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The nurse is preparing a discharge teaching plan for a patient who is taking ciprofloxacin hydrochloride tablets due to suspected anthrax exposure. What instructions should be included in the teaching plan?
- A. Crush and mix the tablets with pudding if you have trouble swallowing the tablets.
- B. Increase fluid intake while taking the medication.
- C. Use nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve mild joint aches and pains caused by the medication.
- D. Report any tendon pain or swelling to the healthcare provider immediately.
- E. Limit exposure to sunlight and avoid tanning beds.
Correct Answer: B,D,E
Rationale: Ciprofloxacin requires high fluid intake (B) to prevent crystalluria, immediate reporting of tendon pain/swelling (D) due to rupture risk, and sun protection (E) due to photosensitivity. Crushing tablets (A) alters release, risking side effects. NSAIDs (C) increase seizure risk with ciprofloxacin.
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An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCI. What should the nurse include in the patient’s teaching plan?
- A. Consume with milk or antacids to prevent gastrointestinal irritation.
- B. Protect your skin from sunlight while on this medication.
- C. Enhance gastrointestinal absorption by taking with orange juice.
- D. Return to the clinic weekly for serum drug level checks.
Correct Answer: B
Rationale: Tetracycline causes photosensitivity, increasing sunburn risk, so sun protection (B) is essential. Milk/antacids (A) reduce absorption by chelating tetracycline. Orange juice (C) contains calcium, impairing absorption. Weekly drug level checks (D) are not required for tetracycline.
A client is receiving intravenous vancomycin, and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times would provide the best determination of these levels?
- A. One hour after completion of the IV dose and one hour before the next administration of the medication.
- B. Two hours after completion of the IV dose and two hours before the next administration of the medication.
- C. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication.
- D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.
Correct Answer: A
Rationale: This question is identical to Question 30. Peak vancomycin levels are drawn 1 hour post-infusion, troughs 1 hour pre-dose (A). Other timings (B, C, D) miss accurate concentrations. Note: Duplicate question; consider removing.
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.
A patient with peptic ulcer disease has been prescribed cimetidine. Which statement made by the patient indicates the need for further instruction by the nurse?
- A. Decrease cigarette use to a pack per day.
- B. Notify the healthcare provider of lethargy.
- C. Take the medication an hour after antacids.
- D. Monitor for any signs of sexual dysfunction.
Correct Answer: C
Rationale: Cimetidine should be taken with meals or immediately after, not 1 hour after antacids (C), which interferes with absorption. Reducing smoking (A) is insufficient; cessation is ideal. Lethargy (B) and sexual dysfunction (D) are valid monitoring points.
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.