NCLEX-PN
Pharmacology
NCLEX
Questions
27.)
Sildenafil
(Viagra)
is
prescribed
to
treat
a
client
with
erectile
dysfunction.
A
nurse
reviews
the
client's
medical
record
and
would
question
the
prescription
if
which
of
the
following
is
noted
in
the
client's
history?
1.
Neuralgia
2.
Insomnia
3.
Use
of
nitroglycerin
4.
Use
of
multivitamins
-
ANSWER-3.
Use
of
nitroglycerin
Rationale:
Sildenafil
(Viagra)
enhances
the
vasodilating
effect
of
nitric
oxide
in
the
corpus
cavernosum
of
the
penis,
thus
sustaining
an
erection.
Because
of
the
effect
of
the
medication,
it
is
contraindicated
with
concurrent
use
of
organic
nitrates
and
nitroglycerin.
Sildenafil
is
not
contraindicated
with
the
use
of
vitamins.
Neuralgia
and
insomnia
are
side
effects
of
the
medication.
54.)
A
nurse
reinforces
discharge
instructions
to
a
postoperative
client
who
is
taking
warfarin
sodium
(Coumadin).
Which
statement,
if
made
by
the
client,
reflects
the
need
for
further
teaching?
1.
"I
will
take
my
pills
every
day
at
the
same
time."
2.
"I
will
be
certain
to
avoid
alcohol
consumption."
3.
"I
have
already
called
my
family
to
pick
up
a
Medic-Alert
bracelet."
4.
"I
will
take
Ecotrin
(enteric-coated
aspirin)
for
my
headaches
because
it
is
coated."
-
ANSWER-4.
"I
will
take
Ecotrin
(enteric-coated
aspirin)
for
my
headaches
because
it
is
coated."
Rationale:
Ecotrin
is
an
aspirin-containing
product
and
should
be
avoided.
Alcohol
consumption
should
be
avoided
by
a
client
taking
warfarin
sodium.
Taking
prescribed
medication
at
the
same
time
each
day
increases
client
compliance.
The
Medic-Alert
bracelet
provides
health
care
personnel
emergency
information. 55.)
A
client
who
is
receiving
digoxin
(Lanoxin)
daily
has
a
serum
potassium
level
of
3.0
mEq/L
and
is
complaining
of
anorexia.
A
health
care
provider
prescribes
a
digoxin
level
to
rule
out
digoxin
toxicity.
A
nurse
checks
the
results,
knowing
that
which
of
the
following
is
the
therapeutic
serum
level
(range)
for
digoxin?
1.
3
to
5
ng/mL
2.
0.5
to
2
ng/mL
3.
1.2
to
2.8
ng/mL
4.
3.5
to
5.5
ng/mL
-
ANSWER-2.)
0.5
to
2
ng/mL
Rationale:
Therapeutic
levels
for
digoxin
range
from
0.5
to
2
ng/mL.
Therefore,
options
1,
3,
and
4
are
incorrect.
56.)
Heparin
sodium
is
prescribed
for
the
client.
The
nurse
expects
that
the
health
care
provider
will
prescribe
which
of
the
following
to
monitor
for
a
therapeutic
effect
of
the
medication?
1.
Hematocrit
level
2.
Hemoglobin
level
3.
Prothrombin
time
(PT)
4.
Activated
partial
thromboplastin
time
(aPTT)
-
ANSWER-4.
Activated
partial
thromboplastin
time
(aPTT)
Rationale:
The
PT
will
assess
for
the
therapeutic
effect
of
warfarin
sodium
(Coumadin)
and
the
aPTT
will
assess
the
therapeutic
effect
of
heparin
sodium.
Heparin
sodium
doses
are
determined
based
on
these
laboratory
results.
The
hemoglobin
and
hematocrit
values
assess
red
blood
cell
concentrations.
57.)
A
nurse
is
monitoring
a
client
who
is
taking
propranolol
(Inderal
LA).
Which
data
collection
finding
would
indicate
a
potential
serious
complication
associated
with
propranolol?
1.
The
development
of
complaints
of
insomnia
2.
The
development
of
audible
expiratory
wheezes
3.
A
baseline
blood
pressure
of
150/80
mm
Hg
followed
by
a
blood
pressure
of
138/72
mm
Hg
after
two
doses
of
the
medication
4.
A
baseline
resting
heart
rate
of
88
beats/min
followed
by
a
resting
heart
rate
of
72
beats/min
after
two
doses
of
the
medication
-
ANSWER-2.
The
development
of
audible
expiratory
wheezes
Rationale: Audible
expiratory
wheezes
may
indicate
a
serious
adverse
reaction,
bronchospasm.
β-
Blockers
may
induce
this
reaction,
particularly
in
clients
with
chronic
obstructive
pulmonary
disease
or
asthma.
Normal
decreases
in
blood
pressure
and
heart
rate
are
expected.
Insomnia
is
a
frequent
mild
side
effect
and
should
be
monitored.
70.)
Oxybutynin
chloride
(Ditropan
XL)
is
prescribed
for
a
client
with
neurogenic
bladder.
Which
sign
would
indicate
a
possible
toxic
effect
related
to
this
medication?
1.
Pallor
2.
Drowsiness
3.
Bradycardia
4.
Restlessness
-
ANSWER-4.
Restlessness
Rationale:
Toxicity
(overdosage)
of
this
medication
produces
central
nervous
system
excitation,
such
as
nervousness,
restlessness,
hallucinations,
and
irritability.
Other
signs
of
toxicity
include
hypotension
or
hypertension,
confusion,
tachycardia,
flushed
or
red
face,
and
signs
of
respiratory
depression.
Drowsiness
is
a
frequent
side
effect
of
the
medication
but
does
not
indicate
overdosage.
73.)
A
client
with
myasthenia
gravis
is
suspected
of
having
cholinergic
crisis.
Which
of
the
following
indicate
that
this
crisis
exists?
1.
Ataxia
2.
Mouth
sores
3.
Hypotension
4.
Hypertension
-
ANSWER-4.
Hypertension
Rationale:
Cholinergic
crisis
occurs
as
a
result
of
an
overdose
of
medication.
Indications
of
cholinergic
crisis
include
gastrointestinal
disturbances,
nausea,
vomiting,
diarrhea,
abdominal
cramps,
increased
salivation
and
tearing,
miosis,
hypertension,
sweating,
and
increased
bronchial
secretions.
74.)
A
client
with
myasthenia
gravis
is
receiving
pyridostigmine
(Mestinon).
The
nurse
monitors
for
signs
and
symptoms
of
cholinergic
crisis
caused
by
overdose
of
the
medication.
The
nurse
checks
the
medication
supply
to
ensure
that
which
medication
is
available
for
administration
if
a
cholinergic
crisis
occurs?
1.
Vitamin
K
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