A nurse is caring for a female client in a provider's office.

Exhibits

The nurse notifies the client and provides teaching about the newly prescribed medication. For each of the statements made by the client, click to specify whether the statement indicates an understanding or no understanding of the teaching provided.

Client Education: Understanding / No Understanding

"I should avoid taking antacids while on this medication."

"If I experience black stools, I should notify my provider."

"I should rinse my mouth after taking this medication."

"I should take this medication with orange juice."

"I should take my medication on an empty stomach.”

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

A.   Antacids can interfere with the absorption of ferrous sulfate, reducing its effectiveness. The client should avoid taking antacids concurrently with the iron supplement.
B.   Black stools are a common and expected side effect of taking iron supplements. This is generally not a cause for concern and does not require notifying the provider unless accompanied by other symptoms such as pain or blood in the stool.

C.   Liquid forms of iron supplements can stain teeth. Rinsing the mouth after taking the medication can help prevent this staining. Even if taking a tablet, this practice can be a good habit to avoid any residual taste.
D.   Vitamin C, which is present in orange juice, can enhance the absorption of iron from the gastrointestinal tract, making the iron supplement more effective.
E.   Iron supplements are best absorbed on an empty stomach. However, if the client experiences gastrointestinal upset, it can be taken with a small amount of food, but avoiding dairy products and antacids is important.

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Correct Answer is D

Explanation

A. Blood pressure within this range is not a contraindication for warfarin administration.
B. A history of artificial heart valve, is actually an indication for warfarin, not a contraindication, as it helps prevent thromboembolic events.
C. Heart rate within this range is not a contraindication for warfarin administration.

D. Warfarin is an anticoagulant that works by inhibiting the synthesis of vitamin K- dependent clotting factors. Therefore, a decreased level of vitamin K would potentiate the effects of warfarin, increasing the risk of bleeding, which is a contraindication for its use.

A. mild headaches B. Yesterday I was very nauseated and threw up before breakfast C. difficulty remembering the times they are taking their axcarbazepine D. Sodium 124 mEq/L (136 to 145 mEq/L) E. Hct 40% (37% to 47%)

Correct Answer is ["A","B","C","D"]

Explanation

Nurses' Notes Day 1:

Client is seen by provider for routine follow-up after being started on axcarbazepine 150mg PO twice a day, last week. Client reports no nausea, headache, dizziness, or ataxia. Provider increased oxcarbazepine to 300 mg PO twice a day. Client is to return for a follow-up in 2 weeks.

Day 14:

Client returns for follow-up after increasing oxcarbazepine dosage. Client reports starting to have mild headaches earlier this week. Also states, "Yesterday I was very nauseated and threw up before breakfast." When talking to client they have difficulty remembering the times they are taking their axcarbazepine. Client reports using oral contraceptives as the only means of birth control.

Laboratory Results Day 14

Hct 40% (37% to 47%)

Hgb 13g/dL (12 to 16g/dL)

Sodium 124 mEq/L (136 to 145 mEq/L) Vitals Signs

Day 14:

Temperature 36.3°C (97.4° F)

Heart rate 86/min

Rationale:

The patient's follow-up findings on Day 14, particularly the reported symptoms and laboratory results, suggest potential side effects from the increased dosage of oxcarbazepine. Common side effects of oxcarbazepine include dizziness, nausea, and vomiting. The patient's symptoms of mild headaches and nausea, along with difficulty remembering medication times, could be indicative of these side effects. Additionally, the sodium level of 124 mEq/L is below the normal range (136 to 145 mEq/L), indicating hyponatremia, which is a known side effect of oxcarbazepine and can be serious.

Hyponatremia can cause symptoms such as nausea, vomiting, exhaustion, and dizziness, aligning with the patient's reported condition. These findings warrant immediate medical attention to assess the need for adjusting the medication dosage or considering alternative treatments.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer warfarin to a client. Which of the following findings indicates a contraindication?

Correct Answer is D

Explanation

Correct Answer is ["A","B","C","D"]

Explanation

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