PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers, Exams of Nursing

Download PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers and more Exams Nursing in PDF only on Docsity! Looking for the complete collection of practice questions? Please visit our Nursing Test Bank. PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 SCREEN SHOTS Welcome to our collection of free NCLEX practice questions to help you achieve success on your NCLEX-RN exam! Included in this updated guide for 2021 are 1,000+ practice questions, a primer on what is the NCLEX- RN exam, frequently asked questions about the NCLEX, question types, the NCLEX-RN test plan, and test-taking tips and strategies. NCLEX-RN Practice Questions Test Bank For this nursing test bank, we have included more than 1,000+ NCLEX practice questions covering different nursing topics! Weʼve made a significant effort to provide you with the most challenging questions along with insightful rationales for each questions to reinforce learning. We recommend you do all practice questions before you take the actual exam. Doing so will help reduce your test anxiety and help identify nursing topics you need to review. To make the most of the practice exams, try to minimize mistakes to less than 15 questions and make sure to take your time in answering the questions especially when reading the rationales. Included NCLEX-RN question sets for this nursing test bank are as follows: PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2022/2023 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Comprehensive NCLEX-RN Practice Questions | Set 1 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 2 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 3 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 4 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 5 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 6 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 7 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 8 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 9 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 10 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 11 (75 Questions) Comprehensive NCLEX-RN Practice Questions | Set 12 (75 Questions) NEW! More practice questions available at our Nursing Test Bank. Guidelines Read and understand each question before choosing the best answer. Since this is a review, answers and rationales are shown after you click on the "Check" button. There is no time limit, answer the questions at your own pace. Once all questions are answered, you'll be prompted to click the "Quiz Summary" button where you'll be shown the questions you've answered or placed under "Review". Click on the "Finish Quiz" button to show your rating. After the quiz, please make sure to read the questions and PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2022/2023 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Correct Incorrect PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2022/2023 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 1. Question A nurse was instructed by a physician to give clarithromycin (Biaxin) for a child whose BSA is 0.55 m2. The usual adult dose is 500 mg. Biaxin is available in an oral suspension. The 100ml bottle is labeled 50 mg/ml. How many ml would the nurse give per dose? Fill in the blanks. Record your answer using one decimal place. Answer: (3.2) mL. Incorrect Correct answer: 3.2 mL. Formula: BSA Formula: BSA Formula: Rationale: Use the BSA formula first then the standard formula as shown above. To get the childʼs dose, multiply 0.55m2(childʼs BSA) to 500 mg (usual adult dose) to get 275. PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2022/2023 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Divide 275 with 1.7 m2to get 161.76 mg. Use the standard formula above. Divide 161.76 mg (desired pedia dose) with 50 mg (drug on hand) and multiply by 1 ml (vehicle) to get 3.2 ml. Computation: 2. Question A 28-year-old male has been found wandering around in a confusing pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first? A. Blood sugar check B. CT scan C. Blood cultures D.Arterial blood gases PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2022/2023 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 B. The child's ability to understand instruction C. The overall mental and physical abilities of the child PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2022/2023 https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 11 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 D.Frequent attempts with positive reinforcement Incorrect Correct Answer: C. The overall mental and physical abilities of the child. Age is not the greatest factor in potty training. The overall mental and physical abilities of the child are the most important factor. Option A: Readiness for toilet training varies with every age of the child. Option B: A child who can follow simple instructions may start toilet training. However, it is not considered the most important factor. Option D: Positive reinforcement is a great tool for toilet training, yet, it may not be the most important one. 4. Question A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank for 20 minutes. Which of the following is the most important instruction