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A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client?
- A. Please come into the clinic immediately to have a pregnancy test done.'
- B. You might consider another form of birth control if you keep missing your pills.'
- C. If you have missed fewer than three of your pills, you do not need to worry.'
- D. You should use an alternative form of birth control for the rest of this cycle.'
Correct Answer: D
Rationale: Missing several contraceptive pills compromises efficacy, requiring an alternative method for the cycle to prevent pregnancy. Testing assesses outcome, not prevention. Future methods don't address now. Fewer than three still risks failure. D ensures immediate protection, making it the best instruction.
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A client has a new prescription for alendronate to treat osteoporosis. Which of the following instructions should be included in the teaching?
- A. Take the medication with a full glass of water after rising in the morning.
- B. Lie down for 30 minutes after taking the medication.
- C. Take the medication with a meal to reduce gastric irritation.
- D. Crush the tablet and mix it with applesauce if difficulty swallowing.
Correct Answer: A
Rationale: The correct instruction for taking alendronate is to take it with a full glass of water after rising in the morning to prevent esophageal irritation. It is important to remain upright for at least 30 minutes after taking the medication to reduce the risk of esophageal irritation and ensure proper absorption. Taking the medication with a meal or crushing the tablet are not recommended instructions for alendronate administration. Choice A is the correct answer as it aligns with the proper administration guidelines for alendronate.
A client is prescribed levothyroxine for hypothyroidism. Which of the following findings should indicate to the nurse that the medication is effective?
- A. Decreased heart rate
- B. Increased energy levels
- C. Weight loss
- D. Improved mental clarity
Correct Answer: B
Rationale: Increased energy levels are a key indicator of the effectiveness of levothyroxine in treating hypothyroidism. Levothyroxine works to regulate thyroid hormone levels, which can lead to improved energy levels as the body's metabolism is restored. While the other options may also improve with treatment, increased energy levels directly reflect the correction of the thyroid hormone imbalance. Decreased heart rate can be an indicator of overmedication, weight loss can be attributed to increased metabolism but may not directly reflect the effectiveness of levothyroxine, and improved mental clarity is a more general cognitive improvement that may not directly relate to thyroid function.
A client has a new prescription for Valsartan, and a nurse is providing discharge teaching. Which of the following instructions should the nurse include?
- A. Take this medication with food.
- B. Avoid potassium-rich foods.
- C. Expect to feel drowsy.
- D. Monitor your blood pressure daily.
Correct Answer: D
Rationale: Monitoring blood pressure daily is crucial for clients taking Valsartan, an angiotensin II receptor blocker, to ensure effective management of hypertension. Valsartan helps lower blood pressure by relaxing blood vessels, and regular monitoring helps track the medication's effectiveness and any potential side effects. Choices A, B, and C are incorrect because Valsartan does not need to be taken with food, avoiding potassium-rich foods is not specifically required for this medication, and feeling drowsy is not a common side effect of Valsartan.
Drugs can cause adverse events in a patient. Bone marrow toxicity is one of the most frequent types of drug-induced toxicity. The most serious form of bone marrow toxicity is:
- A. Aplastic anemia.
- B. Thrombocytosis.
- C. Leukocytosis.
- D. Granulocytosis.
Correct Answer: A
Rationale: Aplastic anemia is the most severe form of bone marrow toxicity, characterized by pancytopenia and bone marrow failure. It can be life-threatening and requires immediate intervention. Thrombocytosis, leukocytosis, and granulocytosis are not typically associated with drug-induced bone marrow toxicity.
A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?
- A. Four medications decrease the risk of a severe allergic reaction.
- B. Four medications reduce the chance that the bacteria will become resistant.
- C. Four medications reduce the risk of adverse reactions.
- D. Four medications decrease the chance of having a positive tuberculin skin test.
Correct Answer: B
Rationale: The correct answer is B. When treating tuberculosis, using a combination of medications is crucial to reduce the risk of bacteria developing resistance to any single drug. This approach helps prevent treatment failure and ensures successful treatment outcomes. Choice A is incorrect because the primary purpose of using multiple medications is not related to allergic reactions. Choice C is incorrect as the risk reduction is mainly focused on bacterial resistance rather than adverse reactions. Choice D is not relevant as the purpose of taking multiple medications is not to affect the tuberculin skin test results.