NCLEX RN Pharmacology Study Guide 21-25

During your shifts, you’ll probably mostly encounter these 5 NCLEX RN Pharmacology Study Guide Questions.

 21. Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson’s disease. The nurse monitors the client for side/ adverse effects to the medication. Which finding indicates that the client is experiencing an adverse effect?

a) Pruritus
b) Tachycardia
c) Hypertension
d) Impaired voluntary movements

22. The home health nurse visits a client who is taking phenytoin (Dilantin) for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information should the nurse include in the teaching plan?

a) Pregnancy should be avoided while taking phenytoin.
b) The client may stop the medication if it is causing severe gastrointestinal effects.
c) There is the potential of decreased effectiveness of birth control pills while taking phenytoin.
d) There is the increased risk of thrombophlebitis while taking phenytoin and birth control pills together.

23. NCLEX RN Pharmacology Study Guide question about the nurse who is caring for a client in the emergency department who has been diagnosed with Bell’s palsy. The client has been taking acetaminophen (Tylenol), and acetaminophen overdose is suspected. Which antidote should the nurse anticipate to be prescribed?

a) Pentostatin (Nipent)
b) Auranofin (Ridaura)
c) Fludarabine (Fludara)
d) Acetylcysteine (Mucomyst)

24. Meperidine hydrochloride (Demerol) has been prescribed for a client to treat pain. Which are side/ adverse effects of this medication? Select all that apply.

a) Diarrhea
b) Tremors
c) Drowsiness
d) Hypotension
e) Urinary frequency
f) Increased respiratory rate

25. A client is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/ mL. Which finding would be expected as a result of this laboratory result?

a) Hypotension
b) Tachycardia
c) Slurred speech
d) No abnormal finding

NCLEX RN Pharmacology Study Guide
Answers and Rationale

21) D
- Rationale: Dyskinesia and impaired voluntary movement may occur with high levodopa dosages. Nausea, anorexia, dizziness, orthostatic hypotension, bradycardia, and akinesia are frequent side effects of the medication.

- Test-Taking Strategy: Focus on the subject, an adverse effect. Options B and C are comparable or alike and are cardiac-related options, so these options can be eliminated first. Next, focus on the client’s diagnosis and select the correct option over option A because it relates to the neurological system.

22) C
- Rationale: Phenytoin enhances the rate of estrogen metabolism, which can decrease the effectiveness of some birth control pills. Options A, B, and D are inappropriate instructions.

- NCLEX RN Pharmacology Study Guide Test-Taking Strategy: Focus on the subject, teaching points for the client taking phenytoin. Telling a client that there is an increased risk of thrombophlebitis is incorrect and inappropriate and could cause anxiety in the client. A client should not be instructed to stop anticonvulsant medication, as indicated in option B. Pregnancy does not need to be “avoided” while taking phenytoin; however, because phenytoin may cause some risk to the fetus (Pregnancy Category D drug), consultation with the health care provider should be done if pregnancy is considered.

23) D
- Rationale: The antidote for acetaminophen is acetylcysteine (Mucomyst). The normal therapeutic serum level of acetaminophen is 10 to 20 mcg/ mL. A toxic level is higher than 50 mcg/ mL, and levels higher than 200 mcg/ mL could indicate hepatotoxicity. Auranofin (Ridaura) is a gold preparation used to treat rheumatoid arthritis. Pentostatin (Nipent) and fludarabine (Fludara) are antineoplastic agents.

- Test-Taking Strategy: Eliminate options A and C first because they are comparable or alike (antineoplastic agents). Recalling that auranofin is used to treat rheumatoid arthritis will direct you to the correct option.

24) B, C, D
- NCLEX RN Pharmacology Study Guide Rationale: Meperidine hydrochloride is an opioid analgesic. Side/ adverse effects include respiratory depression, drowsiness, hypotension, constipation, urinary retention, nausea, vomiting, and tremors.

- Test-Taking Strategy: Note the subject of the question, side/ adverse effects of meperidine. Recalling that this medication is an opioid analgesic and recalling the effects of an opioid analgesic will assist in identifying the correct options.

25) C
- Rationale: The therapeutic phenytoin level is 10 to 20 mcg/ mL. At a level higher than 20 mcg/ mL, involuntary movements of the eyeballs (nystagmus) occur. At a level higher than 30 mcg/ mL, ataxia and slurred speech occur.

- Test-Taking Strategy: Focus on the subject, a phenytoin level of 35 mcg/ mL. Use knowledge regarding the therapeutic phenytoin level. From this point, you must know the symptoms that would be noted in the client when the phenytoin level is 35 mcg/ mL. Remember that ataxia and slurred speech occur with levels higher than 30 mcg/ mL.

After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

NCLEX RN Pharmacology Study Guide 1-5

 Or proceed to the next set of questions:

NCLEX RN Pharmacology Study Guide 26-34

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