NCLEX RN 2024 PHARMACOLOGY
PREDICTOR EXAM WITH VERIFIED
ANSWERS AND RATIONALE
GRADED A+
1. James teenage patient is admitted to the hospital
because of acetaminophen (Tylenol) overdose. Overdoses
of acetaminophen can precipitate life-threatening
abnormalities in which of the following organs?
a. Lungs
b. Liver
c. Kidney
d. Adrenal Glands - ANSWERS-1.Answer B.
Acetaminophen is extensively metabolized by pathways in
the liver. Toxic doses of acetaminophen deplete hepatic
glutathione, resulting in accumulation of the intermediate
1
,agent, quinine, which leads to hepatic necrosis. Prolonged
use of acetaminophen may result in an increased risk of
renal dysfunction, but a single overdose does not
precipitate life-threatening problems in the respiratory
system, renal system, or adrenal glands.
2. A contraindication for topical corticosteroid usage in a
male patient with atopic dermatitis (eczema) is:
a. Parasite infection.
b. Viral infection.
c. Bacterial infection.
d. Spirochete infection. - ANSWERS-2.Answer B. Topical
agents produce a localized, rather than systemic effect.
When treating atopic dermatitis with a steroidal
preparation, the site is vulnerable to invasion by organisms.
2
,Viruses, such as herpes simplex or varicella-zoster, present
a risk of disseminated infection. Educate the patient using
topical corticosteroids to avoid crowds or people known to
have infections and to report even minor signs of an
infection. Topical corticosteroid usage results in little
danger of concurrent infection with these agents.
3. In infants and children, the side effects of first
generation over-the-counter (OTC) antihistamines, such as
diphenhydramine (Benadryl) and hydroxyzine (Atarax)
include:
a. Reye's syndrome.
b. Cholinergic effects.
c. Paradoxical CNS stimulation.
d. Nausea and diarrhea. - ANSWERS-3.Answer C. Typically,
3
, first generation OTC antihistamines have a sedating effect
because of passage into the CNS. However, in some
individuals, especially infants and children, paradoxical CNS
stimulation occurs and is manifested by excitement,
euphoria, restlessness, and confusion. For this reason, use
of first generation OTC antihistamines has declined, and
second generation product usage has increased. Reye's
syndrome is a systemic response to a virus. First generation
OTC antihistamines do not exhibit a cholinergic effect.
Nausea and diarrhea are uncommon when first generation
OTC antihistamines are taken.
4. Reye's syndrome, a potentially fatal illness associated
with liver failure and encephalopathy is associated with the
administration of which over-the-counter (OTC)
medication?
4
PREDICTOR EXAM WITH VERIFIED
ANSWERS AND RATIONALE
GRADED A+
1. James teenage patient is admitted to the hospital
because of acetaminophen (Tylenol) overdose. Overdoses
of acetaminophen can precipitate life-threatening
abnormalities in which of the following organs?
a. Lungs
b. Liver
c. Kidney
d. Adrenal Glands - ANSWERS-1.Answer B.
Acetaminophen is extensively metabolized by pathways in
the liver. Toxic doses of acetaminophen deplete hepatic
glutathione, resulting in accumulation of the intermediate
1
,agent, quinine, which leads to hepatic necrosis. Prolonged
use of acetaminophen may result in an increased risk of
renal dysfunction, but a single overdose does not
precipitate life-threatening problems in the respiratory
system, renal system, or adrenal glands.
2. A contraindication for topical corticosteroid usage in a
male patient with atopic dermatitis (eczema) is:
a. Parasite infection.
b. Viral infection.
c. Bacterial infection.
d. Spirochete infection. - ANSWERS-2.Answer B. Topical
agents produce a localized, rather than systemic effect.
When treating atopic dermatitis with a steroidal
preparation, the site is vulnerable to invasion by organisms.
2
,Viruses, such as herpes simplex or varicella-zoster, present
a risk of disseminated infection. Educate the patient using
topical corticosteroids to avoid crowds or people known to
have infections and to report even minor signs of an
infection. Topical corticosteroid usage results in little
danger of concurrent infection with these agents.
3. In infants and children, the side effects of first
generation over-the-counter (OTC) antihistamines, such as
diphenhydramine (Benadryl) and hydroxyzine (Atarax)
include:
a. Reye's syndrome.
b. Cholinergic effects.
c. Paradoxical CNS stimulation.
d. Nausea and diarrhea. - ANSWERS-3.Answer C. Typically,
3
, first generation OTC antihistamines have a sedating effect
because of passage into the CNS. However, in some
individuals, especially infants and children, paradoxical CNS
stimulation occurs and is manifested by excitement,
euphoria, restlessness, and confusion. For this reason, use
of first generation OTC antihistamines has declined, and
second generation product usage has increased. Reye's
syndrome is a systemic response to a virus. First generation
OTC antihistamines do not exhibit a cholinergic effect.
Nausea and diarrhea are uncommon when first generation
OTC antihistamines are taken.
4. Reye's syndrome, a potentially fatal illness associated
with liver failure and encephalopathy is associated with the
administration of which over-the-counter (OTC)
medication?
4
