# Classify each finding for a client receiving voriconazole by the medication-safety decision it supports.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522756&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Classify each finding for a client receiving voriconazole by the medication-safety decision it supports.

|  | Promptly escalate | Review route or interaction before next dose | Teach and monitor |
| --- | --- | --- | --- |
| New syncope with QTc 535 ms and potassium 2.9 mEq/L |  |  |  |
| New jaundice with rapidly rising aminotransferases |  |  |  |
| Creatinine clearance 32 mL/min while the intravenous formulation is prescribed |  |  |  |
| New strong CYP3A4-interacting medication on the list |  |  |  |
| Brief altered color perception after a dose without other neurologic findings |  |  |  |
| Plan for serial liver tests, electrolytes, medication review, and visual assessment |  |  |  |

## Explanation

Voriconazole requires review of liver injury, QT and electrolyte risk, major CYP interactions, visual effects, and route selection in renal impairment. Transient visual change is taught and monitored, while syncope with QT prolongation or jaundice requires prompt escalation.

## In-depth explanation

Quick answer
Sort route, interaction, monitoring, and urgent toxicity cues.

Why this is correct
The intravenous formulation contains a solubilizing vehicle that can accumulate with impaired renal clearance. Voriconazole itself can also affect hepatic function, cardiac repolarization, vision, and concentrations of interacting drugs.

Easy analogy or mental picture
Build a medication safety chain: identify the cue cluster, connect it to the drug mechanism, stop preventable exposure, stabilize the client, and verify the response with measurable findings.

Memory hook
Cue cluster, medication mechanism, protective action, and measurable reassessment.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving treatment for the underlying condition.

Why the other choices are wrong
Options that rely on one reassuring value, continue a suspect exposure, bypass monitoring, or delay escalation leave the medication hazard active.References
1DailyMed: VFEND (voriconazole) prescribing informationHepatic monitoring, QT risk, visual effects, interactions, and IV vehicle considerations in renal impairment

## Clinical scenario

Medication-safety review
Verify the indication, current assessment, laboratory trend, timing, route, interactions, authorized action, and measurable follow-up.

## Related questions

- [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en)
- [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en)
- [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en)
- [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en)
- [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en)
- [A nurse is monitoring a client receiving a continuous IV heparin infusion for pulmonary em…](https://mymerci.kr/pages/nclex_q.php?qn_id=363988&lang=en)
- [A nurse is preparing to initiate a weight-based continuous IV unfractionated heparin infus…](https://mymerci.kr/pages/nclex_q.php?qn_id=364107&lang=en)
- [A nurse is providing discharge teaching to a 65-year-old client newly prescribed warfarin …](https://mymerci.kr/pages/nclex_q.php?qn_id=364872&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=522756&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=522756&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=522756&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=522756&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=522756&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._