A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for

the nurse to provide this client?

Breast feeding is not recommended while taking this medication.

Baseline liver function results must be obtained during therapy.

Do not take multiple vitamins that contain vitamin A while taking this drug.

Answer and Explanation

The Correct Answer is D

Choice A reason: Breast feeding is not recommended while taking this medication, as isotretinoin can pass into breast milk and harm

the nursing infant. However, this information is not as important as choice d, as the client may not be breast feeding or planning to breast feed.

Choice B reason: Baseline liver function results must be obtained during therapy, as isotretinoin can cause liver damage and increase liver enzymes. However, this information is not as important as choice d, as the client may not have liver problems or need liver function tests.

Choice C reason: Do not take multiple vitamins that contain vitamin A while taking this drug, as isotretinoin is a derivative of vitamin A and can cause vitamin A toxicity if taken in excess. However, this information is not as important as choice d, as the client may not take multiple vitamins or have vitamin A toxicity.

Choice D reason: Discontinue this medication one month before attempting to conceive, as isotretinoin can cause severe birth defects and miscarriages if taken during pregnancy. Therefore, this information is most important for the nurse to provide this client, as the client is planning to become pregnant and should avoid isotretinoin exposure.

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Correct Answer is A

Explanation

Choice A reason: Tetracycline HCl can make the skin more sensitive to sunlight and increase the risk of sunburn. Therefore, the client should avoid exposure to direct sunlight and use sunscreen or protective clothing while taking the drug.

Choice B reason: Orange juice is acidic and can decrease the absorption of tetracycline HCl in the GI tract. Therefore, the client should not take the drug with orange juice or other acidic beverages.

Choice C reason: Serum drug levels are not routinely monitored for tetracycline HCl, as there is no established therapeutic range or toxicity level for this drug. Therefore, the client does not need to return to the clinic weekly to obtain serum drug levels.

Choice D reason: Milk and antacids can bind to tetracycline HCl and reduce its effectiveness. Therefore, the client should not take the drug with milk or antacids or within 2 hours of consuming them.

A. Takes concurrent iron therapy without adverse effects. B. Reports of increased energy levels and decreased fatigue. C. Hemoglobin level increased to 12 g/dL (7.45 mmol/L). D. Food diary shows increased consumption of iron-rich foods.

Correct Answer is C

Explanation

Choice B reason: Epoetin alfa is a synthetic form of erythropoietin, a hormone that stimulates the production of red blood cells (RBCs) in the bone marrow. Epoetin alfa is used to treat anemia, or low RBC count, which can be caused by CKD, chemotherapy, HIV infection, or other conditions. Anemia can cause symptoms such as weakness, fatigue, shortness of breath, pale skin, and chest pain. Hemoglobin is the protein in RBCs that carries oxygen throughout the body. The normal range of hemoglobin for males is 14 to 18 g/dL (8.7 to 11.2 mmol/L). Therefore, an increase in hemoglobin from below normal to within normal indicates that epoetin alfa has been effective in increasing RBC production and improving oxygen delivery. The nurse should monitor the client's hemoglobin level regularly and adjust the dose of epoetin alfa as needed.

Choice A reason:While iron therapy supports the effectiveness of epoetin alfa by providing the necessary substrate for erythropoiesis, tolerating iron therapy is not an indicator of epoetin alfa's efficacy.

Choice C reason: Epoetin alfa is used to treat anemia associated with chronic kidney disease (CKD) by stimulating erythropoiesis (red blood cell production). The primary measure of its effectiveness is an increase in hemoglobin (Hgb) levels toward the target range. The hemoglobin level increasing to 12 g/dL (7.45 mmol/L) reflects a significant improvement from an anemic state and is within the target range for patients receiving epoetin alfa therapy (generally 10–12 g/dL). This is the most objective and definitive indicator of the medication's effectiveness.

Choice D reason: Taking concurrent iron therapy without adverse effects is not a finding that best indicates that the medication is effective, but rather a preventive measure that can reduce the risk of iron deficiency and improve the efficacy of epoetin alfa. Iron therapy refers to taking oral or intravenous iron supplements to increase iron levels in the blood. Iron therapy can cause side effects such as nausea, vomiting, constipation, diarrhea, dark stools, metallic taste, or allergic reactions. The nurse should instruct the client on how to take iron therapy safely and monitor for any adverse effects.

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A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The healthcare provider prescribes the antibiotic tetracycline HCl for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

Correct Answer is A

Explanation

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]

Correct Answer is C

Explanation

The nurse is planning the home care of a client who is receiving a mydriatic medication. Which environment is best for this client?

When administering medications to a group of clients, which client should the nurse closely monitor for development of acute kidney injury (AKI)?

The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?

A client receives a prescription for dalteparin 2500 units subcutaneously 2 hours before a scheduled procedure. The medication is available in a 5000 units/0.2 mL prefilled syringe. How many mL should the nurse administer? (Enter numeric value only)

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A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?