Pharm 1 exam NCLEX
The nurse is preparing to administer the albuterol to a client. Which parameters should the nurse assess before and during therapy? a) NV b) headache and LOC c) lung sounds and presence of dyspnea d) urine output and BUN
C
A client with squamous cell carcinoma of the larynx is receiving Bleomycin IV. The nurse caring for the client anticipates that which diagnostic study will be prescribed? a) echo b) EKG c) cervical radiography d) pulmonary function studies
D
A client with laryngeal cancer is receiving chemo. Which lab report is most important for the nurse to monitor when considering the effects of chemo? a) platelets b) hemoglobin level c) red blood cell count d) white blood cell count
D
The nurse is evaluating the results of treatment with erythropoietin. Which assessment finding indicates an improvement in the underlying condition being treated? a) 2+ pedal pulses b) decreased pallor c) decreased jaundice d) 2+ deep tendon reflexes
B
The nurse is administering a dose of pirbuterol to a client. The nurse should monitor for which side or adverse effect of this medication? a) drowsiness b) hypokalemia c) hyperglycemia d) increased pulse
D
A client who had an organ transplant is receiving cyclosporine. The nurse would monitor for which serious adverse effect of cyclosporine? a) hirsutism b) constipation c) dysrhythmias d) increased creatinine
D ( nephrotoxic)
A client with a prescription to take theophylline daily has been given medication instructions by the nurse. What statement by the client indicates the need for further education regarding the prescription? a)I will take the daily dose at bedtime b) I need to drink at least 2 liters of fluid per day c) I know to avoid changing brands of the medication without my primary health care providers approval d) Ill avoid OTC cough and cold medications unless approved by my health care provider
A
The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase, an Antineoplastic medication. The nurse contacts the MD before administering the medication if which disorder is documented in the client's history? a) pancreatitis b) diabetes mellitus c) MI d) COPD
A
A client with Hodgkin's disease is started on chemo. The nurse teaches the client to notify the MD for which adverse response? a) hair loss b) sores in mouth c) moderate diarrhea d) nausea for 6 hours after tx
B ( may need a rinse to be prescribed)
Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administration of chemo? a) measure the client's abdominal girth b) calculate the client's BMI c) measure the client's current weight and height d) ask the client about his or her weight and height
C
A client with lymphosarcoma is receiving allopurinol and methotrexate. The nurse can help the client prevent complications related to uric acid nephropathy by administering which medication in relation to which changes in fluid intake? a) allopurinol and restricting the fluid intake b) methotrexate and restricting fluid intake c) allopurinol and encouraging increased fluid intake d) methotrexate and encouraging increased fluid intake
C ( allopurinol decreases uric acid levels before and during chemo)
A client who was admitted with a diagnosis of acute lymphoblastic leukemia is receiving chemo. Which assessment findings would alert the nurse to the possible development of thrombocytopenia? SATA a) fever b) diarrhea c) Melena d) hematuria e) ecchymosis
C, D, E
A CBC is needed before each round of chemo. Which component of the CBC is of greatest concern to the nurse? a) platelets b) hematocrit c) RBCs d) WBCs
D
A chromodynamics sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the adverse effects of this medication and should tell the client that which undesirable effect is associated with this medication? a) insomnia b) constipation c) hypotension d) bronchospasm
D
Chromodynamics sodium is prescribed for the client with allergic asthma. What goal does the nurse expect to achieve by administration of this medication? a) dilation of bronchi b) increase in the number of eosinophils c) promotion of the migration of eosinophils into the inflammatory site d) inhibition of the release of mediators from mast cells after exposure to an antigen
D
Megestrol acetate, an Antineoplastic medication, is prescribed for a client with endometrial cancer. The nurse reviews the client's history and should contact the MD if which diagnosis is documented? a) gout b)asthma c) MI d) venous thromboembolism
D
A client who is immunosuppressed is receiving filgrastim. When monitoring effectiveness, the nurse will check for an increase in which blood component? a) platelets b) erythrocytes c) lymphocytes d) WBCs
D ( colony stimulating factor, increases WBC production)
A client receives doxorubicin infusions for treatment of acute lymphocytic leukemia. Which clinical finding indicates that toxicity has occurred? a) alopecia b) dyspnea c) metallic taste to food d) cardiac rhythm abnormalities
D ( med is cardiotoxic)
A client is receiving Imatinib for chronic myelogenous leukemia (CML). The nurse will assess for which complication of this protein-tyrosine kinase inhibitor? SATA a) hair loss b) stomatitis c) dehydration d) signs of infection e) bleeding tendencies
D, E
