Nokea
A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?
- A. Breastfeeding is not recommended while taking this medication.
- B. Do not take multiple vitamins that contain vitamin A while taking this drug.
- C. Baseline liver function results must be obtained during therapy.
- D. Discontinue this medication one month before attempting to conceive.
Correct Answer: D
Rationale: Isotretinoin is highly teratogenic, requiring discontinuation at least one month before conception to prevent birth defects. Breastfeeding, vitamin A, and liver monitoring are secondary concerns.
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A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?
- A. Notify the healthcare provider.
- B. Administer a PRN dose of an antianxiety drug.
- C. Obtain orthostatic blood pressure readings.
- D. Collect a capillary glucose level.
Correct Answer: A
Rationale: Tremors are a potential side effect of pregabalin, warranting notification of the healthcare provider for possible dose adjustment. Antianxiety drugs, blood pressure readings, or glucose levels are not directly related to addressing pregabalin-induced tremors.
The nurse is preparing the client's plan of care. Select 4 findings that would indicate to the nurse that the administration of the vancomycin antibiotic would be safe to administer.
- A. Dosage in safe range
- B. Peripheral IV in large vein
- C. No known allergies
- D. Used for prophylaxis
- E. Blood urea nitrogen 17 mg/dL (6.07 mmol/L)
- F. Potassium 4.4 mEq/L (4.4 mmol/L)
Correct Answer: A,B,C,E
Rationale: A: Safe dosage prevents toxicity. B: Large vein reduces phlebitis risk. C: No allergies avoids reactions. E: Normal BUN indicates renal function for vancomycin excretion. D and F are less directly related to safety.
When administering zolpidem to an older client, which computer documentation indicates that the desired outcome has been achieved?
- A. Exhibits fewer emotional outbursts.
- B. Improved ability to concentrate.
- C. Decreased episodes of incontinence.
- D. Sleeps soundly through the night.
Correct Answer: D
Rationale: Zolpidem is a sedative for insomnia, and sleeping soundly through the night indicates its effectiveness. Emotional outbursts, concentration, and incontinence are not primary targets of zolpidem.
Before administering a laxative to a bedfast client, it is most important for the nurse to perform which assessment?
- A. Assess the client's strength in moving and turning in the bed.
- B. Observe the skin integrity of the client's rectal and sacral areas.
- C. Evaluate the client's ability to recognize the urge to defecate.
- D. Determine the frequency and consistency of bowel movements.
Correct Answer: D
Rationale: Assessing bowel movement frequency and consistency is critical to determine the need for a laxative and monitor its effectiveness. Strength, skin integrity, and urge recognition are less directly related to laxative administration.
During a home visit, the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?
- A. Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed.
- B. Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started.
- C. Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety.
- D. Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's insomnia.
Correct Answer: B
Rationale: Insomnia is a common, often temporary side effect of rivastigmine. Explaining this reassures the caregiver. Rivastigmine is for cognition, not sleep, and withholding or increasing the dose is inappropriate without provider guidance.