NCLEX-RN Pharmacology version 1/NCLEX RN
Pharmacology Test Bank 1 Actual Exam
Newest With Complete Questions And
Correct Detailed Answers| Brand New
Version!
A nurse is interacting with a depressed, suicidal client. What themes in the client's conversation
are of most concern to the nurse?
a) Power
b) Betrayal
c) Loneliness
d) Hopelessness
e) Indecisiveness c) Loneliness
d) Hopelessness
Loneliness and a sense of isolation may play a role in the intent to commit suicide. A real or
perceived lack of support increases the risk for suicide because there is no "lifeline of caring."
The main factor leading to acting-out on suicidal impulses is the feeling of hopelessness; there
are no longer reasons to live. The struggle for power and dominance is more commonly
encountered in the verbalizations of clients with paranoid schizophrenia. Betrayal is a feeling
more often verbalized by clients with a diagnosis of a borderline personality disorder. An
indecisive individual usually will not make the decision to commit suicide.
A depressed client has feelings of failure and a low self-esteem. In what activity should the client
initially be encouraged to become involved?
a) Joining other clients in playing a board game
b) Singing in a karaoke contest to be held at the end of the week
c) Assisting a staff member in working on the monthly bulletin board
d) Selecting the movie to be played during the evening recreation period c) Assisting a staff
member in working on the monthly bulletin board
Working on the bulletin board with staff members involves minimal energy and decision-making
and is the least threatening activity. Playing a board game is too stressful at this time; it will be a
better intervention when self-esteem improves and depression lessens. Singing karaoke is too
stressful an activity because it requires energy and good self-esteem, which the client does not
have at this time. Selecting a movie is too stressful at this time; it will be a better intervention
when self-esteem improves and depression lessens.
Test-Taking Tip: Do not select answers that contain exceptions to the general rule, controversial
material, or degrading responses.
1
,An infant is being admitted with bacterial meningitis. The nurse knows the priority nursing
action is:
a) Assessing the infant's neurological status
b) Beginning intravenous fluids and antibiotics
c) Implementing respiratory isolation precautions
d) Teaching the parents the importance of maintaining a quiet environment
c) Implementing respiratory isolation precautions
The infant's illness is contagious, and the nurse, as well as other clients, must first be protected
with the implementation of respiratory isolation precautions. Assessment of neurological status,
implementation of prescribed fluids and antibiotics, and parental teaching may be done after
assessment. Also, antibiotics are usually not administered until after all cultures have been
obtained.
An older client is transferred to a nursing home from a hospital with a diagnosis of dementia.
One morning, after being in the nursing home for several days, the client is going to join a group
of residents in recreational therapy. The nurse sees that the client has laid out several outfits on
the bed but is still wearing nightclothes. What should the nurse do?
a) Help the client dress and explain when residents are expected at the activity
b) Prompt the client to dress more quickly to avoid delaying the other residents
c) Help the client select appropriate attire and offer to help the client get dressed
d) Allow the client time to dress but explain that client has missed the opportunity to attend the
activityc) Help the client select appropriate attire and offer to help the client get dressed
Helping the client select appropriate attire and offering help in getting dressed aid the client in
decision-making; new situations may be stressful and may lead to ambivalent feelings. Helping
the client dress and explaining when residents are expected at the activity are not sharing
decision-making; the client may not remember this explanation in the future. Reminding the
client to dress more quickly to avoid delaying the other residents may make the client feel guilty
and may increase anxiety. The client may perceive being told that the opportunity to attend the
activity has been missed as punishment.
When teaching a client about using a diaphragm as a form of contraception, the nurse should tell
her that the diaphragm:
a) May or may not be used with a spermicidal lubricant
b) Should remain in place for at least 6 hours after intercourse
c) Must be inserted with the dome facing down to be maximally effective
d) Often appears puckered but that this will not interfere with its effectiveness b) Should
remain in place for at least 6 hours after intercourse
The should remain in place for at least 6 hours after intercourse because the spermicidal jelly or
cream requires this amount of time to be effective. The diaphragm must always be used with a
2
,spermicide to be effective. The diaphragm may be inserted with the dome facing either up or
down and still be effective. Puckering, especially near the rim, may indicate thin spots that could
rupture during intercourse; the diaphragm should be replaced if puckering is found.
