111. NCLEX Medication Review question about a client who has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept, which is most important for the nurse to assess?
a) The injection site for itching and edema
b) The white blood cell counts and platelet counts
c) Whether the client is experiencing fatigue and joint pain
d) Whether the client is experiencing a metallic taste in the mouth, and a loss of appetite
112. Allopurinol (Zyloprim) is prescribed for a client and the nurse provides medication instructions to the client. Which instruction should the nurse provide?
a) Drink 3000 mL of fluid a day.
b) Take the medication on an empty stomach.
c) The effect of the medication will occur immediately.
d) Any swelling of the lips is a normal expected response.
113. Colchicine (Colcrys) is prescribed for a client with a diagnosis of gout. The nurse reviews the client’s record, knowing that this medication would be used with caution in which disorder?
a) Myxedema
b) Kidney disease
c) Hypothyroidism
d) Diabetes mellitus
114. Alendronate (Fosamax) is prescribed for a client with osteoporosis and the nurse is providing instructions on administration of the medication. Which instruction should the nurse provide?
a) Take the medication at bedtime.
b) Take the medication in the morning with breakfast.
c) Lie down for 30 minutes after taking the medication.
d) Take the medication with a full glass of water after rising in the morning.
115. NCLEX Medication Review question about the nurse who is preparing discharge instructions for a client receiving baclofen. Which instruction should be included in the teaching plan?
a) Restrict fluid intake.
b) Avoid the use of alcohol.
c) Stop the medication if diarrhea occurs.
d) Notify the health care provider (HCP) if fatigue occurs.
116. NCLEX Medication Review question about the nurse who is analyzing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would identify an adverse effect associated with the administration of this medication?
a) Platelet count
b) Creatinine level
c) Liver function tests
d) Blood urea nitrogen level
117. Cyclobenzaprine hydrochloride (Flexeril) is prescribed for a client for muscle spasms and the nurse is reviewing the client’s record. Which disorder, if noted in the record, would indicate a need to contact the health care provider about the administration of this medication?
a) Glaucoma
b) Emphysema
c) Hypothyroidism
d) Diabetes mellitus
118. In monitoring a client’s response to disease-modifying antirheumatic drugs (DMARDs), which assessment findings would the nurse consider acceptable responses? Select all that apply.
a) Symptom control during periods of emotional stress
b) Normal white blood cell, platelet, and neutrophil counts
c) Radiological findings that show no progression of joint degeneration
d) An increased range of motion in the affected joints 3 months into therapy
e) Inflammation and irritation at the injection site 3 days after the injection is given
f) A low-grade temperature on rising in the morning that remains throughout the day
119. NCLEX Medication Review question about the nurse who is administering an intravenous dose of methocarbamol (Robaxin) to a client with multiple sclerosis. For which side/ adverse effects should the nurse monitor?
a) Tachycardia
b) Rapid pulse
c) Bradycardia
d) Hypertension
NCLEX Medication Review
Answers and Rationale
111) B
- Rationale: Infection and pancytopenia are side/ adverse effects of etanercept. Laboratory studies are performed prior to and during medication treatment. The appearance of abnormal white blood cell counts and abnormal platelet counts can alert the nurse to a potentially life-threatening
infection. Injection site itching is a common occurrence following administration. A metallic taste and loss of appetite are not common signs of side/ adverse effects of this medication.
- Test-Taking Strategy: Note the strategic words most important. Option D can be eliminated, because this is not a common side/ adverse effect. In early treatment, residual fatigue and joint pain may still be apparent. For the remaining options, the correct option monitors for a hematological disorder, which could indicate a reason for discontinuing this medication and should be reported.
112) A
- NCLEX Medication Review Rationale: Clients taking allopurinol are encouraged to drink 3000 mL of fluid a day. A full therapeutic effect may take 1 week or longer. Allopurinol is to be given with, or immediately after, meals or milk. A client who develops a rash, irritation of the eyes, or swelling of the lips or mouth should contact the health care provider because this may indicate hypersensitivity.
