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A client has a new prescription for Tetracycline. Which of the following instructions should be included?
- A. Take the medication with milk.
- B. Avoid prolonged sun exposure.
- C. Take the medication at bedtime.
- D. Expect urine to turn dark yellow.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A 52-year-old man undergoes three surgical procedures in a 2-week period involving debridement of a deep skin abscess. Each surgical anesthesia procedure involves the use of halothane. Which of the following pathologic processes is possible as a result of the surgical procedures?
- A. Cholelithiasis
- B. Hepatic necrosis
- C. Nephrolithiasis
- D. Steatorrhea
Correct Answer: B
Rationale: Repeated halothane anesthesia risks hepatic necrosis . Halothane, a halogenated anesthetic, can cause hepatitis or necrosis, especially with multiple exposures, due to toxic metabolites. Cholelithiasis , kidney stones , steatorrhea , and tinnitus (E) aren't linked. Hepatic necrosis, though rare, is a documented risk, particularly in short-interval surgeries, making it the plausible complication here.
Individuals who are slow acetylators (i.e. have a relatively low activity of hepatic N-acetyltransferase):
- A. Have a prevalence of 15-20 per cent in European caucasians
- B. Are more likely to develop thrombocytopenia, nephrotic syndrome and rash during gold treatment
- C. Are more likely to develop hepatotoxicity following halothane anaesthesia
- D. Are more likely to develop antinuclear antibodies during hydralazine therapy
Correct Answer: D
Rationale: Slow acetylators have reduced hepatic N-acetyltransferase (NAT2) activity, affecting metabolism of drugs like hydralazine, isoniazid, and procainamide. In European Caucasians, prevalence is actually 50-60%, not 15-20%, making that statement inaccurate. Gold treatment side effects like thrombocytopenia or nephrotic syndrome aren't strongly linked to acetylation status, but rather to immune responses, so that's less relevant. Halothane hepatotoxicity relates to immune-mediated reactions or metabolites, not acetylation speed. Hydralazine, metabolized by NAT2, accumulates in slow acetylators, increasing risk of drug-induced lupus with antinuclear antibodies (ANA), a well-documented association. Agranulocytosis with clozapine isn't tied to acetylation but to idiosyncratic reactions. The ANA risk with hydralazine is the most accurate, reflecting its pharmacogenetic implications, critical for personalized dosing and monitoring.
A client with asthma has a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?
- A. Check the pulse after using the inhaler.
- B. Take the medication with food.
- C. Rinse the mouth after using the inhaler.
- D. Reduce caffeine consumption.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with congestive heart failure taking digoxin refused breakfast and is complaining of nausea and weakness. Which action should the nurse take first?
- A. Check the client's vital signs.
- B. Request a dietitian consult.
- C. Suggest that the client rests before eating the meal.
- D. Request an order for an antiemetic.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client has a new prescription for Amlodipine. Which of the following side effects should the client monitor for and report?
- A. Swelling of the ankles.
- B. Increased urination.
- C. Persistent cough.
- D. Dark-colored urine.
Correct Answer: A
Rationale: Amlodipine, a calcium channel blocker, can cause peripheral edema (swelling of the ankles) as a side effect. This occurs due to the dilation of blood vessels and increased fluid retention. It is important for the client to monitor for ankle swelling as it could indicate a potential adverse reaction to the medication. Reporting this side effect to the healthcare provider is crucial to ensure appropriate management and potential adjustment of the treatment plan.