A client is hospitalized with a diagnosis of emphysema. The nurse provides teaching and should
begin with which aspect of care?
a) The disease process and breathing exercises
b) How to control or prevent respiratory infections
c) Using aerosol therapy, especially nebulizers
d) Priorities in carrying out everyday activities a) The disease process and breathing
exercises
Clients need to understand the disease process and how interventions, such as breathing
exercises, can improve ventilation. Learning to control or prevent respiratory infections is
important, but it should be taught later. Although it is helpful to know about aerosol therapy and
nebulizers, knowing how to use aerosol therapy, especially nebulizers, should be taught later.
Although it is important to teach the client how to set priorities in carrying out everyday
activities, this should be taught later.
Test-Taking Tip: Being prepared reduces your stress or tension level and helps you maintain a
positive attitude.
A client who is having a difficult labor is found to have cephalopelvic disproportion. Which
medical order should the nurse question?
a) Maintain NPO status.
b) Start peripheral IV of ¼ NS.
c) Record fetal heart tones every 15 minutes.
d) Piggyback another 10-unit bag of oxytocin (Pitocin). d) Piggyback another 10-unit bag of
oxytocin (Pitocin).
When there is cephalopelvic disproportion, a is indicated; infusing oxytocin (Pitocin) at this time
could result in fetal compromise and uterine rupture. The nothing-by-mouth (NPO) status is
appropriate in anticipation of a cesarean birth. A peripheral IV is needed not only for hydration
but also for venous access if IV medications become necessary. The client probably has an
electronic monitor recording the fetal heart rate and uterine contractions; the findings of these
assessments should be documented regularly in accordance with hospital protocol.
A client is found to have paranoid schizophrenia, and the practitioner prescribes a typical
antipsychotic medication. After a 1-month hospitalization the client is discharged home with
instructions to continue the antipsychotic and a referral for weekly mental health counseling. The
picture illustrates the client's physical status as observed by the nurse on the client's first visit to
the community mental health clinic. What extrapyramidal side effect has developed?
a) Dystonia
b) Akathisia
c) Tardive dyskinesia
3
, d) Pseudoparkinsonism b) Akathisia
Akathisia, an extrapyramidal side effect of typical antipsychotics, is motor restlessness. The
client is unable to sit or stand still and feels the need to move, pace, rock, swing the legs, or tap
the feet. The condition occurs within 5 to 90 days of the initiation of therapy. Dystonia is muscle
spasms of the face, tongue, head, neck, jaw, or back, usually resulting in exaggerated posturing.
This extrapyramidal side effect of typical antipsychotics occurs within 1 hour to 1 week of the
initiation of therapy. Tardive dyskinesia is facial, ocular, oral/buccal, lingual/masticatory, and
systemic movements. This extrapyramidal side effect of typical antipsychotics may occur 6
months or more after the initiation of therapy. Pseudoparkinsonism has characteristics similar to
those of Parkinson's disease (e.g., shuffling gait, tremors, rigidity, bradykinesia). This
extrapyramidal side effect of typical antipsychotics may occur anytime after the initiation of
therapy.
What should the nurse discuss with new parents to help them prepare for infant care?
a) Allowing crying time to help the lungs develop
b) Establishing a set feeding schedule to promote steady weight gain
c) Counting the number of stool diapers daily to confirm adequate hydration
d) Learning specific behaviors involving states of wakefulness to promote positive interactions
d) Learning specific behaviors involving states of wakefulness to promote positive
interactions
Discussing behaviors during the baby's waking times that will promote positive interaction helps
parents understand the unique features of their newborn and promotes interaction and care during
periods of wakefulness. A healthy infant's lungs are developed at birth. It is best that infants be
on a demand feeding schedule, not a routine schedule. Demand feeding provides for
individuality; healthy infants gain weight steadily. Counting the number of stool diapers daily is
not a reliable method of determining adequate hydration.
A client is admitted with the diagnosis of possible myocardial infarction, and a series of
diagnostic tests are prescribed. Which blood level should the nurse expect will increase first if
this client has had a myocardial infarction?
a) Alanine aminotransferase (ALT)
b) Serum aspartate aminotransferase (AST)
c) Total lactate dehydrogenase (LDH)
d) Troponin T (cTnT) d) Troponin T (cTnT)
Troponin T has an extraordinarily high specificity for myocardial cell injury. Cardiac troponins
elevate sooner and remain elevated longer than many of the other enzymes that reflect
myocardial injury. ALT is found predominantly in the liver; it is found in lesser quantities in the
kidneys, heart, and skeletal muscles, and is primarily used to diagnose and monitor liver, not
heart, disease. AST, also known as (serum glutamic-oxaloacetic transaminase (SGOT), is
elevated 8 hours after a myocardial infarction. Total LDH () levels elevate 24 to 48 hours after a
myocardial infarction.
