PHARM NCLEX

Select the atypical antidepressant that is correctly and accurately paired with its mechanism of action. A. Mirtazapine: It increases the release of serotonin and norepinephrine. B. Trazodone: It inhibits norepinephrine and serotonin uptake. C. Venlafaxine: It selectively blocks serotonin receptors. D. Duloxetine: It directly increases levels of serotonin.

A. Trazodone moEn

A nurse is working in the day surgery area of the medical center. What type of catheter would the nurse use most often when caring for ambulatory day surgery clients? A. An 18 gauge catheter B. A 24 gauge catheter C. A midline peripheral catheter D. A PICC

A. An 18 gauge is used for preop clients so it can accommodate the rapid infusion of blood and blood product should the client experience operative or postop hemorrhage.

A nurse is teaching a group of student nurses about administration of total parenteral nutrition. Which of the following statements by a student nurse indicates correct understanding? A. TPN should be administered through a designated port on a multi-lumen central venous catheter. B. TPN can be administered through a central line or through a peripheral IV. C. TPN requires an unfiltered tubing set except when the solution is administered by gravity. D. TPN tubing must be changed every 24 hours to prevent the risk of infection.

A. If the client has a multi-lumen central line, one lumen should be designated for TPN administration to avoid mixing substances. The amount of dextrose in TPN requires that it be administered through a central line and not a peripheral IV. TPN requires a tubing set that has a filter and it is never run by gravity. TPN tubing is typically changed every 24 hours depending on facility protocol, however, it MUST be changed every 72 hours at a minimum.

A nurse is preparing to remove a client's PICC line. Which of the following best describes the process of removing the catheter? A. Put on sterile gloves remove exterior dressing, withdraw the catheter, apply pressure for five minutes. B. Remove exterior dressing, flush catheter and clamp, withdraw the catheter, apply a gauze dressing. C. Remove exterior dressing, cleanse the site with chlorhexidine, withdraw the catheter, apply firm pressure for 20 minutes. D. Put on sterile gloves, remove exterior dressing, withdraw the catheter, apply a gauze dressing.

A. Put on sterile gloves remove exterior dressing, withdraw the catheter, apply pressure for five minutes.

A nurse is caring for client who will be beginning a relatively long course of therapy with gentamicin for pulmonary exacerbations of cystic fibrosis. What baseline assessment data should be collected prior to the initiation of this therapy? A Snellen chart testing B. Audiometric testing C. Liver enzyme testing D. None -- gentamicin is not indicated for cystic fibrosis

B. Audiometric testing should be done to establish the client's baseline hearing prior to the initiation of a long course of therapy with gentamicin for pulmonary exacerbation cystic fibrosis. Gentamicin is an aminoglycoside antibiotic that can be toxic to the auditory nerve, as well as the kidney.

A nurse is inserting a peripheral IV into a vein in a client's wrist. She has inserted the needle under the skin with the bevel facing up and sees a flash of blood in the catheter. Which step is most appropriate next? A. Apply countertraction to the skin and rotate the catheter so the bevel is down. B. Lower the end of the catheter and slowly advance forward into the vein. C. Maintain pressure and secure the catheter to the wrist. D. Remove the catheter and choose another location to start the IV.

B. Lower the end of the catheter and slowly advance forward into the vein

A nurse is caring for a client diagnosed with a flare of chronic pancreatitis. Which of the following prescriptions does the nurse anticipate for this client? A. A diet that is high in potassium B. Enzymatic therapy C. A diet that is low in complex proteins D. Corticosteroid therapy

B. Pancreatic enzyme replacement therapy is prescribed for clients with chronic pancreatitis to facilitate digestion, maintain nutritional status, and to relieve pain.

A nursing is caring for a client who is taking an opioid drug and a NSAID in combination for pain. What kind of action will this combination of drugs lead to? A. An adverse action B. A potentiating action C. An inhibiting action D. A rescue action

B. The combo of an opioid drug and a NSAID leads to a desired potentiating action. The NSAID is considered an adjuvant medication. Corticosteroids, anticonvulsants, and antidepressants are also commonly-used adjuvant medication.

Select the type of IV solution that is correctly paired with an example of it and its actions. A. Isotonic IV solution: 3% NaCl -- it draws fluid out of the intracellular spaces B. Hypertonic IV solution: 0.9% NaCl -- it increases intravascular fluids. C. Hypotonic IV solution: 0.33% NaCl -- it moves fluid into the cells. D. Normal osmolarity IV solution: 0.33% NaCl -- it moves fluid into the cells.

C. 0.33% NaCl move fluid from the intravascular space to the interstitial and intracellular space, along an osmotic gradient, thus hydrating the cells while depleting circulatory fluids. Isotonic fluids like 0.9% NaCl, move fluid into intravascular spaces without any significant change to the balance, Hypertonic fluids like 3% NaCl, draw fluid out of the intracellular space to the extracellular space.

A nurse is preparing to administer mannitol 1 g/kg of 20% solution IV. Which of the following conditions should be considered a contraindication for using this type of medication? A. Cerebral edema B. Oliguria C. Heart failure D. Increased intraocular pressure

C. Mannitol is an osmotic diuretic that is most commonly used to reduce increased intracranial pressure by moving intracellular fluid into the extracellular space. Mannitol is not used for clients with heart failure because its effects can ultimately cause fluid overload in the intravascular space when the medication pulls excess fluid out of edematous tissues.

A nurse is caring for a client who has had a right-sided radical mastectomy for breast cancer and must start a peripheral IV. The client's left arm is very edematous, but the right arm is not edematous. What is the appropriate action by the Nurse? A. Call the doctor and recommended a vein cut-down to start the IV B. Apply a warm compress to the edematous selected IV site. C. Apply digital pressure to the selected IV site to push the edema away. D. Use the right arm because there is no swelling or lymphadema in the arm.

C. You should apply digital pressure to the selected IV site to push the edema away and then insert the catheter as rapidly as possible. IVs on the side of a mastectomy are contraindicated.

What is the nurse's first priority action when a client has an extravasation? A. Stop the infusion and remove the catheter. B. Lower the arm below the level of the heart. C. Apply a tourniquet above the site. D. Stop the infusion.

D. Immediately stop the infusion buvesicant.t leave the catheter in place because you must attempt to aspirate any remaining vesicant. The arm should be elevated, not lowered.

A nurse is preparing to take a blood sample for laboratory tests from a client's subclavian central venous catheter. Which of the following statements is most accurate regarding blood sampling from this type of central line? A. The nurse should use at least a 5 milliliter (mL) syringe to draw the blood sample to regulate the sample size. B. If the nurse has previously taken a blood sample from the access site, there is no need to draw extra blood to discard. C. If the port has more than one lumen, the nurse should use the same port for blood sampling as that which is used for total parenteral nutrition. D. When continuous IV fluids are already infusing, the nurse should clamp the tubing before obtaining a blood sample.

D. When continuous IV fluids are already infusing, the nurse should clamp the tubing before obtaining a blood sample.