NCLEX EXAM zm
Exam Solution zm
NCLEX PN Review Pharmacology 2026 A+ GRADE ASSU
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RED COMPLETE SOLUTIONS AND VERIFIED ANSWERS (
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A181E)
QUESTION 1 zm
Term
ANSWER
Definition
QUESTION 2 zm
229. The nurse is caring for a client with metastatic breast cancer who is taking tamo
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xifen citrate (Nolvadex). The nurse plans to monitor for which trend in laboratory val
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ues for this client? 1. Prolonged bleeding time 2. Decreasing sodium level 3. Rising ser
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um calcium level 4. Increasing blood glucose level
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ANSWER
Answer: 3 Rationale: Tamoxifen citrate may increase calcium, cholesterol, and triglyceride levels. Bef
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ore initiation of therapy, a complete blood count, platelet count, and serum calcium level should be
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obtained. These blood levels should continue to be monitored periodically during therapy. Options 1,
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m2, and 4 are not a concern with this medication. Test-
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Taking Strategy: Focus on the subject, laboratory values related to tamoxifen. Knowledge about the e
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ffects of tamoxifen citrate is required to answer this question. Remember that this medication affects
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the calcium level. Review: tamoxifen
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QUESTION 3 zm
231. Which finding indicates the presence of systemic toxicity from topical salicylic aci
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d? 1. Tinnitus 2. Vomiting 3. Constipation 4. Decreased respirations
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ANSWER
Answer: 1 Rationale: Salicylic acid is readily absorbed through the skin, and systemic toxicity (salicyl
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ism) can result. Symp-
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, toms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Vomiting and constipati
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on are not associated with salicylism. Test-
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Taking Strategy: Focus on the subject, toxicity. Remember that tinnitus indicates toxicity from salicyl
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ic acid. Review: salicylic acid.
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QUESTION 4 zm
234. The nurse is caring for a client who shows signs of benzodiazepine withdrawal. T
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he nurse should ask the client about abruptly discontinuing which medication? 1. Pre
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dnisone 2. Sertraline (Zoloft) 3. Diazepam (Valium) 4. Fluoxetine (Prozac)
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ANSWER
Answer: 3 Rationale: The only benzodiazepine presented in the options is diazepam (Valium). Short-
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acting benzodiazepines can produce withdrawal symptoms within 1 to 2 days, whereas the long-
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acting ones take 5 to 10 days for withdrawal symptoms to occur following discontinuation. Manifest
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ations include insomnia, agitation, anxiety, irritability, nausea, and diaphoresis. The other options are
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a corticosteroid (option 1) and antidepressants (options 2 and 4). Test-
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Taking Strategy: Note the subject, a benzodiazepine. Recalling the medication classifications will dire
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ct you to the correct option. Review: benzodiazepine withdrawal.
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QUESTION 5 zm
235. The nurse is caring for a client who has been prescribed sucralfate (Carafate). Th
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e nurse notifies the health care provider if which other medication is noted in the me
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dical record? 1. Bumetanide 2. Digoxin (Lanoxin) 3. Cyclobenzaprine (Flexeril) 4. Spiro
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nolactone (Aldactone) zm
ANSWER
Answer: 2 Rationale: Medication interactions can occur if the client is taking sucralfate (Carafate) co
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ncurrently with digoxin (Lanoxin), phenytoin (Dilantin), theophylline, warfarin sodium (Coumadin), a
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nd certain antibiotics. Medication interactions do not occur with the medications noted in options 1,
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m3, or 4. Test-
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Taking Strategy: Note the subject, a medication interaction. Note that options 1 and 4 are comparabl
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e or alike in that they are both diuretics; therefore, these options can be eliminated. From the remai
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ning options, it is necessary to know which medications can result in an interaction. Review: sucralf
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ate.
QUESTION 6 zm
236. A client has begun therapy with theophylline (Theo-
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24). The nurse plans to teach the client to limit the intake of which items while takin
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g this medication? (Select all that apply.) 1. Tea 2. Cola 3. Milk 4. Chocolate 5. Orange
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juice
ANSWER
,Answer: 1, 2, 4 Rationale: Theophylline is a methylxanthine bronchodilator. The nurse teaches the cl
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ient to limit the intake of xanthine-
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containing foods while taking this medication. These include tea, coffee, cola, and chocolate. Test-
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Taking Strategy: Recall that theophylline is a methylxanthine bronchodilator and the foods that are n
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aturally high in xanthines. Note that the correct options are comparable or alike and contain caffein
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e. Review: teaching points for methylxanthine bronchodilators.