4
Pharmacology Test Bank 1 Actual Exam
Newest With Complete Questions And
Correct Detailed Answers| Brand New
Version!
A nurse is interacting with a depressed, suicidal client. What themes in the client's conversation
are of most concern to the nurse?
a) Power
b) Betrayal
c) Loneliness
d) Hopelessness
e) Indecisiveness c) Loneliness
d) Hopelessness
Loneliness and a sense of isolation may play a role in the intent to commit suicide. A real or
perceived lack of support increases the risk for suicide because there is no "lifeline of caring."
The main factor leading to acting-out on suicidal impulses is the feeling of hopelessness; there
are no longer reasons to live. The struggle for power and dominance is more commonly
encountered in the verbalizations of clients with paranoid schizophrenia. Betrayal is a feeling
more often verbalized by clients with a diagnosis of a borderline personality disorder. An
indecisive individual usually will not make the decision to commit suicide.
A depressed client has feelings of failure and a low self-esteem. In what activity should the client
initially be encouraged to become involved?
a) Joining other clients in playing a board game
b) Singing in a karaoke contest to be held at the end of the week
c) Assisting a staff member in working on the monthly bulletin board
d) Selecting the movie to be played during the evening recreation period c) Assisting a staff
member in working on the monthly bulletin board
Working on the bulletin board with staff members involves minimal energy and decision-making
and is the least threatening activity. Playing a board game is too stressful at this time; it will be a
better intervention when self-esteem improves and depression lessens. Singing karaoke is too
stressful an activity because it requires energy and good self-esteem, which the client does not
have at this time. Selecting a movie is too stressful at this time; it will be a better intervention
when self-esteem improves and depression lessens.
Test-Taking Tip: Do not select answers that contain exceptions to the general rule, controversial
material, or degrading responses.
1
,An infant is being admitted with bacterial meningitis. The nurse knows the priority nursing
action is:
a) Assessing the infant's neurological status
b) Beginning intravenous fluids and antibiotics
c) Implementing respiratory isolation precautions
d) Teaching the parents the importance of maintaining a quiet environment
c) Implementing respiratory isolation precautions
The infant's illness is contagious, and the nurse, as well as other clients, must first be protected
with the implementation of respiratory isolation precautions. Assessment of neurological status,
implementation of prescribed fluids and antibiotics, and parental teaching may be done after
assessment. Also, antibiotics are usually not administered until after all cultures have been
obtained.
An older client is transferred to a nursing home from a hospital with a diagnosis of dementia.
One morning, after being in the nursing home for several days, the client is going to join a group
of residents in recreational therapy. The nurse sees that the client has laid out several outfits on
the bed but is still wearing nightclothes. What should the nurse do?
a) Help the client dress and explain when residents are expected at the activity
b) Prompt the client to dress more quickly to avoid delaying the other residents
c) Help the client select appropriate attire and offer to help the client get dressed
d) Allow the client time to dress but explain that client has missed the opportunity to attend the
activityc) Help the client select appropriate attire and offer to help the client get dressed
Helping the client select appropriate attire and offering help in getting dressed aid the client in
decision-making; new situations may be stressful and may lead to ambivalent feelings. Helping
the client dress and explaining when residents are expected at the activity are not sharing
decision-making; the client may not remember this explanation in the future. Reminding the
client to dress more quickly to avoid delaying the other residents may make the client feel guilty
and may increase anxiety. The client may perceive being told that the opportunity to attend the
activity has been missed as punishment.
When teaching a client about using a diaphragm as a form of contraception, the nurse should tell
her that the diaphragm:
a) May or may not be used with a spermicidal lubricant
b) Should remain in place for at least 6 hours after intercourse
c) Must be inserted with the dome facing down to be maximally effective
d) Often appears puckered but that this will not interfere with its effectiveness b) Should
remain in place for at least 6 hours after intercourse
The should remain in place for at least 6 hours after intercourse because the spermicidal jelly or
cream requires this amount of time to be effective. The diaphragm must always be used with a
2
,spermicide to be effective. The diaphragm may be inserted with the dome facing either up or
down and still be effective. Puckering, especially near the rim, may indicate thin spots that could
rupture during intercourse; the diaphragm should be replaced if puckering is found.
