A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?

Notify the healthcare provider of the contraindication to tetracyclines.

Advise the client that the oral birth control will be less effective while taking doxycycline hyclate.

Instruct the client to take the two medications at least two hours apart.

Encourage the client to stop taking oral birth control until she has finished taking all the doxycycline hyclate

Answer and Explanation

The Correct Answer is B

A) Notify the healthcare provider of the contraindication to tetracyclines: Tetracyclines, including doxycycline hyclate, are not contraindicated in clients taking birth control pills. While there may be interactions between these medications, they are not absolute contraindications.

B) Advise the client that the oral birth control will be less effective while taking doxycycline hyclate: Doxycycline hyclate, like other antibiotics, may reduce the effectiveness of oral contraceptives by altering the gut flora and interfering with the enterohepatic circulation of estrogen. Clients should be informed of this potential interaction and advised to use an additional form of contraception (such as condoms) while taking the antibiotic and for a period afterward.

C) Instruct the client to take the two medications at least two hours apart: While separating the administration of doxycycline hyclate and oral contraceptives by two hours may reduce the potential for interaction, it is not the standard recommendation. It is generally advised to use additional contraceptive methods during antibiotic therapy and for a period afterward, rather than relying solely on timing of medication administration.

D) Encourage the client to stop taking oral birth control until she has finished taking all the doxycycline hyclate: Stopping oral contraceptives abruptly is not recommended and may lead to unintended pregnancy. Instead, clients should be advised to use additional contraceptive methods while taking doxycycline hyclate and for a period afterward to ensure continued protection against pregnancy.

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Correct Answer is B

Explanation

A) Irritable bowel syndrome: While it's im’ortant to consider the client's me’ical history comprehensively, sumatriptan succinate is primarily contraindicated in clients with a history of coronary artery disease due to its potential vasoconstrictive effects.

B) Coronary artery disease: This is the correct response. Sumatriptan succinate is contraindicated in clients with a history of coronary artery disease or ischemic heart disease due to its potential to cause coronary vasospasm and increase the risk of myocardial ischemia or infarction.

C) Type 2 diabetes mellitus: While it's im’ortant to consider the client's ov’rall medical history, type 2 diabetes mellitus is not specifically contraindicated with sumatriptan succinate use.

D) Seasonal allergic rhinitis: While seasonal allergic rhinitis is relevant to the client's me’ical history, it is not directly related to the contraindications of sumatriptan succinate.

Therefore, the most crucial consideration before administering sumatriptan succinate is to determine if the client has a history of coronary artery disease or ischemic heart disease to avoid potential adverse cardiac effects.

A. Serum creatinine 1.0 mg/dL (88.4 μmol/L) B. Platelet count of 100,000/mm3 (100 x 10°/L). C. Hematocrit 459% (0.45 volume fraction). D. Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L)

Correct Answer is B

Explanation

A) A serum creatinine level of 1.0 mg/dL falls within the reference range (0.5 to 1.1 mg/dL) and does not indicate immediate action by the nurse. Creatinine levels within the reference range suggest normal kidney function.

B) A platelet count of 100,000/mm3 (100 x 10^9/L) is below the lower limit of the reference range (150,000 to 400,000/mm3). Thrombocytopenia, or low platelet count, increases the risk of bleeding complications, especially when administering anticoagulants like enoxaparin. Therefore, a platelet count of 100,000/mm3 requires immediate action by the nurse to assess for bleeding and notify the healthcare provider.

C) A hematocrit of 45% (0.45 volume fraction) falls within the reference range (42% to 52%) and does not indicate immediate action by the nurse.

D) A blood urea nitrogen (BUN) level of 20 mg/dL (7.1 mmol/L) falls within the reference range (10 to 20 mg/dl) and does not indicate immediate action by the nurse.

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A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Before administering the initial dose of sumatriptan succinate to a client with a migraine headache, it is most important to determine if the client's hi’tory includes which problem?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

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