Comprehensive Review for the NCLEX-PN

The client with myasthenia gravis is receiving pyridostigmine. The nurse monitors for signs and symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs?

Atropine sulfate4

A client is being discharged home, and the health care provider has prescribed spironolactone for the client. The nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching by the nurse?

"I know I need to eat foods that are high in potassium because of the diuretic effect of the medication." Submit

Griseofulvin is prescribed for a child with tinea capitis. The nurse reinforces instructions to the family regarding administration of the medication. Which statement by the mother indicates a need for further teaching?

"I need to administer the medication 2 hours before meals."4

The nurse reviews the medication history of a client admitted to the hospital and notes that the client is taking leflunomide. During data collection, the nurse asks which question to determine if the medication is effective?

"Do you have any joint pain?"2

The home care nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. The nurse reinforces teaching for the client about the medication. Which statement made by the client indicates a need for further teaching?

"I can take aspirin or my antihistamine if I need it."2

A client receiving total parenteral nutrition (TPN) has a history of heart failure. The primary health care provider has prescribed furosemide 40 mg orally daily to prevent fluid overload. The nurse is giving instructions about taking furosemide in relation to the client's health plan. Which statement by the client indicates a need for further teaching?

"I need to talk to my doctor about increasing my digoxin." Submit

A client with a prescription to take theophylline daily has been given medication instructions by the nurse. The nurse determines that the client needs further teaching about the medication if the client makes which statement?

"I will take the daily dose at bedtime."2

An adult client with hypothyroidism is admitted to the hospital. When reviewing the client's health record, the nurse notes that the client is taking a maintenance dose of levothyroxine. The nurse is also reviewing instructions concerning taking levothyroxine with the client. There is a need for further teaching when the client makes which statement?

"I will take the pill with milk to keep from upsetting my stomach." Submit

Magnesium sulfate is prescribed for a client with severe preeclampsia. Which statement by the student nurse indicates the need for further teaching regarding the action of this medication?

"It increases acetylcholine and blocks neuromuscular transmission."3

A client with a diagnosis of human immunodeficiency virus (HIV) who was prescribed an oral solution of ritonavir complains about the taste of the solution. Which response would the nurse give the client?

"Mix the oral solution with chocolate milk."4

Zidovudine is prescribed for an adult client diagnosed with human immunodeficiency virus (HIV). Which statement by the nurse would provide the best instruction to the client about the medication?

"Space the medication doses evenly around the clock."4

Antibiotics are prescribed for a child and the nurse provides instructions to the parents regarding the administration of the antibiotics. Which statement made by a parent would indicate that the instructions were understood?

"We will administer the antibiotics until they are gone."2

A client with acute muscle spasms has been taking baclofen. The client calls the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about discontinuing the medication. The nurse would make which appropriate response to the client?

"Weakness and fatigue commonly occur and will diminish with continued medication use." Submit

A pediatric client with a ventricular septal defect repair is placed on a maintenance dose of digoxin. The safe dose is 0.03 mg/kg/day, and the client's weight is 7.2 kg. The primary health care provider (PHCP) prescribes the digoxin to be given twice daily. How much digoxin would the nurse administer to the client at each dose?

0.1 mg2

A client is receiving a maintenance dose of oral dantrolene sodium for the treatment of spasticity. The nurse reviews the medication record, expecting which dose to be prescribed?

100 mg twice daily4

A client with multiple sclerosis is receiving dantrolene for relief of muscle spasticity. When would this medication be discontinued if there is no relief of spasticity?

2 months Submit

A 15-year-old child is scheduled to receive a series of the hepatitis B vaccine. The child arrives at the clinic for the first dose. The nurse collects data on the child before administering the vaccine and would ask the child about a history of an allergy to which primary product?

Baker's yeast4

Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse effects of the medication. Which sign/symptom indicates the client is experiencing an adverse effect?

Impaired voluntary movements Submit

A client arrives at the health care clinic and tells the nurse that they have been doubling their daily dosage of bupropion hydrochloride to help them get better faster. The nurse understands that the client is now at risk for which problem?

