Saunders NCLEX Pharmacology Respiratory Medications
– TB, Bronchodilators & Hepatotoxicity | Complete
Verified Questions & A+ Rationales 2026
Pharmacology NCLEX
4.Aspartate aminotransferase (AST) 55 U/L (55 U/L)
Rationale:Because isoniazid therapy can cause elevated hepatic enzymes and hepatitis, liver
enzymes are monitored when therapy is initiated and during the first 3 months of therapy. They
may be monitored longer in the client who is older than 50 years of age or who abuses alcohol.
The normal AST level is 0 to 35 U/L (0 to 30 U/L). The other options are not monitored routinely
and are also normal.
A client with a documented exposure to tuberculosis is on medication therapy with isoniazid.
The nurse is monitoring laboratory results and determines that which laboratory value indicates
the need for follow-up?
1.Platelet count 325,000 mm3 (325 × 109/L) 2.Serum creatinine 1.0 mg/dL (88.3
mcmol/L) 3.Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L) 4.Aspartate aminotransferase
(AST) 55 U/L (55 U/L)
1, 2, 3, 5
Rationale:Rifabutin may be prescribed for a client with active MAC disease and tuberculosis. It
inhibits mycobacterial DNA-dependent RNA polymerase and suppresses protein synthesis. Side
and adverse effects include rash, gastrointestinal disturbances, neutropenia (low neutrophil
count), red-orange–colored body secretions, uveitis (blurred vision and eye pain), myositis,
arthralgia, hepatitis, chest pain with dyspnea, and flu-like syndrome. Vitamin B6 deficiency and
numbness and tingling in the extremities are associated with the use of isoniazid.
Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease
and tuberculosis. The nurse should monitor for which side and adverse effects of
rifabutin? Select all that apply.
1.Signs of hepatitis 2.Flu-like syndrome 3.Low neutrophil count 4.Vitamin B6 deficiency 5.Ocular
pain or blurred vision 6.Tingling and numbness of the fingers
3.Diabetes mellitus
, Rationale:Terbutaline is a bronchodilator and is contraindicated in clients with hypersensitivity
to sympathomimetics. It should be used with caution in clients with impaired cardiac function,
diabetes mellitus, hypertension, hyperthyroidism, or a history of seizures. The medication may
increase blood glucose levels.
Terbutaline is prescribed for a client with bronchitis. The nurse checks the client's medical
history for which disorder in which the medication should be used with caution?
1.Osteoarthritis 2.Hypothyroidism 3.Diabetes mellitus 4.Polycystic disease
2.Report yellow eyes or skin immediately.
Rationale:Isoniazid is hepatotoxic, and therefore the client is taught to report signs and
symptoms of hepatitis immediately, which include yellow skin and sclera. For the same reason,
alcohol should be avoided during therapy. The client should avoid intake of Swiss cheese, fish
such as tuna, and foods containing tyramine, because they may cause a reaction characterized
by redness and itching of the skin, flushing, sweating, tachycardia, headache, or
lightheadedness. The client can avoid developing peripheral neuritis by increasing the intake of
pyridoxine (vitamin B6) during the course of isoniazid therapy.
A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach
the client to take which action?
1.Use alcohol in small amounts only. 2.Report yellow eyes or skin immediately. 3.Increase intake
of Swiss or aged cheeses. 4.Avoid vitamin supplements during therapy.
2.Chart the finding as a normal response to the rifampin.
Rationale:Brown-tinged urine is a normal finding associated with rifampin; thus, there is no
need to notify the PHCP. There is no indication that the client is in shock, so eliminate the
options that indicate to start prescribed IV fluids and to place the client in modified
Trendelenburg's position. The nurse should also inform the client that his is a harmless side
effect.
A client taking rifampin reports, "My urine has blood in it." When the nurse assesses the urine,
it is brown. Which is the nurse's best action?
1.Notify the primary health care provider (PHCP). 2.Chart the finding as a normal response to
the rifampin. 3.Immediately start prescribed intravenous (IV) fluids to prevent shock. 4.Get the
client into bed, and put the bed in modified Trendelenburg's position.
