Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow
Student Elements

NCLEX Review

Please read each question and select your answer from the choices provided. You must complete all of the questions in order to view your results. At the end of each exam, you have the option to e-mail your results to your instructor.

1:  Which statements about the use of drotrecogin alpha activated (Xigris) for the treatment of severe sepsis is correct?
A: The effectiveness of the drug has been established for pediatric, adult, and geriatric populations.
B: The drug acts by inhibiting protein synthesis in gram-negative microorganisms.
C: Bleeding is the most common adverse effect of the drug.
D: A daily dose of the medication is administered intravenously for a period of 10 days.

2:  The school nurse is teaching a class that warns against the use of anabolic steroids to enhance athletic performance for high school athletes. Which statement by the nurse should be a focus of the presentation?
A: There is no athletic enhancement benefit for females from anabolic steroids.
B: Use of these prescription drugs for athletic enhancement is illegal.
C: Lutienizing hormone (LH) is the primary endogenous androgen found in anabolic steroids.
D: Anabolic steroids bring a decreased risk for the development of atherosclerosis caused by the lowering of LDL cholesterol and the elevation of HDL cholesterol.

3:  A patient is seen in the clinic with an acute asthma exacerbation. Which medication should cause a reduction in the symptoms?
A: Cromolyn (Intal) via metered-dose inhaler.
B: Oral montelukast (Singular).
C: Budesonide (Pulmicort) via dry-powder inhaler.
D: Albuterol (Proventil) via jet nebulizer.

4:  Which drug used in the treatment of obesity acts by decreasing the absorption of dietary fat in the gastrointestinal tract?
A: Bupropion (Wellbutrin).
B: Sibutramine (Meridia).
C: Orlistat (Xenical).
D: Rimonabant (Acomplia).

5:  The nurse is reading the drug insert for Humolog insulin. The insert states that the drug is produced by recombinant DNA technology. Which description applies to this technology?
A: Technology that inserts a chromosome into unicellular bacteria to produce endogenous substances.
B: Inoculation of genetic vehicles to stimulate stem cells to produce hormones and enzymes.
C: Genetic engineering that involves recombining genes into hybrid molecules that are then duplicated.
D: Reproduction of genetic maps to identify a hormone site in the body and stimulate substance production.

6:  Which statement about the use of botulinum toxin Type A (Botox or Botox Cosmetic) is incorrect?
A: The botulinum toxin is a potent poison produced by the bacterium Clostridium botulinum.
B: Botox Cosmetic permanently eliminates glabellar lines.
C: Botulinum toxin type A is a neurotoxin that blocks the release of acetylcholine and blocks transmission at the neuromuscular junctions and cholinergic synapses.
D: Botox is approved for use in the ocular conditions strabismus (lazy eye) and blepharospasm (involuntary, intermittent forced closure of the eyelid).

7:  Which patients is most likely to develop an iatrogenic effect of drug therapy?
A: A patient in the third trimester of pregnancy.
B: An elderly patient with a genetic defect of liver metabolism.
C: A patient taking an antipsychotic who develops pseudo-Parkinson's symptoms.
D: An adult patient who is being treated for cancer with chemotherapy.

8:  Identify the anticancer drug that acts to suppress the formation of new blood vessels and deprive solid tumors of the blood supply needed for growth.
A: Trastuzumab (Herceptin).
B: Bevacizumab (Avastin).
C: Interferon alfa-2A (Roferon-A).
D: Tamoxifen (Nolvadex).

9:  Which scheduled drug level indicates that the drug has accepted medical application and the least potential for abuse under the Controlled Substances Act?
A: Schedule 2.
B: Schedule 3.
C: Schedule 4.
D: Schedule 5.

10:  Which statement about the administration of the smallpox vaccination is true?
A: The vaccination is given in the upper thigh.
B: The vaccine is introduced through multiple skin punctures.
C: Intramuscular injection is the route of administration.
D: A 22-gauge 5/8 needle should be used for administration of the vaccine.

11:  Morphine sulfate 6 mg IV push is administered to a patient with postoperative pain. The patient is assessed 15 minutes after the morphine is administered. Which assessment finding represents an adverse effect of morphine administration?
A: Sleeping, but arouses when name is called.
B: Respiratory rate of 7 breaths/min.
C: Numerical scale pain report indicating that the pain level decreases from 6 to 4.
D: Pulse oximeter reading of SaO2 equal to 96%.

12:  The nurse is preparing to infuse nesiritide (Natrecor). What is the expected action of this medication?
A: Increase myocardial contractility.
B: Decrease preload.
C: Increase intravascular volume.
D: Promote vasodilation.

