The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct Answer: A
Rationale: Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.
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The healthcare provider is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The healthcare provider consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
- A. Pancreatitis
- B. Diabetes mellitus
- C. Myocardial infarction
- D. Chronic obstructive pulmonary disease
Correct Answer: A
Rationale: Asparaginase is contraindicated in clients with a history of pancreatitis due to the risk of impairing pancreatic function and causing complications. Therefore, the healthcare provider should consult with the registered nurse to assess the client's history of pancreatitis before administering asparaginase.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which of the following food items?
- A. Milk
- B. Water
- C. Apple juice
- D. Orange juice
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions?
- A. It is not necessary to avoid the use of alcohol.
- B. The medication should be taken with meals to decrease flushing.
- C. Clay-colored stools are a common side effect and should not be of concern.
- D. Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing.
Correct Answer: D
Rationale: Aspirin or a nonsteroidal anti-inflammatory drug can be taken 30 minutes before taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it will enhance this side effect. The medication should be taken with meals, this will decrease gastrointestinal upset. Taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic dysfunction and should be immediately reported to the health care provider (HCP).
A client is receiving vancomycin (Vancocin). Which of the following is the most important action for the nurse to take?
- A. Monitor the client for signs of nephrotoxicity.
- B. Monitor the client for signs of ototoxicity.
- C. Ensure adequate hydration.
- D. Administer the medication with food.
Correct Answer: A
Rationale: The most important action for the nurse to take when a client is receiving vancomycin is to monitor for signs of nephrotoxicity. Vancomycin can cause kidney damage, so monitoring kidney function and signs of nephrotoxicity are crucial to prevent harm. While monitoring for ototoxicity and ensuring adequate hydration are important nursing actions, they are not as critical as preventing nephrotoxicity when administering vancomycin.
A client with portosystemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse assesses which of the following to determine medication effectiveness?
- A. Lung sounds
- B. Blood pressure
- C. Blood ammonia level
- D. Serum potassium level
Correct Answer: C
Rationale: In portosystemic encephalopathy, the liver's ability to detoxify ammonia is impaired, leading to elevated blood ammonia levels, which can cause neurological symptoms such as encephalopathy. Lactulose is given to reduce ammonia levels by promoting its excretion through the bowel. Therefore, assessing the blood ammonia level is crucial to determine the effectiveness of lactulose therapy in managing portosystemic encephalopathy.
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