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A nurse is reinforcing teaching about the IPLEDGE program with a female client who has a new prescription for isotretinoin. The nurse should tell the client that which of the following is a requirement of the program?
- A. Clients must have a Papanicolaou test every 6 months during treatment.
- B. Sexually active female clients must use two forms of birth control during treatment.
- C. Clients must begin a daily supplement of vitamin A for 1 month prior to initiating therapy.
- D. Female clients must have a negative mammogram prior to beginning therapy.
Correct Answer: B
Rationale: The correct answer is B: Sexually active female clients must use two forms of birth control during treatment. This is a requirement of the IPLEDGE program for isotretinoin due to the teratogenic effects of the medication. Isotretinoin can cause severe birth defects if taken during pregnancy, so using two forms of birth control is crucial to prevent pregnancy while on the medication. This requirement aims to ensure the safety of the fetus.
Choices A, C, and D are incorrect because they are not specific requirements of the IPLEDGE program for isotretinoin. A Papanicolaou test every 6 months, a daily supplement of vitamin A, and a negative mammogram are not mandatory components of the program. It is essential to focus on the specific requirements outlined by the IPLEDGE program to ensure the safe use of isotretinoin.
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A nurse is reinforcing teaching about phenytoin with a client who had a tonic-clonic seizure. Which of the following information should the nurse include in the teaching?
- A. Taking ginkgo biloba increases phenytoin levels.
- B. Taking phenytoin diminishes potassium levels.
- C. Monitor for gingival hyperplasia.
- D. Minimize exposure to sunlight.
Correct Answer: C
Rationale: The correct answer is C: Monitor for gingival hyperplasia. This is important because phenytoin can cause gingival overgrowth, leading to oral health issues. The nurse should educate the client to maintain good oral hygiene and visit the dentist regularly for check-ups.
A: Taking ginkgo biloba increases phenytoin levels - This statement is incorrect. Ginkgo biloba is known to interact with certain medications, but it does not specifically increase phenytoin levels.
B: Taking phenytoin diminishes potassium levels - This statement is incorrect. Phenytoin does not directly affect potassium levels. It is more likely to cause issues with calcium and vitamin D metabolism.
D: Minimize exposure to sunlight - This statement is incorrect. While some antiepileptic medications can increase sensitivity to sunlight, phenytoin is not typically associated with this side effect.
Overall, monitoring for gingival hyperplasia is the most relevant information for the client
A nurse is caring for a client who is receiving an oral solution of codeine to suppress a nonproductive cough. Which of the following is the nurse's data collection priority following administration of this medication?
- A. Heart rate
- B. Respiratory rate
- C. Blood pressure
- D. Level of consciousness
Correct Answer: B
Rationale: The correct answer is B: Respiratory rate. Codeine is a central nervous system depressant that can cause respiratory depression as a side effect. Therefore, monitoring the client's respiratory rate is crucial to detect any signs of respiratory distress or suppression. This should be the nurse's priority to ensure the client's safety.
A: Heart rate may be affected by codeine, but respiratory rate is a more direct indicator of respiratory depression.
C: Blood pressure is not typically affected by codeine in the context of suppressing a cough.
D: Level of consciousness is important, but respiratory rate takes precedence as it directly reflects potential respiratory depression.
A nurse is caring for a client who had abdominal surgery. The client is grimacing and has a respiratory rate of 24/min. Which of the following actions should the nurse take first?
- A. Offer the client a cold compress.
- B. Play music in the client's room as a distraction.
- C. Check the client's current level of pain.
- D. Assist the client to reposition in bed.
Correct Answer: C
Rationale: The correct answer is C: Check the client's current level of pain. The nurse should assess the client's pain first to determine the cause of grimacing and tachypnea. Pain after abdominal surgery can indicate complications like infection or inadequate pain management. Addressing pain is a priority to ensure the client's comfort and prevent further complications. Options A, B, and D do not address the underlying issue of pain and are therefore not the most appropriate actions. Offering a cold compress or playing music may provide temporary relief but do not address the root cause. Repositioning may help with comfort but should come after assessing and addressing the pain.
A nurse in an influenza clinic is collecting data from four clients. Which of the following clients should the nurse identify as having a contraindication for receiving the live attenuated form of the influenza vaccine?
- A. An adolescent who received a new tattoo last week
- B. A client is at 27 weeks of gestation
- C. A client who is about to travel to a different country
- D. A school-age child who has rhinitis
Correct Answer: B
Rationale: The correct answer is B - A client at 27 weeks of gestation. Pregnant individuals are contraindicated to receive live attenuated influenza vaccine due to theoretical risk to the fetus. This is because live vaccines are not recommended during pregnancy. Choice A is incorrect as a recent tattoo does not contraindicate the vaccine. Choice C is incorrect as travel plans do not affect the decision to administer the vaccine. Choice D is incorrect as rhinitis is not a contraindication.
A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take?
- A. Inject 0.3 to 0.5 mL of the solution.
- B. Select an injection site that is free of scar tissue.
- C. Hold the needle at a 30° angle during injection.
- D. Massage the site following the injection.
Correct Answer: B
Rationale: Correct Answer: B - Select an injection site that is free of scar tissue.
Rationale: Selecting an injection site that is free of scar tissue is crucial for accurate tuberculin skin test results. Scar tissue can interfere with the test by affecting the absorption of the solution and potentially leading to false results. Choosing a site free of scar tissue ensures proper administration and interpretation of the test.
Incorrect Choices:
A: Injecting 0.3 to 0.5 mL of the solution is not the key factor in ensuring accurate results. The volume to be injected may vary based on the specific test kit used, but the injection site's condition is more critical.
C: Holding the needle at a 30° angle is not a standard requirement for administering a tuberculin skin test. The angle of injection may vary based on the client's skin thickness and other factors.
D: Massaging the site following the injection is unnecessary and could potentially lead to inaccurate results. Massaging can alter the distribution