NCLEX Pharmacology Questions (76-80)

NCLEX Pharmacology Questions

76. The home care nurse provides medication instructions to an older hypertensive client who is taking lisinopril (Prinivil), 20 mg orally daily. Which statement, if made by the client, indicates that further teaching is necessary?

a) I can skip a dose once a week
b) I need to change my position slowly
c) I take the pill after breakfast each day
d) If I get bad headache, I should call my doctor immediately

77. The nurse is providing medication instructions to an older client who is taking digoxin (Lanoxin) daily. Th nurse notes that which age-related body changes could place the client at risk for digoxin toxicity?

a) decreased muscle strength and loss of bone density
b) decreased cough efficiency and decreased vital capacity
c) decrease salivation and decreased gastrointestinal motility
d) decreased lean body mass and decreased glomerular filtration rate



78. Antibiotics are prescribed for a child after myringotomy with insertion of tymphanostomy tubes and the nurse provides discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates that they understood the instructions?

a) administer the antibiotics until they are gone
b) administer the antibiotics if the child has a fever
c) administer the antibiotics until the child feels better
d) begin to taper the antibiotics after 3 days of full course

79. Acetylsalicylic acid (aspirin) is prescribed for a child with rheumatic fever. A nurse would question this order if there were documented evidence that the child had which of the following?

a) joint pain
b) arthralgia
c) facial edema
d) a viral infection

80. Cloxacillin, 200mg orally every 8 hours, is prescribed for a child with an elevated temperature who is suspected of having a respiratory tract infection. The child weighs 17 lb. The safe pediatric dosage is 50 mg/kg/day. The nurse determines that:

a) the dose prescribed is safe
b) the dose prescribed is too low
c) the dose prescribed is too high
d) there is not enough information to determine the safe dose




NCLEX Pharmacology Questions:
ANSWERS AND RATIONALE

76) A

- lisinopril is an antihypertensive angiotensin-converting enzyme inhibitor. The usual dosage range is 20 to 40 mg daily. Adverse effects include headache, dizziness, fatigue, orthostatic hypotnesion, tachycardia, and angioedema. Specific client teaching points include taking one pill a day, not stopping the medication without consulting the physician, and monitoring for side effects and adverse reactions. The client should notify the physician if side effects occur.

77)  D

- the older client is at risk for medication toxicity because of decreased lean body mass and an age-associated decreased glomerular filtration rate. Although options A, B, and C identify age-related changes that occur in the older client, they are not associated specifically with this risk.

78) A

- A myringotomy is the insertion of tympanoplasty tubes into the middle ear to equalize pressure and keep the ear aerated. The nurse must instruct parents regarding the administration of antibiotics. Antibiotics need to be taken as prescribed, and the full course needs to be completed. Options B, C, and D are incorrect. Antibiotics are not tapered but are administered for the full course of therapy.

79) D

- Anti-inflammatory agents, including aspirin, may be prescribed for the child with rheumatic fever. Aspirin should not be given to a child who has chickenpox or other viral infections, such as the flu. Options A and B are clinical manifestations of rheumatic fever. Facial edema may be associated with the development of a cardiac complication.

80) C

- Convert pounds to kilograms by dividing by 2.2. The dose is unsafe because it is higher than the safe dosage parameters of 386 mg/day.

pounds to kilogram: 17lb/2.2 lb/kg = 7.72 kg
dosage parameters: 50mg/kg/day x 7.72 kg = 386 mg/day
dosage frequency: 200 mg x 3 doses (every 8 hours) = 600 mg/day



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