NCLEX Pharmacology Practice Questions (96-100)

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96. A client with schizophrenia tells the nurse, "I stopped taking my chlorpromazine (Thorazine) because of the way it made me feel." Which side effect is the nurse likely to note during further assessment of the client's complaint?

a) drowsiness
b) nervousness
c) hard tremors
d) increased urination

97. A nurse is caring for a client diagnosed with a skin infection who is receiving tobramycin sulfate (Nebcin) intravenously every 8 hours. Which of the following would indicate to the nurse that the client is experiencing an adverse reaction related to the medication?

a) a total bilirubin of 0.5 mg/dL
b) a sedimentation rate of 15 mm/hr
c) a blood urea nitrogen (BUN) of 30 mg/dL
d) a white blood cell count (WBC) of 6000 cells/mm3

98. A client has been taking an anti-hypertensive for approximately 2 months. A home care nurse monitoring  the effects of therapy determines that drug tolerance has developed if which of the following are noted in the client?

a) decrease in weight
b) output greater than intake
c) decrease in blood pressure
d) gradual rise in blood pressure

99. A nurse has an order to administer hydroxyzine (Vistaril) to a client by the intramuscular route. Before administering the medication, the nurse tells the client that:

a)  excessive salivation is a side effect
b) there will be some pain at the injection site
c) there will be relief from nausea within 5 minutes
d) the client will have increased alertness for about 2 hours

100. A nurse is preparing to administering diazepam (Valium) by the intravenous (IV) route to a client who is having a seizure. The nurse plans to:

a) administer the prescribed dose over at least 60 minutes
b) dilute the prescribed dose in 50 ml of 5% dextrose in water
c) administer the prescribed by IV push directly into the vein
d) mix the prescribed dose into the existing IV of 5% dextrose in normal saline

NCLEX Pharmacology Practice Questions
Answers and Rationale

96) A
- Side effects of chlorpromazine can include hypotension, dizziness and fainting especially with parenteral use, drowsiness, blurred vision, dry mouth, lethargy, constipation or diarrhea, nasal congestion, peripheral edema, and urinary retention. Options B, C, and D are not side effects of chlorpromazine.

97) C
- Adverse reactions or toxic effects of tobramycin sulfate include nephrotoxicity as evidenced by an increased BUN and serum creatinine; irreversible ototoxicity as evidenced by tinnitus, dizziness, ringing or roaring in the ears, and reduced hearing; and neurotoxicity as evidenced by headaches, dizziness, lethargy, tremors, and visual disturbances. A normal WBC is 4500 to 11,000 cells/mm3. The normal sedimentation rate is 0 to 30 mm/hour. The normal total bilirubin level is less than 1.5 mg/dL. The normal BUN is 5 to 20 mg/dL.

98) D
- Drug tolerance can develop in a client taking an antihypertensive, which is evident by rising blood pressure levels. The physician should be notified, who may then increase the medication dosage or add a diuretic to the medication regimen. The client is also at risk of developing fluid retention, which would be manifested as dependent edema, intake greater than output, and an increase in weight. This would also warrant adding a diuretic to the course of therapy.

99) B
- Hydroxyzine is an antiemetic and sedative/hypnotic that may be used in conjunction with opioid analgesics for added effect. The injection can be extremely painful. Medications administered by the intramuscular route generally take 20 to 30 minutes to become effective. Hydroxyzine causes dry mouth and drowsiness as side effects.

100) C
- Intravenous diazepam is given by IV push directly into a large vein (reduces the risk of thrombophlebitis), at a rate no greater than 1 mg per minute. It should not be mixed with other medications or solutions and can be diluted only with normal saline.

After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

NCLEX Pharmacology Practice Questions (1-5)

Or proceed to the next set of questions:

NCLEX Pharmacology Practice Questions (101-105)