13:  The nurse is caring for a patient with a history of chronic alcoholism. Based on the patient's history, which pharmacokinetic process will most likely be affected?
A: Excretion.
B: Absorption.
C: Metabolism.
D: Distribution.

14:  A patient experiences anaphylactic shock in response to the administration of penicillin. Which medication would the nurse anticipate administering first?
A: Dobutamine.
B: Corticosteroids.
C: Furosemide.
D: Epinephrine.

15:  A patient who underwent a kidney transplant is prescribed the medication Cyclosporine (Sandimmune). Identify how the immunosuppressant therapy works to prevent organ rejection.
A: Suppresses B- and T-cell proliferation by inhibiting DNA synthesis.
B: Inhibits antigen replication by suppressing RNA synthesis.
C: Selective inhibitor of B- and T-cell proliferation.
D: Inhibits production of interleukin-2.

16:  A patient with primary hypothyroidism is prescribed levothyroxine (Synthroid). Which statement should be included in the patient education?
A: "You will need to take this medication until your symptoms are gone. Then your dose will be tapered off and discontinued."
B: "Symptoms such as tremors, nervousness, and insomnia may indicate your dose is too high."
C: "You should begin to see your symptoms improve immediately after starting your medication."
D: "The reason for taking the drug is because the thyroid gland produces too much thyroxine."

17:  Which use of estrogen hormone replacement therapy is no longer recommended?
A: Protection against cardiovascular disease.
B: Treatment of severe vasomotor symptoms of menopause.
C: Prevention of urogenital atrophy.
D: In combination with progestin for contraception.

18:  The nurse is planning an in-service educational program on sildenafil (Viagra). Which statement should the nurse include in the in-service program?
A: The drug should be taken with grapefruit juice to promote its absorption.
B: Patients taking nitrates should not take sildenafil (Viagra).
C: Severe hypertension can be an adverse effect of the drug.
D: The medication has also been approved for use in women.

19:  Vancomycin (Vancocin), linezolid (Zyvox), and dalfopristin/quinupristin (Synercid) are all antibiotics indicated for the treatment of infections caused by what organism?
A: Pseudomonas aeruginosa.
B: Klebsiella.
C: Candida.
D: Methicillin-resistant Staphylococcus aureus.

20:  Identify the statement that correctly describes the action of a drug agonist.
A: The activation of the receptor site is blocked by the drug.
B: A partial drug effect is achieved due to a reduced action on the receptor site.
C: The drug competes with the body's chemicals at the receptor site and intensifies the response.
D: The drug binds with and activates the receptor site.

21:  Oral hypoglycemic medications are recommended for patients who have which type of diabetes mellitus?
A: New-onset type 2 diabetes complicated by obesity and lack of activity.
B: New-onset type 1 diabetes in the honeymoon phase.
C: Gestational diabetes complicated by obesity.
D: Type 2 diabetes not controlled by dietary and activity modifications.

22:  What is the purpose for administering donepezil (Aricept) to a patient with Alzheimer's disease?
A: To enhance transmission of cholinergic neurons in the central nervous system.
B: To decrease the transmission of gamma-aminobutyric acid (GABA) in the central nervous system.
C: To intensify the effects of dopamine at the neural junction.
D: To inhibit the influx of sodium into the neurons.

23:  The nurse is reviewing a medication list for a patient with intrinsic (intra-renal) failure. Which medication should the nurse question because of the associated nephrotoxic adverse effects?
A: Vancomycin (Vancocin).
B: Amphotericin (Amphotec).
C: Erythropoietin (Epogen).
D: Furosemide (Lasix).

24:  In which situation would the prophylactic use of antibiotics be inappropriate?
A: Fever of unknown origin in a patient with an intact immune system.
B: Neutropenia following cancer chemotherapy.
C: Following surgical debridement of an animal bite.
D: Emergency cesarean section.

25:  What are the most common adverse effects from the use of inhaled glucocorticoids?
A: Elevation of blood sugar and potassium levels.
B: Hypertension and congestive heart failure.
C: Adrenocortical dysfunction and hyperglycemia.
D: Oropharyngeal candidiasis and dysphonia.

26:  The nurse is caring for a single patient who was infected with aerosolized Bacillus anthracis (anthrax). What is the expected initial pharmacologic treatment for an infection with inhaled anthrax?
A: Intravenous ciprofloxacin (Cipro) or doxycycline (Vibramycin).
B: Oral fluconazole (Diflucan) or traconazole (Sporanox).
C: Intravenous tobramycin (Nebcin) or gentamycin (Garamycin).
D: Oral vancomycin (Vancocin) or dirithromycin (Dynabec).

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