NCLEX : Side Effects

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #1 : Side Effects

What is the most common vitamin deficiency seen in patients taking metformin?

Possible Answers:

D

B12

B6

K2

Correct answer:

B12

Explanation:

B12 deficiency is common in patients on metformin, and should be monitored and supplemented either sublingually or intramuscularly.

Example Question #2 : Side Effects

A male client is receiving 150mg of gentamicin every 8 hours for a soft tissue infection. The nurse giving this medication is aware there are several serious side effects associated with gentamicin, including ototoxicity.

Which statement by the client indicates that he may be experiencing this serious side effect? 

Possible Answers:

"I have a metallic taste in my mouth"

"I am feeling nauseous"

"I am having difficulty swallowing"

"There is a severe rash on my neck and chest"

"I have a high pitch ringing sound in my ear"

Correct answer:

"I have a high pitch ringing sound in my ear"

Explanation:

The ringing in the ear is tinnitus, which is indicative of ototoxicity. Nausea, metallic taste in mouth, difficulty swallowing and skin reactions are not associated with the development of ototoxicity. 

Example Question #2 : Side Effects

Which of the following is the most serious potential adverse effect of enalapril?

Possible Answers:

Nausea and vomiting

Dry cough

Low blood pressure

Angioedema

Correct answer:

Angioedema

Explanation:

All of these are potential side effects of ACE (angiotensin-converting enzyme) inhibitors such as enalapril, but angioedema (the swelling of the face, lips, and/or tongue) is a potentially life threatening condition, as swelling can obstruct the airway.

Example Question #3 : Side Effects

Which of the following is a symptom of digoxin toxicity?

Possible Answers:

Tremor

Nausea, vomiting, and diarrhea

Rash

Mood swings

Correct answer:

Nausea, vomiting, and diarrhea

Explanation:

Nausea, vomiting, and diarrhea are common symptoms of digoxin toxicity. Other symptoms may include confusion, anorexia, irregular heartbeat, and palpitations. Tremors, mood swings, and rash are not generally seen with digoxin toxicity. 

Example Question #52 : Nclex

A 19-year-old client presents to the emergency department explaining that he has a history of sickle cell anemia. He is complaining of severe pain in his arms and legs. The nurse recognizes that the patient is experiencing a sickle cell crisis, and is going to administer pain medication as ordered. 

The nurse is aware that which of the following pain medications is contraindicated for this disorder?

Possible Answers:

Hydromorphone

Fentanyl

Meperidine

Ibuprofen

Morphine

Correct answer:

Meperidine

Explanation:

Meperidine is contraindicated because in high doses it can form a toxic metabolite that can lead to seizures. All other drugs listed are appropriate for pain control for sickle cell crisis. 

Example Question #53 : Nclex

Which of the following best describes extrapyramidal side effects?

Possible Answers:

Dystonia, tremor, slurred speech, restlesness and anxiety

Cutaneous flushing, hypertensive crisis, tachycardia, sweating

Altered color vision, altered taste sensation

Nausea and vomiting, diminished consciousness, disorientation

Correct answer:

Dystonia, tremor, slurred speech, restlesness and anxiety

Explanation:

Extrapyramidal side effects generally present as slow or repetitive motions or postures (dystonia), spasm, tremor, slurred speech, slowed thought process, restlessness and anxiety, paranoia, and general overall distress. These effects are caused by antipsychotic drugs that act as dopamine D2 receptor antagonists.

Example Question #51 : Nclex

Which of the following drugs would be least likely to cause extrapyramidal side effects?

Possible Answers:

Bupropion

Fluoxetine

Haloperidol

Alprazolam

Correct answer:

Alprazolam

Explanation:

Extrapyramidal side effects are common with typical antipsychotic drugs that act as dopamine D2 receptor antagonists. These include many selective serotonin reuptake inhibitors (SSRI's), serotonin–norepinephrine reuptake inhibitors (SNRI's), and norepinephrine–dopamine reuptake inhibitors (NDRI's), as well as antiemetics such as metclopramide.

Alprazolam is a benzodiazepine and is not associated with extrapyramidal adverse effects.

Example Question #55 : Nclex

Which of the following medications is associated with increased risk of SIADH (syndrome of inappropriate antidiuretic hormone secretion)?

Possible Answers:

Drospirenone 

Metronidazole

Chlorpropamide

Eszopiclone

Correct answer:

Chlorpropamide

Explanation:

Chlorpropamide, an antidiabetic medication in the sulfonylurea class, has been associated with drug-induced SIADH (syndrome of inappropriate antidiuretic hormone secretion). This is a rare but serious complication that will generally resolve once drug treatment has stopped. None of the other drugs listed are associated with this side effect. 

Example Question #53 : Pharmacology

Which of the following medications can cause the (benign) side effect of causing an orange-red tint to urine and tears?

Possible Answers:

Metronidazole

Vancomycin

Rifampicin

Clindamycin

Correct answer:

Rifampicin

Explanation:

Of the drugs listed, the only one associated with this bizarre side effect is rifampicin, a broad spectrum antibiotic used in tuberculosis. Urine, sweat, saliva, or tears may be turned any shade from red to reddish orange.

Example Question #1 : Side Effects

Which of the following antibiotics is potentially ototoxic and may cause irreversible hearing loss? 

Possible Answers:

Doxycycline

Penicillin 

Gentamicin

Azithromycin

Correct answer:

Gentamicin

Explanation:

Gentamicin is an aminoglycoside antibiotic. Most antibiotics in the aminoglycoside class can have significant ototoxic effects. Of these, streptomycin and gentamicin are primarily toxic to the vestubular system, while amikacin, neomycin, dihydrosterptomycin, and kanamicin primarily affect the cochlea. None of the other antibiotics listed are generally associated with ototoxicity.

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