A client develops severe bone marrow suppression related to cancer treatment. Which instruction is important for the nurse to include in the client's teaching? a) be prepared to experience alopecia b) increase fluids to at least 3 L per day c) use a soft toothbrush for oral hygiene d) monitor your intake and output of fluids
C
A client with Hodgkin's disease adds doxorubicin to current therapy. Which advice will the nurse provide about this medication? a) cease taking any meds that contain vitamin D b) keep the doxorubicin in a dark place protected from light c) expect urine to turn red for a few days after taking this medication d) take the doxorubicin on an empty stomach with large amounts of fluids
C
A client has begun using a methylxanthine bronchodilator. What beverage should the nurse plan to teach the client to avoid while taking this medication? a) coffee b) orange juice c) mineral water d) cranberry juice
A
Which mechanism of action is associated with vincristine? a) arresting mitosis in metaphase b) inhibiting the synthesis of thymidine c) alkylating nucleic acids needed for mitosis d) inactivating DNA while inhibiting RNA synthesis
A
The nurse has a prescription to give a client salmeterol, 2 puffs, and beclomethasone dipropionate, 2 puffs, by metered-dose inhaler. The nurse should administer the medication using which procedure? a)beclomethasone first and then the salmeterol b) salmeterol first and then the beclomethasone c) alternating a single puff of each, beginning with the salmeterol d) alternating a single puff of each, beginning with the beclomethasone
B
The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tell the client to take which action? a) take the medication with food b) increase fluid intake to 2000-3000mL daily. C) decrease sodium intake while taking the medication d) increase potassium intake while taking the medication
B
The nurse should monitor the client receiving the first dose of albuterol for which side or adverse effect? a) drowsiness b) tachycardia c) hyperkalemia d) hyperglycemia
B
The nurse teaches a client who is scheduled for a kidney transplant about the need for immunosuppressive medications. The nurse determines that the client understands the teaching when the client says that medications must be taken for which period of time? a) for the rest of my life b) until the surgery is over c) until the surgery heals d) during the intraoperative period
A
When evaluation an asthmatic client's knowledge of self care, the nurse recognized that additional instruction is needed when the client makes which statement? a) I use my corticosteroid inhaler each time I feel SOB b) I see my doctor if I have an URI and always get a flu shot c) I use my bronchodilator inhaler before walking so I dont become SOB d) I use my bronchodilator inhaler before I visit places like the zoo because of my allergies
A
Dexamethasone has been prescribed for a client after a craniotomy for a brain tumor. Which physiological response is responsible for this medication's therapeutic effect? a) reduced cell growth b) reduced cerebral edema c) increased renal reabsorption d) increased response to sedation
B
Which mechanism of action explains the ability of nitrogen mustard to interfere with growth of cancer cells? A) interference of the cellular protein synthesis b) inhibition of the synthesis of purine and pyrimidine c) binding with DNA to interfere with RNA production d) combining with DNA strands and interfering with cell replication
D
The nurse is caring for a client with COPD who is receiving theophylline. The nurse monitors the serum theophylline level and concludes that the medication dosage may need to be increased if which value is noted? a) 5 mg/mL b) 10 mg/mL c) 15 mg/mL d) 20 mg/mL
A
The nurse administers erythropoietin 3 times a week to a client receiving chemo for cancer. Which client response demonstrates a therapeutic effect? a) increase in band cells b) elevated hematocrit c) normalization of platelets d) increase in the WBC count
B
The nurse assesses a client's IV site. Which clinical finding leads the nurse to conclude that the IV has infiltrated, rather than caused inflammation? a) pain b) coolness c) localized swelling d) cessation in flow of solution
B
A client is receiving chemo with doxorubicin. Which development will the nurse teach the client to report immediately? a) nausea b) sore throat c) loss of hair d) constipation
B (respiratory tract infection may be first sign of bone marrow suppression)
A client with stage 2 Hodgkin's disease is started on a multiple drug regimen of doxorubicin, Bleomycin, vinblastine, and dacarbazine. Why are so many drugs necessary? a) using smaller doses of several drugs reduces the likelihood of serious side effects b) each drug destroys the cancer cell at a different time in the cell cycle c) several drugs are used to destroy cells that are not susceptible to radiation therapy d) because there are stages of Hodgkin's disease, if one drug is ineffective, another will work
B