the nurse can give the parent? A. This too shall pass B. Take the child immediately to the ER https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 12 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 C. Contact the Poison Control Center quickly D.Give the child syrup of ipecac Incorrect Correct Answer: C. Contact the Poison Control Center quickly. The poison control center will have an exact plan of action for this child. Option A: Ingestion of a chemical is an emergency and should not be delayed. Option B: Taking the client to the ER may be correct, however, they will still have to contact the Poison Control Center. Option D: It should not be given to someone who swallowed chemicals that cause burns on contact or medicines that can cause seizures very quickly. It can be dangerous to people with some types of medical problems. When such poisoning victims got Ipecac anyway, they developed serious complications or even died. 5. Question A nurse is administering a shot of Vitamin K to a 30 day-old infant. Which of the following target areas is the most appropriate? https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 15 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4-year-old boy who is non-verbal. This child does not have any e name of the child by the fatherʼs d the medication from the child aft rovider is unnecessary and may tak ust have folks with them inside the olks would be the most appropriat ve not yet developed his writing able to write their names at age 4, hildren still er who is in the room the childʼs abilities. Some children are some typically developing c age. Option C: Asking a https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 16 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 identification on. What should the nurse do? A. Contact the provider B. Ask the child to write their name on paper C. Ask a coworker about the identification of the child D.Ask the father who is in the room the childʼs name Home Incorrect Correct Answer: D. Ask the fath name. In this case, you can determine th statement. You should not withhol identification. Option A: Contacting the p time. A pediatric patient m Care Plans Exams Study Not s er Care r e NurseLife room, so asking the childʼs f e intervention. Option B: The child may ha Shamanism New s bu t https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 17 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 to Click now to find out about our webinars, online courses, e nst the patientʼs confidentiality. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 20 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 the concentration of plasma calcium by increasing the release of calcium and phosphate from bone matrix, increasing calcium reabsorption by the kidney, and increasing renal production of 1,25-dihydroxyvitamin D-3 (calcitriol), which increases intestinal absorption of calcium. Option C: The body will lower the level of vitamin D in an attempt to lower calcium. Vitamin D levels should be measured in the evaluation of primary hyperparathyroidism. Vitamin D deficiency (a 25-hydroxyvitamin D level of less than 20 ng per milliliter) can cause secondary hyperparathyroidism, and repletion of vitamin D deficiency can help to reduce parathyroid hormone levels. Option D: Urine calcium may be elevated, with calcium spilling over from elevated serum levels. This may cause renal stones. In addition, the chronically increased excretion of calcium in the urine can predispose to the formation of renal stones. 8. Question A patient with Addisonʼs disease asks a nurse for nutrition and diet advice. Which of the following diet modifications is not recommended? A. A diet high in grains https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 21 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 B. A diet with adequate caloric intake C. A high protein diet https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 22 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 D.A restricted sodium diet Incorrect Correct Answer: D. A restricted sodium diet A patient with Addisonʼs disease requires normal dietary sodium to prevent excess fluid loss. Patients should eat an unrestricted diet. Those with primary adrenal insufficiency (Addison disease) should have ample access to salt because of the salt-wasting that occurs if their condition is untreated. Infants with primary adrenal insufficiency often need 2-4 g of sodium chloride per day. Option A: A well-balanced diet is the best way to keep the body healthy and to regulate sugar levels. Doctors recommend balancing protein, healthy fats, and high- quality, nutrient-dense carbohydrates. Option B: High-calorie comfort food reduces symptoms of neuroglycopenia in Addison patients, suggesting that Addisonʼs disease is associated with a deficit in cerebral energy supply that can partly be alleviated by intake of palatable food. Option C: Healthy fats and high-quality proteins slow the blood sugar rollercoaster and promote stable blood sugar levels throughout the day. 9. Question A patient with a history of diabetes mellitus is on the second https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 25 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 catecholamines is the absolute level of plasma glucose; the rate of decrease of glucose is less important. Option B: Neuropathy affects up to 50% of patients with type 1 DM, but symptomatic neuropathy is typically a late development, https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 26 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 developing after many years of chronic prolonged hyperglycemia. Peripheral neuropathy presents as numbness and tingling in both hands and feet, in a glove- and-stocking pattern; it is bilateral, symmetric, and ascending. Option D: Symptoms of hyperglycemia associated with diabetic ketoacidosis may include thirst, polyuria, polydipsia, and nocturia. 