NCLEX Saunders Pharmacology Exam Questions and Answers
Question 1
The nurse transcribes a medication prescription for ifosfamide for a client with a diagnosis of germ cell cancer of the testes.
The nurse reviews the client's history and looks for another prescription for which medication, which usually is administered
with the antineoplastic medication?
Mesna
Melphalan
Prednisone
Bleomycin sulfate
Correct Answer
Mesna
Ifosfamide is used to treat refractory germ cell cancer of the testes. Concurrent therapy with mesna and at least 2 L of
oral or intravenous fluid daily will limit the toxicity of this medication, evidenced by bone marrow depression and
hemorrhagic cystitis. Mesna is a detoxifying agent used to inhibit the hemorrhagic cystitis induced by ifosfamide. The
medications in options 2, 3, and 4 are not routinely administered with ifosfamide.
Page 1 of 98
,Question 2
A client reports frequent use of acetaminophen for relief of headaches and other discomforts. The nurse should evaluate
which diagnostic data to determine if the client is at risk for toxicity?
Chest x-ray
Electrocardiogram
Liver function studies
Upper gastrointestinal x-ray results
Correct Answer
Liver function studies
In adults, overdose of acetaminophen causes liver damage. In addition, clients with liver disorders are at a higher risk of
experiencing hepatotoxicity with chronic acetaminophen use. Options 1, 2, and 4 are not associated with acetaminophen
overdose.
Page 2 of 98
,Question 3
A client is taking cetirizine. The nurse should inform the client of which side effect of this medication?
Diarrhea
Excitability
Drowsiness
Excess salivation
Correct Answer
Drowsiness
Cetirizine is an antihistamine; frequent side effects are drowsiness or sedation. Others include blurred vision,
hypertension (and sometimes hypotension), dry mouth, constipation, urinary retention, and sweating. Therefore, the
other options are incorrect.
Page 3 of 98
, Question 4
The client has a prescription to receive pirbuterol 2 puffs and beclomethasone dipropionate 2 puffs by metered-dose
inhaler. The nurse plans to give these medications in which way to ensure effectiveness?
Administering the pirbuterol before the beclomethasone
Alternating a single puff of each hourly, beginning with the beclomethasone
Alternating a single puff of beclomethasone with pirbuterol, repeating the steps
Administering the pirbuterol, waiting 30 minutes, and administering the beclomethasone
Correct Answer
Administering the pirbuterol before the beclomethasone
Pirbuterol is a bronchodilator. Beclomethasone is a glucocorticoid. Bronchodilators are administered before
glucocorticoids when both are to be given on the same time schedule. This allows for widening of the air passages by the
bronchodilator, which then makes the glucocorticoid more effective.
Page 4 of 98
Question 1
The nurse transcribes a medication prescription for ifosfamide for a client with a diagnosis of germ cell cancer of the testes.
The nurse reviews the client's history and looks for another prescription for which medication, which usually is administered
with the antineoplastic medication?
Mesna
Melphalan
Prednisone
Bleomycin sulfate
Correct Answer
Mesna
Ifosfamide is used to treat refractory germ cell cancer of the testes. Concurrent therapy with mesna and at least 2 L of
oral or intravenous fluid daily will limit the toxicity of this medication, evidenced by bone marrow depression and
hemorrhagic cystitis. Mesna is a detoxifying agent used to inhibit the hemorrhagic cystitis induced by ifosfamide. The
medications in options 2, 3, and 4 are not routinely administered with ifosfamide.
Page 1 of 98
,Question 2
A client reports frequent use of acetaminophen for relief of headaches and other discomforts. The nurse should evaluate
which diagnostic data to determine if the client is at risk for toxicity?
Chest x-ray
Electrocardiogram
Liver function studies
Upper gastrointestinal x-ray results
Correct Answer
Liver function studies
In adults, overdose of acetaminophen causes liver damage. In addition, clients with liver disorders are at a higher risk of
experiencing hepatotoxicity with chronic acetaminophen use. Options 1, 2, and 4 are not associated with acetaminophen
overdose.
Page 2 of 98
,Question 3
A client is taking cetirizine. The nurse should inform the client of which side effect of this medication?
Diarrhea
Excitability
Drowsiness
Excess salivation
Correct Answer
Drowsiness
Cetirizine is an antihistamine; frequent side effects are drowsiness or sedation. Others include blurred vision,
hypertension (and sometimes hypotension), dry mouth, constipation, urinary retention, and sweating. Therefore, the
other options are incorrect.
Page 3 of 98
, Question 4
The client has a prescription to receive pirbuterol 2 puffs and beclomethasone dipropionate 2 puffs by metered-dose
inhaler. The nurse plans to give these medications in which way to ensure effectiveness?
Administering the pirbuterol before the beclomethasone
Alternating a single puff of each hourly, beginning with the beclomethasone
Alternating a single puff of beclomethasone with pirbuterol, repeating the steps
Administering the pirbuterol, waiting 30 minutes, and administering the beclomethasone
Correct Answer
Administering the pirbuterol before the beclomethasone
Pirbuterol is a bronchodilator. Beclomethasone is a glucocorticoid. Bronchodilators are administered before
glucocorticoids when both are to be given on the same time schedule. This allows for widening of the air passages by the
bronchodilator, which then makes the glucocorticoid more effective.
Page 4 of 98