A client has a prescription to take gualifenesin. The nurse should conclude that the client understands the most effective use of this medication if the client states that they need to take which action? a) watch for irritability as a side effect b) take the tablet with a full glass of water c) take an extra dose if the cough is accompanied by fever d) crush the sustained release tablet if immediate relief is needed
B
A client is receiving doxorubicin as a part of chemo. The nurse will assess the client for which system toxicity? a) neurotoxicity b) cardio toxicity c) ototoxicity d) nephrotoxicity
B
A client is to receive metoclopramide IV 30 minutes before initiating chemo for cancer of the colon. The nurse explains that this med is given for which purpose? a) to stimulate production of GI secretions b) to stimulate peristalsis of the upper GI tract c) to prolong excretion of the chemo medication d) to increase absorption of the chemo medication
B (decreases GI upset/ NV)
A client is receiving chemo develops bone marrow suppression. The nurse will monitor for which thrombocytopenia effect? SATA a) DVT b) melena c) purpura d) emboli e) hematuria
B, C, E
The client questions the nurse as to why the PHCP switched the usual prescription from a mentor dose inhaler to a dry powder inhaler. The nurse should respond correctly by providing which facts? SATA a) dry powder inhalers have fewer side effects b) dry powder inhalers pose no environmental risk c) dry powder inhalers can be administered more frequently d) dry powder inhalers deliver more medication to the lungs e) Dry powder inhalers require less hand to lung coordination
B, D, E
A client has begun therapy with xanthine bronchodilator. The nurse determines that the client understands dietary alterations if the client states to limit which items while taking this medication? SATA a) milk b) coffee c) oysters D) oranges e) pineapple f) chocolate
B, F
A client has been given a prescription for benzonatate. Which observation should the nurse look for to evaluate the effectiveness of the medication? a) increasing the client's comfort level b) decreasing the client's anxiety level c) calming the client's persistent cough d) eliminating the client's NV
C
A client taking albuterol by inhalation cannot cough up secretions. What should the nurse suggest that the client do to assist in expectoration of secretions? a) get more exercise each day b) use a dehumidifier in the home c) drink increased amounts of fluids every day d) take an extra dose of albuterol before bedtime
C
Tamoxifen citrate is prescribed for a client with metastatic breast cancer. The client asks the nurse is her sister with bladder cancer can also take this medication. How should the nurse respond? a) This medication can be used only to treat breast cancer b) Yes, your sister can take this for bladder cancer as well c) This medication can be taken to prevent and treat clients with breast cancer d) This medication can be taken by anyone with cancer, as long as their Dr approves it
C
Terbutaline is prescribed for a Client with bronchitis. Which disorder in the client's medical history requires caution by the nurse? a) osteoarthritis b) hypothyroidism c) diabetes mellitus d) polycystic disease
C
The nurse considers that the age administration of high dose methotrexate therapy would include which intervention? a) maintaining an acidic urine b) restricting IV fluids c) providing a diet high in folic acid d) monitoring plasma levels of the medication
D
A client taking theophylline has a serum level of 15 mcg/mL. How does the nurse interpret this lab value? a) below the therapeutic range b) in excess of the therapeutic range c) near the top of the therapeutic range d) in the middle of the therapeutic range
D
A client with adenocarcinoma receives doxorubicin IV to reduce the tumor mass. Which clinical finding indicates that doxorubicin toxicity may have occurred? a) fever b) blue tinge to the urine c) alteration in cardiac rhythm d) increasing anxiety
C
The client has a prescription to receive pirbuterol 2 puffs and beclomethasone dipropionate 2 puffs by metered dose inhaler. The nurse plans to give these medications in which way to ensure effectiveness? a) administering the pirbuterol before the beclomethasone b) alternating a single puff hourly, beginning with the beclomethasone c) alternating a single puff of beclomethasone with pirbuterol, repeating the steps d) administering the pirbuterol, waiting 30 minutes, and the administering the other
A
The client undergoing cancer chemotherapy develops bone marrow suppression and stomatitis. Which instruction will the nurse provide to the client? a) use an electric razor when shaving b) drink citrus juices frequently for nourishment c) increase activity level to the point of fatigue d) sleep with the head of the bed slightly elevated
A
A client receives doxorubicin as a part of chemo protocol. The nurse would assess the client for signs and symptoms of which adverse effect? a) toxic epidermal Necrolysis b) heart failure c) pulmonary fibrosis d) ototoxicity
B
A client with acute myelocytic leukemia is being treated with Busulfan. Which lab value would the nurse specifically monitor during treatment with this medication? a) clotting time b) uric acid level c) potassium level d) blood glucose level
B