A client is hospitalized with a diagnosis of emphysema. The nurse provides teaching and should
begin with which aspect of care?
a) The disease process and breathing exercises
b) How to control or prevent respiratory infections
c) Using aerosol therapy, especially nebulizers
d) Priorities in carrying out everyday activities a) The disease process and breathing
exercises
Clients need to understand the disease process and how interventions, such as breathing
exercises, can improve ventilation. Learning to control or prevent respiratory infections is
important, but it should be taught later. Although it is helpful to know about aerosol therapy and
nebulizers, knowing how to use aerosol therapy, especially nebulizers, should be taught later.
Although it is important to teach the client how to set priorities in carrying out everyday
activities, this should be taught later.
Test-Taking Tip: Being prepared reduces your stress or tension level and helps you maintain a
positive attitude.
A client who is having a difficult labor is found to have cephalopelvic disproportion. Which
medical order should the nurse question?
a) Maintain NPO status.
b) Start peripheral IV of ¼ NS.
c) Record fetal heart tones every 15 minutes.
d) Piggyback another 10-unit bag of oxytocin (Pitocin). d) Piggyback another 10-unit bag of
oxytocin (Pitocin).
When there is cephalopelvic disproportion, a is indicated; infusing oxytocin (Pitocin) at this time
could result in fetal compromise and uterine rupture. The nothing-by-mouth (NPO) status is
appropriate in anticipation of a cesarean birth. A peripheral IV is needed not only for hydration
but also for venous access if IV medications become necessary. The client probably has an
electronic monitor recording the fetal heart rate and uterine contractions; the findings of these
assessments should be documented regularly in accordance with hospital protocol.
A client is found to have paranoid schizophrenia, and the practitioner prescribes a typical
antipsychotic medication. After a 1-month hospitalization the client is discharged home with
instructions to continue the antipsychotic and a referral for weekly mental health counseling. The
picture illustrates the client's physical status as observed by the nurse on the client's first visit to
the community mental health clinic. What extrapyramidal side effect has developed?
a) Dystonia
b) Akathisia
c) Tardive dyskinesia
3
, d) Pseudoparkinsonism b) Akathisia
Akathisia, an extrapyramidal side effect of typical antipsychotics, is motor restlessness. The
client is unable to sit or stand still and feels the need to move, pace, rock, swing the legs, or tap
the feet. The condition occurs within 5 to 90 days of the initiation of therapy. Dystonia is muscle
spasms of the face, tongue, head, neck, jaw, or back, usually resulting in exaggerated posturing.
This extrapyramidal side effect of typical antipsychotics occurs within 1 hour to 1 week of the
initiation of therapy. Tardive dyskinesia is facial, ocular, oral/buccal, lingual/masticatory, and
systemic movements. This extrapyramidal side effect of typical antipsychotics may occur 6
months or more after the initiation of therapy. Pseudoparkinsonism has characteristics similar to
those of Parkinson's disease (e.g., shuffling gait, tremors, rigidity, bradykinesia). This
extrapyramidal side effect of typical antipsychotics may occur anytime after the initiation of
therapy.
What should the nurse discuss with new parents to help them prepare for infant care?
a) Allowing crying time to help the lungs develop
b) Establishing a set feeding schedule to promote steady weight gain
c) Counting the number of stool diapers daily to confirm adequate hydration
d) Learning specific behaviors involving states of wakefulness to promote positive interactions
d) Learning specific behaviors involving states of wakefulness to promote positive
interactions
Discussing behaviors during the baby's waking times that will promote positive interaction helps
parents understand the unique features of their newborn and promotes interaction and care during
periods of wakefulness. A healthy infant's lungs are developed at birth. It is best that infants be
on a demand feeding schedule, not a routine schedule. Demand feeding provides for
individuality; healthy infants gain weight steadily. Counting the number of stool diapers daily is
not a reliable method of determining adequate hydration.
A client is admitted with the diagnosis of possible myocardial infarction, and a series of
diagnostic tests are prescribed. Which blood level should the nurse expect will increase first if
this client has had a myocardial infarction?
a) Alanine aminotransferase (ALT)
b) Serum aspartate aminotransferase (AST)
c) Total lactate dehydrogenase (LDH)
d) Troponin T (cTnT) d) Troponin T (cTnT)
Troponin T has an extraordinarily high specificity for myocardial cell injury. Cardiac troponins
elevate sooner and remain elevated longer than many of the other enzymes that reflect
myocardial injury. ALT is found predominantly in the liver; it is found in lesser quantities in the
kidneys, heart, and skeletal muscles, and is primarily used to diagnose and monitor liver, not
heart, disease. AST, also known as (serum glutamic-oxaloacetic transaminase (SGOT), is
elevated 8 hours after a myocardial infarction. Total LDH () levels elevate 24 to 48 hours after a
myocardial infarction.
4
