NCLEX RN EXAMS TESTBANK
(3 NEWEST VERSIONS, 2023, 2024 & 2025) |2500 Qs
AND As WITH RATIONALES |
A 23-year-old woman is admitted to the infusion clinic after a Multiple
Sclerosis Exacerbation. The physician orders methylprednisolone infusions
(Solu-Medrol). The RN would expect which of the following outcomes after
administration of this medication?
1. A decrease in muscle spasticity and involuntary movements
2. A slowed progression of Multiple Sclerosis related plaques
3. A decrease in the length of the exacerbation
4. A stabilization of mood and sleep
- ANSWER1. A decrease in muscle spasticity and involuntary
movements
Incorrect - While muscle spasticity and involuntary movements can be
symptoms of MS, a corticosteroid infusion is not meant to directly treat these
symptoms.
2. A slowed progression of Multiple Sclerosis related plaques
Incorrect - Special drugs like Interferon Beta, Natalizumab, or Glatiramir
acetate are used as first-line treatments to slow the progression of MS. While
corticosteroids can be used in conjunction with these drugs on a long-term
basis, they would not be infused.
They would be taken orally.
3. A decrease in the length of the exacerbation
Correct - A methylprednisolone infusion is the first line of treatment during an
acute exacerbation and is used to decrease the length and severity of a
relapse.
4. A stabilization of mood and sleep
Incorrect - Some of the frequent side effects of a Methylprednisolone infusion
are anxiety, insomnia, and mood swings.
A 30-year old Caucasian woman who works the night shift has been found to
have early bone loss and has a high risk for osteomalacia and bone
degradation. She asks the RN exactly why she should take Vitamin D
supplements. What is the RN's best response?
,1. "It's a standard part of the overall nutritional treatment for the
prevention of osteomalacia"
2. "It helps your intestines absorb calcium, which is critical for bone formation."
3. "It stimulates skin cells to produce calcium, which is then released
into the bloodstream to be used for bone formation."
4. "Vitamin D supplements should not be taken by someone of your age." -
ANSWER1. "It's a standard part of the overall nutritional treatment for the
prevention of osteomalacia" Incorrect - While this is true, it doesn't answer
the woman's question.
2. "It helps your intestines absorb calcium, which is critical for bone formation."
Correct - This is the correct mechanism of action for Vitamin D
3. "It stimulates skin cells to produce calcium, which is then released
into the bloodstream to be used for bone formation."
Incorrect- This is not the correct mechanism of action for Vitamin D
4. "Vitamin D supplements should not be taken by someone of your age."
Incorrect - Vitamin D supplements should be taken for clients who are
homebound, institutionalized, or by some other limitations, unable to meet
daily requirements. This woman works the night shift, which may limit her
ability to absorb Vitamin D naturally.
A 45-year old woman is prescribed ropinirole (Requip) for Parkinson's
Disease. The client is living at home with her daughter. The RN is most
concerned about which side effect of ropinirole?
1. Slurred speech
2. Sudden dizziness
3. Masklike facial expression
4. Stooped Posture
- ANSWER1. Slurred speech
Incorrect - Slurred speech is a common symptom of PD, not a side effect of this
drug.
2. Sudden dizziness
Correct - Dizziness and orthostatic hypotension are serious adverse effects of
this drug that can lead to an increased risk of falls. Ropinirole's drug class is a
dopamine agonist, which mimic dopamine in the brain (PD is characterized by
,a lack of dopamine).
3. Masklike facial expression
Incorrect - Masklike facial expression is a common symptom of PD, not a side
effect of this drug.
4. Stooped Posture
Incorrect - Stooped Posture is a common symptom of PD, not a side effect of
this drug.
A 65 year old man is prescribed Flomax (Tamsulosin) for Benign Prostatic
Hyperplasia. The client lives in an upstairs apartment. The RN is most
concerned about which side effect of Flomax?
1. Hypotension
2. Tachycardia
3. Back Pain
4. Difficulty Urinating - ANSWER1. Hypotension
Correct - Hypotension can lead to dizziness and a risk for injury to the client.
2. Tachycardia
, Tachycardia can be a side effect of Flomax, but is not an immediate safety risk,
nor is it a common side effect.
3. Back Pain
Back Pain can be a side effect of Floma, but is not a safety risk
4. Difficulty Urinating
Dysuria is a symptom of Benign Prostatic Hyperplasia, not a side effect of
Flomax
A client with Multiple Sclerosis reports a constant, burning, tingling pain in
the shoulders. The RN anticipates that the physician will order which
medication for this type of pain?
1. alprazolam (Xanax)
2. Corticosteroid injection
3. gabapentin (Neurontin)
4. hydrocodone/acetaminophen (Norco)
- ANSWER1. alprazolam (Xanax) Incorrect - alprazolam is
used to reduce anxiety
2. Corticosteroid injection
Incorrect - Corticosteroid injections are used to reduce inflammation in a
localized area, often due to joint breakdown. In MS clients it is used to treat
acute exacerbations ("flare-ups"), but the symptoms described do not
constitute an acute exacerbation.
3. gabapentin (Neurontin)
Correct - Anticonvulsants like gabapentin are often the first line of treatment
for nerve pain
4. hydrocodone/acetaminophen (Norco)
Incorrect - Opioids would not be the appropriate medication to treat nerve pain.
A female client is prescribed metformin for glucose control. The client is on
NPO status pending a diagnostic test. The RN is most concerned about which
side effect of metformin?