10. Question A nurse assigned to the emergency department evaluates a patient who underwent fiberoptic colonoscopy 18 hours previously. The patient reports increasing abdominal pain, fever, and chills. Which of the following conditions poses the most immediate concern? A. Bowel perforation B. Viral Gastroenteritis C. Colon cancer D.Diverticulitis https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 27 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Incorrect https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 30 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 B. Contaminated food C. Blood transfusion D. Illegal drug use Incorrect Correct Answer: B. Contaminated food Hepatitis A is the only type that is transmitted by the fecal-oral route through contaminated food. HAV is a single-stranded, positive-sense, linear RNA enterovirus of the Picornaviridae family. In humans, viral replication depends on hepatocyte uptake and synthesis, and assembly occurs exclusively in the liver cells. Virus acquisition results almost exclusively from ingestion (eg, fecal-oral transmission) Option A: Hepatitis B infection, caused by the hepatitis B virus (HBV), is commonly transmitted via body fluids such as blood, semen, and vaginal secretions. [1] Consequently, sexual contact, accidental needle sticks or sharing of needles, blood transfusions, and organ transplantation are routes for HBV infection. Option C: Before widespread screening of the blood supply in 1992, hepatitis C was also spread through blood transfusions and organ transplants. Now, the risk of transmission to recipients of blood or blood products is extremely low. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 31 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Option D: Today, most people become infected with hepatitis B, C, or D by sharing needles, syringes, or any other equipment used to prepare and inject drugs. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 32 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 12. Question A leukemia patient has a relative who wants to donate blood for transfusion. Which of the following donor medical conditions would prevent this? A. A history of hepatitis C five years previously B. Cholecystitis requiring cholecystectomy one year previously C. Asymptomatic diverticulosis D.Crohn's disease in remission Incorrect Correct Answer: A. A history of hepatitis C five years previously Hepatitis C is a viral infection transmitted through bodily fluids, such as blood, causing inflammation of the liver. Patients with hepatitis C may not donate blood for transfusion due to the high risk of infection in the recipient. Option B: Cholecystitis is the inflammation of the gallbladder. This condition does not transmit through bodily fluids. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 35 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 it is contraindicated in a patient with gastritis. Naproxen is used to relieve pain from various https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 36 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 conditions such as headache, muscle aches, tendonitis, dental pain, and menstrual cramps. It also reduces pain, swelling, and joint stiffness caused by arthritis, bursitis, and gout attacks. Option B: Calcium carbonate is used as an antacid for the relief of indigestion and is not contraindicated. Calcium carbonate is a dietary supplement used when the amount of calcium taken in the diet is not enough. Calcium is needed by the body for healthy bones, muscles, nervous system, and heart. Calcium carbonate also is used as an antacid to relieve heartburn, acid indigestion, and upset stomach. It is available with or without a prescription. Option C: Clarithromycin is an antibacterial often used for the treatment of Helicobacter pylori in gastritis. Clarithromycin is used to treat certain bacterial infections, such as pneumonia (a lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the ears, sinuses, skin, and throat. It also is used to treat and prevent disseminated Mycobacterium avium complex (MAC) infection [a type of lung infection that often affects people with human immunodeficiency virus (HIV)]. It is used in combination with other medications to eliminate H. pylori, a bacterium that causes ulcers. Clarithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria. Option D: Furosemide is a loop diuretic and is NOT contraindicated in a patient with gastritis. Furosemide is used alone or in combination with other medications to treat high blood pressure. Furosemide is used to treat edema (fluid retention; excess fluid held in body tissues) caused by various medical problems, including heart, https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 37 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 kidney, and liver disease. Furosemide is in a class of medications called diuretics (‘water pillsʼ). