NCLEX RN NEWEST (3-LATEST VERSIONS) TEST BANK ACTUAL EXAM 2500
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QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED
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A 23-year-old woman is admitted to the infusion clinic after a Multiple Sclerosis
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Exacerbation. The physician orders methylprednisolone infusions (Solu-Medrol). The
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nurse would expect which of the following outcomes after administration of this
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medication?
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1. A decrease in muscle spasticity and involuntary movements
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2. A slowed progression of Multiple Sclerosis related plaques
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3. A decrease in the length of the exacerbation
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4. A stabilization of mood and sleep - ans1. A decrease in muscle spasticity and
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involuntary movements
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Incorrect - While muscle spasticity and involuntary movements can be symptoms of MS, a
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corticosteroid infusion is not meant to directly treat these symptoms.
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2. A slowed progression of Multiple Sclerosis related plaques
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Incorrect - Special drugs like Interferon Beta, Natalizumab, or Glatiramir acetate are used
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as first-line treatments to slow the progression of MS. While corticosteroids can be used
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in conjunction with these drugs on a long-term basis, they would not be infused. They
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would be taken orally.
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3. A decrease in the length of the exacerbation
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Correct - A methylprednisolone infusion is the first line of treatment during an acute
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exacerbation and is used to decrease the length and severity of a relapse.
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4. A stabilization of mood and sleep
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Incorrect - Some of the frequent side effects of a Methylprednisolone infusion are anxiety,
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insomnia, and mood swings.
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A 30-year old Caucasian woman who works the night shift has been found to have early
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bone loss and has a high risk for osteomalacia and bone degradation. She asks the nurse
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exactly why she should take Vitamin D supplements. What is the nurse's best response?
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1. "It's a standard part of the overall nutritional treatment for the prevention of
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osteomalacia"
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2. "It helps your intestines absorb calcium, which is important for bone formation."
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3. "It stimulates skin cells to produce calcium, which is then released into the bloodstream
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to be used for bone formation."
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4. "Vitamin D supplements should not be taken by someone of your age." - ans1. "It's a
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standard part of the overall nutritional treatment for the prevention of osteomalacia"
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Incorrect - While this is true, it doesn't answer the woman's question.
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,NCLEX RN NEWEST (3-LATEST VERSIONS) TEST BANK ACTUAL EXAM 2500
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QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED
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2. "It helps your intestines absorb calcium, which is important for bone formation."
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Correct - This is the correct mechanism of action for Vitamin D
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3. "It stimulates skin cells to produce calcium, which is then released into the bloodstream
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to be used for bone formation."
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Incorrect- This is not the correct mechanism of action for Vitamin D
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4. "Vitamin D supplements should not be taken by someone of your age."
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Incorrect - Vitamin D supplements should be taken for patients who are homebound,
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institutionalized, or by some other limitations, unable to meet daily requirements. This
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woman works the night shift, which may limit her ability to absorb Vitamin D naturally.
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A 45-year old woman is prescribed ropinirole (Requip) for Parkinson's Disease. The
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patient is living at home with her daughter. The nurse is most concerned about which side
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effect of ropinirole?
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1. Slurred speech
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2. Sudden dizziness
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3. Masklike facial expression
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4. Stooped Posture - ans1. Slurred speech
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Incorrect - Slurred speech is a common symptom of PD, not a side effect of this drug.
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2. Sudden dizziness
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Correct - Dizziness and orthostatic hypotension are serious adverse effects of this drug
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that can lead to an increased risk of falls. Ropinirole's drug class is a dopamine agonist,
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which mimic dopamine in the brain (PD is characterized by a lack of dopamine).
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3. Masklike facial expression
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Incorrect - Masklike facial expression is a common symptom of PD, not a side effect of this
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drug.
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4. Stooped Posture
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Incorrect - Stooped Posture is a common symptom of PD, not a side effect of this drug.
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A 65 year old man is prescribed Flomax (Tamsulosin) for Benign Prostatic Hyperplasia.
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The patient lives in an upstairs apartment. The nurse is most concerned about which side
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effect of Flomax?
