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WorksheetsNCLEX - Pharma and parenteral Day1
Total questions: 25
Worksheet time: 25mins
Name
Class
Date
1.
The nurse is preparing to administer a scheduled dose of metoclopramide IV to a client with diabetic gastroparesis. Which clinical finding causes the nurse to question the prescription?
a)
Diarrhea
b)
Frequent burping
c)
Headache
d)
Sucking lip motions
e)
-
2.
The home health nurse is reviewing current medications with a client who has hypertension. Which of the following statements by the client would require follow-up?
a)
I take omeprazole daily to prevent heartburn.
b)
I regularly take ibuprofen for chronic low back pain.
c)
I occasionally take docusate sodium for constipation.
d)
I take hydrochlorothiazide daily to lower my blood pressure.
e)
-
3.
The nurse plans discharge teaching for a client with active herpes lesions who has a new prescription for oral acyclovir and topical lidocaine. What information will the nurse include in the teaching plan?
a)
Adhesive bandaging should remain on the lesions to prevent virus shedding
b)
Blood tests will be drawn to ensure the virus is eradicated
c)
Condoms should be used during intercourse until the lesions are healed
d)
Gloves should be used to apply the medication to the lesions
e)
-
4.
The nurse is reviewing new prescriptions from the health care provider. Which prescription would require further clarification?
a)
Atorvastatin for hyperlipidemia in a client with angina pectoris
b)
Bupropion for smoking cessation in a client with emphysema
c)
Cyclobenzaprine for muscle spasms in a client with hepatitis
d)
Metronidazole for trichomoniasis in a client with Crohn disease
e)
-
5.
The nurse is caring for a client who is receiving epidural analgesia. It would be a priority for the nurse to monitor the client for
a)
pruritis (4%)
b)
hypotension (62%)
c)
headache (16%)
d)
paresthesia (15%)
e)
-
6.
An elderly client is prescribed codeine for a severe cough. The home health nurse teaches the client how to prevent the common adverse effects associated with codeine. Which client statements indicate an understanding of how to prevent them? Select all that apply.
a)
I'll be sure to apply sunscreen if I go outside.
b)
I'll drink at least 8 glasses of water a day.
c)
I'll drink decaffeinated coffee so I can sleep at night.
d)
I'll sit on the side of my bed for a few minutes before getting up.
e)
I'll take my medicine with food.
7.
The clinic nurse is reviewing telephone messages from four clients. Which client's call should the nurse return first?
a)
Client who has just taken albuterol and reports a heart rate of 108/min and a coarse tremor in both arms (14%)
b)
Client who is prescribed azithromycin and reports frequent, foul-smelling, liquid stools and abdominal cramping (12%)
c)
Client who is prescribed metformin and reports a blood glucose of 284 mg/dL (15.76 mmol/L) and frequent urination (13%)
d)
Client who takes amiodarone and reports a dry cough and increased dyspnea when walking around the house (59%)
e)
-
8.
A client is scheduled for allergy skin testing to identify asthmatic triggers. Which medications should the nurse instruct the client to withhold before the test to ensure accurate results? Select all that apply.
a)
Acetaminophen
b)
Albuterol
c)
Diphenhydramine
d)
Enalapril
e)
Loratadine
9.
A nurse has received new medication prescriptions for a client admitted with hypertension and an exacerbation of chronic obstructive pulmonary disease. Which prescription should the nurse question?
a)
Amlodipine (12%)
b)
Codeine (63%)
c)
Ipratropium (12%)
d)
Methylprednisolone (11%)
e)
-
10.
A client who is 24 hours postoperative bowel resection is receiving IV opioids PRN for severe pain. The nurse reviews the health care provider's prescription to discontinue the continuous IV normal saline. What is the nurse's most appropriate action?
a)
Convert to a saline lock
b)
Remove the IV catheter
c)
Request a prescription for a saline lock
d)
Slow the IV fluids to a keep-vein-open rate
e)
-
11.
The nurse is providing teaching to the parents of a 1-year-old who was just prescribed a 10-day course of amoxicillin for acute otitis media. Which of the following instructions are appropriate for the nurse to include in the teaching? Select all that apply.
a)
Give your child over-the-counter decongestants to help speed up recovery.
b)
If your child develops loose stools, please discontinue the antibiotic.
c)
Return to the clinic if your child does not improve within 48-72 hours.
d)
Stop administering the amoxicillin if your child is feeling better in 5-7 days.
e)
Your child may need a hearing screening after the ear infection has resolved.
12.
The nurse is reviewing new medication prescriptions for a client with asthma and nasal polyps. The nurse should clarify the prescription for
a)
cimetidine
b)
ibuprofen
c)
montelukast
d)
prednisone
e)
-
13.
The nurse is caring for a client with heart failure who has gained 5 lb (2.26 kg) in the last 3 days and has a decreased serum sodium level. Which of the following medications should the nurse expect to administer to the client?
a)
furosemide
b)
calcium gluconate
c)
0.45% sodium chloride
d)
sodium polystyrene sulfonate
e)
-
14.
