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Home » My Account » NCLEX-RN Pharmacological Therapies Exam

NCLEX-RN Pharmacological Therapies Exam

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Question 1 of 20

1. Question

Vancomycin 500mg in 100ml of normal saline (NS) is to be administered over 1 hour. The drop factor of the macrodrip tubing is 20 drops (gtt)/1 mL.

> How many drops per minute should the nurse set the flow rate? Fill in the blank and round to the nearest whole number.

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Question 2 of 20

2. Question

A laboring client receiving an oxytocin infusion begins exhibiting recurrent late decelerations on the fetal monitor.

> What action should the nurse take first?

1. Discontinue the oxytocin infusion.
Correct Incorrect Correct answer

2. Assess maternal temperature.
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3. Increase the intravenous maintenance fluid rate.
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4. Encourage the client to bear down with contractions.
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Question 3 of 20

3. Question

A client prescribed potassium iodide for severe hyperthyroidism reports a metallic taste and tenderness of the gums.

> Which instruction should the nurse give the client?

1. Continue the medication as planned.
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2. Stop the medication and contact the provider.
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3. Reduce the dose for the next 24 hours.
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4. Skip today’s dose and resume tomorrow.
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Question 4 of 20

4. Question

A client has been prescribed topical minoxidil solution for androgenic alopecia. The nurse provides instructions on how to use the medication.

> Which statement by the client shows that the teaching was effective?

1. “I will apply the recommended amount only once each morning.”
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2. “I will apply the solution four times a day to speed up hair growth.”
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3. “I will apply the solution every other day and see how it goes.”
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4. “I will apply the prescribed amount to the scalp two times each day.”
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Question 5 of 20

5. Question

A postpartum client who is Rh negative delivered an Rh positive infant. Rho(D) immune globulin is ordered before discharge.

> The nurse evaluates that teaching is successful if the client states that this medication will help protect future babies from which problem?

1. Being born with Rh positive blood
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2. Getting infected with rubella
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3. Being harmed by Rh incompatibility
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4. Developing normal newborn jaundice
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Question 6 of 20

6. Question

A client with severe pancreatitis has been receiving total parenteral nutrition (TPN) for several days. The provider orders the TPN to be tapered off over the next 8 hours. The client asks, “Why can’t you just stop the TPN now?”

> Which explanation should the nurse provide?

1. “Stopping it suddenly could cause you to become very dehydrated.”
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2. “Stopping it quickly can cause your potassium level to drop.”
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3. “Stopping it quickly can cause your sodium level to become too high.”
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4. “Stopping it suddenly can cause your blood sugar to drop too low.”
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Question 7 of 20

7. Question

The nurse reviews the medication list of several clients.

> Which client is at greatest risk for developing hyperkalemia?

1. A client taking spironolactone for ascites
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2. A client taking bumetanide for heart failure
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3. A client taking furosemide for pulmonary edema
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4. A client taking hydrochlorothiazide for hypertension
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Question 8 of 20

8. Question

A client with gastroesophageal reflux disease (GERD) receives a new prescription for pantoprazole.

> Which instruction should the nurse provide?

1. “Chew the tablet completely before swallowing.”
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2. “Headaches are normal and you do not need to report them.”
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3. “Swallow the tablet whole without crushing it.”
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4. “Crush the tablet if it is difficult for you to swallow.”
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Question 9 of 20

9. Question

A pediatric oncology nurse is caring for a child receiving asparaginase.

> The nurse evaluates treatment effectiveness by monitoring for improvement in which diagnosis?

1. Small cell lung carcinoma
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2. Breast carcinoma
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3. Acute lymphoblastic leukemia
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4. Metastatic prostate cancer
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Question 10 of 20

10. Question

A client receives intravesical chemotherapy for bladder cancer.

> Which instruction should the nurse provide following medication instillation?

