A nurse is reinforcing teaching about the iPLEDGE program with a female client who has a new prescription for isotretinoin.
The nurse should tell the client that which of the following is a requirement of the program?

Female clients must have a negative mammogram prior to beginning therapy.

Clients must have a Papanicolaou test every 6 months during treatment.

Clients must begin a daily supplement of vitamin A for 1 month prior to initiating therapy.

Sexually active female clients must use two forms of birth control during treatment.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

A negative mammogram is not a requirement of the iPLEDGE program. Mammograms are used to screen for breast cancer and are not related to isotretinoin therapy.

Choice B rationale:

Regular Papanicolaou tests, which screen for cervical cancer, are not a requirement of the iPLEDGE program. These tests are not related to isotretinoin therapy.

Choice C rationale:

There is no requirement for clients to begin a daily supplement of vitamin A prior to initiating therapy. In fact, taking additional vitamin A while on isotretinoin can increase the risk of vitamin A toxicity.

Choice D rationale:

Sexually active female clients must use two forms of birth control during treatment. This is because isotretinoin can cause severe birth defects.

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Correct Answer is A

Explanation

Choice A rationale:

Administering an IV fluid bolus can help increase blood volume and thus increase blood pressure, which can alleviate symptoms of dizziness and lightheadedness. This is a common side effect of ramipril, especially after the first dose.

Choice B rationale:

Naloxone is an opioid antagonist and is not relevant in this context. It’s used to reverse the effects of opioid overdose, not to treat symptoms associated with antihypertensive medications.

Choice C rationale:

Diphenhydramine is an antihistamine used to treat allergic reactions or insomnia, not symptoms associated with antihypertensive medications.

Choice D rationale:

Administering 15 g of carbohydrates would be appropriate for a hypoglycemic patient, not for a patient experiencing dizziness and lightheadedness due to antihypertensive medication.

A. "Using morphine PCA increases the client's risk of toxicity.” B. "Diarrhea is an adverse effect of morphine PCA.” C. "Check the client's pain level every 8 hours.” D. "Instruct the client's visitors not to operate the PCA pump.”

Correct Answer is D

Explanation

Choice Arationale:

Using PCA does not necessarily increase the client’s risk of toxicity. PCA allows the client to self-administer preset doses of pain medication, which can lead to better pain control with less risk of overdose.

Choice B rationale:

Diarrhea is not a common adverse effect of morphine. Constipation, not diarrhea, is a common side effect due to slowed gastrointestinal motility.

Choice Crationale:

Checking the client’s pain level every 8 hours is not sufficient when using PCA. Pain levels should be assessed more frequently, ideally before and after each administration of the medication. This allows for timely adjustments to the medication regimen if needed.

Choice D rationale:

Instructing the client’s visitors not to operate the PCA pump is crucial. Only the patient should administer doses to prevent overdose.

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A nurse is reinforcing teaching about the iPLEDGE program with a female client who has a new prescription for isotretinoin.The nurse should tell the client that which of the following is a requirement of the program?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is administering the first dose of ramipril to a client who has hypertension.The client reports feeling dizzy and lightheaded.Which of the following should the nurse administer?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a newly licensed nurse about monitoring morphine patient-controlled analgesia (PCA). Which of the following information should the nurse include?

Correct Answer is D

Explanation

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A nurse is reinforcing teaching about the iPLEDGE program with a female client who has a new prescription for isotretinoin.
The nurse should tell the client that which of the following is a requirement of the program?