1. Diarrhea and Vomiting
2. Dizziness and Drowsiness
3. Metallic taste
4. Hypoglycemia - ANSWER1. Diarrhea and Vomiting
(3 NEWEST VERSIONS, 2023, 2024 & 2025) |2500 Qs
AND As WITH RATIONALES |
A 23-year-old woman is admitted to the infusion clinic after a Multiple
Sclerosis Exacerbation. The physician orders methylprednisolone infusions
(Solu-Medrol). The RN would expect which of the following outcomes after
administration of this medication?
1. A decrease in muscle spasticity and involuntary movements
2. A slowed progression of Multiple Sclerosis related plaques
3. A decrease in the length of the exacerbation
4. A stabilization of mood and sleep
- ANSWER1. A decrease in muscle spasticity and involuntary
movements
Incorrect - While muscle spasticity and involuntary movements can be
symptoms of MS, a corticosteroid infusion is not meant to directly treat these
symptoms.
2. A slowed progression of Multiple Sclerosis related plaques
Incorrect - Special drugs like Interferon Beta, Natalizumab, or Glatiramir
acetate are used as first-line treatments to slow the progression of MS. While
corticosteroids can be used in conjunction with these drugs on a long-term
basis, they would not be infused.
They would be taken orally.
3. A decrease in the length of the exacerbation
Correct - A methylprednisolone infusion is the first line of treatment during an
acute exacerbation and is used to decrease the length and severity of a
relapse.
4. A stabilization of mood and sleep
Incorrect - Some of the frequent side effects of a Methylprednisolone infusion
are anxiety, insomnia, and mood swings.
A 30-year old Caucasian woman who works the night shift has been found to
have early bone loss and has a high risk for osteomalacia and bone
degradation. She asks the RN exactly why she should take Vitamin D
supplements. What is the RN's best response?
,1. "It's a standard part of the overall nutritional treatment for the
prevention of osteomalacia"
2. "It helps your intestines absorb calcium, which is critical for bone formation."
3. "It stimulates skin cells to produce calcium, which is then released
into the bloodstream to be used for bone formation."
4. "Vitamin D supplements should not be taken by someone of your age." -
ANSWER1. "It's a standard part of the overall nutritional treatment for the
prevention of osteomalacia" Incorrect - While this is true, it doesn't answer
the woman's question.
2. "It helps your intestines absorb calcium, which is critical for bone formation."
Correct - This is the correct mechanism of action for Vitamin D
3. "It stimulates skin cells to produce calcium, which is then released
into the bloodstream to be used for bone formation."
Incorrect- This is not the correct mechanism of action for Vitamin D
4. "Vitamin D supplements should not be taken by someone of your age."
Incorrect - Vitamin D supplements should be taken for clients who are
homebound, institutionalized, or by some other limitations, unable to meet
daily requirements. This woman works the night shift, which may limit her
ability to absorb Vitamin D naturally.
A 45-year old woman is prescribed ropinirole (Requip) for Parkinson's
Disease. The client is living at home with her daughter. The RN is most
concerned about which side effect of ropinirole?
1. Slurred speech
2. Sudden dizziness
3. Masklike facial expression
4. Stooped Posture
- ANSWER1. Slurred speech
Incorrect - Slurred speech is a common symptom of PD, not a side effect of this
drug.
2. Sudden dizziness
Correct - Dizziness and orthostatic hypotension are serious adverse effects of
this drug that can lead to an increased risk of falls. Ropinirole's drug class is a
dopamine agonist, which mimic dopamine in the brain (PD is characterized by
,a lack of dopamine).
3. Masklike facial expression
Incorrect - Masklike facial expression is a common symptom of PD, not a side
effect of this drug.
4. Stooped Posture
Incorrect - Stooped Posture is a common symptom of PD, not a side effect of
this drug.
A 65 year old man is prescribed Flomax (Tamsulosin) for Benign Prostatic
Hyperplasia. The client lives in an upstairs apartment. The RN is most
concerned about which side effect of Flomax?
1. Hypotension
2. Tachycardia
3. Back Pain
4. Difficulty Urinating - ANSWER1. Hypotension
Correct - Hypotension can lead to dizziness and a risk for injury to the client.
2. Tachycardia
, Tachycardia can be a side effect of Flomax, but is not an immediate safety risk,
nor is it a common side effect.
3. Back Pain
Back Pain can be a side effect of Floma, but is not a safety risk
4. Difficulty Urinating
Dysuria is a symptom of Benign Prostatic Hyperplasia, not a side effect of
Flomax
A client with Multiple Sclerosis reports a constant, burning, tingling pain in
the shoulders. The RN anticipates that the physician will order which
medication for this type of pain?
1. alprazolam (Xanax)
2. Corticosteroid injection
3. gabapentin (Neurontin)
4. hydrocodone/acetaminophen (Norco)
- ANSWER1. alprazolam (Xanax) Incorrect - alprazolam is
used to reduce anxiety
2. Corticosteroid injection
Incorrect - Corticosteroid injections are used to reduce inflammation in a
localized area, often due to joint breakdown. In MS clients it is used to treat
acute exacerbations ("flare-ups"), but the symptoms described do not
constitute an acute exacerbation.
3. gabapentin (Neurontin)
Correct - Anticonvulsants like gabapentin are often the first line of treatment
for nerve pain
4. hydrocodone/acetaminophen (Norco)
Incorrect - Opioids would not be the appropriate medication to treat nerve pain.
A female client is prescribed metformin for glucose control. The client is on
NPO status pending a diagnostic test. The RN is most concerned about which
side effect of metformin?
1. Diarrhea and Vomiting
2. Dizziness and Drowsiness
3. Metallic taste
4. Hypoglycemia - ANSWER1. Diarrhea and Vomiting