Seizure activity4

A client informs the nurse that she has been taking acarbose as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which laboratory value is noted?

A 2-hour postprandial serum glucose of 120 mg/dL Submit

The nurse is preparing for the administration of ribavirin to a child with respiratory syncytial virus. Which supplies will the nurse obtain for the administration of this medication?

A pair of goggles2

The client with myasthenia gravis becomes increasingly weak. The primary health care provider (PHCP) prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which change in condition indicates that the client is in cholinergic crisis?

A temporary worsening of the condition Submit

A client with schizophrenia has been started on medication therapy with loxapine. The nurse determines that the client is experiencing the intended effects of the medication if which client behavior is observed?

Absence of delusional statements3

The nurse is caring for a client with chronic heart failure who is taking digoxin 0.125 mg daily. Before administering the medication, the nurse reviews the serum digoxin level that was drawn earlier in the day. The result is 1 ng/mL. Which action would the nurse take based on this laboratory result?

Administer the dose of the medication as scheduled.4

A client has a prescription to receive albuterol, two puffs and beclomethasone dipropionate, two puffs by metered-dose inhaler. Which would the nurse plan when administering these medications?

Administering the albuterol before the beclomethasone dipropionate2

The nurse is admitting a client to the nursing unit who is scheduled for several diagnostic tests. When obtaining a medication history, the nurse discovers that the client is prescribed tacrolimus daily. On further data collection, which would the nurse expect to note in the client history?

Allogenic liver transplant Submit

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?

An increased amount of daily Humulin NPH insulin4

The nurse is preparing discharge instructions for a client receiving baclofen. Which instruction would be included in the teaching plan?

Avoid the use of alcohol.3

The nurse is reviewing the laboratory results for a client receiving tacrolimus. Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?

Blood glucose of 200 mg/dL2

The nurse reinforces instructions to a client who has been prescribed betaxolol eye drops for the treatment of glaucoma. The nurse instructs the client regarding the administration of the medication and about the importance of returning to the clinic for which assessment?

Blood pressure and apical pulse Submit

A client with advanced ovarian cancer is being treated with paclitaxel. The nurse monitors the client closely for which side effect of the medication?

Bradycardia

The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?

Calcium level3

A client returning to the medical nursing unit following cardiac catheterization has a stat prescription to receive a dose of procainamide. The licensed practical nurse assisting in caring for the client obtains which piece of equipment to adequately determine the client's response to this medication?

Cardiac monitor4

A client with breast cancer is being treated with cyclophosphamide. The nurse plans care, knowing that this medication fits which classification?

Cell cycle phase nonspecific Submit

A client receiving nitrofurantoin calls the primary health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?

Chest pain Submit

A long-term care nurse is caring for an older client taking cimetidine. The nurse would observe this client frequently for which most common central nervous system (CNS) side effect of this medication?

Confusion

A client is receiving phenytoin. Which findings would indicate that the client is experiencing side/adverse effects related to this medication? Select all that apply.

Constipation Bleeding gums4 Decreased white blood cells5 Decreased platelet count

A client with bladder cancer is receiving cisplatin and vincristine. The nurse plans care, knowing that which is the purpose of administering both of these medications?

Decrease medication resistance and reduce medication toxicity Submit

A client has been taking benzonatate as prescribed. The nurse determines that the medication is having the intended effect if the client experiences which response?

Decreased frequency and intensity of cough Submit

A client with multiple sclerosis is receiving baclofen. The nurse monitoring this client would look for which outcome to indicate a primary therapeutic response from the medication?

Decreased muscle spasms3

A client has a history of seizures. The primary health care provider has prescribed amitriptyline three times daily. The nurse seeks clarification of the prescription, knowing that the client is at risk for injury because of which adverse effect of the amitriptyline?

Decreased seizure threshold3

The client has been given a prescription for trimethoprim. The nurse would determine the client understands how to use the medication properly if the client states an intention to perform which action?

