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RN NCLEX EXAM WITH ANSWERS & RATIONALE ( ENDOCRINE DRUGS) .
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RN NCLEX EXAM WITH ANSWERS & RATIONALE ( ENDOCRINE DRUGS) .RN NCLEX EXAM WITH ANSWERS & RATIONALE ( ENDOCRINE DRUGS) .
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RN NCLEX EXAM WITHANSWERS & RATIONALE
(ENDOCRINE DRUGS)
2023/2024
P a g e 1 | 23
, 1. Which of the following is a contraindication for use of oxytocin to induce labor?
A. Missed abortion
B. Placenta previa
C. Hyperbilirubinemia
D. Pregnancy past due date
Answer: B. Placenta previa
Use of oxytocin is contraindicated in the presence of placenta previa. Labor induction in this condition
could be fatal to the fetus. Placenta previa is an indication for cesarean section. Specific
contraindications to oxytocin include hypersensitivity to the hormone itself or any part of its synthetic
version and vaginal deliveries that are in themselves contraindicated. These include the patient having
an active genital herpes infection, vasa previa, complete placenta previa, invasive cervical cancer, and
prolapse or presentation of the umbilical cord).
Option A: Oxytocin is indicated and approved by the FDA for two specific time frames in the
obstetric world: antepartum and postpartum. In the antepartum period, exogenous oxytocin is
FDA-approved for strengthening uterine contractions with the aim of successful vaginal delivery
of the fetus. There are three situations during the antepartum period in which oxytocin is
indicated for mothers who have preeclampsia, maternal diabetes, premature rupture of the
membranes; for mothers with inactive uteri that require stimulation to start labor; and for
mothers with inevitable or incomplete abortions in their second trimester.
Option C: Hypoosmolarity causes swelling of the red blood cells and makes them fragile and
susceptible to hemolysis. Various studies have approved the effects of oxytocin on jaundice.
Some studies have suggested that the extensive use of oxytocin in labor induction is one of the
factors leading to neonatal jaundice
Option D: When oxytocin is released, it stimulates uterine contractions, and these uterine
contractions, in turn, cause more oxytocin to be released; this is what causes the increase in
both the intensity and frequency of contractions and enables a mother to carry out vaginal
delivery completely. The head of the fetus pushes against the cervix, the nerve impulses from
this action travel to the mother’s brain, which activates the posterior pituitary to secrete
oxytocin. This oxytocin is then carried through the blood to the uterus to increase uterine
contractions further, and the cycle continues until parturition.
2. Which of the following insulin cannot be mixed with any other type of insulin?
A. Insulin glargine
P a g e 2 | 23
, B. Insulin aspart
C. Insulin isophane
D. Insulin lispro
Answer: A. Insulin glargine
Insulin glargine when mixed with any other types of insulin changes its duration of action ( a
combination of long-acting and short-acting insulin) so it is advised that it should not be mixed with any
other type of insulin.
3. A client with diabetes mellitus type I was prescribed with exenatide (Bydureon). The nurse will
take which of the following appropriate actions?
A. Withdraw the insulin from the prefilled pen into an insulin syringe
B. Monitor for signs of nausea, vomiting, and gastric upset
C. Administer the medication twice a day during pre-meals
D. Hold the medication and call the physician to question the prescription
Answer: D. Hold the medication and call the physician to question the prescription
Exenatide (Bydureon) is only used to treat diabetes mellitus type 2 only. Therefore, holding the
medication and calling the physician to question the order.
Option A: Prefilled pens are ready for injection.
Options B & C: Although these are correct about the medication, it should not be administered
in this kind of situation.
4. A relative contraindication to therapy with androgens is:
A. Hepatic failure
B. Pregnancy
C. Prostate cancer
D. Hypogonadism
Answer: A. Hepatic failure
Hepatic failure is considered a relative contraindication because antiandrogens have been known to
cause hepatotoxicity. While topical testosterone delivery systems avoid first-pass hepatic metabolism,
there remains concern regarding TRT in patients with chronic liver disease. The majority of reports of
liver toxicity and jaundice are limited to orally-administered alkylated forms of testosterone.
P a g e 3 | 23
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