medication bound to protein can have which of the following effects

NCLEX-PN

PN Nclex Questions 2024

1. How can medication bound to protein affect drug availability?

A. enhanced drug availability
B. rapid distribution of the drug to receptor sites
C. less availability to produce desired medicinal effects
D. increased metabolism of the drug by the liver

Correct answer: C

Rationale: Medication bound to protein reduces the availability of the drug to produce desired medicinal effects because only unbound drugs can effectively bind to active receptor sites. When a drug is bound to protein, it cannot bind with receptor sites, limiting its therapeutic impact. Choice A is incorrect because drug availability is reduced when it is bound to protein. Choice B is incorrect as rapid distribution to receptor sites is not possible if the drug is bound to protein and cannot bind with receptors. Choice D is incorrect as metabolism does not increase when the drug is bound to protein; the liver first needs to separate the drug from the protein before metabolism can occur.

2. Which of the following solutions is routinely used to flush an IV device before and after the administration of blood to a client?

A. 0.9% sodium chloride
B. 5% dextrose in water solution
C. Sterile water
D. Heparin sodium

Correct answer: A

Rationale: The correct answer is 0.9% sodium chloride. Normal saline is 0.9% sodium chloride, which has the same osmolarity as blood and does not cause cell lysis. Choices 2 and 3, 5% dextrose in water solution and sterile water, are hypotonic solutions that can lead to cell lysis. Choice 4, Heparin sodium, is an anticoagulant and is not routinely used to flush an IV device before and after the administration of blood.

3. Using clich�s in therapeutic communication leads the client to:

A. viewing the nurse as less understanding.
B. accepting themselves as human.
C. self-disclosing.
D. feeling discounted.

Correct answer: D

Rationale: The use of clich�s in therapeutic communication is commonly construed by the client as the nurse's lack of understanding, involvement, and caring, which can lead the client to feel demeaned and discounted. Choice A is incorrect because clich�s do not make the client view the nurse as less understanding but rather as lacking depth in communication. Choice B is incorrect as clich�s do not directly lead the client to accepting themselves as human. Choice C is incorrect because clich�s usually hinder self-disclosure rather than encourage it.

4. A client is admitted with a diagnosis of Multiple Drug Use. The nurse should plan care based on knowledge that

A. Multiple drug use is common.
B. People might use more than one drug to enhance the effect or relieve withdrawal symptoms.
C. Combining alcohol and barbiturates can be dangerous due to their combined depressant effects.
D. Assessment and intervention are more complex with multiple drug use due to the synergistic effects.

Correct answer: B

Rationale: When caring for a client with Multiple Drug Use, it is important to understand that individuals may use more than one drug simultaneously or sequentially to enhance the effect of a particular drug or to relieve withdrawal symptoms. This practice is common among substance users. For example, heroin users may also consume alcohol, marijuana, or benzodiazepines. Combining drugs can have various effects, such as intensifying intoxication or alleviating withdrawal symptoms. It is crucial to recognize that multiple drug use can complicate assessment and intervention due to the diverse effects of different substances on the client's health. Option A is incorrect as multiple drug use is indeed common, not uncommon. Option C is incorrect because combining alcohol and barbiturates can be dangerous due to their combined depressant effects. Option D is incorrect because multiple drug use complicates assessment and intervention rather than making them easier, as the effects of different drugs on the client need to be carefully considered.

5. An adult who had been abused as a child is discussing the group therapy program. Which statement indicates that the client has gained insight?

A. "I think I was a lonely child because I could not tell anyone about my abuse."?
B. "I am now aware of how deep-seated my anger is. Before, I did not realize I was angry."?
C. "The program has given me the courage to tell my mother how I felt about her role in my hurt."?
D. "There are so many people just like me, who are just normal people that had bad things happen to them."?

Correct answer: B

Rationale: The correct answer demonstrates insight gained by the client regarding their emotional state. Recognizing deep-seated anger that was previously unrecognized indicates progress in understanding their emotions and the impact of past abuse. Choice A reflects a sense of loneliness due to an inability to share about the abuse, which does not directly address emotional insight. Choice C shows progress in addressing relationships but does not specifically relate to emotional awareness. Choice D acknowledges shared experiences but does not reflect personal emotional growth or insight.