Drink extra fluids while taking the medication.3

Fludrocortisone is prescribed for a client with Addison's disease. The primary health care provider needs to be notified if the client experiences which conditions? Select all that apply.

Edema Chest pain3 Muscle cramps5

A client with a urinary tract infection with dysuria is given a prescription for phenazopyridine hydrochloride for symptom relief. Which would the nurse reinforce instructing the client about this medication?

Expect the urine to become reddish orange.4

A client has arrived at the emergency department complaining of weakness, an irregular heartbeat, and lethargy. The nurse is attempting to discover what caused these symptoms. The nurse asks the client "Have you been prescribed any new medications?" The client tells the nurse "About 2 weeks ago I was prescribed a drug to make me pee, but I don't know the name." The nurse determines that the client is referring to which medication?

Furosemide

Metformin is prescribed for a client with type 2 diabetes mellitus. Which would the nurse tell the client is a common side effect of the medication?

Gastrointestinal (GI) disturbances Submit

Cyclobenzaprine is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which disorder would indicate a need to contact the primary health care provider (PHCP) regarding the administration of this medication?

Glaucoma2

The nurse is reinforcing dietary instructions to a client prescribed cyclosporine. Which priority food item would the nurse instruct the client to avoid?

Grapefruit juice4

The nurse is collecting medication information from a client, and the client states that she is taking garlic as an herbal supplement. The nurse understands that the client is most likely treating which condition?

Hyperlipidemia Submit

A client with chronic atrial fibrillation is being started on maintenance therapy with atenolol for dysrhythmia suppression. The nurse determines that the client needs further teaching about this medication when making which statement?

I can stop taking the prescribed digoxin after starting this new medication." Submit

The nurse is providing instructions to a client who is taking codeine sulfate for severe back pain. Which action does the nurse instruct the client to do?

Increase fluid intake.2

The nurse employed in a neighborhood health care clinic notes that the primary health care provider has prescribed oseltamivir. The nurse would reinforce teaching the client specific home care measures after determining this medication was prescribed for which condition?

Influenza virus3

A client has been given a prescription for chloral hydrate for short-term use. The nurse includes which nursing intervention in caring for this client?

Instruct the client to call for help to get out of bed. Submit

The nurse is reinforcing medication instructions to a client who has been prescribed simvastatin. Which is the action of simvastatin?

It inhibits hepatic synthesis of cholesterol.2

A client takes digoxin 0.25 mg by prescription every day. When the nurse enters the client's room with the medication, the client's meal tray is untouched and the client says he has no appetite. Which action is the most appropriate?

Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold the medication. Submit

A client diagnosed as human immunodeficiency virus (HIV) seropositive has been prescribed zalcitabine as a component of treatment. The nurse would instruct the client that which laboratory test will need to be monitored while taking this medication?

Liver function studies Submit

The nurse is caring for a client prescribed an oral hypoglycemic agent who has just been diagnosed with a urinary tract infection. The primary health care provider plans to treat the infection with sulfamethoxazole. The nurse would expect that because of medication interactions, the primary health care provider will adjust which prescription?

Lower dose of the oral hypoglycemic3

The nurse is providing care for a client with a diagnosis of germ cell cancer of the testes who has been prescribed ifosfamide. The nurse anticipates that the client will also be prescribed which additional antineoplastic medication?

Mesna

Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Which interventions would the nurse include when administering this medication? Select all that apply.

Monitor liver function studies.3 Instruct the client to avoid alcohol.4 Instruct the client to avoid exposure to the sun.6

A client is being treated for acute heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats per minute; and respirations, 24 breaths per minute. After the initial dose, which is the priority assessment?

Monitoring blood pressure4

The nurse is assisting in monitoring a pregnant client receiving nalbuphine for pain management. Which statement is true with regard to the use of nalbuphine?

Nalbuphine is not likely to cause significant respiratory depression. Submit

An opioid analgesic is administered to a client in labor. The nurse assigned to care for the client ensures that which medication is readily available if respiratory depression occurs?

Naloxone

A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select all that apply.

