NCLEX Med-Surg Pharm

A client is diagnosed with diabetic ketoacidosis. Which insulin should the nurse expect the health care provider to prescribe? A. NPH insulin B. Inhaled insulin C. Regular insulin D. Insulin glargine

C. Regular insulin

A client is prescribed metformin extended release to control type 2 diabetes mellitus. Which statement made by this client indicates the need for further education? A. "I will take the drug with food." B. "I must swallow my medication whole and not crush or chew it." C. "I will notify my doctor if I develop muscular or abdominal discomfort." D. "I will stop taking metformin for 24 hours before and after having a test involving dye."

D. "I will stop taking metformin for 24 hours before and after having a test involving dye."

A client with an intractable infection is receiving vancomycin. Which laboratory blood test result should the nurse report? A. Hematocrit: 45% B. Calcium: 9.0 mg/dL (2.25 mmol/L) C. White blood cells (WBC): 10,000 mm3 (10 X 109/L) D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)

D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)

Which interventions should the nurse anticipate will be prescribed initially for a client who had a hemorrhoidectomy? Select all that apply. A. Giving an enema B. Applying moist heat C. Administering stool softeners D. Encouraging showers as needed E. Providing occlusive dressings to the area

B. Applying moist heat C. Administering stool softeners

A primary health care provider prescribes total parenteral nutrition for a client with cancer of the pancreas. A central venous access device is inserted. What does the nurse identify as the most important reason for using this type of access? A. Infection is uncommon. B. It permits free use of the hands. C. The chance of the infusion infiltrating is decreased. D. The amount of blood in a major vein helps to dilute the solution.

D. The amount of blood in a major vein helps to dilute the solution.

Carbidopa-levodopa is prescribed for a client with Parkinson disease. The nurse assesses for which adverse responses that are associated with this medication? Select all that apply. A. Nausea B. Lethargy C. Bradycardia D. Polycythemia E. Emotional changes

A. Nausea E. Emotional changes

A toddler who weighs 33 pounds is admitted to the hospital with moderately severe atypical pneumonia. Intravenous azithromycin 10 mg/kg is prescribed for the first 24 hours. The medication is available in powdered form in a vial containing 300 mg. Instructions indicate that the medication must be reconstituted with 3.8 mL of sterile water and that the powdered medication displaces 0.2 mL. What volume of reconstituted medication should the nurse add to the intravenous piggyback solution? If rounding is necessary, record your answer using one decimal place. Do not include units in your answer. ___ mL

2

During administration of a whole blood transfusion, the client begins to complain of shortness of breath. The nurse notes the presence of jugular venous distension, bibasilar crackles, and tachycardia. Prioritize the following nursing actions. 1. Apply oxygen via nasal cannula 2. Elevate the head of the bed to 45 degrees 3. Document findings in the client record 4. Reduce the flow rate of the transfusion 5. Administer furosemide (Lasix) per provider prescription

2. Elevate the head of the bed to 45 degrees 1. Apply oxygen via nasal cannula 4. Reduce the flow rate of the transfusion 5. Administer furosemide (Lasix) per provider prescription 3. Document findings in the client record

A nurse mixes a short-acting and an intermediate-acting insulin in the same syringe to administer to a client with diabetes. List the actions in the order the nurse should perform them. 1. Withdraw the prescribed amount of short-acting insulin. 2. Put air into the short-acting insulin vial. 3. Put air into the intermediate-acting insulin vial. 4. Withdraw the prescribed amount of intermediate-acting insulin.

3. Put air into the intermediate-acting insulin vial. 2. Put air into the short-acting insulin vial. 1. Withdraw the prescribed amount of short-acting insulin. 4. Withdraw the prescribed amount of intermediate-acting insulin.

A client with a gastric hemorrhage is scheduled to receive two units of whole blood. List the nurse's activities in the order that they should be performed when administering a blood transfusion. 1. Obtain venous access, preferably with a 19-gauge needle or larger. 2. Ask another nurse to check the blood identification at the client's bedside. 3. Run the blood at a slower rate during the first 10 minutes of the transfusion. 4. Prime the blood infusion set tubing with normal saline at the bedside. 5. Verify that a type and crossmatch blood sample has been sent to the lab.

5. Verify that a type and crossmatch blood sample has been sent to the lab. 1. Obtain venous access, preferably with a 19-gauge needle or larger. 4. Prime the blood infusion set tubing with normal saline at the bedside. 2. Ask another nurse to check the blood identification at the client's bedside. 3. Run the blood at a slower rate during the first 10 minutes of the transfusion.

A nurse is caring for a client with diabetes who is scheduled for a radiographic study requiring contrast. Which should the nurse expect the health care provider to prescribe? A. Acetylcysteine before the test B. Renal-friendly contrast medium for the test C. Forced diuresis with mannitol after the test D. Hydration with dextrose and water throughout the test

A. Acetylcysteine before the test

A nurse is giving an educational program to paramedics who have volunteered to give the smallpox vaccine in a community vaccination drive. Which type of needle and method of administration should the nurse teach the volunteers to use when administering the smallpox vaccine? A. Bifurcated needle for 15 injections within 5 mm B. Intradermal needle for 15 injections within 5 mm C. Bifurcated needle for 10 dermal injections within 5 mm D. Double-lumen needle for 10 dermal injections within 5 mm

