NACE Pharmacological and Parenteral Therapies 5

Question 1

A patient with type 2 diabetes is prescribed metformin. Which condition is an absolute contraindication to its use?

Accepted Answer

Stage 3b chronic kidney disease (GFR < 45 mL/min)

Answer

Metformin is contraindicated in significant renal impairment (GFR < 30 mL/min and used cautiously below 45) due to risk of lactic acidosis.

Question 2

A nurse is administering potassium chloride 40 mEq IV. Which practice is safest?

Accepted Answer

Dilute in at least 100 mL and infuse no faster than 10 mEq/hour

Answer

IV potassium must be diluted and infused slowly (≤10 mEq/hr peripherally) to prevent cardiac dysrhythmias; IV push is never acceptable.

Question 3

A patient taking phenytoin for seizure disorder has a serum level of 25 mcg/mL. Which symptom should the nurse assess for?

Accepted Answer

Nystagmus, ataxia, and confusion

Answer

Phenytoin toxicity (therapeutic range 10–20 mcg/mL) commonly manifests as nystagmus, ataxia, and mental status changes.

Question 4

Which nursing action is most important before administering the first dose of an aminoglycoside antibiotic such as gentamicin?

Accepted Answer

Obtain baseline hearing assessment and renal function tests

Answer

Aminoglycosides are ototoxic and nephrotoxic; baseline hearing and renal function must be established before initiating therapy.

Question 5

A patient receiving morphine for post-operative pain has a respiratory rate of 8 breaths/min and is difficult to arouse. What is the priority intervention?

Accepted Answer

Administer naloxone (Narcan) per protocol

Answer

Respiratory depression with altered consciousness is opioid toxicity requiring immediate naloxone administration to reverse the effect.

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

NACE Pharmacological and Parenteral Therapies 5