- Test-Taking Strategy: Focus on the subject, client instructions for allopurinol. Option D can be eliminated easily because it indicates hypersensitivity, which is not a normal expected response. From the remaining options, recalling that this medication is used to treat gout will direct you to the correct option.
113) B
- Rationale: Colchicine is used with caution in older clients, debilitated clients, and clients with cardiac, kidney, or gastrointestinal disease. The disorders in options A, C, and D are not concerns with administration of this medication.
- NCLEX Medication Review Test-Taking Strategy: Focus on the subject, the cautions associated with colchicine. Note that options A, C, and D are comparable or alike and are endocrine-related disorders. The correct option is different from the others.
114) D
- Rationale: Precautions need to be taken with the administration of alendronate to prevent gastrointestinal side/ adverse effects (especially esophageal irritation) and to increase absorption of the medication. The medication needs to be taken with a full glass of water after rising in the morning. The client should not eat or drink anything for 30 minutes following administration and should not lie down after taking the medication.
- Test-Taking Strategy: Focus on the subject, the administration of alendronate. Recalling that this medication can cause esophageal irritation will direct you to the correct option.
115) B
- Rationale: Baclofen is a skeletal muscle relaxant. The client should be cautioned against the use of alcohol and other central nervous system depressants because baclofen potentiates the depressant activity of these agents. Constipation rather than diarrhea is a side/ adverse effect. Restriction of fluids is not necessary, but the client should be warned that urinary retention can occur. Fatigue is related to a central nervous system effect that is most intense during the early phase of therapy and diminishes with continued medication use. The client does not need to notify the HCP about fatigue.
- Test-Taking Strategy: Focus on the subject, teaching points for baclofen. Recalling that baclofen is a skeletal muscle relaxant will direct you easily to the correct option. If you were unsure of the correct option, use general principles related to medication administration. Alcohol should be avoided with the use of medications.
116) C
- Rationale: Dose-related liver damage is the most serious adverse effect of dantrolene. To reduce the risk of liver damage, liver function tests should be performed before treatment and throughout the treatment interval. Dantrolene is administered at the lowest effective dosage for the shortest time necessary.
- Test-Taking Strategy: Eliminate options B and D because these tests assess kidney function and are comparable or alike. From the remaining options, you must recall that this medication affects liver function.
117) A
- NCLEX Medication Review Rationale: Because cyclobenzaprine (Flexeril) has anticholinergic effects, it should be used with caution in clients with a history of urinary retention, glaucoma, and increased intraocular pressure. Cyclobenzaprine should be used only for a short time (2 to 3 weeks). The conditions in options B, C, and D are not a concern with this medication.
- Test-Taking Strategy: Focus on the subject, a contraindication to cyclobenzaprine. Recalling that this medication has anticholinergic effects will direct you to the correct option.
118) A, B, C, D
- Rationale: Because emotional stress frequently exacerbates the symptoms of rheumatoid arthritis, the absence of symptoms is a positive finding. DMARDs are given to slow the progression of joint degeneration. In addition, an improvement in the range of motion after 3 months of therapy with normal blood work is a positive finding. Temperature elevation and inflammation and irritation at the medication injection site could indicate signs of infection.
- Test-Taking Strategy: Focus on the subject, acceptable responses to therapy. Recalling that signs of an infection can indicate an unexpected finding will assist in eliminating options E and F.
119) C
- Rationale: Intravenous administration of methocarbamol can cause hypotension and bradycardia. The nurse needs to monitor for these side/ adverse effects. Options A, B, and D are not effects with administration of this medication.
- Test-Taking Strategy: Eliminate options A and B first because they are comparable or alike. Knowledge about the specific side/ adverse effects related to the intravenous use of this medication will direct you to the correct option. Remember that hypotension and bradycardia can occur with intravenous administration of methocarbamol.
After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:
NCLEX Medication Review 1-5
Or proceed to the next set of questions:
NCLEX Medication Review 119-125