Nizatidine2 Ranitidine3 Famotidine Cimetidine

A hospitalized client states he has chest pain, and the nurse notes a prescription for "sublingual nitroglycerin 1 tablet every 5 minutes times 3 to relieve chest pain prn." How would the nurse administer the medication?

Place one pill under the tongue and reassess for relief in 5 minutes.3

The nurse is assisting in developing a plan of care for a client receiving warfarin sodium. The nurse selects which problem as the priority in caring for this client?

Potential for injury2

The client is prescribed tacrolimus to prevent organ rejection. The nurse would expect to administer the dose with which medication that is also normally prescribed?

Prednisone2

The nurse assists with creating a plan of care for a client with hyperparathyroidism receiving calcitonin-human. Which outcome has the highest priority regarding this medication?

Reaching normal serum calcium levels4

The primary health care provider has prescribed morphine sulfate intravenous push for a client with pulmonary edema. Which therapeutic effects would the nurse expect in this client? Select all that apply.

Relief of anxiety2 Reduction of oxygen consumption4 Improvement in efficacy of breathing Submit

The nurse is reviewing the results of serum laboratory studies drawn on a client diagnosed with acquired immunodeficiency syndrome (AIDS) who is receiving didanosine. The nurse determines that the client may have the medication discontinued by the primary health care provider (PHCP) if which significantly elevated result is noted?

Serum amylase4

The nurse is assisting in reinforcing a teaching plan for a client given a prescription for pioglitazone. The nurse plans to reinforce instructions to the client about which information related to this medication?

Signs of hypoglycemia3

A client with acute nonlymphocytic anemia receives treatment with cytarabine. The nurse reinforces medication instructions to the client and tells the client that it is important to report which adverse effect to the primary health care provider?

Sore throat Submit

A client diagnosed with hyperthyroidism will be taking propylthiouracil. The nurse reinforces medication instructions and determines that the client understands the information if the client states that it is most important to report which symptoms to the primary health care provider?

Sore throat2

The clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to the child. The nurse would administer this vaccine by which method?

Subcutaneously in the outer aspect of the upper arm4

Diphenhydramine hydrochloride 25 mg orally every 6 hours is prescribed for a child with an allergic reaction. The child weighs 25 kg. The safe pediatric dosage is 5 mg/kg/day. Which conclusion would the nurse infer?

The dose is within the safe dosage range.4

The nurse is caring for a client diagnosed with herpes simplex virus (HSV) who has just been prescribed acyclovir. The nurse explains that which statement is true about treatment with this medication?

The medication can help reduce the severity of the outbreak.4

Vancomycin has been prescribed for the client. The nurse would plan to monitor which item associated with effectiveness of this medication?

Therapeutic serum levels4

The nurse is reviewing the primary health care provider's (PHCP) prescriptions for a client scheduled for a cardiac catheterization and notes that the PHCP has prescribed tirofiban. The nurse understands that this medication has been prescribed for which purpose?

To inhibit thrombus formation Submit

The nurse is caring for a client who has been prescribed carbidopa/levodopa. The nurse would monitor the client for which side effects? Select all that apply.

Urinary retention5 Orthostatic hypotension Submit

A client is receiving a daily dose of oral fluphenazine. The nurse would reinforce instructions to the client to practice which intervention to minimize common side effects of this medication?

Use hard, sour candy or sugarless gum.4

A client is receiving digoxin daily. The nurse suspects digoxin toxicity after noting which signs and symptoms? Select all that apply.

Visual disturbances2 Nausea and vomiting3 Serum digoxin level of 2.3 ng/mL (2.93 nmol/L)5

Ketoconazole is prescribed for an assigned client. The nurse would prepare to administer the medication in which manner?

With food2

A client is receiving a continuous intravenous (IV) infusion of heparin in the treatment of deep vein thrombosis. The nurse is told that the client's activated partial thromboplastin time (aPTT) level is 65 seconds and that the client's baseline before the initiation of therapy was 30 seconds. The nurse identifies these results as characteristic of which description?

Within the therapeutic range Submit

The nurse is administering an intravenous dose of methocarbamol to a client with multiple sclerosis. For which adverse effect would the nurse monitor?