1. Void immediately after the procedure
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2. Reposition every 15 to 30 minutes
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3. Remain on strict bed rest
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4. Retain the medication for 20 minutes only
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Question 11 of 20

11. Question

A primigravida at 38 weeks’ gestation presents in active labor. Prenatal records indicate a positive group B streptococcus culture. On examination, the cervix is 5 cm dilated and 80% effaced.

> What is the nurse’s priority action?

1. Begin coaching the client to push
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2. Obtain a prescription for IV antibiotic prophylaxis
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3. Notify the provider to come for delivery
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4. Prepare neonatal resuscitation equipment
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Question 12 of 20

12. Question

A client receiving growth hormone replacement therapy is being monitored for complications.

> Which adverse effect is the nurse most likely to observe?

1. Hypocalcemia
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2. Hypoglycemia
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3. Hyperglycemia
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4. Hyperthyroidism
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Question 13 of 20

13. Question

A client with rheumatoid arthritis is prescribed auranofin. The nurse explains expected effects versus toxicity.

> Which symptom should the client report immediately because it may indicate toxicity?

1. Mild nausea during the first weeks
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2. Loose stools that improve with diet changes
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3. Decreased appetite on some days
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4. Metallic taste in the mouth
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Question 14 of 20

14. Question

A child is diagnosed with acute otitis media and presents with fever, irritability, and ear pain.

> Which interventions should the nurse include in the plan of care? Select all that apply.

1. Encourage soft foods during the acute phase
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2. Position the child with the affected ear downward
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3. Irrigate the ear canal twice daily
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4. Administer antipyretics as prescribed
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5. Teach caregivers to complete the antibiotic course
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6. Administer antihistamines routinely
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Correct / 3 Points

Incorrect / 3 Points
Question 15 of 20

15. Question

A client admitted with diabetic ketoacidosis is receiving IV regular insulin and isotonic fluids. The blood glucose level has decreased from 900 mg/dL to 260 mg/dL.

> What should the nurse anticipate as the next intervention?

1. Administration of IV dextrose 50 percent
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2. Addition of dextrose to the IV fluids
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3. Transition to subcutaneous long-acting insulin
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4. Discontinuation of insulin infusion
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Question 16 of 20

16. Question

A client is prescribed ondansetron 4 mg IV. The medication is supplied as 8 mg in 4 mL.

> How many milliliters will the nurse administer? Fill in the blank.

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Question 17 of 20

17. Question

A client with primary Addison’s disease is discharged on oral cortisone. The nurse provides teaching about long-term therapy.

> Which instructions should the nurse include? Select all that apply.

1. Add extra salt to meals daily unless otherwise instructed
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2. Take the medication with food or milk
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3. Increase intake of potassium-rich foods (e.g., bananas, oranges)
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4. Avoid close contact with people who have active infections
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5. Stop the medication once energy level returns to normal
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6. Notify the provider if illness occurs or surgery is planned
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Correct / 4 Points

Incorrect / 4 Points
Question 18 of 20

18. Question

The nurse completes discharge teaching for a client newly prescribed carbamazepine.

> Which client statement indicates correct understanding of the primary therapeutic effect of this medication?

1. “This medication interferes with DNA production.”
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2. “The main effect is a decrease in intraocular pressure.”
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3. “This medication has an anticonvulsant effect.”
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4. “The main action is prevention of cellular division.”
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Question 19 of 20

19. Question

Parents of a toddler with iron-deficiency anemia are instructed on administering liquid iron.

> Which instruction should the nurse include?

1. Give iron with meals to reduce stomach upset
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2. Mix iron with cereal for easier intake
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3. Add iron to milk or formula
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4. Administer through a straw or dropper toward the back of the mouth
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Question 20 of 20

20. Question

A client with urge incontinence is prescribed oxybutynin. After several doses, the nurse evaluates for side effects and possible toxicity.

> Which finding would most strongly suggest a possible toxic effect?

1. Pale skin and cool extremities
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2. Mild daytime sleepiness
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3. Slow heart rate with fatigue
Correct Incorrect Correct answer

4. New agitation with restlessness and inability to sit still
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