting an immediate call to the HCP. B: A rash is a side effect of acetaminophen (Tylenol). However, the rash is not potentially life-threatening or warranting an immediate call to the HCP. C: An adverse effect of clindamycin (Cleocin) is hypotension. A BP of 92/56 mm Hg is low for a 16-year-old. Normal BP for a 16-year-old male is 111/63 mm Hg to 136/90 mm Hg, depending on height percentile. The nurse should compare the previous BP readings with the current one to determine the degree of BP variation and then immediately notify the HCP because the BP can decrease further. D: Tiredness and drowsiness are side effects of phenobarbital (Luminal). However, these are expected. The nurse would not withhold phenobarbital unless there were additional neurological alterations that would warrant contacting the HCP.

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The client undergoing detoxification from chronic alcohol abuse is to receive Phenobarbital 120 mg IM and promethazine 50 mg IM. Which explanation by the nurse about using this medication combination is correct?

  • A. Promethazine will prevent a potential allergic reaction to the phenobarbital.
  • B. Combining promethazine and phenobarbital will have a greater sedative effect.
  • C. Promethazine will decrease the nausea from phenobarbital when it is given IM.
  • D. Combining these reduces the sedative effects and prevents a ‘hangover' feeling.
Correct Answer: B

Rationale: Promethazine (Phenergan) potentiates the CNS depression of phenobarbital, producing a greater sedative effect.

A client receiving drug therapy with furosemide and digitalis requires careful observation and care. In planning care for this client, the nurse should recognize that which of the following electrolyte imbalances is most likely to occur?

  • A. hyperkalemia
  • B. hypernatremia
  • C. hypokalemia
  • D. hypomagnesemia
Correct Answer: C

Rationale: Furosemide, a diuretic, commonly causes potassium loss, leading to hypokalemia, which can potentiate digitalis toxicity, requiring close monitoring.

A client had a colostomy done one day ago. Which of the following is an abnormal finding when assessing the stoma?

  • A. Mild edema
  • B. Minimal bleeding
  • C. Rose color
  • D. Dark red color
Correct Answer: D

Rationale: A dark red stoma indicates inadequate blood supply, an abnormal finding requiring intervention. Mild edema, minimal bleeding, and rose color are normal postoperative findings.

The nurse is preparing to administer the client's medication for treatment of TB. Which medication, if on the client's MAR, should the nurse plan to administer?

  • A. Isoniazid
  • B. Fluconazole
  • C. Azithromycin
  • D. Acyclovir
Correct Answer: A

Rationale: A: Isoniazid (INH) is an antimycobacterial medication affecting bacterial cell wall synthesis; it is used in the treatment of TB or other mycobacterial infections. B: Fluconazole (Diflucan) is an antifungal agent that inhibits synthesis of fungal sterols, a necessary component of the cell membrane. C: Azithromycin (Zithromax) is a macrolide antibiotic that is bacteriostatic against susceptible bacteria and is usually used for treating lower respiratory tract infections, skin infections, acute otitis media, tonsillitis, or Mycobacterium avium. D: Acyclovir (Zovirax) is an antiviral agent limited to treatment of herpes viruses.

The client with chronic, stable angina telephones the clinic nurse and reports a headache lasting for several days after taking one dose of isosorbide mononitrate. The client also reports symptoms of orthostatic hypotension and palpitations. Which is the nurse's best action?

  • A. Recommend that the client make an appointment with the health care provider.
  • B. Have the client retime the dose for a later time when the client is more active.
  • C. Instruct the client to take two acetaminophen 325-mg tablets with the next dose.
  • D. Teach Immaculate that the headaches will subside over time with continued use.
Correct Answer: A

Rationale: A: Severe headaches, orthostatic hypotension, and palpitations may be a sign of isosorbide mononitrate (Imdur) toxicity; thus, the client should be evaluated by an HCP. Other signs of toxicity include syncope, dizziness, blurred vision, and light-headedness. B: Isosorbide mononitrate should be taken in the morning to improve blood flow to the heart and prevent angina attacks that can occur due to increased oxygen demand from activity. C: A headache (but not a severe headache) can be treated with or prevented by analgesics taken either before or at the same time as the isosorbide mononitrate. D: Although the headaches will subside over time, the client is experiencing symptoms of isosorbide mononitrate toxicity.

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