The nurse is preparing to administer a unit of packed RBCs to a client. The client is currently receiving 5% dextrose in water (D5W) through a 20-gauge peripheral venous access device (VAD). Which of the following actions should the nurse take?
a)
Administer the transfusion as an IV piggyback using an infusion pump.
b)
Attach the transfusion tubing to the port closest to the client on the existing IV tubing.
c)
Discontinue the infusion of D5W, flush the VAD with normal saline, and start the transfusion.
d)
Discontinue the 20-gauge VAD, select a new VAD site on the opposite extremity, and insert an 18-gauge VAD.
e)
-
15.
A client with type 1 diabetes has a prescription for 20 units of NPH insulin daily at 7:30 AM and regular insulin before meals, based on a sliding scale. At 7:00 AM, the client's blood glucose level is 220 mg/dL (12.2 mmol/L), and the client's breakfast tray has arrived. What action should the nurse take?
a)
Administer 20 units of NPH insulin now and then 6 units of regular insulin after the morning meal
b)
Administer 26 units of insulin: 20 units of NPH insulin and 6 units of regular insulin in 2 separate injections
c)
Administer 26 units of insulin: 20 units of NPH mixed with 6 units of regular insulin in the same syringe, drawing up the NPH into the syringe first
d)
Administer 26 units of insulin: 20 units of NPH mixed with 6 units of regular insulin in the same syringe, drawing up the regular insulin first
e)
-
16.
The nurse has taught a client with newly diagnosed atrial fibrillation who is being discharged with a prescription for warfarin. Which of the following statements by the client would indicate a correct understanding of the teaching?
a)
Antibiotics can affect my INR value.
b)
I am going to eat more leafy green vegetables.
c)
I will take the medication at the same time every day.
d)
Black, tarry stools are expected while taking this medication.
e)
If I miss a dose of medication, I will double my dose the next day.
17.
The nurse is caring for a client who is receiving an infusion via a peripheral venous access device (VAD). The nurse notes fluid leaking from the VAD site, and the skin appears edematous and feels cool to the touch. Which of the following actions should the nurse take?
a)
Decrease the infusion rate.
b)
Discontinue the use of the VAD.
c)
Gently massage the edematous area.
d)
Flush the VAD to assess patency.
e)
Elevate the affected extremity.
18.
A client with multidrug-resistant tuberculosis (MDR-TB) has a 1-month follow up visit after beginning medication therapy. The client states, "I've had really bad nausea and fatigue, but because my cough has already improved, I knew it would be alright to stop taking the medications." The nurse identifies which priority nursing diagnosis (ND) in this client's care plan?
a)
Activity intolerance
b)
Imbalanced nutrition, less than body requirements
c)
Knowledge deficit of prescribed therapeutic regimen
d)
Nausea
e)
-
19.
The nurse is caring for a 64-year-old client taking newly prescribed amitriptyline for a recent herpes zoster infection and severe postherpetic neuralgia. What is the priority nursing action?
a)
Encourage increased fluid intake
b)
Provide the client with frequent rest periods
c)
Teach the client to change positions slowly
d)
Tell the client to wear sunglasses when outdoors
e)
-
20.
The nurse is teaching a client who has a newly inserted levonorgestrel-releasing intrauterine device. Which of the following information should the nurse include?
a)
The device will provide protection from pregnancy for up to 10 years.
b)
The use of oil-based personal lubricants can damage the device and should be avoided.
c)
Notify your health care provider if the string of the device feels longer or shorter after your menses.
d)
Placement of the device should be reassessed if you experience a significant change in body weight
e)
-
21.
The nurse is caring for a female client with liver cirrhosis and chronic anemia who is hospitalized for deep venous thrombosis. The client is receiving a heparin infusion and develops epistaxis. Which laboratory value would indicate that the heparin infusion needs to be turned off? Click the exhibit button for additional client information.
a)
activated PTT
b)
hematocrit
c)
platelets
d)
PT
e)
-
22.
The nurse is caring for a client who has gastroesophageal reflux disease and has been receiving long-term omeprazole therapy. The nurse should recognize that the client is at highest risk for developing
a)
1. jaw necrosis (8%)
b)
2. vision changes (15%)
c)
3. gait disturbance (18%)
d)
4. Clostridioides difficile infection (57%)
e)
-
23.
The nurse receives telephone messages from the following 4 clients. Which client should the nurse call back first?
a)
1. Client taking cyclosporine who reports swollen and bleeding gums for several days (15%)
b)
2. Client taking doxycycline who reports severe sunburn after sun exposure (3%)
c)
3. Client taking phenytoin who reports flu-like symptoms and a new painful skin rash (71%)
d)
4. Client taking sildenafil who reports dizziness when standing up from a seated position (9%)
e)
-
24.
The nurse is caring for a client who has active pulmonary tuberculosis and is receiving ethambutol. It would require immediate follow-up if the client reports
a)
1. dark-colored urine (11%)
b)
2. difficulty hearing (18%)
c)
3. blurred vision (62%)
d)
4. nausea (8%)
e)
-
25.
The nurse is caring for a client diagnosed with serotonin syndrome caused by overdose of citalopram and tramadol. Which of the following assessment findings does the nurse expect? Select all that apply.
a)
1. Absent deep tendon reflexes
b)
2. Agitation
c)
3. Hypoactive bowel sounds
d)
4. Shivering
e)
5. Tachycardia
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