# Clinical context A 34-year-old with persistent asthma is starting zileuton while continuing a rescue inhaler and also takes three medicines with important interaction potential; baseline safety teaching is planned. Which actions belong in the safety plan for a client starting zileuton? Select exactly 4 responses.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=603008&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Clinical context
A 34-year-old with persistent asthma is starting zileuton while continuing a rescue inhaler and also takes three medicines with important interaction potential; baseline safety teaching is planned.

Which actions belong in the safety plan for a client starting zileuton? Select exactly 4 responses.

Select exactly 4 responses.

1

Review theophylline, warfarin, and propranolol for clinically important interactions.

2

Obtain liver-function testing before and during therapy.

3

Use zileuton for prevention and delay the rescue bronchodilator when acute bronchospasm begins.

4

Teach the client to report right-upper-quadrant pain, jaundice, or dark urine.

5

Continue therapy despite aminotransferases five times the upper limit of normal if asthma symptoms improve.

6

Continue the prescribed rescue bronchodilator plan.

## Explanation

Zileuton can cause hepatotoxicity and raise concentrations or effects of theophylline, warfarin, and propranolol. It is maintenance therapy and does not replace rescue bronchodilation.

## In-depth explanation

Quick answer
Pair zileuton with liver surveillance, interaction review, and a separate rescue plan.

Why this is correct
Respiratory benefit does not make a hepatic signal safe to ignore.

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

Memory hook
Drug, urgent cue, protective action, and reassessment endpoint.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.

Why the other choices are wrong
Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.References
1DailyMed: ZYFLO (zileuton)Hepatic monitoring, major interactions, and maintenance-only use

## Clinical scenario

Clinical context
A 34-year-old with persistent asthma is starting zileuton while continuing a rescue inhaler and also takes three medicines with important interaction potential; baseline safety teaching is planned.

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