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QUESTION 7 zm
237. A client who is human immunodeficiency virus (HIV) seropositive has been takin
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g stavudine (Zerit). The nurse should monitor which item closely while the client is ta
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king this medication? 1. Appetite 2. Presence of paresthesias 3. Gastrointestinal functi
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on 4. Level of consciousness
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ANSWER
Answer: 2 Rationale: Stavudine is an antiretroviral (protease inhibitor) used in the management of
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HIV infection in clients who do not respond to or who cannot tolerate conventional therapy. The me
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dication can cause peripheral neuropathy; the nurse should closely monitor the client's gait and ask
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the client about paresthesia. Options 1, 3, and 4 are not directly associated with the use of this med
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ication. Test- zm
Taking Strategy: Focus on the subject, side effects of this medication. Knowledge regarding the specif
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ic side effects of this medication is needed to answer this question. Remember that stavudine causes
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peripheral neuropathy. Review: stavudine.
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QUESTION 8 zm
238. The nurse caring for the client who has been prescribed tamoxifen (Nolvadex) fo
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r off-
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label use understands that which condition may be present? 1. Gynecomastia 2. Breast
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cancer 3. Uterine cancer 4. Ductal carcinoma
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ANSWER
Answer: 1 Rationale: Of- zm zm zm
label uses of tamoxifen include melanoma, induction of ovulation, gynecomastia, pancreatic tumors, a
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nd precocious puberty in females. Breast cancer, uterine cancer, and ductal carcinoma are therapeuti
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c (not off-label) uses. Test-Taking Strategy: Focus on the subject, an off-
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label use of the medication. Noting that options 2 and 4 are comparable or alike in that they are bo
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th forms of breast cancer will assist in eliminating these options. From the remaining options, recall
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mthat this medication is indicated for uterine cancer to assist in eliminating this option. Review: tamo
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xifen.
QUESTION 9 zm
239. A client with allergic dermatitis has been given a prescription for a tube of diphe
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nhydramine (Benadryl) to use as a topical agent. The nurse evaluates on a follow-
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, up visit that the medication was effective if which effect was noted? 1. Nighttime seda
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tion 2. Decrease in urticaria 3. Absence of ecchymoses 4. Healing of irritated skin
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ANSWER
Answer: 2 Rationale: Diphenhydramine reduces the symptoms of allergic reaction, such as itching or
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murticaria, when used as a topical agent on the skin. The medication also has many other uses, such
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as to provide mild nighttime sedation when given in the oral form. It is not used to heal irritated sk
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in or ecchymoses. Test-
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Taking Strategy: Note the strategic word "effective" and the client's diagnosis, "allergic dermatitis." T
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his tells you that the correct option is one that indicates relief of an allergic skin condition, which w
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ill direct you to the correct option. Review: uses of antihistamines.
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QUESTION 10 zm
241. A client is scheduled to receive chemotherapy with asparaginase (Elspar). The nu
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rse anticipates that this medication will be discontinued from the regimen after notin
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g which disorder in the client's medical record? 1. Heart failure 2. Hypersensitivity 3.
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Hypothyroidism 4. Chronic airflow limitation zm zm zm zm
ANSWER
Answer: 2 Rationale: Asparaginase is contraindicated if the client has shown hypersensitivity or has
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pancreatitis or a history of the same. Because this medication impairs pancreatic function, tests to m
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onitor pancreatic function should be performed before initiating therapy and when 1 week or more
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has elapsed between doses. The client is also monitored for signs of pancreatitis, which include naus
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ea, vomiting, and abdominal pain. Options 1, 3, and 4 are not contraindications for the use of this m
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edication. Test- zm
Taking Strategy: Focus on the subject, a contraindication. Remember that asparaginase is contraindic
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ated in hypersensitivity and pancreatitis. Review: asparaginase.
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QUESTION 11 zm
242. The health care provider has prescribed codeine sulfate for a client with a nonpr
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oductive cough to suppress the cough reflex. The nurse tells the client to take measur
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es to prevent which frequent side effect of this medication? 1. Constipation 2. Increase
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d salivation 3. Abdominal discomfort 4. Difficulty swallowing
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ANSWER
Answer: 1 Rationale: A frequent side effect of codeine sulfate is constipation. Additional side effects
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include drowsiness, nausea, and vomiting. Options 2, 3, and 4 are unrelated to the administration of
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mthis medication. Test-
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Taking Strategy: Focus on the subject, a frequent side effect. Recalling that this medication is an opi
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oid analgesic will direct you to the correct option. Remember that codeine sulfate can cause constip
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ation. Review: side effects of opioid analgesics.
