Nokea
The nurse is providing education to a client who is prescribed terbinafine for onychomycosis affecting the toenails. Which statements by the client demonstrate understanding regarding the teaching about terbinafine? Select all that apply.
- A. Following a successful course of treatment, my chance of getting cured is 90%.
- B. I will have to take terbinafine for 3 to 6 months.
- C. I will need liver function tests before starting terbinafine.
- D. I will take this on an empty stomach to help improve its absorption.
- E. It may cause taste or vision changes, so I will report vision changes to my doctor.
- F. Dark urine, pale stools, and persistent nausea may indicate a serious side effect.
Correct Answer: B,C,E
Rationale: Choice B is correct; terbinafine treatment for toenail onychomycosis typically lasts 3-6 months. Choice C is correct; liver function tests are required before and during treatment due to the risk of hepatotoxicity. Choice E is correct; terbinafine can cause taste or vision changes, and vision changes should be reported. Choice A is incorrect; the cure rate is approximately 70-80%, not 90%. Choice D is incorrect; terbinafine can be taken with or without food, and an empty stomach is not required. Choice F is correct; dark urine, pale stools, and nausea may indicate liver toxicity, a serious side effect.
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A client post-extracorporeal shock wave lithotripsy should report:
- A. Mild hematuria.
- B. Severe flank pain.
- C. Clear urine.
- D. Bruising.
Correct Answer: B
Rationale: Severe flank pain may indicate a complication like hematoma or obstruction.
The teaching plan for the client with rheumatoid arthritis includes rest promotion. Which of the following would the nurse expect to instruct the client to avoid during rest periods?
- A. Proper body alignment.
- B. Elevating the part.
- C. Prone lying positions.
- D. Positions of flexion.
Correct Answer: D
Rationale: Positions of flexion can exacerbate joint stiffness and deformity in rheumatoid arthritis. Proper alignment, elevation, and prone positions (if comfortable) support joint health.
As an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3 mg given sublingually. This drug's principal effects are produced by:
- A. Antispasmodic effects on the pericardium.
- B. Causing an increased myocardial oxygen demand.
- C. Vasodilation of peripheral vasculature.
- D. Improved conductivity in the myocardium.
Correct Answer: C
Rationale: Nitroglycerin causes vasodilation of peripheral and coronary vasculature, reducing preload and myocardial oxygen demand, relieving angina.
A client with a hip fracture has undergone surgery for insertion of a femoral head prosthesis. Which of the following activities should the nurse instruct the client to avoid?
- A. Crossing the legs while sitting down.
- B. Sitting on a raised commode seat.
- C. Using an abductor splint while lying on the side.
- D. Rising straight from a chair to a standing position.
Correct Answer: A
Rationale: Crossing the legs risks hip dislocation post-surgery.
A client with vasospastic disorder (Raynaud's phenomenon) is scheduled for sympathectomy. This surgery is performed:
- A. In the early stages of the disease to prevent further circulatory disturbances
- B. When the disease is controlled by medication
- C. When the client is unable to control stress-related vasospasm
- D. When all other treatment alternatives have failed
Correct Answer: D
Rationale: Sympathectomy, which severs sympathetic nerves to reduce vasospasm, is a last-resort treatment for Raynaud's when all other options (medications, lifestyle changes) fail. It is not performed early, when controlled, or solely for stress-related vasospasm.