NCLEX PHARMACOLOGY VATI, RN VATI PHARMACOLOGY 2019 WITH COMPLETE SOLUTIONS

NCLEX PHARMACOLOGY VATI, RN VATI PHARMACOLOGY 2019 WITH COMPLETE SOLUTIONS 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 - 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.