NCLEX PHARMACOLOGY VATI COMPLETE
QUESTIONS AND ANSWERS A+ GUIDE 2023 UPDATE
2019EXAM.
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 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 Correct Answer: b. 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 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 Correct 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 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 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 Correct 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 Correct 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 Correct 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.
QUESTIONS AND ANSWERS A+ GUIDE 2023 UPDATE
2019EXAM.
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 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 Correct Answer: b. 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 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 Correct 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 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 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 Correct 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 Correct 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 Correct 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.