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 40 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 formation of gallstones. Vitamin C, which is abundant in plants and absent from meat affects the rate-limiting step in the catabolism of cholesterol to bile acids and is inversely related to the risk of gallstones and cholecystitis. Individuals consuming the most refined carbohydrates have a 60% greater risk for developing gallstones, compared with those who consumed the least. Option C: Replacing sugary drinks with drinks high in fiber would reduce the risk of gallbladder stones by 15%. 15. Question A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit? A. Slow, deep respirations B. Stridor C. Bradycardia D.Air hunger https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 41 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Incorrect Correct Answer: D. Air hunger Patients with pulmonary edema experience air hunger, anxiety, and agitation. Symptoms may also include coughing up blood or bloody froth; difficulty breathing when lying down (orthopnea); feeling of “air hunger” or “drowning” (this feeling is called “paroxysmal nocturnal dyspnea” if it causes you to wake up 1 to 2 hours after falling asleep and struggle to catch your breath). Option A: Physical findings in patients with pulmonary edema are notable for tachypnea and tachycardia. Patients may be sitting upright, they may demonstrate air hunger, and they may become agitated and confused. Patients usually appear anxious and diaphoretic. Option B: Auscultation of the lungs usually reveals fine, crepitant rales, but rhonchi or wheezes may also be present. Rales are usually heard at the bases first; as the condition worsens, they progress to the apices. Option C: Cardiovascular findings are usually notable for S3, accentuation of the pulmonic component of S2, and jugular venous distention. Auscultation of murmurs can help in the diagnosis of acute valvular disorders manifesting with pulmonary edema. 16. Question A nurse caring for several patients in the cardiac unit is told that one is scheduled for implantation of an automatic internal cardioverter-defibrillator. Which of the following patients is most https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 42 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 likely to have this procedure? https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 45 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 17. Question A patient is scheduled for a magnetic resonance imaging (MRI) scan for suspected lung cancer. Which of the following is a contraindication to the study for this patient? A. The patient is allergic to shellfish. B. The patient has a pacemaker. C. The patient suffers from claustrophobia. D.The patient takes antipsychotic medication. Incorrect Correct Answer: B. The patient has a pacemaker The implanted pacemaker will interfere with the magnetic fields of the MRI scanner and may be deactivated by them. Patients with cardiac implantable electronic devices or CIED are at risk for inappropriate device therapy, device heating/movement, and arrhythmia during MRI. These patients must be scheduled in a CIED blocked slot or scheduled with electrophysiology nurse or technician support. But nowadays MRI conditional cardiac implantable electronic devices are widely available. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 46 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Option A: Shellfish/iodine allergy is not a contraindication because the contrast used in MRI scanning is not iodine- based. MRI https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 47 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 contrast agents are gadolinium chelates with different stability, viscosity, and osmolality. Gadolinium is a relatively very safe contrast; however, it rarely might cause allergic reactions in patients. Options C: Open MRI scanners and anti-anxiety medications are available for patients with claustrophobia. Claustrophobic patients might refuse to complete the MRI scan and need sedation. These patients need to be well informed about the MRI scan procedure. The recommendation is that a physician has a discussion with them about the details in advance. Using Larger and opener MRI systems might be helpful in claustrophobic patients. Option D: Psychiatric medication is not a contraindication to MRI scanning. MRI helps in high-resolution investigations of soft tissues without the use of ionizing radiation. This safe modality currently becomes the imaging technique of choice for diagnosing musculoskeletal, neurologic, and cardiovascular disease. However, there are restrictions and contraindications caused by MRI magnetic fields, machine structure, and gadolinium contrast agents. 