A nurse at a family practice clinic receives a call from a client who is prescribed oral contraceptives but forgot to take one dose. The client reports she is in the first week of a 28-day cycle pack. Which of the following instructions should the nurse provide?

“Stop taking the pills and switch to a different contraceptive method”

"Take a home pregnancy test.

"Do not have vaginal intercourse until after your next period."

"Take the missed dose now, then continue the medication as ordered."

Answer and Explanation

The Correct Answer is D

During the first week or last week of a 28-day cycle pack of oral contraceptives increases the risk of contraceptive failure. However, the client should take the missed dose as soon as they remember, even if it means taking two pills in one day. After taking the missed dose, the client should continue taking the remaining pills in the pack at the usual time, one pill per day. Due to increased risk of failure, client should use an emergency pill or condom for the next 7 days
A -stopping the pills and switching to a different contraceptive method is not necessary after missing one dose
B –missing a pill does not automatically indicate pregnancy. Testing can be considered in presence of typical signs and symptoms of pregnancy
C- abstaining from vaginal intercourse until after the next period is not necessary. Risk of pregnancy can be addressed by use of back up contraception like condoms.

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Correct Answer is B

Explanation

Spironolactone is a potassium-sparing diuretic used in the management of ascites associated with liver failure. Its mechanism of action includes blocking the actions of aldosterone, a hormone that promotes sodium retention and potassium excretion in the kidneys. This results in increased urinary sodium excretion and hyponatremia and hyperkalemia.
A. Decreased chloride level is not typically associated with spironolactone use.
C. Spironolactone is a potassium-sparing diuretic, so it leads to an increased potassium level (hyperkalemia)
D. Spironolactone is not associated with decreased phosphate levels.

A. A client received crushed bupropion XL tablet mixed with applesauce. B. A nurse injected Demerol 1M into the vastus lateralis site of adult. C. A nurse used a 25-gauge inch needle to administer heparin injection. D. A client received gentamicin intermittent IV bolus over I hr.

Correct Answer is A

Explanation

Bupropion XL tablets should be taken whole. Crushing the tablet interferes with the pharmacokinetics of the drug leading to reduced efficacy and increased risk of toxicity. Administering bupropion XL inappropriately could result in harm to the client and should prompt the nurse to file an incident report to document the error and ensure appropriate follow-up and monitoring.

B. Meperidine is a commonly administered opioid analgesic and can be given intramuscularly in appropriate doses and sites.

C. Selection of the needle length and gauge depend on the route of administration and individual client's characteristics

D.Gentamicin can be administered by intermittent IV bolus over a prolonged period as part of its dosing regimen.

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A nurse at a family practice clinic receives a call from a client who is prescribed oral contraceptives but forgot to take one dose. The client reports she is in the first week of a 28-day cycle pack. Which of the following instructions should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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