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NCLEX Style Pharmacology Exam #2 questions with complete solution
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NCLEX Style Pharmacology Exam #2 questions with complete solution
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NCLEXStyle
Pharmacology
Exam
#2
7]
The
nurse
has
completed
an
assessment
on
a
client
with
a
decreased
cardiac
output.
Which
findings
should
receive
highest
priority?
a.
BP
110/62,
atrial
fibrillation
with
HR
82,
bibasilar
crackles
b.
Confusion,
urine
output
15mL
over
the
last
2
hours,
orthopnea.
c.
SpO2
92
on
2
liters
nasal
cannula,
respirations
20,
1+
edema
of
lower
extremities.
d.
Weight
gain
of
1kg
in
3
days,
BP
130/80,
mild
dyspnea
with
exercise.
-
ANSWER-b.
A
low
urine
output
and
confusion
are
signs
of
decreased
tissue
perfusion.
Orthopnea
is
a
sign
of
left-sided
heart
failure.
Crackles,
edema
and
weight
gain
should
be
monitored
closely,
but
the
levels
are
not
as
high
a
priority.
With
atrial
fibrillation
there
is
a
loss
of
atrial
kick,
but
the
blood
pressure
and
heart
rate
are
stable
10]
A
60-year-old
male
client
comes
into
the
emergency
department
with
a
complaint
of
crushing
substernal
chest
pain
that
radiates
to
his
shoulder
and
left
arm.
The
admitting
diagnosis
is
acute
myocardial
infarction
(MI).
Immediate
admission
orders
include
oxygen
by
nasal
cannula
at
4L/minute,
blood
work,
a
chest
radiograph,
a
12-lead
electrocardiogram
(ECG),
and
2mg
of
morphine
sulfate
given
IV.
The
nurse
should
first:
a.
Administer
the
morphine
b.
Obtain
a
12-lead
ECG
c.
Obtain
the
blood
work
d.
Order
the
chest
radiograph
-
ANSWER-a.
Although
obtaining
the
ECG,
chest
radiograph,
and
blood
work
are
all
important,
the
nurse's
priority
action
should
be
to
relieve
the
crushing
chest
pain.
Therefore,
administering
morphine
sulfate
is
the
priority
action.
20]
Which
of
the
following
is
an
expected
outcome
when
a
client
is
receiving
an
IV
administration
of
furosemide?
a.
Increased
blood
pressure
b.
Increased
urine
output c.
Decreased
pain
d.
Decreased
premature
ventricular
contractions
-
ANSWER-b.
Furosemide
is
a
loop
diuretic
that
acts
to
increase
urine
output.
Furosemide
does
not
increase
blood
pressure,
decrease
pain,
or
decrease
arrhythmias
23]
The
nurse
is
assessing
clients
at
a
health
fair.
Which
client
is
at
greatest
risk
for
coronary
artery
disease?
a.
a
32-year-old
female
with
mitral
valve
prolapse
who
quit
smoking
10
years
ago.
b.
a
43-year-old
male
with
a
family
history
of
CAD
and
cholesterol
level
of
158
c.
A
56-year-old
male
with
an
HDL
of
60
who
takes
atorvastatin
(Lipitor)
d.
A
65-year-old
female
who
is
obese
with
an
LDL
of
188
-
ANSWER-d.
The
woman
who
is
65-years-old,
over
weight
and
has
an
elevated
LDL
is
at
greatest
risk.
Total
cholesterol
>200,
LDL
>100,
HDL
<40
in
men,
HDL
<50
in
women,
men
45-years
and
older,
women
55-years
and
older,
smoking
and
obesity
increase
the
risk
of
CAD.
Atorvastatin
is
a
medication
to
reduce
LDL
and
decrease
risk
of
CAD.
The
combination
of
postmenopausal,
obesity
and
high
LDL
cholesterol
places
this
client
at
greatest
risk.
24]
A
58-year-old
female
with
a
family
history
of
CAD
is
being
seen
for
her
annual
physical
exam.
Fasting
lab
test
results
include:
Total
cholesterol
198;
LDL
cholesterol
120;
HDL
cholesterol
58;
Triglycerides
148;
Blood
sugar
102;
and
C-reactive
protein
(CRP)
4.2.
The
health
care
provider
informs
the
client
that
she
will
be
started
on
a
statin
medication
and
aspirin.
The
client
asks
the
nurse
why
she
needs
to
take
these
medications.
Which
is
the
best
response
by
the
nurse?
a.
"The
labs
indicate
severe
hyperlipidemia
and
the
medications
will
lower
your
LDL,
along
with
a
low-fat
diet."
b.
"The
triglycerides
are
elevated
and
will
not
return
to
normal
without
these
medications."
c.
"The
CRP
is
elevated
indicating
inflammation
seen
in
cardiovascular
disease,
which
can
be
lowered
by
the
medications
ordered."
d.
"The
medications
are
not
indicated
since
your
lab
values
are
all
normal."
-
ANSWER-c.
CRP
is
a
marker
of
inflammation
and
is
elevated
in
the
presence
of
cardiovascular
disease.
The
high
sensitivity
CRP
(hs-CRP)
is
the
blood
test
for
greater
accuracy
in
measuring
the
CRP
to
evaluate
cardiovascular
risk.
The
family
history,
post-menopausal
age,
LDL
above
optimum
levels
and
elevated
CRP
place
the
client
at
risk
of
CAD.
