Nokea
A client is taking phenytoin (Dilantin) for seizure control, and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range?
- A. 5 to 10 mcg/mL
- B. 10 to 20 mcg/mL
- C. 20 to 30 mcg/mL
- D. 30 to 40 mcg/mL
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select one that doesn't apply.
- A. Diarrhea can occur secondary to the metformin.
- B. The repaglinide is not taken if a meal is skipped.
- C. The repaglinide is taken 30 minutes before eating.
- D. Nausea and vomiting
Correct Answer: D
Rationale: Repaglinide is a rapid-acting oral hypoglycemic that should be taken before meals and withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide, so carrying a simple sugar is essential. Metformin decreases hepatic glucose production and can cause diarrhea. Muscle pain may occur as an adverse effect and should be reported to the HCP.
A client with hyperlipidemia is prescribed simvastatin (Zocor). Which instruction should the nurse include in the teaching plan?
- A. Take the medication in the evening.
- B. Report any muscle pain to your healthcare provider.
- C. Avoid increasing your intake of grapefruit juice.
- D. Do not take the medication with a high-fat meal.
Correct Answer: B
Rationale: Muscle pain can be a sign of a serious side effect of simvastatin (Zocor) known as rhabdomyolysis and should be reported to the healthcare provider immediately. The medication is usually taken in the evening to coincide with the body's natural production of cholesterol. Grapefruit juice should be avoided as it can increase the risk of toxicity by affecting the metabolism of the medication. Additionally, taking simvastatin with a high-fat meal can reduce its effectiveness, so it should be taken without food or with a light meal.
A healthcare professional prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The healthcare professional plans to include which of the following in the instructions?
- A. Instruct the client to drink 3000 mL of fluid per day.
- B. Instruct the client to take the medication with food.
- C. Inform the client that the effect of the medication will occur immediately.
- D. Instruct the client that, if swelling of the lips occurs, this is a normal expected response.
Correct Answer: A
Rationale: Allopurinol is an antigout medication that works by reducing the production of uric acid in the body. To prevent kidney stones and promote the excretion of uric acid, increased fluid intake is essential. Instructing the client to drink 3000 mL of fluid per day helps to reduce the risk of kidney stones and assists in the elimination of uric acid, thereby enhancing the effectiveness of allopurinol therapy.
A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions?
- A. I need to watch for signs of infection.
- B. I need to discontinue the medication after 14 days of use.
- C. I can take the medication with meals to minimize nausea.
- D. I need to call the health care provider (HCP) if more than one dose is missed.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:
- A. Drink at least 2 L of fluid per day.
- B. Take the daily dose at bedtime.
- C. Avoid changing brands of the medication without health care provider (HCP) approval.
- D. Avoid over-the-counter (OTC) cough and cold medications unless approved by the HCP.
Correct Answer: B
Rationale: The correct answer is B. Taking theophylline at bedtime is inappropriate because it can cause insomnia. The medication should be taken early in the morning to avoid disrupting sleep patterns. It is important to follow the healthcare provider's instructions regarding the timing of the medication to achieve optimal therapeutic effects.