Sample NCLEX Questions
1. A 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. Kidneys
d. Adrenal glands
Answer B
Rationale: Acetaminophen is extensively metabolized by pathways in the liver. Toxic doses of acetaminophen deplete hepatic glutathione, resulting in accumulation of the intermediate 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 patient with atopic dermatitis (eczema) is:
a. Parasite infection
b. Viral infection
c. Bacterial infection
d. Spirochete infection
Answer B
Rationale: 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. 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 (Benedryl) and hydroxyzine (Atarax) include:
a. Reye’s syndrome.
b. Cholinergic effects.
c. Paradoxical CNS stimulation.
d. Nausea and diarrhea.
Answer C
Rationale: Typically, 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?
a. Acetaminophen (Tylenol)
b. Ibuprofen (Motrin)
c. Aspirin
d. Brompheniramine/psudoephedrine (Dimetapp)
Answer C
Rationale: Virus-infected children who are given aspirin to manage pain, fever, and inflammation are at an increased risk of developing Reye’s syndrome. Use of acetaminophen has not been associated with Reye’s syndrome and can be safely given to patients with fever due to viral illnesses. Ibuprofen adverse effects include GI irritation and bleeding, and in toxic doses, both renal and hepatic failure are reported. However, ibuprofen has not been associated with the onset of Reye’s disease. Brompheniramine/psudoephedrine contains a first generation OTC antihistamine and a decongestant. Neither agent has been associated with the development of Reye’s syndrome.
5. Patients who are allergic to intravenous contrast media are usually also allergic to which of the following products?
a. Eggs
b. Shellfish
c. Soy
d. Acidic fruits
Answer B
Rationale: Some types of contrast media contain iodine as an ingredient. Shellfish also contain significant amounts of iodine. Therefore, a patient who is allergic to iodine will exhibit an allergic response to both iodine containing contrast media and shellfish. These products do not contain iodine.
NCLEX Questions for Pharmacologies Therapies 1/5
NCLEX Questions for Pharmacologies Therapies 2/5
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