Unit 2
Of course. Here are 5 NCLEX-style questions for each of the four units you provided, with an emphasis on the drug exemplars.
Unit 2: Reproduction
1. A client is being induced with an IV infusion of oxytocin (Pitocin). The nurse observes the fetal heart rate drop to 90 bpm following a uterine contraction. What is the nurse's priority action?
a) Increase the rate of the oxytocin infusion.
b) Administer a dose of terbutaline (Brethine).
c) Stop the oxytocin infusion.
d) Document the finding as a normal variation.
c) Stop the oxytocin infusion.
A nurse is administering a unit of Packed Red Blood Cells (PRBCs) to a client. Fifteen minutes into the transfusion, the client reports feeling flushed, has chills, and complains of low back pain. What is the nurse's first action?
a) Slow the rate of the transfusion.
b) Administer an antihistamine as ordered.
c) Stop the transfusion immediately.
d) Check the client's temperature.
c) Stop the transfusion immediately.
A client with diabetic ketoacidosis (DKA) is being treated with a continuous IV infusion of regular insulin. Which of the following assessments is essential for the nurse to monitor closely?
a) Serum potassium levels
b) Signs of peripheral neuropathy
c) Daily weight
d) Oral glucose tolerance test results
a) Serum potassium levels
A nurse is administering a norepinephrine (Levophed) infusion to a client in shock. The nurse notes that the skin around the IV insertion site is pale, cool, and swollen. What is the nurse's priority action?
a) Stop the infusion and infiltrate the area with phentolamine as prescribed.
b) Apply a warm compress to the site to increase absorption.
c) Increase the infusion rate to improve perfusion to the limb.
d) Document the finding and continue to monitor the site.
a) Stop the infusion and infiltrate the area with phentolamine as prescribed.
A client is prescribed both IV piperacillin-tazobactam (Zosyn) and IV gentamicin (Garamycin) for a severe infection. Both medications are due at 10:00 AM. Which scheduling consideration is most important for the nurse to implement?
a) Administer both medications at the same time through separate IV lines.
b) Administer the gentamicin, then immediately administer the piperacillin-tazobactam.
c) Contact the pharmacy to have the medications mixed in the same IV bag.
d) Separate the administration times of the two medications by at least 2 hours.
d) Separate the administration times of the two medications by at least 2 hours.
A nurse is preparing to administer methylergonovine (Methergine) to a client experiencing a postpartum hemorrhage. Which assessment finding would cause the nurse to hold the medication and contact the provider?
a) Blood pressure of 150/95 mmHg
b) Heart rate of 95 bpm
c) A fundus that is boggy and difficult to locate
d) Report of moderate uterine cramping
a) Blood pressure of 150/95 mmHg
An Rh-negative client requires a blood transfusion. Which blood type is safe for the nurse to administer? a) O positive
b) AB positive
c) A negative
d) B positive
c) A negative
A client with Type 1 diabetes is found unresponsive, with cool, clammy skin. The fingerstick blood glucose is 35 mg/dL. What is the nurse's priority intervention?
a) Administer glucagon IM.
b) Administer D50W IV.
c) Give the client a glass of orange juice.
d) Prepare to administer regular insulin IV.
b) Administer D50W IV
A client in cardiogenic shock is to receive an infusion of dopamine. The nurse knows that when administered at a high dose, dopamine will have which of the following effects?
a) It causes vasodilation to increase renal blood flow.
b) It causes vasoconstriction to increase blood pressure and cardiac output.
c) It selectively dilates the coronary arteries.
d) It decreases myocardial contractility to lower cardiac workload.
b) It causes vasoconstriction to increase blood pressure and cardiac output
A nurse is preparing to administer the fourth dose of IV vancomycin (Vancocin) to a client. The order states to check a trough level with this dose. The nurse should contact the laboratory to have the blood sample drawn at which time?
a) 90 minutes after the infusion is complete.
b) 30 minutes before the infusion begins.
c) Immediately after the infusion is complete.
d) Midway through the infusion
b) 30 minutes before the infusion begins.
A client is receiving terbutaline (Brethine) for preterm labor. The nurse should prioritize monitoring for which of the following maternal adverse effects? a) Bradycardia and hypotension
b) Hypoglycemia and flushing
c) Tachycardia and restlessness
d) Headache and constipation
c) Tachycardia and restlessness
A client receiving a blood transfusion suddenly develops wheezing, shortness of breath, and hypotension. The nurse recognizes these as signs of a severe allergic reaction. After stopping the transfusion, what is the nurse's next priority action? a) Send the blood bag and tubing to the lab.
b) Keep the IV line open with normal saline using new tubing.
c) Administer an antipyretic for the fever.
d) Document the reaction in the client's chart.
b) Keep the IV line open with normal saline using new tubing.
