Published - Thu, 23 Feb 2023
NCLEX-PN Exam Questions - Part 28
1. 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
2. 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.
3. 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.
4. The nurse wishes to decrease a client - s use of denial and increase the client - s expression of feelings. To do this the nurse should:
A) tell the client to stop using the defense mechanism of denial.
B) positively reinforce each expression of feelings.
C) instruct the client to express feelings.
D) challenge the client each time denial is used.
5. A 57-year-old woman is recently widowed. She states, 'I will never be able to learn how to manage the finances. My husband did all of that.' Select the nurse - s response that could help raise the clients self-esteem.
A) 'You feel inadequate because you have never learned to balance a checkbook.'
B) 'You should have insisted your husband teach you about the finances.'
C) 'You are strong and will learn how to manage your finances after awhile.'
D) 'Why don - t you take a class in basic finance from the local college?'
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
2. 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.
3. 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.
4. The nurse wishes to decrease a client - s use of denial and increase the client - s expression of feelings. To do this the nurse should:
A) tell the client to stop using the defense mechanism of denial.
B) positively reinforce each expression of feelings.
C) instruct the client to express feelings.
D) challenge the client each time denial is used.
5. A 57-year-old woman is recently widowed. She states, 'I will never be able to learn how to manage the finances. My husband did all of that.' Select the nurse - s response that could help raise the clients self-esteem.
A) 'You feel inadequate because you have never learned to balance a checkbook.'
B) 'You should have insisted your husband teach you about the finances.'
C) 'You are strong and will learn how to manage your finances after awhile.'
D) 'Why don - t you take a class in basic finance from the local college?'
1. Right Answer: C
Explanation: 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. Choice 1 is incorrect because less drug is available if it is bound to protein. Choice 2 is incorrect because distribution to receptor sites is irrelevant if the drug, which is bound to protein, cannot bind with a receptor site. Choice 4 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. Pharmacological Therapies
2. Right Answer: B
Explanation: A client with an infection needs both antibiotics as soon a possible. However, the pH of ampicillin is 810, and the pH of gentamicin is 35.5 (making them incompatible when given together). Flushing well between drugs is necessary. Choice 3 is incorrect because the PN determines the correct steps and consults with the pharmacist and the physician as necessary. Choice 4 is incorrect because delaying the second medication by several hours slows the treatment of the clients infection. Pharmacological Therapies
3. Right Answer: A
Explanation: 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 2, 3, and 4 are incorrect because fat emulsions are essentially pH neutral and isotonic. Pharmacological Therapies
4. Right Answer: B
Explanation: The nurse should positively reinforce each expression of feelings. Psychosocial Integrity
5. Right Answer: C
Explanation: The nurse can raise the clients self-esteem by communicating confidence the client can participate in actively finding solutions to the problem. The nurse also conveys the client is a worthwhile person by listening and accepting the clients feelings and praising the client for seeking assistance. Psychosocial Integrity
Explanation: 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. Choice 1 is incorrect because less drug is available if it is bound to protein. Choice 2 is incorrect because distribution to receptor sites is irrelevant if the drug, which is bound to protein, cannot bind with a receptor site. Choice 4 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. Pharmacological Therapies
2. Right Answer: B
Explanation: A client with an infection needs both antibiotics as soon a possible. However, the pH of ampicillin is 810, and the pH of gentamicin is 35.5 (making them incompatible when given together). Flushing well between drugs is necessary. Choice 3 is incorrect because the PN determines the correct steps and consults with the pharmacist and the physician as necessary. Choice 4 is incorrect because delaying the second medication by several hours slows the treatment of the clients infection. Pharmacological Therapies
3. Right Answer: A
Explanation: 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 2, 3, and 4 are incorrect because fat emulsions are essentially pH neutral and isotonic. Pharmacological Therapies
4. Right Answer: B
Explanation: The nurse should positively reinforce each expression of feelings. Psychosocial Integrity
5. Right Answer: C
Explanation: The nurse can raise the clients self-esteem by communicating confidence the client can participate in actively finding solutions to the problem. The nurse also conveys the client is a worthwhile person by listening and accepting the clients feelings and praising the client for seeking assistance. Psychosocial Integrity
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