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1. Hypotension
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2. Tachycardia
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3. Back Pain
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4. Difficulty Urinating - ans1. Hypotension
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Correct - Hypotension can lead to dizziness and a risk for injury to the patient.
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2. Tachycardia
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,NCLEX RN NEWEST (3-LATEST VERSIONS) TEST BANK ACTUAL EXAM 2500
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Tachycardia can be a side effect of Flomax, but is not an immediate safety risk, nor is it aII II II II II II II II II II II II II II II II II II
common side effect.
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3. Back Pain
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Back Pain can be a side effect of Floma, but is not a safety risk
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4. Difficulty Urinating
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Dysuria is a symptom of Benign Prostatic Hyperplasia, not a side effect of Flomax
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A client with Multiple Sclerosis reports a constant, burning, tingling pain in the shoulders.
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The nurse anticipates that the physician will order which medication for this type of pain?
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1. alprazolam (Xanax)
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2. Corticosteroid injection
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3. gabapentin (Neurontin)
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4. hydrocodone/acetaminophen (Norco) - ans1. alprazolam (Xanax)
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Incorrect - alprazolam is used to reduce anxiety II II II II II II II
2. Corticosteroid injection
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Incorrect - Corticosteroid injections are used to reduce inflammation in a localized area,
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often due to joint breakdown. In MS patients it is used to treat acute exacerbations ("flare-
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ups"), but the symptoms described do not constitute an acute exacerbation.
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3. gabapentin (Neurontin)
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Correct - Anticonvulsants like gabapentin are often the first line of treatment for nerve pain
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4. hydrocodone/acetaminophen (Norco)
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Incorrect - Opioids would not be the appropriate medication to treat nerve pain.
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A female patient is prescribed metformin for glucose control. The patient is on NPO status
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pending a diagnostic test. The nurse is most concerned about which side effect of
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metformin?
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1. Diarrhea and Vomiting
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2. Dizziness and Drowsiness
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3. Metallic taste
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4. Hypoglycemia - ans1. Diarrhea and Vomiting
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Incorrect - While these may occur, the patient is at higher risk for another adverse effect.
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2. Dizziness and Drowsiness
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Incorrect - While these may occur, the patient is at higher risk for another adverse effect.
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3. Metallic taste
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Incorrect - While this may occur, the patient is at higher risk for another adverse effect.
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, NCLEX RN NEWEST (3-LATEST VERSIONS) TEST BANK ACTUAL EXAM 2500
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QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED
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4. Hypoglycemia
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Correct - The patient is at risk because she is on NPO status and continuing to take an
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anti-glycemic drug.
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A female patient with atrial fibrillation has the following lab results: Hemoglobin of 11 g/dl,
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a platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which result is
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critical and should be reported to the physician immediately?
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1. Hemoglobin 11 g/dl
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2. Platelet of 150,000
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3. INR of 2.5
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4. Potassium of 2.7 mEq/L - ans1. Hemoglobin 11 g/dl
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This is below normal, but a normal female hemoglobin is 12-14. There is a more critical lab
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result.
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2. Platelet of 150,000
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This is also below the normal values, but is not the most critical lab result.
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3. INR of 2.5
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This is a therapeutic range for a patient who is taking an anticoagulant for atrial fibrillation
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4. Potassium of 2.7 mEq/L
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CORRECT - A potassium imbalance for a patient with a history of dysrhythmia can be life-
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threatening and can lead to cardiac distress. II II II II II II
A man is has been taking lisinopril for CHF. The patient is seen in the emergency room for
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persistent diarrhea. The nurse is concerned about which side effect of lisinopril?
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1. VertigoII
2. Hypotension
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3. Palpitations
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4. Nagging, dry cough - ans1. Vertigo
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Incorrect - While this may occur, the patient is at higher risk due to another adverse effect.
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2. Hypotension
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Correct - The patient is particularly at risk for hypotension due to possible dehydration
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from fluid loss.
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3. Palpitations
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Incorrect - While this may occur, the patient is at higher risk for another adverse effect.
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4. Nagging, dry cough
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Incorrect - While this is a common side effect, the patient is at higher risk for another
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adverse effect..
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