18. Question A nurse calls a physician with the concern that a patient has developed a pulmonary embolism. Which of the following symptoms has the nurse most likely observed? https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 50 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 may include productive cough and wheezing. Option D: A patient with fever, chills, and loss of appetite may be https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 51 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 developing pneumonia. Fever of less than 39°C (102.2ºF) may be present in 14% of patients; however, a temperature higher than 39.5°C (103.1º) F is not from a pulmonary embolism. 19. Question A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect? A. The patient will be admitted to the medicine unit for observation and medication. B. The patient will be admitted to the day surgery unit for sclerotherapy. C. The patient will be admitted to the surgical unit and resection will be scheduled. D.The patient will be discharged home to follow-up with his cardiologist in 24 hours. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 52 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Incorrect https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 55 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 C. Consider transfusion of packed red blood cells. D.Check for signs of bleeding, including examination of urine and stool for blood. Incorrect Correct Answer: D. Check for signs of bleeding, including examination of urine and stool for blood. A platelet count of 25,000/microliter is severely thrombocytopenic and should prompt the initiation of bleeding precautions, including monitoring urine and stool for evidence of bleeding. Option A: According to three retrospective case reviews of childhood leukemia (in which 75% to 100% of the cases were acute lymphoblastic leukemia), common presenting signs and symptoms include fever (17% to 77%), lethargy (12% to 39%), and bleeding (10% to 45%). Option B: Requiring protective clothing is indicated to prevent infection if white blood cells are decreased. Protective garments consisting of gloves, chemotherapy gowns, eye protection e.g.; goggles, N95 respirator, and shoe covers will be worn according to the task being performed with a Chemotherapy/Biotherapy agent or excreta of a patient who has received a Chemotherapy/Biotherapy agent within the last 48 hours. Option C: Transfusion of red cells is indicated for severe anemia. Blood transfusions represent one of the most https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 56 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 important forms of supportive care for patients with leukemia. Cancer is the major cause of transfusion. One- third of transfused patients have a malignant disease, with acute leukemia being the malignancy in a https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 57 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 large part of them. 21. Question A nurse in the emergency department is observing a 4-year-old child for signs of increased intracranial pressure after a fall from a bicycle, resulting in head trauma. Which of the following signs or symptoms would be cause for concern? A. Bulging anterior fontanel B. Repeated vomiting C. Signs of sleepiness at 10 PM D. Inability to read short words from a distance of 18 inches Incorrect Correct Answer: B. Repeated vomiting Increased pressure caused by bleeding or swelling within the skull can damage delicate brain tissue and may become life- threatening. Repeated vomiting can be an early sign of pressure as the vomiting center within the medulla is https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 60 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 C. There is low-grade fever. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 61 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 D.The lesions have a "teardrop-on-a-rose-petal" appearance. Incorrect Correct Answer: A. Small blue-white spots are visible on the oral mucosa. Koplikʼs spots are small blue-white spots visible on the oral mucosa and are characteristic of measles infection. Near the end of the prodrome, Koplik spots (ie, bluish-gray specks or “grains of sand” on a red base) appear on the buccal mucosa opposite the second molars. The Koplik spots generally are first seen 1-2 days before the appearance of the rash and last until 2 days after the rash appears. This enanthem begins to slough as the rash appears. Although this is the pathognomonic enanthem of measles, its absence does not exclude the diagnosis. Option B: The body rash typically begins on the face and travels downward. Blanching, erythematous macules and papules begin on the face at the hairline, on the sides of the neck, and behind the ears (see the images below). Within 48 hours, they coalesce into patches and plaques that spread cephalocaudally to the trunk and extremities, including the palms and soles, while beginning to regress cephalocaudally, starting from the head and neck. Lesion density is greatest above the shoulders, where macular lesions may coalesce. The eruption may also be petechial or ecchymotic in nature. Option C: High fever (may spike to more than 104°F) is often present. The first sign of measles is usually a high fever (often https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 62 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 >104o F [40o C]) that typically lasts 4-7 days. This prodromal phase is marked by malaise, fever, anorexia, and the classic triad of conjunctivitis (see the image below), cough, and coryza (the “3 