NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 371:

  A contraindication for topical corticosteroid use in a client with atopic dermatitis (eczema) is ___________.

  A. parasite infection

  B. viral infection

  C. fungal infection

  D. spirochete infection

  Correct Answer: B

  Topical agents produce a localized, rather than systemic, effect.

  When treating atopic dermatitis with a steroidal preparation, the site is vulnerable to invasion by

  organisms. Viruses, such as herpes simplex or varicella zoster, present a risk of disseminated infection.

  Educate the client using topical corticosteroids to avoid crowds or people known to have infections and to

  report even minor signs of an infection.

  Topical corticosteroid use results in little danger of concurrent infection with parasite infection,

  fungal infection and spirochete infection.

• Question 372:

  A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression.

  The physician is likely to order the administration of __________.

  A. naloxone (Narcan)

  B. labetalol (Normodyne)

  C. neostigmine (Prostigmin)

  D. thiothixene (Navane)

  Correct Answer: B

  Tolerance is the capacity to ingest an increasing amount of a substance without effect and the experience

  of decreased sensitivity to the substance. Tolerance can develop with long-term use of many drugs.

  Naloxone (Narcan) is the dose required to produce a defined magnitude of drug effect.

  Neostigmine (Prostigmin) binds to a receptor and causes an action.

  Thiothixene (Navane) is the maximal response produced by a drug.

• Question 373:

  A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression.

  The physician is likely to order the administration of __________.

  A. naloxone (Narcan)

  B. labetalol (Normodyne)

  C. neostigmine (Prostigmin)

  D. thiothixene (Navane)

  Correct Answer: A

  Naloxone is an opiate antagonist. It attaches to opiate receptors and blocks or reverses the action of

  narcotic analgesics.

  Labetalol (Normodyne) is incorrect because Labetalol is a beta blocker.

  Neostigmine (Prostigmin) is incorrect because Neostigmine is an anticholinesterase agent.

  Tthiothixene (Navane) is incorrect because Thiothixene is an antipsychotic agent.

• Question 374:

  A chemical reaction between drugs prior to their administration or absorption is known as __________.

  A. a drug incompatibility

  B. a side effect

  C. an adverse event

  D. an allergic response

  Correct Answer: A

  This occurs most often when drug solutions are combined before they are given intravenously but can occur with orally administered drugs as well. A side effect, an adverse event and an allergic response are incorrect choices because drugs can cause these events after administration and absorption.

• Question 375:

  A client can receive the mumps, measles, rubella (MMR) vaccine if he or she __________.

  A. is pregnant

  B. is immunocompromised

  C. is allergic to neomycin

  D. has a cold

  Correct Answer: D

  A simple cold without fever does not preclude vaccination. Choices "is pregnant" and "is immunocompromised" are incorrect because pregnant women and immunocompromised individuals cannot have the MMR vaccine because the rubella component is a live virus and might cause birth defects and/or disease. Choice "is allergic to neomycin" is incorrect because the American Academy of Pediatrics states, "Persons who have experienced anaphylactic reactions to topically or systemically administered neomycin should not receive measles vaccine."

• Question 376:

  Narrow therapeutic index medications __________.

  A. are drug formulations with limited pharmacokinetic variability.

  B. have limited value and require no monitoring of blood levels.

  C. have less than a twofold difference in minimum toxic levels and minimum effective concentration in the blood.

  D. have limited potency and side effects.

  Correct Answer: C

  The therapeutic index is the ratio between the median lethal dose and median effective dose of a drug. It provides a general indication of the margin of safety of a drug. Choice "are drug formulations with limited pharmacokinetic variability." is incorrect because pharmacokinetics is the process of adsorption, distribution, metabolism, and elimination. Choice "have limited value and require no monitoring of blood levels." is incorrect because narrow therapeutic index drugs require close monitoring since there is often little difference between the desired drug effect and toxicity. Choice "have limited potency and side effects." is incorrect because narrow therapeutic index drugs have the potential for severe toxic effects with only slight increases in the dose or slight decreases in elimination.

• Question 377:

  Distribution of a drug to various tissues is dependent on the amount of cardiac output to each type of tissue.

  Which tissue would receive the highest amount of cardiac output and thus the highest amount of a drug?

  A. skin

  B. adipose tissue

  C. skeletal muscle

  D. myocardium

  Correct Answer: D

  Highly perfused tissue includes all vital organs: the brain, heart, kidneys, adrenal glands, and liver. Skin, adipose tissue and skeletal muscle are incorrect choices because the skin and adipose tissue are poorly perfused, while the skeletal muscle is better perfused.

• Question 378:

  A syringe pump is a type of electronic infusion pump used to infuse fluids or medications directly from a syringe.

  This device is commonly used for __________.

  A. solutions administered in obstetrics

  B. dilute antibiotics

  C. large volumes of IV solution

  D. the neonatal and pediatric populations

  Correct Answer: D

  Small volumes of medication or fluids are delivered and sometimes at slow rates to neonates and pediatric clients. The syringe pump allows precise infusion of small volumes. Solutions administered in obstetrics is incorrect because a syringe pump can be used in almost any setting, but is not generally for adult clients. Dilute antibiotics and large volumes of IV solution are incorrect because large volumes of fluids are not administered with a syringe pump.

• Question 379:

  Fat emulsions are frequently administered as a part of total parenteral nutrition.

  Which statement is true regarding fat emulsions?

  A. They have a high energy-to-fluid-volume ratio.

  B. Even though hypertonic, they are well tolerated.

  C. They are a basic solution secondary to the addition of sodium hydroxide (NaOH).

  D. The pH is alkaline, making them compatible with most medications.

  Correct Answer: A

  They have a high energy-to-fluid-volume ratio. Fat emulsions are formulated in 10%, 20%, and 30% solutions and supply 1.1, 2, and 3 kilocalories respectively for each milliliter. A milliliter of 5% dextrose only supplies 0.17 kilocalories. Choices "Even though hypertonic, they are well tolerated.", "They are a basic solution secondary to the addition of sodium hydroxide (NaOH)." and "The pH is alkaline, making them compatible with most medications." are incorrect because fat emulsions are essentially pH neutral and isotonic.

• Question 380:

  The physician orders the antibiotics ampicillin (Omnipen) and gentamicin (Garamycin) for a newly admitted client with an infection.

  The nurse should __________.

  A. administer both medications simultaneously.

  B. give the medications sequentially, and flush well between them.

  C. ask the physician or pharmacy which medication to give first and how long to wait before giving the other drug.

  D. start one medication now and begin the other medication in 2-4 hours.

  Correct Answer: B

  A client with an infection needs both antibiotics as soon as possible. However, the pH of ampicillin is 8-10, and the pH of gentamicin is 3-5.5 (making them incompatible when given together). Flushing well between drugs is necessary. To ask the physician or pharmacy which medication to give first and how long to wait before giving the other drug is incorrect because the PN determines the correct steps and consults with the pharmacist and the physician as necessary. To start one medication now and begin the other medication in 2-4 hours is incorrect because delaying the second medication by several hours slows the treatment of the client's infection.