NCLEX-RN Pharmacological Therapies Exam

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.

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

> What action should the nurse take first?

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?

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?

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?

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?

The nurse reviews the medication list of several clients.

> Which client is at greatest risk for developing hyperkalemia?

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

> Which instruction should the nurse provide?

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

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

A client receives intravesical chemotherapy for bladder cancer.

> Which instruction should the nurse provide following medication instillation?

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?

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

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

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?

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.

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?

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.

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.

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?

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

> Which instruction should the nurse include?

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?