Cs”). https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 65 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 A child weighing 30 kg arrives at the clinic with diffuse itching as the result of an allergic reaction to an insect bite. Diphenhydramine (Benadryl) 25 mg 3 times a day is prescribed. The correct pediatric dose is 5 mg/kg/day. Which of the following best describes the prescribed drug dose? https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 66 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 A. It is the correct dose B. The dose is too low C. The dose is too high D.The dose should be increased or decreased, depending on the symptoms Incorrect Correct Answer: B. The dose is too low This child weighs 30 kg, and the pediatric dose of diphenhydramine is 5 mg/kg/day (5 X 30 = 150/day). Therefore, the correct dose is 150 mg/day. Divided into 3 doses per day, the child should receive 50 mg 3 times a day rather than 25 mg 3 times a day. Dosage should not be titrated based on symptoms without consulting a physician. Option A: Diphenhydramine is used to relieve red, irritated, itchy, watery eyes; sneezing; and runny nose caused by hay fever, allergies, or the common cold. Diphenhydramine is also used to relieve coughs caused by minor throat or airway irritation. Option C: Diphenhydramine comes as a tablet, a rapidly disintegrating (dissolving) tablet, a capsule, a liquid-filled capsule, a dissolving strip, powder, and a liquid to take https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 67 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 by mouth. When diphenhydramine is used for the relief of allergies, cold, and cough symptoms, it is usually taken every 4 to 6 hours. Option D: Before you give a diphenhydramine product to a child, https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 70 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 common for the testes to retract into the inguinal canal when the environment is cold or the cremasteric reflex is stimulated. The exam should be done in a warm room with warm hands. It is most likely that both testes are present and will descend by a year. If not, a full assessment will determine the appropriate treatment. Option A: The testes usually descend by one year of age. Most of the time, a boyʼs testicles descend by the time he is 9 months old. Undescended testicles are common in infants who are born early. The problem occurs less in full-term infants. Option B: Surgical intervention is unnecessary; the testes descend by one year of age. The testicles will descend normally at puberty and surgery is not needed. Testicles that do not naturally descend into the scrotum are considered abnormal. An undescended testicle is more likely to develop cancer, even if it is brought into the scrotum with surgery. Cancer is also more likely in the other testicle. Option C: In young infants, it is common for the testes to retract into the inguinal canal when the environment is cold or the cremasteric reflex is stimulated. 26. Question A child is admitted to the hospital with a diagnosis of Wilms tumor, stage II. Which of the following statements most accurately describes this stage? https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 71 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 A. The tumor is less than 3 cm. in size and requires no chemotherapy. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 72 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 B. The tumor did not extend beyond the kidney and was completely resected. C. The tumor extended beyond the kidney but was completely resected. D.The tumor has spread into the abdominal cavity and cannot be resected. Incorrect Correct Answer: C. The tumor extended beyond the kidney but was completely resected. The staging of Wilms tumor is confirmed at surgery as follows: Stage I, the tumor is limited to the kidney and completely resected; stage II, the tumor extends beyond the kidney but is completely resected; stage III, the residual non-hematogenous tumor is confined to the abdomen; stage IV, hematogenous metastasis has occurred with spread beyond the abdomen; and stage V, bilateral renal involvement is present at diagnosis. Option A: The mass is solid at presentation and usually >10 cm. Option B: This option describes stage 1, wherein the tumor is limited to the kidney and completely resected. Option D: In stage IV, hematogenous metastasis has occurred with spread beyond the abdomen. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 75 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 intravascular volume, edema, and, frequently, systemic hypertension. Option C: This is a universal finding, even if it is microscopic. Gross hematuria is reported in 30% of pediatric patients, often manifesting as smoky-, coffee-, or cola-colored urine. Option D: There is periorbital edema, but generalized edema is seen in nephrotic syndrome, not acute glomerulonephritis. Most often, the patient is a boy, aged 2-14 years, who suddenly develop puffiness of the eyelids and facial edema in the setting of a post- streptococcal infection. 28. Question Which of the following conditions most commonly causes acute glomerulonephritis? A. A congenital condition leading to renal dysfunction. B. Prior infection with group A Streptococcus within the past 10-14 days. C. Viral infection of the glomeruli. D.Nephrotic syndrome. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 76 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Incorrect Correct Answer: B. Prior infection with group A Streptococcus within the past 10-14 days. Acute glomerulonephritis is most commonly caused by the immune response to a prior upper respiratory infection with group A Streptococcus. Glomerular inflammation occurs about 10-14 days after the infection, resulting in scant, dark urine, and retention of body fluid. Periorbital edema and hypertension are common signs at diagnosis. Option A: No congenital condition predisposes to glomerulonephritis. Noninfectious causes of acute GN may be divided into primary renal diseases, systemic diseases, and miscellaneous conditions or agents. Option C: Viruses may cause acute glomerulonephritis but rarely. Cytomegalovirus (CMV), coxsackievirus, Epstein- Barr virus (EBV), hepatitis B virus (HBV), rubella, rickettsiae (as in scrub typhus), parvovirus B19, and mumps virus are accepted as viral causes only if it can be documented that a recent group A beta-hemolytic streptococcal infection did not occur. Acute GN has been documented as a rare complication of hepatitis A. Option D: Nephrotic syndrome does not cause acute glomerulonephritis. PSGN usually develops 1-3 weeks after acute infection with specific nephritogenic strains of group A beta- hemolytic streptococcus. The incidence of GN is approximately 5- 10% in persons with pharyngitis and 25% in those with skin infections. 29. Question https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 77 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 An infant with hydrocele is seen in the clinic for a follow-up visit at 1 month of https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 80 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 size or if the scrotal sac is compressed, fluid can flow back into the abdomen. Communicating hydroceles are often associated with inguinal hernia. Option B: A hydrocele that doesnʼt disappear on its own might need to be surgically removed, typically as an outpatient procedure. The surgery to remove a hydrocele (hydrocelectomy) can be done under general or regional anesthesia. An incision is made in the scrotum or lower abdomen to remove the hydrocele. If a hydrocele is found during surgery to repair an inguinal hernia, the surgeon might remove the hydrocele even if itʼs causing no discomfort. Option D: A babyʼs hydrocele typically disappears on its own. But if the babyʼs hydrocele doesnʼt disappear after a year or if it enlarges, ask the childʼs doctor to examine the hydrocele again. 30. Question A nurse is caring for a patient with peripheral vascular disease (PVD). The patient complains of burning and tingling of the hands and feet and cannot tolerate touch of any kind. Which of the following is the most likely explanation for these symptoms? A. Inadequate tissue perfusion leading to nerve damage. B. Fluid overload leading to compression of nerve tissue. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 81 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 C. Sensation distortion due to psychiatric disturbance. D. Inflammation of the skin on the hands and feet. Incorrect Correct Answer: A. Inadequate tissue perfusion leading to nerve damage. Patients with peripheral vascular disease often sustain nerve damage as a result of inadequate tissue perfusion. Ischemic rest pain is more worrisome; it refers to pain in the extremity that is due to a combination of PVD and inadequate perfusion. Ischemic rest pain often is exacerbated by poor cardiac output. The condition is often partially or fully relieved by placing the extremity in a dependent position, so that perfusion is enhanced by the effects of gravity. Option B: Fluid overload is not characteristic of PVD. Assess the heart for murmurs or other abnormalities. Investigate all peripheral vessels, including carotid, abdominal, and femoral, for pulse quality and bruit. Note that the dorsalis pedis artery is absent in 5- 8% of normal subjects, but the posterior tibial artery usually is present. Both pulses are absent in only about 0.5% of patients. Exercise may cause the obliteration of these pulses. Option C: There is nothing to indicate a psychiatric disturbance in the patient. Option D: Skin changes in PVD are secondary to decreased tissue perfusion rather than primary https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 82 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 inflammation. The skin may have an atrophic, shiny appearance and may demonstrate trophic changes, including alopecia; dry, scaly, or erythematous skin; chronic pigmentation changes; and brittle nails. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 85 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Option C: Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesnʼt allow enough oxygen to reach the bodyʼs tissues. Option D: Advancing age increases the risk of atherosclerosis but is not a hereditary factor. As one gets older, the risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in the arteries as one ages. By the time one is middle- aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after age 45. In women, the risk increases after age 55. 