A clinic nurse prepares a teaching plan for a client receiving Antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? a) You can take aspirin as needed for headache b) you can drink alcohol in moderation each evening c) you need to consult with your PHCP before receiving immunizations d) It is fine to receive the flu vaccine at the local health fair
C
Neomycin is prescribed preoperatively for a client with colon cancer. The client asks why this is necessary. Which response would the nurse provide? a) it kills cancer cells that may be missed during surgery b) this medication is helpful in decreasing the inflammatory response associated with surgical procedures c) it kills intestinal bacteria to decrease the risk for infection d) this medication alters the body flora to prevent the occurrence of superinfections
C
A client who experiences allergic rhinitis asks the nurse about a nasal corticosteroid. How should the nurse reply? a) clear the nasal passages after use b)take the medication only as needed c) the medication should start to work immediately d) the medication works locally and decreases inflammation
D
A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which medication? a) diuretics b) antibiotics c) antilipemics d) decongestants
D
The chemo protocol prescribed for a client with TB includes vitamin B6 and isoniazid. Which would the nurse identify as the reason for prescribing the B6? a) to improve the nutritional status of the client b) to enhance the TB effect of INH c) to accelerate the destruction of dormant TB d) to counteract the peripheral neuritis that INH may cause
D
The nurse is caring for a client who is receiving Azathioprine, cyclosporine, and prednisone before receiving a kidney transplant. Which medication action would the nurse identify as the purpose of these medications? a) stimulate leukocytosis b) provide passive immunity c) prevent iatrogenic infection d) reduce antibody production
D
Which statement made by a client taking montelukast indicates the need for further teaching? a) I will need to have my liver function checked b) I can take the medication with food or without c) I may be able to decrease the use of my metered dose inhaler d) I will take the medication when I first notice I am having trouble breathing
D
A client is receiving ABVD ( doxorubicin, Bleomycin, vinblastine, and dacarbazine) therapy for cancer. When the client reports burning and tingling of the feet, which medication would the nurse determine is likely the cause? a) neurotoxicity caused by vinblastine b) hypersensitivity caused by dacarbazine c) endocrine alterations caused by doxorubicin d) peripheral vasoconstriction caused by Bleomycin
A
The client asks why leukovorin calcium is administered with methotrexate therapy. Which statement about leucovorin calcium accurately informs the nurse's response a) it ensures that adequate folic acid is available for blood forming organs B) it potentiates methotrexate's ability to destroy cancer cells c) it replaces lost calcium to prevent hypocalcemia d) it prevents phagocytes destruction of noncancerous cells
A
The nurse is caring for a client receiving an albuterol/ ipatropium nebulized breathing treatment. Which report from the client should the nurse note as an expected side effect of this combination medication? a) I feel like my heart is racing b) I feel more bloated than usual c) my eyes have been watering lately d_ I havent had a bowel movement in 4 days
A
The nurse teaches a client about the effects of diphenhydramine, which has been prescribed as a cough suppressant. The nurse determines that the client needs further instruction if the client makes which statement? a) I will take the medication on an empty stomach b) I wont drink alcohol while taking this medication c) I wont do activities that require mental alertness while taking this medication d) I will use sugarless gum, candy, or oral rinses to decrease dryness in my mouth
A
A client with metastatic melanoma is being treated with interferon gamma 1b. The nurse concludes that the teaching about this medication is understood when the client makes which statement? a) I will increase my fluid intake to several liters every day b) I need to discard any reconstituted solution at the end of the week c) I can continue driving my car as before as long as I have the stamina d) I should be able to continue my usual activity while taking this med
A ( drug can cause nephrotoxicity)
The nurse is monitoring the lab results of a client receiving an antineoplastic medication by IV route. The nurse plans to initiate bleeding precautions if which lab result is noted? a) a clotting time of 10 minutes b) an ammonia level of 10 c) a platelet count of 50,000 d) a WBC count of 5,000
C
A home care nurse has observed a client self administer a dose of an adrenergic bronchodilator via metered-dose inhaler. Within a short time, the client begins to wheeze loudly. The nurse understands that this is the result of which occurrence? a) insufficient dosage of medication which needs to be increased b) probable interaction of this medication with an OTC cold remedy c) tolerance to the medication, indicating a need for a stronger type of bronchodilator d) paradoxical bronchospasm, which must be reported to the PHCP
D
