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The nurse is providing patient education for a patient taking an oral contraceptive. Which drugs may cause interactions with oral contraceptives? (Select all that apply.)
- A. Cephalexin
- B. Guaifenesin
- C. Warfarin
- D. Ibuprofen
- E. Theophylline
Correct Answer: A,C,E
Rationale: Cephalexin, warfarin, and theophylline can interact with oral contraceptives, reducing their efficacy or altering drug levels. Antibiotics like cephalosporins may decrease contraceptive effectiveness, and contraceptives can affect warfarin and theophylline metabolism.
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A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition?
- A. Hypocalcemia
- B. Breast cancer
- C. Stress fractures
- D. Venous thromboembolism
Correct Answer: D
Rationale: SERMs like raloxifene are contraindicated in patients with venous thromboembolism (e.g., DVT, PE) due to increased clotting risk. Hypocalcemia, breast cancer, and stress fractures are not contraindications.
The nurse is providing teaching for a patient who is to receive progestin therapy. Which statement is correct to include in the teaching session?
- A. If you miss a dose, double-up on the next dose.
- B. There's no need to be concerned about breast lumps or bumps that occur.
- C. Be sure to report any weight gain of 5 pounds or more per week.
- D. Take the medication on an empty stomach to enhance absorption.
Correct Answer: C
Rationale: Significant weight gain (5 pounds or more per week) during progestin therapy may indicate fluid retention or other adverse effects, requiring medical evaluation. Doubling doses, ignoring breast lumps, or taking on an empty stomach are incorrect.
The nurse is preparing to administer the contraceptive form of medroxyprogesterone. What route is appropriate?
- A. Subcutaneous
- B. Intramuscular
- C. Vaginal
- D. Transdermal
Correct Answer: B
Rationale: Medroxyprogesterone (Depo-Provera) as a contraceptive is administered intramuscularly for sustained release. Other routes are not appropriate for this formulation.
A woman is preparing for a 10 hour trans-Pacific flight. She has been taking the SERM raloxifene for 6 months. The nurse will provide which instructions to this patient?
- A. She needs to stop taking the drug at least 72 hours before the trip.
- B. She must remember to take this drug with a full glass of water each morning.
- C. She will not take the drug while traveling on the plane.
- D. No change in how the drug is taken will be needed.
Correct Answer: A
Rationale: Raloxifene should be stopped 72 hours before prolonged immobility (e.g., long flights) to reduce the risk of thromboembolism. Continuing the drug during travel increases this risk.
The nurse is providing patient teaching about the oral bisphosphonate alendronate (Fosamax). Which statement by the patient indicates a good understanding of when this drug should be taken?
- A. I will take it in the evening just before bedtime.
- B. I will take it in the morning with an 8-ounce glass of water.
- C. I will take it with the first bite of the morning meal.
- D. I will take it between meals on an empty stomach.
Correct Answer: B
Rationale: Alendronate must be taken in the morning with 6â??8 ounces of water, followed by staying upright for 30 minutes, to prevent esophageal irritation. Taking it with food or at other times is incorrect.