NCLEX-PN
2024 Nclex Questions
1. A 20-year-old female has a prescription for tetracycline. While teaching the client how to take her medicine, the nurse learns that the client is also taking Ortho-Novum oral contraceptive pills. Which instructions should be included in the teaching plan?
- A. The oral contraceptives will decrease the effectiveness of the tetracycline.
- B. Nausea often results from taking oral contraceptives and antibiotics.
- C. Toxicity can result when taking these two medications together.
- D. Antibiotics can decrease the effectiveness of oral contraceptives, so the client should use an alternate method of birth control.
Correct answer: D
Rationale: When antibiotics and oral contraceptives are taken together, the effectiveness of the oral contraceptives can be reduced, increasing the risk of pregnancy. Therefore, it is important to advise the client to use an alternate method of birth control to prevent unintended pregnancy. Choices A, B, and C are incorrect because there is no evidence to suggest that oral contraceptives decrease the effectiveness of tetracycline, cause nausea, or result in toxicity when taken with antibiotics.
2. Which information obtained from the mother of a child with cerebral palsy most likely correlates to the diagnosis?
- A. She was born at 42 weeks gestation.
- B. She had meningitis when she was 6 months old.
- C. She had physiologic jaundice after delivery.
- D. She has frequent sore throats.
Correct answer: B
Rationale: The diagnosis of meningitis at age 6 months correlates to a diagnosis of cerebral palsy. Cerebral palsy, a neurological disorder, is often associated with birth trauma or infections of the brain or spinal column. Answers A, C, and D are not related to the question. Gestational length (choice A) is not a direct risk factor for cerebral palsy. Physiologic jaundice (choice C) and frequent sore throats (choice D) are not typically associated with cerebral palsy.
3. When medications have an additive, synergistic, or antagonistic effect on a tissue, a ________ reaction has occurred.
- A. pharmaceutical
- B. pharmacodynamic
- C. pharmacokinetic
- D. drug incompatibility
Correct answer: B
Rationale: The correct answer is 'pharmacodynamic.' Pharmacodynamics pertain to the effect of a drug on receptors, explaining how drugs affect tissues. Pharmaceutical reactions refer to chemical reactions between drugs before administration or absorption, not their effect on tissues. Pharmacokinetic reactions involve how the body affects the drug, not the tissue. Drug incompatibilities are essentially pharmaceutical reactions, not the specific effects on tissues seen in pharmacodynamic reactions.
4. A complication of total parenteral nutrition (TPN) is the development of cholestasis. What is this condition?
- A. an inflammatory process of the extrahepatic bile ducts
- B. an arrest of the normal flow of bile
- C. an inflammation of the gallbladder
- D. the formation of gallstones
Correct answer: B
Rationale: Cholestasis due to TPN administration is an intrahepatic process that interrupts the normal flow of bile. It is characterized by a reduction or stoppage of bile flow. Choice A, an inflammatory process of the extrahepatic bile ducts, refers to cholangitis, not cholestasis. Choice C, an inflammation of the gallbladder, describes cholecystitis, a different condition. Choice D, the formation of gallstones, is not correct as cholestasis is about the flow of bile, not the formation of gallstones.
5. Some drugs are excreted into bile and delivered to the intestines. Prior to elimination from the body, the drug might be absorbed. This process is known as:
- A. hepatic clearance.
- B. total clearance.
- C. enterohepatic cycling.
- D. first-pass effect.
Correct answer: C
Rationale: The correct answer is 'enterohepatic cycling.' This process involves drugs being excreted into bile, delivered to the intestines, reabsorbed into the circulation, and can prolong the drug's presence in the body. 'Hepatic clearance' (Choice A) refers to the amount of drug eliminated by the liver. 'Total clearance' (Choice B) is the sum of all types of clearance including renal, hepatic, and respiratory. 'First-pass effect' (Choice D) is the amount of drug absorbed from the GI tract and metabolized by the liver before entering circulation, reducing the amount of drug available for systemic circulation.
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