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A patient is currently on an oral contraceptive and has been prescribed erythromycin. What advice should the nurse provide to the patient?
- A. Utilize an additional form of contraception.
- B. Immediately discontinue the oral contraceptive.
- C. Ensure a 12-hour gap between taking the medications.
- D. Avoid prolonged exposure to direct sunlight.
Correct Answer: A
Rationale: Erythromycin may reduce oral contraceptive efficacy by inducing hepatic metabolism. Using an additional contraceptive method (A) prevents unintended pregnancy. Discontinuing the contraceptive (B) is unnecessary. Timing gaps (C) don’t mitigate the interaction. Sunlight avoidance (D) relates to other antibiotics like tetracycline.
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A patient has received a new prescription for levothyroxine. Which statement made by the patient indicates that the education was effective?
- A. Avoid the use of iron supplements.
- B. Consume foods that are high in iodine.
- C. Take medication on an empty stomach.
- D. Administer levothyroxine at bedtime.
Correct Answer: C
Rationale: Levothyroxine should be taken on an empty stomach (C), 30-60 minutes before breakfast, for optimal absorption. Iron supplements (A) should be timed separately, not avoided. High-iodine foods (B) don’t enhance efficacy. Bedtime dosing (D) is less effective than morning.
The nurse administers naloxone to a patient with opioid-induced respiratory depression. An hour later, the nurse finds the patient has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unresponsive. What action should the nurse take?
- A. Administer a second dose of naloxone.
- B. Prepare to assist with chest tube insertion.
- C. Determine Glasgow Coma Scale score.
- D. Initiate cardiopulmonary resuscitation (CPR).
Correct Answer: D
Rationale: Severe respiratory depression (4 breaths/min), hypoxia (75% SpO₂), and unresponsiveness require immediate CPR (D) to restore circulation/oxygenation. A second naloxone dose (A) may be needed but is secondary. Chest tubes (B) are irrelevant. Glasgow scoring (C) delays critical intervention.
The nurse is administering sodium polystyrene sulfonate to a client with acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?
- A. Serum potassium level of 3.8 mEq/L (3.8 mmol/L)
- B. Hemoglobin level of 13.5 g/dL (135 g/L).
- C. Serum glucose level of 120 mg/dL (6.7 mmol/L)
- D. Serum ammonia level of 30 Mcg/dL (17.62 Mermol/L)
Correct Answer: A
Rationale: Sodium polystyrene sulfonate treats hyperkalemia by exchanging sodium for potassium. A potassium level of 3.8 mEq/L (A) indicates effectiveness (normal range: 3.5-5.0 mEq/L). Hemoglobin (B), glucose (C), and ammonia (D) are unrelated to its action.
A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?
- A. Determine when the last dose was administered.
- B. Review the history for past use of recreational drugs.
- C. Ask the client to rate the current level of pain using a pain scale.
- D. Encourage the client to use diversional thoughts to manage pain.
Correct Answer: C
Rationale: Assessing the client’s pain level using a pain scale (C) is the first step to quantify pain and guide appropriate dosing. Determining the last dose (A) and reviewing drug history (B) are secondary. Diversional thoughts (D) are a non-pharmacological adjunct, not the priority.
A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client’s plan of care?
- A. Replace salt with a salt substitute.
- B. Cover your skin before going outside.
- C. Limit intake of high-potassium foods.
- D. Monitor skin for excessive bruising.
Correct Answer: C
Rationale: Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia. Limiting high-potassium foods (C) prevents this risk. Salt substitutes (A) often contain potassium, worsening hyperkalemia. Sun protection (B) and bruising (D) are unrelated to spironolactone’s primary risks.