4.Sputum culture
– TB, Bronchodilators & Hepatotoxicity | Complete
Verified Questions & A+ Rationales 2026
Pharmacology NCLEX
4.Aspartate aminotransferase (AST) 55 U/L (55 U/L)
Rationale:Because isoniazid therapy can cause elevated hepatic enzymes and hepatitis, liver
enzymes are monitored when therapy is initiated and during the first 3 months of therapy. They
may be monitored longer in the client who is older than 50 years of age or who abuses alcohol.
The normal AST level is 0 to 35 U/L (0 to 30 U/L). The other options are not monitored routinely
and are also normal.
A client with a documented exposure to tuberculosis is on medication therapy with isoniazid.
The nurse is monitoring laboratory results and determines that which laboratory value indicates
the need for follow-up?
1.Platelet count 325,000 mm3 (325 × 109/L) 2.Serum creatinine 1.0 mg/dL (88.3
mcmol/L) 3.Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L) 4.Aspartate aminotransferase
(AST) 55 U/L (55 U/L)
1, 2, 3, 5
Rationale:Rifabutin may be prescribed for a client with active MAC disease and tuberculosis. It
inhibits mycobacterial DNA-dependent RNA polymerase and suppresses protein synthesis. Side
and adverse effects include rash, gastrointestinal disturbances, neutropenia (low neutrophil
count), red-orange–colored body secretions, uveitis (blurred vision and eye pain), myositis,
arthralgia, hepatitis, chest pain with dyspnea, and flu-like syndrome. Vitamin B6 deficiency and
numbness and tingling in the extremities are associated with the use of isoniazid.
Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease
and tuberculosis. The nurse should monitor for which side and adverse effects of
rifabutin? Select all that apply.
1.Signs of hepatitis 2.Flu-like syndrome 3.Low neutrophil count 4.Vitamin B6 deficiency 5.Ocular
pain or blurred vision 6.Tingling and numbness of the fingers
3.Diabetes mellitus
, Rationale:Terbutaline is a bronchodilator and is contraindicated in clients with hypersensitivity
to sympathomimetics. It should be used with caution in clients with impaired cardiac function,
diabetes mellitus, hypertension, hyperthyroidism, or a history of seizures. The medication may
increase blood glucose levels.
Terbutaline is prescribed for a client with bronchitis. The nurse checks the client's medical
history for which disorder in which the medication should be used with caution?
1.Osteoarthritis 2.Hypothyroidism 3.Diabetes mellitus 4.Polycystic disease
2.Report yellow eyes or skin immediately.
Rationale:Isoniazid is hepatotoxic, and therefore the client is taught to report signs and
symptoms of hepatitis immediately, which include yellow skin and sclera. For the same reason,
alcohol should be avoided during therapy. The client should avoid intake of Swiss cheese, fish
such as tuna, and foods containing tyramine, because they may cause a reaction characterized
by redness and itching of the skin, flushing, sweating, tachycardia, headache, or
lightheadedness. The client can avoid developing peripheral neuritis by increasing the intake of
pyridoxine (vitamin B6) during the course of isoniazid therapy.
A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach
the client to take which action?
1.Use alcohol in small amounts only. 2.Report yellow eyes or skin immediately. 3.Increase intake
of Swiss or aged cheeses. 4.Avoid vitamin supplements during therapy.
2.Chart the finding as a normal response to the rifampin.
Rationale:Brown-tinged urine is a normal finding associated with rifampin; thus, there is no
need to notify the PHCP. There is no indication that the client is in shock, so eliminate the
options that indicate to start prescribed IV fluids and to place the client in modified
Trendelenburg's position. The nurse should also inform the client that his is a harmless side
effect.
A client taking rifampin reports, "My urine has blood in it." When the nurse assesses the urine,
it is brown. Which is the nurse's best action?
1.Notify the primary health care provider (PHCP). 2.Chart the finding as a normal response to
the rifampin. 3.Immediately start prescribed intravenous (IV) fluids to prevent shock. 4.Get the
client into bed, and put the bed in modified Trendelenburg's position.
4.Sputum culture