32. Question Claudication is a well-known effect of peripheral vascular disease. Which of the following facts about claudication is correct? Select all that apply: A. It results when oxygen demand is greater than oxygen supply. B. It is characterized by pain that often occurs during rest. C. It is a result of tissue hypoxia. D. It is characterized by cramping and weakness. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 86 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 E. It always affects the upper extremities. Incorrect Correct Answer: A, C, & D. Claudication describes the pain experienced by a patient with a peripheral vascular disease when oxygen demand in the leg muscles exceeds the oxygen supply. The tissue becomes hypoxic, causing cramping, weakness, and discomfort. Option A: Claudication refers to muscle pain due to lack of oxygen thatʼs triggered by activity and relieved by rest. Option B: This most often occurs during activity when demand increases in muscle tissue. Option C: The condition is also called intermittent claudication because the pain usually isnʼt constant. It begins during exercise and ends with rest. As claudication worsens, however, the pain may occur during rest. Option D: Claudication is pain caused by too little blood flow to muscles during exercise. Most often this pain occurs in the legs after walking at a certain pace and for a certain amount of time — depending on the severity of the condition. Option E: Pain in the shoulders, biceps, and forearms may occur, but less often. 33. Question https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 87 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 A nurse is providing discharge information to a patient with peripheral vascular disease. Which of the following information should be included in the https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 90 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 34. Question A patient who has been diagnosed with the vasospastic disorder (Raynaudʼs disease) complains of cold and stiffness in the fingers. Which of the following descriptions is most likely to fit the patient? A. An adolescent male B. An elderly woman C. A young woman D.An elderly man Incorrect Correct Answer: C. young woman. Raynaudʼs disease is most common in young women and is frequently associated with rheumatologic disorders, such as lupus and rheumatoid arthritis. Vasospasm of the arteries reduces blood flow to the fingers and toes. In people who have Raynaudʼs, the disorder usually affects the fingers. In about 40 https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 91 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 percent of people who have Raynaudʼs, it affects the toes. Rarely, the disorder affects the nose, ears, nipples, and lips. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 92 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 Option A: Primary Raynaudʼs usually develops before the age of 30. In primary Raynaudʼs (also called Raynaudʼs disease), the cause isnʼt known. Primary Raynaudʼs are more common and tend to be less severe than secondary Raynaudʼs. Option B: Secondary Raynaudʼs usually develops after the age of 30. Secondary Raynaudʼs is caused by an underlying disease, condition, or other factors. This type of Raynaudʼs is often called Raynaudʼs phenomenon. Option D: Although anyone can develop the condition, Raynaudʼs disease often begins between the ages 15 to 30, but it mostly affects women. If one has primary or secondary Raynaudʼs, cold temperatures or stress can trigger “Raynaudʼs attacks.” During an attack, little or no blood flows to affected body parts. 35. Question A 23-year-old patient in the 27th week of pregnancy has been hospitalized on complete bed rest for 6 days. She experiences sudden shortness of breath, accompanied by chest pain. Which of the following conditions is the most likely cause of her symptoms? A. Myocardial infarction due to a history of atherosclerosis. B. Pulmonary embolism due to deep vein thrombosis (DVT). https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 95 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 continue to increase in prominence as a major health problem in the United States. https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 96 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 36. Question Thrombolytic therapy is frequently used in the treatment of suspected stroke. Which of the following is a significant complication associated with thrombolytic therapy? A. Air embolus. B. Cerebral hemorrhage. C. Expansion of the clot. D.Resolution of the clot. Incorrect Correct Answer: B. Cerebral hemorrhage. Cerebral hemorrhage is a significant risk when treating a stroke victim with thrombolytic therapy intended to dissolve a suspected clot. The success of the treatment demands that it be instituted as soon as possible, often before the cause of stroke has been determined. Option A: Air embolism is not a concern. Thrombosis is an important part of the normal hemostatic response that https://nurseslabs.com/nclex-practice- questions/2/ 11/07/2021, 6=55 PM Page 97 of 153 PHARMACY PHARM 4 NCLEX-RN Practice Questions Test Bank Questions and Answers best Rated A+ latest update 2023/2024 limits hemorrhage caused by microscopic or macroscopic vascular