NCLEX Pharmacology VATI, RN VATI Pharmacology 2023/2024

NCLEX Pharmacology VATI, RN VATI Pharmacology 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 - correct answersb. 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 - correct answersb. Tachycardia Albuterol is a beta2-agonist, which can cause excessive stimulation of 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 - correct answersd. 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 - correct answersd. Electrolyte imbalance Acetazolamide promotes renal excretion of sodium and potassium and reduces the formation of bicarbonate, increasing the client's risk of electrolyte and acid-base imbalances. Therefore, the nurse should monitor the client for findings of electrolyte imbalance. 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 - correct answersb. 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 - correct answersb. 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 - correct answersb. 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/d