Bradycardia

The nurse has observed a client self-administer a dose of metaproterenol sulfate via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. Which interpretation would the nurse make of this occurrence?

Bronchospasm, which must be reported to the primary health care provider2

Albuterol, two puffs and fluticasone propionate, two puffs by metered-dose inhaler have been prescribed for a client with chronic obstructive pulmonary disease. The nurse caring for the client provides instructions regarding administration of the medication. Which statement by the client indicates an understanding of how to take these medications?

"I will take the two puffs of the albuterol first and then the two puffs of the fluticasone propionate." Submit

A licensed practical nurse is caring for a postoperative client who is receiving demand-dose hydromorphone via a patient-controlled analgesia (PCA) pump for pain control. The nurse enters the client's room and finds the client drowsy and records the following vital signs: temperature 36.2° C (97.2° F) orally, pulse 52 beats per minute, blood pressure 101/58 mm Hg, respiratory rate 11 breaths per minute, and SpO2 of 93% on 3 liters of oxygen via nasal cannula. Which action would the nurse take first?

Attempt to arouse the client.3

The nurse is caring for a client with muscle spasticity characterized by heightened muscle tone, spasm, and loss of dexterity caused by multiple sclerosis. Which centrally acting skeletal muscle relaxants might be prescribed for this client? Select all that apply.

Baclofen2 Diazepam Dantrolene

The nurse is administering a dose of a prescribed diuretic to an assigned client. The nurse would plan to monitor the client for hypokalemia as a side effect of therapy if the client is receiving which medication?

Bumetanide

The nurse is caring for a client who has been taking diuretics on a long-term basis. The nurse reviews the medication record, knowing that which medications if prescribed for this client would place the client at risk for hypokalemia?

Bumetanide2

A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse would check the client for which sign/symptom?

Sudden increase in pain4

The nurse is collecting data on a client admitted to the hospital with a diagnosis of a respiratory infection unresponsive to oral antibiotics. The nurse discovers that the client has a history of bronchial asthma and has been taking zafirlukast. The nurse assists in developing a plan of care for the client and suggests monitoring of which data?

Liver function tests Submit

A client with diabetes mellitus who has been controlled with daily insulin has been placed on atenolol for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which is the most reliable indicator of hypoglycemia?

Low blood glucose level Submit

A glucocorticoid is prescribed for a client with adrenal insufficiency, and the nurse reinforces medication instructions to the client. The nurse determines that the client needs further teaching if the client states which action is necessary?

Discontinue the medication when symptoms subside. Submit

The nurse is reviewing instructions to a client diagnosed with otitis media who is prescribed amoxicillin 500 mg orally every 8 hours. The nurse would determine that which statement by the client most indicates an understanding of the adverse effects related to the medication?

"If I get diarrhea, I need to call the doctor."2

The nurse is attending an in-service education session on the therapeutic use of calcium-channel blockers. The instructor of the session determines that teaching has been effective when the nurse correctly identifies that these medications are used for which disorders? Select all that apply.

Angina2 Hypertension4 Dysrhythmias5

The nurse is reinforcing dietary instructions to a client who is taking triamterene. The nurse instructs the client that it is acceptable to consume which food item daily?

Apple

A primary health care provider has written a prescription for ranitidine 300 mg once daily on the client's discharge medication list. The nurse determines to instruct the client to take the medication at which time?

At bedtime2

Efavirenz, an antiviral medication, is prescribed for a client diagnosed with human immunodeficiency virus (HIV) infection. Which time would the nurse instruct the client is best to take this medication?

At bedtime2

The nurse is reviewing the health care provider's prescription sheet for the preoperative client, which states that the client must be on nothing by mouth (NPO) status after midnight. The nurse would clarify whether which medication would be given to the client rather than withheld?

Atenolol2

A client is taking nicotinic acid for hyperlipidemia, and the nurse reinforces instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions?

"Ibuprofen taken 30 minutes before the nicotinic acid should decrease the flushing." Submit