NCLEX PHARMACOLOGY VATI, RN VATI PHARMACOLOGY 2019
WITH COMPLETE SOLUTIONS
Albuterol is a beta2-agonist, which can cause excessive stimulation of
... [Show More] cardiac and
skeletal muscle beta cells. Therefore, the nurse should monitor the client for
tachycardia and dysrhythmias.
A nurse is planning care for a client who has asthma and a prescription for
methylprednisolone. Which of the following lab values should the nurse monitor?
a. Aspartate aminotransferase (AST)
b. Fibrin split products
c. BUN
d. Glucose - ANSWER-d. Glucose
Methylprednisolone therapy increases the synthesis of glucose and decreases the
uptake of glucose by the muscles and adipose tissues, resulting in increased
circulating glucose. Therefore, it is important for the nurse to regularly monitor
blood glucose levels while clients are receiving corticosteroid therapy.
A nurse planning care for a client who has a prescription for acetazolamide. Which
of the following findings should the nurse plan to monitor for as an adverse effect
of this medication?
a. Bronchospasm
b. Constipation
c. Diplopia
d. Electrolyte imbalance - ANSWER-d. Electrolyte imbalance
Acetazolamide promotes renal excretion of sodium and potassium and reduces
the formation of bicarbonate, increasing the client's risk of electrolyte and acidbase imbalances. Therefore, the nurse should monitor the client for findings of
electrolyte imbalance.
A nurse is caring for a client who ingested a toxic amount of acetaminophen 36 hr
ago. For which of the following findings should the nurse monitor? Select all that
apply
a. elevated troponin level
b. diaphoresis
c. hyperglycemia
d. abdominal discomfort
e. increased alanine aminotransferase (ALT) level - ANSWER-b. Diaphoresis is
correct. The nurse should monitor the client for early manifestations of
acetaminophen toxicity, which includes diaphoresis. Later manifestations of
toxicity include liver failure, which manifest 48 to 72 hr following ingestion of the
toxic dose.
d. Abdominal discomfort is correct. The nurse should monitor the client for early
manifestations of acetaminophen toxicity, which include abdominal discomfort,
nausea, vomiting, and diarrhea.
e. Increased alanine aminotransferase (ALT) level is correct. The nurse should
monitor ALT levels because these enzymes may elevate with liver inflammation
from acetaminophen overdose.
A nurse is assessing a client who has a prescription for oral albuterol for the
long-term management of asthma. For which of the following adverse effects
should the nurse monitor?
a. Nystagmus
b. Tachycardia
c. Drowsiness
d. Oral fungal infections - ANSWER-b. Tachycardia
A nurse is caring for a client who reports an increase in migraine headaches over
the past 2 weeks and asks if sumatriptan might be helpful. Which of the following
conditions from the client's medical history should the nurse recognize as a
contraindication for this medication?
a. Gastrointestinal reflux
b. Angina pectoris
c. Routine acetylsalicylic acid use
d. Eczema - ANSWER-b. Angina pectoris
Sumatriptan is a vasoconstrictor and can cause angina from coronary
vasospasm. The nurse should identify uncontrolled hypertension, coronary artery
disease, ischemic heart disease, and angina pectoris as contraindications for
receiving sumatriptan.
A nurse on a telemetry unit is caring for a client who has a new prescription for
digoxin. The nurse should identify that which of the following cardiac rhythms is a
contraindication for administration of the medication?
a. Atrial flutter
b. Second-degree heart block
c. Atrial fibrillation
d. Narrow QRS complexes - ANSWER-b. Second-degree heart block
A second-degree heart block results when there is a problem in the
atrioventricular conduction system. Each atrial impulse takes progressively
longer to go from the AV node to the ventricles until a QRS complex drops. Digoxin
slows atrioventricular conduction and can cause progression to a complete heart
block; therefore, the nurse should identify second-degree heart block as a
contraindication for digoxin therapy.
A nurse is caring for a client who is postoperative following orthopedic surgery
and receiving IV ketorolac. Which of the following findings should the nurse
identify as the priority to report to the provider?
a. Dry mouth
b. Oliguria
c. Nausea
d. Altered taste - ANSWER-b. Oliguria
The nurse should identify that the greatest risk to the client is renal insufficiency
or renal toxicity, both of which are potential adverse effects of ketorolac.
Therefore, oliguria, or decreased urine output, is the priority finding for the nurse
to report to the provider.
A nurse is reviewing the laboratory report for a client who has been taking sodium
polystyrene sulfonate. Which of the following findings indicates a therapeutic
response to the medication?
a. magnesium 1.5 mEq/L
b. calcium 9.2 mg/dL
c. sodium 140 mEq/L
d. potassium 4.8 mEq/L - ANSWER-d. potassium 4.8 mEq/L
Sodium polystyrene sulfonate is a cationic exchange resin administered to treat
hyperkalemia. A potassium level of 4.8 is within the expected reference range of
3.5 to 5 mEq/L and indicates that the client has experienced a therapeutic
response to the medication. The nurse should closely monitor the client's
potassium level throughout treatment and notify the provider when the potassium
level drops within 4 to 5 mEq/L.
A nurse is providing discharge teaching to a client who has a gastric ulcer and a
new prescription for esomeprazole. Which of the following information should the
nurse include in the teaching?
a. Continue taking ibuprofen for pain relief.
b. Crush the medication and mix it with applesauce.
c. Take the medication 60 min before a meal.
d. Insomnia is a common adverse effect of the medication. - ANSWER-c. Take the
medication 60 min before a meal.
Food affects the absorption of esomeprazole. For optimal absorption, the client
should take the medication at least 60 min before a meal
A nurse is planning care for a client who is taking tamoxifen for treatment of
breast cancer. Which of the following interventions should the nurse include in the
plan? (select all that apply)
a. Monitor the client's calcium level.
b. Monitor the client for pulmonary embolus.
c. Advise the client of the potential for menstrual irregularities.
d. Advise the client of the potential for peripheral neuropathy.
e. Advise the client of the potential for hot flashes. - ANSWER-a. Monitor the
client's calcium level.
b. Monitor the client for pulmonary embolus.
c. Advise the client of the potential for menstrual irregularities.
e. Advise the client of the potential for hot flashes. [Show Less]