A. Bifurcated needle for 15 injections within 5 mm

When a client is receiving total parenteral nutrition, what is important for the nurse to assess? A. Blood glucose B. Occult blood in stool C. Urine specific gravity D. Presence of bowel sounds

A. Blood glucose

The nurse assesses a client who is receiving total parenteral nutrition for the specific complication of what condition? A. Infection B. Hepatitis C. Anorexia D. Dysrhythmias

A. Infection

Which medication does the nurse anticipate will be prescribed to relieve anxiety and apprehension in a client with pulmonary edema? A. Morphine B. Phenobarbital C. Hydroxyzine D. Chloral hydrate

A. Morphine

A client is prescribed albuterol to relieve severe asthma. What adverse effect will the nurse instruct the client to anticipate? Select all that apply. A. Tremors B. Lethargy C. Palpitations D. Visual disturbances E. Decreased pulse rate

A. Tremors C. Palpitations

The nurse is caring for a client undergoing chemotherapy for cancer treatment. The client's laboratory results indicate bone marrow suppression. What will the nurse encourage the client to do? A. Use an electric razor when shaving B. Drink citrus juices frequently for nourishment C. Increase activity level by ambulating frequently D. Sleep with the head of the bed slightly elevated

A. Use an electric razor when shaving

A client states, "I keep my insulin in the refrigerator because that is where my parents kept it." What reason should the nurse include when explaining that insulin should be stored at room temperature? A. Its potency and effectiveness are maximized. B. Absorption is enhanced and local irritation is decreased. C. It is more convenient and drawing insulin into the syringe is facilitated. D. Adherence of insulin to the syringe and resistance upon injection are decreased.

B. Absorption is enhanced and local irritation is decreased.

A healthcare provider recently made the diagnosis that a client has glaucoma. The nurse is preparing to administer eyedrops to the client. Which ophthalmic solution is contraindicated for this client? A. Timolol B. Atropine C. Pilocarpine D. Epinephrine

B. Atropine

To begin the administration of total parenteral nutrition (TPN), a client has a right subclavian central venous access device inserted. Immediately after insertion of the catheter, what is the priority nursing action? A. Obtain a chest x-ray to determine placement. B. Auscultate the lungs to evaluate breath sounds. C. Draw a blood sample to assess blood glucose level. D. Assess the right upper extremity for neurologic deficits.

B. Auscultate the lungs to evaluate breath sounds.

A nurse administers beclomethasone by inhalation to a client with asthma, and the client asks why this medication is necessary. What should the nurse explain is the purpose of this pharmacologic therapy? A. Promotes comfort B. Decreases inflammation C. Stimulates smooth muscle relaxation D. Reduces bacteria in the respiratory tract

B. Decreases inflammation

A client is taking an antithyroid medication for hyperthyroidism. The nurse provides education about serious health problems that may develop if the medication is not effective and tachycardia continues. The nurse instructs the client to seek medical attention immediately if any of the problems occur. Which should be included in the teaching? Select all that apply. A. Diaphoresis B. Weight gain C. Flushed skin D. Nervousness E. Pedal edema

B. Weight gain E. Pedal edema

A client receiving chemotherapy for cancer develops sores in the mouth and asks the nurse why this happened. What is the nurse's best response? A. "The sores occur because of the direct irritating effects of the drug." B. "These tissues are poorly nourished because you have a decreased appetite." C. "The frequently dividing cells of the gastrointestinal tract are damaged by the drug." D. "This side effect occurs because it targets the cells of the gastrointestinal system."

C. "The frequently dividing cells of the gastrointestinal tract are damaged by the drug."

A nurse is planning care for a client with cancer who is receiving the plant alkaloid vincristine. In contrast to the side effects of most chemotherapeutic agents, what is a common side effect of vincristine that the nurse must address in the client's care plan? A. Nausea B. Alopecia C. Constipation D. Hyperuricemia

C. Constipation

Amlodipine is prescribed for a client with hypertension. Which response to the medication should the nurse instruct the client to report to the healthcare provider? A. Blurred vision B. Dizziness on rising C. Difficulty breathing D. Excessive urination

C. Difficulty breathing

A client has surgery for the insertion of an implanted infusion port for chemotherapy. The client asks, "The doctor said after my chemotherapy is finished, the port will stay in, but it needs to be flushed routinely. How often does this have to be done?" What should the nurse tell the client about how often the port will most likely need to be flushed when not in use? A. Every day B. Once a week C. Every month D. Twice a year

C. Every month

A client who had a kidney transplant develops leukopenia 3 weeks after surgery. What does the nurse conclude is the most probable cause of the leukopenia? A. Bacterial infection B. High creatinine levels C. Rejection of the kidney D. Antirejection medications

D. Antirejection medications

Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. Which action does the nurse mention when replying? A. Increases gastric motility B. Neutralizes gastric acidity C. Facilitates histamine release D. Inhibits gastric acid secretion

D. Inhibits gastric acid secretion

A nurse is reviewing a plan of care for a client who was admitted with dehydration as a result of prolonged watery diarrhea. Which new prescription will the nurse question? A. Oral psyllium B. Oral potassium supplement C. Parenteral half-normal saline D. Parenteral albumin

D. Parenteral albumin

A Total Parenteral Nutrition (TPN) solution is prescribed to infuse one liter every 12 hours for a malnourished client. What is most important for the nurse to monitor? A. Daily weight B. Urinary output C. Administration rate D. Serum glucose levels

D. Serum glucose levels