Statin
medications
can
decrease
LDL, whereas
statins
and
aspirin
can
reduce
CRP
and
decrease
the
risk
of
MI
and
stroke.
25]
If
a
client
displays
risk
factors
for
coronary
artery
disease,
such
as
smoking
cigarettes,
eating
a
diet
high
in
saturated
fat,
or
leading
a
sedentary
lifestyle,
techniques
of
behavior
modification
may
be
used
to
help
the
client
change
the
behavior.
The
nurse
can
best
reinforce
new
adaptive
behaviors
by:
a.
Explaining
how
the
old
behavior
leads
to
poor
health
b.
Withholding
praise
until
the
new
behavior
is
well
established
c.
Rewarding
the
client
whenever
the
acceptable
behavior
is
performed
d.
Instilling
mild
fear
into
the
client
to
extinguish
the
behavior
-
ANSWER-c.
A
basic
principle
of
behavior
modification
is
that
behavior
that
is
learned
and
continued
is
behavior
that
has
been
rewarded.
Other
reinforcement
techniques
have
not
been
found
to
be
as
effective
as
reward.
31]
Crackles
heard
on
lung
auscultation
indicate
which
of
the
following?
a.
Cyanosis
b.
Bronchospasm
c.
Airway
narrowing
d.
Fluid-filled
alveoli
-
ANSWER-d.
Crackles
are
auscultated
over
fluid-filled
alveoli.
Crackles
heard
on
lung
auscultation
do
not
have
to
be
associated
with
cyanosis.
Bronchospasm
and
airway
narrowing
generally
are
associated
with
wheezing
sounds.
36]
The
client
who
experiences
angina
has
been
told
to
follow
a
low-cholesterol
diet.
Which
of
the
following
meals
should
the
nurse
tell
the
client
would
be
best
on
her
low-cholesterol
diet?
a.
Hamburger,
salad,
and
milkshake
b.
Baked
liver,
green
beans,
and
coffee
c.
Spaghetti
with
tomato
sauce,
salad,
and
coffee
d.
Fried
chicken,
green
beans,
and
skim
milk
-
ANSWER-c.
Pasta,
tomato
sauce,
salad,
and
coffee
would
be
the
best
selection
for
the
client
following
a
low-cholesterol
diet.
Hamburgers,
milkshakes,
liver,
and
fried
foods
tend
to
be
high
in
cholesterol.
40]
Which
of
the
following
is
not
a
risk
factor
for
the
development
of
atherosclerosis? a.
Family
history
of
early
heart
attack
b.
Late
onset
of
puberty
c.
Total
blood
cholesterol
level
greater
than
220
mg/dL
d.
Elevated
fasting
blood
glucose
concentration
-
ANSWER-b.
Late
onset
of
puberty
is
not
generally
considered
to
be
a
risk
factor
for
the
development
of
atherosclerosis.
Risk
factors
for
atherosclerosis
include
family
history
of
atherosclerosis,
cigarette
smoking,
hypertension,
high
blood
cholesterol
level,
male
gender,
diabetes
mellitus,
obesity,
and
physical
inactivity
41]
As
an
initial
step
in
treating
a
client
with
angina,
the
physician
prescribes
nitroglycerin
tablets,
0.3
mg
given
sublingually.
This
drug's
principal
effects
are
produced
by:
a.
Antispasmodic
effects
on
the
pericardium
b.
Causing
an
increased
myocardial
oxygen
demand
c.
Vasodilation
of
peripheral
vasculature
d.
Improved
conductivity
in
the
myocardium
-
ANSWER-c.
Nitroglycerin
produces
peripheral
vasodilation,
which
reduces
myocardial
oxygen
consumption
and
demand.
Vasodilation
in
coronary
arteries
and
collateral
vessels
may
also
increase
blood
flow
to
the
ischemic
areas
of
the
heart.
Nitroglycerin
does
not
have
an
effect
on
pericardial
spasticity
or
conductivity
in
the
myocardium.
43]
Sublingual
nitroglycerine
tablets
begin
to
work
within
1
to
2
minutes.
How
should
the
nurse
instruct
the
client
to
use
the
drug
when
chest
pain
occurs?
a.
Take
one
tablet
every
2
to
5
minutes
until
the
pains
stops
b.
Take
one
tablet
and
rest
for
10
minutes.
Call
the
physician
if
pain
persists
after
10
minutes
c.
Take
one
tablet,
then
an
additional
tablet
every
5
minutes
for
a
total
of
three
tablets.
Call
the
physician
if
pain
persists
after
three
tablets
d.
Take
one
tablet.
If
pain
persists
after
5
minutes,
take
two
tablets.
If
pain
still
persists
5
minutes
later,
call
the
physician
-
ANSWER-c.
The
correct
protocol
for
nitroglycerin
use
involves
immediate
administration,
with
subsequent
doses
taken
at
5-minute
intervals
as
needed,
for
a
total
dose
of
three
tablets.
Sublingual
nitroglycerin
appears
in
the
bloodstream
within
2
to
3
minutes
and
is
metabolized
within
about
10
minutes.
A
client
with
congestive
heart
failure,
CHF,
is
prescribed
digoxin
(Lanoxin)
and
furosemide
(Lasix).
Nursing
interventions
will
include:
(Select
all
that
apply.)
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