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The female client diagnosed with herpes simplex 2 is prescribed valacyclovir (Valtrex), an antiviral. Which information should the nurse discuss with the client?
- A. Do not get pregnant while on this medication; it will harm the fetus.
- B. The medication does not prevent the transmission of the disease.
- C. There are no side effects when taking this medication by mouth.
- D. The client should get monthly liver function study tests.
Correct Answer: B
Rationale: Valacyclovir reduces symptoms but does not prevent HSV-2 transmission; education is key. Pregnancy risks, no side effects, or liver tests are inaccurate.
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An adult client is being treated for genital herpes with acyclovir (Zovirax) tablets. Which statement she makes indicates that she understands her therapy?
- A. It is safe now to have sexual relations.
- B. I will stay home from work until the blisters are gone.
- C. This medicine will cure the herpes infection.
- D. If the blisters come back, I will start taking the pills immediately.
Correct Answer: D
Rationale: Acyclovir reduces symptoms and recurrence of herpes but does not cure it. Starting treatment at recurrence is appropriate.
An adult receives NPH insulin at 7:00 A.M. When is a hypoglycemic reaction most apt to develop?
- A. Mid morning
- B. Mid afternoon
- C. During the evening
- D. During the night
Correct Answer: B
Rationale: NPH insulin peaks 6-12 hours after administration (1:00 P.M.-7:00 P.M.), making mid-afternoon the likely time for hypoglycemia.
The client who has had a kidney transplant tells the nurse he has been taking St. John's wort, an herb, for depression. Which action should the nurse take first?
- A. Praise the client for taking the initiative to treat the depression.
- B. Remain nonjudgmental about the client's alternative treatments.
- C. Refer the client to a psychologist for counseling for depression.
- D. Instruct the client to quit taking the medication immediately.
Correct Answer: D
Rationale: St. John’s wort induces CYP3A4, reducing immunosuppressant efficacy (e.g., cyclosporine), risking transplant rejection. Stopping it is the priority.
Keflex 250 mg PO q6h is ordered for an adult. The nurse notes that the client's history indicates that she has an allergy to penicillin. What is the most appropriate initial action for the nurse?
- A. Notify the physician
- B. Observe the client carefully after giving the medication
- C. Administer the Keflex IV instead of PO
- D. Ask the client to describe the reaction that she had to penicillin
Correct Answer: D
Rationale: There is often a cross-allergy between penicillin and cephalosporins like Keflex. The nurse should first determine the type of reaction to assess if Keflex is safe.
The client diagnosed with multiple sclerosis (MS) is receiving Lioresal (baclofen), a muscle relaxant. Which information should the nurse teach the client/family?
- A. The importance of tapering off medication when discontinuing medication.
- B. Baclofen may cause diarrhea, so the client should take antidiarrheal medication.
- C. The client should not be allowed to drive alone while taking this medication.
- D. The need for follow-up visits to obtain a monthly white blood cell count.
Correct Answer: A
Rationale: Baclofen requires tapering to prevent withdrawal symptoms, like seizures, per FDA warnings. Diarrhea, driving, or WBC counts are not primary concerns.