A client has been started on methimazole (Tapazole) for hyperthyroidism. The nurse should instruct the client to report which of the following symptoms to the provider immediately?
a) Mild headache
b) Fever and sore throat
c) Weight gain
d) Paresthesia
b) Fever and sore throat
A client is brought to the emergency department with signs of anaphylactic shock after being stung by a bee. The nurse would anticipate the immediate administration of which medication?
a) Dopamine
b) Phenylephrine
c) Dobutamine
d) Epinephrine
d) Epinephrine
A client with bacterial meningitis is prescribed ceftriaxone (Rocephin). The nurse knows this third-generation cephalosporin is effective for this condition primarily due to which characteristic?
a) It has a narrow spectrum of activity against gram-positive organisms.
b) It can be administered as a single, painless intramuscular injection.
c) It is able to cross the blood-brain barrier.
d) It is known to have synergistic effects only with penicillins.
c) It is able to cross the blood-brain barrier.
A nurse is caring for a client receiving a continuous IV infusion of magnesium sulfate for preeclampsia. Which of the following assessment findings would indicate magnesium toxicity?
a) Hyperactive deep tendon reflexes (DTRs)
b) Respiratory rate of 10 breaths/minute
c) Urine output of 100 mL/hr
d) Increased level of consciousness
b) Respiratory rate of 10 breaths/minute
The nurse is reviewing lab results for four clients. Which client would be the most likely candidate to receive a transfusion of platelets? a) A client with a hemoglobin of 8 g/100ml
b) A client with a coagulation deficiency receiving FFP
c) A client with a platelet count of 20,000/mm3
d) A client in hypovolemic shock receiving albumin
c) A client with a platelet count of 20,000/mm3
A client with neurogenic diabetes insipidus is taking desmopressin (DDAVP). Which assessment finding would indicate to the nurse that the client is experiencing a serious adverse effect of the medication?
a) Decreased signs of dehydration
b) Decreased urine output
c) Headache, confusion, and weight gain
d) Increased thirst
c) Headache, confusion, and weight gain
A client with Class IV heart failure is receiving a short-term infusion of milrinone (Primacor). The nurse should recognize that this client is at the highest risk for developing which of the following complications?
a) Life-threatening ventricular dysrhythmias
b) Severe hypertension
c) Acute kidney injury
d) Pulmonary edema
a) Life-threatening ventricular dysrhythmias
A nurse is reviewing the health history of a client who has a new prescription for imipenem-cilastatin (Primaxin). The nurse should use this medication with caution if the client has a history of which of the following?
a) Diabetes mellitus
b) A head injury or seizures.
c) Peptic ulcer disease
d) Asthma
b) A head injury or seizures.
A nurse is providing education to a client who will begin treatment with clomiphene (Clomid) for anovulation. Which potential risk of the therapy should the nurse be sure to include?
a) A high risk for multiple gestation pregnancy
b) A high probability of developing ovarian cysts c) The development of permanent visual disturbances
d) A guarantee of becoming pregnant within three cycles
a) A high risk for multiple gestation pregnancy
A nurse is administering albumin to a client who is malnourished and in hypovolemic shock. The nurse understands that albumin helps restore volume by which mechanism?
a) It contains clotting factors to stop internal bleeding.
b) It is a hypertonic solution that pulls fluid from the tissues into the vasculature.
c) It stimulates the kidneys to reabsorb sodium and water.
d) It provides red blood cells to improve oxygen-carrying capacity
b) It is a hypertonic solution that pulls fluid from the tissues into the vasculature
A nurse is providing discharge teaching to a client who will be taking hydrocortisone daily for adrenal insufficiency. Which statement by the client indicates a need for further education?
a) "I should wear a medical alert bracelet."
b) "I should take my medication with food to prevent stomach upset."
c) "I can stop taking this medication once I start to feel better."
d) "I need to report any signs of infection, like a fever, to my doctor."
c) "I can stop taking this medication once I start to feel better."
A nurse is reviewing the home medication list for a client who has an order for IV phenylephrine (Neo-Synephrine) to treat hypotension related to vascular shock. Which medication, if taken by the client within the last 3 weeks, would require the nurse to hold the phenylephrine and notify the provider?
a) Furosemide
b) Metformin
c) Phenelzine
d) Atorvastatin
c) Phenelzine
A nurse is providing discharge teaching to a client prescribed levofloxacin (Levaquin). Which statement from the client indicates a need for further instruction?
a) "I should avoid taking antacids at the same time as this medication."
b) "If I develop sudden pain in my heel, I should stop taking the medication and call my doctor."
c) "I can expect my urine to turn a reddish-orange color while taking this drug."
d) "This medication might make my skin more sensitive to the sun."
c) "I can expect my urine to turn a reddish-orange color while taking this drug."