A client with non-Hodgkin's lymphoma is receiving daunorubicin. Which finding would indicate to the nurse that the client is experiencing an adverse effect of this medication? a) fever b) sores in the mouth and throat c) complaints of nausea and vomiting d) crackles on auscultation of the lungs
D
A client with ovarian cancer is being treated with vinicristine. The nurse monitors the client, knowing that which manifestation indicates an adverse effect specific to this medication? a) diarrhea b) hair loss c) chest pain d) peripheral neuropathy
D
A client with severe allergic reaction is prescribed intravenous corticosteroids. The nurse should expect that which desired effect will be achieved? a)pain relief b) enhanced immunity c) increased serum glucose d) decreased inflammation
D
A client has a prescription to take guaifenesin. The nurse determines that the client understands the proper administration of this medication if the client states that she or he will perform which action? a) take an extra dose if fever develops b) take the medication with meals only c) take the tablet with a full glass of water d) decrease the amount of daily fluid intake
C
The health care provider prescribes cisplatin for a client with metastatic cancer. Which action will the nurse take to prevent toxic effects? a) ask the client's health care provider about prescribing leucovorin b) encourage regular vigorous oral care c) increase hydration to promote diuresis d) assist the client in selecting foods appropriate for a high protein, low residue diet
C ( med is nephrotoxic)
The nurse is preparing to administer a dose of Naloxone intravenously to a client with an opioid overdose. Which supportive medical equipment should the nurse plan to have at the client's bedside? a) NG tube b) paracentesis tray c) resuscitation equipment d) central line insertion tray
C
The nurse is monitoring the IV infusion of an antineoplastic medication. During the infusion, the client complains of pain at the intersection site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? SATA a) stop the infusion b) prepare to apply ice or heat to the site c) restart the IV at a distal part of the same vein d) notify the primary health care provider e) prepare to administer a prescribed antidote into the site f) increase the flow rate of the solution to flush the skin and subcutaneous tissue
A, B, D, E
Which medications are immunosuppressives prescribed to prevent kidney rejection? SATA a) cyclosporine b) methotrexate c) methylprednisolone d) tacrolimus e) Mycophenolate mofetil
A, C, D, E
A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which lab value while the client is taking this medication? a) glucose level b) calcium level c) potassium level d) prothrombin time
B
A client with multiple myeloma who is receiving the alkylating agent melphalan (alkylating agent) returns to the oncology clinic for a follow up visit. Which adverse effect will the nurse monitor for? a) hirsutism b) leukopenia c) constipation d) photosensitivity
B
A client with AIDS is prescribed epoetin. Which step would the nurse include during the admin of this med? a) administer the med Via Z track b) shake vial before withdrawing med c) obtain the client's pulse rate before administration d) use a syringe that has a 2 inch, 25 gauge needle
D
A client with a small cell lung cancer is being treated with etoposide. The nurse monitors the client during administration, knowing that which adverse effect is specifically associated with this medication? a) alopecia b) chest pain c) pulmonary fibrosis d) orthostatic hypotension
D
A client with leukemia who is receiving vincristine reports lower leg numbness. Which statement about vincristine explains this occurrence? a) vincristine acts on enlarged lymph nodes in the groin b) vincristine affects peripheral vascular circulation c) vincristine increases the risk for vascular occlusion d) peripheral neuropathies can result from vincristine chemo
D
A client with Hodgkin's disease adds doxorubicin to current therapy. Which advice will the nurse provide about this medication? a) cease taking any medication that contains vitamin D b) keep the doxorubicin in a dark place protected from light c) expect urine to turn red for a few days after taking this medication d) take the doxorubicin on an empty stomach with large amounts of fluids
C
The nurse is analyzing the lab results of a client with leukemia who has received a regimen of chemotherapy. Which lab value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemo? a) anemia b) decreased platelets c) increased uric acid level d) decreased leukocyte count
C
The primary health care provider prescribes cromolyn for the client with asthma. The nurse identifies that the client correctly understands the purpose of this medication when the client states that the medication will produce which effect? a) promote bronchodilation b) decrease the risk of infection c) suppress an allergic response d) eliminate the need for a rescue inhaler
C
A client begins therapy with theophylline. The nurse plans to teach the client to limit the intake of which items while taking this medication? A) coffee, cola, chocolate b) oysters, lobster, shrimp c) melons, oranges, pineapple d) cottage cheese, cream cheese, dairy products
A