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QUESTION 12 zm
Exam Solution zm
NCLEX PN Review Pharmacology 2026 A+ GRADE ASSU
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RED COMPLETE SOLUTIONS AND VERIFIED ANSWERS (
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A181E)
QUESTION 1 zm
Term
ANSWER
Definition
QUESTION 2 zm
229. The nurse is caring for a client with metastatic breast cancer who is taking tamo
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xifen citrate (Nolvadex). The nurse plans to monitor for which trend in laboratory val
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ues for this client? 1. Prolonged bleeding time 2. Decreasing sodium level 3. Rising ser
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um calcium level 4. Increasing blood glucose level
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ANSWER
Answer: 3 Rationale: Tamoxifen citrate may increase calcium, cholesterol, and triglyceride levels. Bef
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ore initiation of therapy, a complete blood count, platelet count, and serum calcium level should be
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obtained. These blood levels should continue to be monitored periodically during therapy. Options 1,
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m2, and 4 are not a concern with this medication. Test-
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Taking Strategy: Focus on the subject, laboratory values related to tamoxifen. Knowledge about the e
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ffects of tamoxifen citrate is required to answer this question. Remember that this medication affects
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the calcium level. Review: tamoxifen
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QUESTION 3 zm
231. Which finding indicates the presence of systemic toxicity from topical salicylic aci
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d? 1. Tinnitus 2. Vomiting 3. Constipation 4. Decreased respirations
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ANSWER
Answer: 1 Rationale: Salicylic acid is readily absorbed through the skin, and systemic toxicity (salicyl
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ism) can result. Symp-
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, toms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Vomiting and constipati
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on are not associated with salicylism. Test-
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Taking Strategy: Focus on the subject, toxicity. Remember that tinnitus indicates toxicity from salicyl
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ic acid. Review: salicylic acid.
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QUESTION 4 zm
234. The nurse is caring for a client who shows signs of benzodiazepine withdrawal. T
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he nurse should ask the client about abruptly discontinuing which medication? 1. Pre
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dnisone 2. Sertraline (Zoloft) 3. Diazepam (Valium) 4. Fluoxetine (Prozac)
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ANSWER
Answer: 3 Rationale: The only benzodiazepine presented in the options is diazepam (Valium). Short-
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acting benzodiazepines can produce withdrawal symptoms within 1 to 2 days, whereas the long-
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acting ones take 5 to 10 days for withdrawal symptoms to occur following discontinuation. Manifest
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ations include insomnia, agitation, anxiety, irritability, nausea, and diaphoresis. The other options are
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a corticosteroid (option 1) and antidepressants (options 2 and 4). Test-
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Taking Strategy: Note the subject, a benzodiazepine. Recalling the medication classifications will dire
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ct you to the correct option. Review: benzodiazepine withdrawal.
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QUESTION 5 zm
235. The nurse is caring for a client who has been prescribed sucralfate (Carafate). Th
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e nurse notifies the health care provider if which other medication is noted in the me
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dical record? 1. Bumetanide 2. Digoxin (Lanoxin) 3. Cyclobenzaprine (Flexeril) 4. Spiro
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nolactone (Aldactone) zm
ANSWER
Answer: 2 Rationale: Medication interactions can occur if the client is taking sucralfate (Carafate) co
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ncurrently with digoxin (Lanoxin), phenytoin (Dilantin), theophylline, warfarin sodium (Coumadin), a
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nd certain antibiotics. Medication interactions do not occur with the medications noted in options 1,
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m3, or 4. Test-
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Taking Strategy: Note the subject, a medication interaction. Note that options 1 and 4 are comparabl
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e or alike in that they are both diuretics; therefore, these options can be eliminated. From the remai
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ning options, it is necessary to know which medications can result in an interaction. Review: sucralf
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ate.
QUESTION 6 zm
236. A client has begun therapy with theophylline (Theo-
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24). The nurse plans to teach the client to limit the intake of which items while takin
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g this medication? (Select all that apply.) 1. Tea 2. Cola 3. Milk 4. Chocolate 5. Orange
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juice
ANSWER
,Answer: 1, 2, 4 Rationale: Theophylline is a methylxanthine bronchodilator. The nurse teaches the cl
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ient to limit the intake of xanthine-
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containing foods while taking this medication. These include tea, coffee, cola, and chocolate. Test-
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Taking Strategy: Recall that theophylline is a methylxanthine bronchodilator and the foods that are n
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aturally high in xanthines. Note that the correct options are comparable or alike and contain caffein
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e. Review: teaching points for methylxanthine bronchodilators.
