NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 381:

  Medication bound to protein can have which of the following effects?

  A. enhancement of drug availability

  B. rapid distribution of the drug to receptor sites

  C. less availability to produce desired medicinal effects

  D. increased metabolism of the drug by the liver

  Correct Answer: C

  Only an unbound drug can be distributed to active receptor sites. Therefore, the more of a drug that is bound to protein, the less it is available for the desired drug effect. Enhancement of drug availability is incorrect because less drug is available if it is bound to protein. Rapid distribution of the drug to receptor sites is incorrect because distribution to receptor sites is irrelevant if the drug, which is bound to protein, cannot bind with a receptor site. Increased metabolism of the drug by the liver is incorrect because metabolism is not increased. The liver first has to remove the drug from the protein molecule before metabolism can occur. The protein is then free to return to circulation and be used again.

• Question 382:

  The chemotherapeutic DNA alkylating agents such as nitrogen mustards are effective because they __________.

  A. cross-link DNA strands with covalent bonds between alkyl groups on the drug and guanine bases on DNA

  B. have few, if any, side effects

  C. are used to treat multiple types of cancer

  D. are cell-cycle-specific agents

  Correct Answer: A

  Alkylating agents are highly reactive chemicals that introduce alkyl radicals into biologically active molecules and thereby prevent their proper functioning, replication, and transcription. Choice "have few, if any, side effects" is incorrect because alkylating agents have numerous side effects including alopecia, nausea, vomiting, and myelosuppression. Choice "are used to treat multiple types of cancer" is incorrect because nitrogen mustards have a broad spectrum of activity against chronic lymphocytic leukemia, nonHodgkin's lymphoma, and breast and ovarian cancer, but they are effective chemotherapeutic agents because of DNA crosslinkage. Choice "are cell-cycle-specific agents" is incorrect because alkylating agents are non-cell-cycle-specific agents.

• Question 383:

  Central venous access devices (CVADs) are frequently utilized to administer chemotherapy.

  What is an advantage of using CVADs for chemotherapeutic agent administration?

  A. CVADs are less expensive than a peripheral IV.

  B. Weekly administration is possible.

  C. Chemotherapeutic agents can be caustic to smaller veins.

  D. The client or family can administer the drug at home.

  Correct Answer: C

  Many chemotherapeutic drugs are vesicants (highly active corrosive materials that can produce tissue damage even in low concentrations). Administration into a large vein is optimal. Choice "CVADs are less expensive than a peripheral IV." is incorrect because CVADs are more expensive than a peripheral IV. Choice "Weekly administration is possible." is incorrect because dosing depends on the drug.

  Choice "The client or family can administer the drug at home." is incorrect because IV chemotherapeutic agents are not routinely administered at home; they are usually given in a hospital or in an outpatient or clinic setting.

• Question 384:

  Which of the following solutions is routinely used to flush an IV device before and after the administration of blood to a client?

  A. 0.9% sodium chloride

  B. 5% dextrose in water solution

  C. sterile water

  D. Heparin sodium

  Correct Answer: A

  Normal saline is 0.9% sodium chloride. This solution has the same osmolarity as blood. Its use does not

  cause lysis of cells.

  Choices "5% dextrose in water solution" and "sterile water" are hypotonic solutions that can cause cell

  lysis.

  Choice "Heparin sodium" is an anticoagulant.

• Question 385:

  A teenage client is admitted to the hospital because of acetaminophen (Tylenol) overdose.

  In which of the following organs overdoses of acetaminophen can precipitate life-threatening abnormalities?

  A. lungs

  B. liver

  C. kidneys

  D. adrenal glands

  Correct Answer: B

  Acetaminophen is extensively metabolized in the liver.

  Lungs, kidneys and adrenal glands are incorrect choices because prolonged use of acetaminophen might

  result in an increased risk of renal dysfunction, but a single overdose does not precipitate life-threatening

  problems in the respiratory system, renal system, or adrenal glands.

• Question 386:

  The LPN is caring for a patient with an NG tube, and the RN administers evening medications through the NG tube. The patient asks if he can lie down when the nurse leaves the room.

  What is the most appropriate response?

  A. Yes, feel free to lie down.

  B. You can lie down in 5 minutes if your NG residual is below 50 mLs.

  C. You can lie down in about 30 minutes.

  D. You can lie down in 1 hour.

  Correct Answer: C

• Question 387:

  While repositioning the patient, the LPN notices a shallow, open ulcer on the sacrum with partial-thickness skin loss.

  What is the classification stage of this ulcer?

  A. Stage IV

  B. Stage III

  C. Stage I

  D. Stage II

  Correct Answer: D

• Question 388:

  The LPN is auscultating for bowel sounds and hears between 3 and 4 bowel sounds per minute. This is a somewhat expected finding for __________ patients.

  A. a 45-year-old male recovering from a knee replacement under general anesthesia

  B. a 56-year-old female with dementia undergoing a swallow study

  C. a 63-year-old female undergoing chemotherapy for breast cancer

  D. a 34-year-old male with a PEG tube newly admitted for diabetic ketoacidosis

  Correct Answer: A

• Question 389:

  When performing an abdominal assessment, what is the correct order of the tasks?

  A. inspect, palpate, auscultate, percuss

  B. inspect, palpate, percuss, auscultate

  C. inspect, auscultate, percuss, palpate

  D. inspect, percuss, palpate, auscultate

  Correct Answer: C

• Question 390:

  The LPN is checking for residual before administering enteral feeding through a PEG tube.

  Which of these steps is incorrect?

  A. If the residual is greater than 200mL, the LPN should not administer the enteral feeding.

  B. The residual should be discarded prior to administering the tube feeding.

  C. The residual pH level is tested to ensure appropriate placement.

  D. The LPN elevates the head of the bed at least 30 degrees.

  Correct Answer: B