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QUESTION 7 zm
237. A client who is human immunodeficiency virus (HIV) seropositive has been takin
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g stavudine (Zerit). The nurse should monitor which item closely while the client is ta
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king this medication? 1. Appetite 2. Presence of paresthesias 3. Gastrointestinal functi
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on 4. Level of consciousness
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ANSWER
Answer: 2 Rationale: Stavudine is an antiretroviral (protease inhibitor) used in the management of
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HIV infection in clients who do not respond to or who cannot tolerate conventional therapy. The me
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dication can cause peripheral neuropathy; the nurse should closely monitor the client's gait and ask
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the client about paresthesia. Options 1, 3, and 4 are not directly associated with the use of this med
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ication. Test- zm
Taking Strategy: Focus on the subject, side effects of this medication. Knowledge regarding the specif
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ic side effects of this medication is needed to answer this question. Remember that stavudine causes
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peripheral neuropathy. Review: stavudine.
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QUESTION 8 zm
238. The nurse caring for the client who has been prescribed tamoxifen (Nolvadex) fo
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r off-
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label use understands that which condition may be present? 1. Gynecomastia 2. Breast
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cancer 3. Uterine cancer 4. Ductal carcinoma
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ANSWER
Answer: 1 Rationale: Of- zm zm zm
label uses of tamoxifen include melanoma, induction of ovulation, gynecomastia, pancreatic tumors, a
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nd precocious puberty in females. Breast cancer, uterine cancer, and ductal carcinoma are therapeuti
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c (not off-label) uses. Test-Taking Strategy: Focus on the subject, an off-
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label use of the medication. Noting that options 2 and 4 are comparable or alike in that they are bo
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th forms of breast cancer will assist in eliminating these options. From the remaining options, recall
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mthat this medication is indicated for uterine cancer to assist in eliminating this option. Review: tamo
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xifen.
QUESTION 9 zm
239. A client with allergic dermatitis has been given a prescription for a tube of diphe
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nhydramine (Benadryl) to use as a topical agent. The nurse evaluates on a follow-
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, up visit that the medication was effective if which effect was noted? 1. Nighttime seda
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tion 2. Decrease in urticaria 3. Absence of ecchymoses 4. Healing of irritated skin
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ANSWER
Answer: 2 Rationale: Diphenhydramine reduces the symptoms of allergic reaction, such as itching or
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murticaria, when used as a topical agent on the skin. The medication also has many other uses, such
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as to provide mild nighttime sedation when given in the oral form. It is not used to heal irritated sk
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in or ecchymoses. Test-
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Taking Strategy: Note the strategic word "effective" and the client's diagnosis, "allergic dermatitis." T
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his tells you that the correct option is one that indicates relief of an allergic skin condition, which w
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ill direct you to the correct option. Review: uses of antihistamines.
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QUESTION 10 zm
241. A client is scheduled to receive chemotherapy with asparaginase (Elspar). The nu
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rse anticipates that this medication will be discontinued from the regimen after notin
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g which disorder in the client's medical record? 1. Heart failure 2. Hypersensitivity 3.
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Hypothyroidism 4. Chronic airflow limitation zm zm zm zm
ANSWER
Answer: 2 Rationale: Asparaginase is contraindicated if the client has shown hypersensitivity or has
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pancreatitis or a history of the same. Because this medication impairs pancreatic function, tests to m
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onitor pancreatic function should be performed before initiating therapy and when 1 week or more
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has elapsed between doses. The client is also monitored for signs of pancreatitis, which include naus
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ea, vomiting, and abdominal pain. Options 1, 3, and 4 are not contraindications for the use of this m
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edication. Test- zm
Taking Strategy: Focus on the subject, a contraindication. Remember that asparaginase is contraindic
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ated in hypersensitivity and pancreatitis. Review: asparaginase.
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QUESTION 11 zm
242. The health care provider has prescribed codeine sulfate for a client with a nonpr
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oductive cough to suppress the cough reflex. The nurse tells the client to take measur
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es to prevent which frequent side effect of this medication? 1. Constipation 2. Increase
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d salivation 3. Abdominal discomfort 4. Difficulty swallowing
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ANSWER
Answer: 1 Rationale: A frequent side effect of codeine sulfate is constipation. Additional side effects
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include drowsiness, nausea, and vomiting. Options 2, 3, and 4 are unrelated to the administration of
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mthis medication. Test-
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Taking Strategy: Focus on the subject, a frequent side effect. Recalling that this medication is an opi
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oid analgesic will direct you to the correct option. Remember that codeine sulfate can cause constip
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ation. Review: side effects of opioid analgesics.
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QUESTION 12 zm
