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

Discontinue this medication one month before attempting to conceive

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 C

Explanation

Choice B reason:While spironolactone can sometimes cause side effects, bruising is not a typical issue associated with this medication.

Choice A reason: Covering your skin before going outside is not an instruction that the nurse should include in this client's plan of care, but rather a general precaution that anyone should take to protect their skin from sun damage. Spironolactone does not increase the risk of sunburn or photosensitivity.

Choice C reason:Spironolactone is a potassium-sparing diuretic that works by blocking aldosterone, which helps reduce fluid retention. However, because it spares potassium, there is a risk of hyperkalemia (high potassium levels). Therefore, clients taking spironolactone should limit their intake of high-potassium foods (e.g., bananas, oranges, spinach, avocados) to avoid dangerous potassium levels.

Choice D reason: Replacing salt with a salt substitute is not an instruction that the nurse should include in this client's plan of care, but rather a dangerous practice that can lead to hyperkalemia. Salt substitutes are often made with potassium chloride, which can increase the potassium level in the blood. The client should use herbs or spices instead of salt or salt substitutes to flavor their food.

A. Assess for orthostatic hypotension before administering the dose. B. Administer the dose and monitor the client's B/P regularly. C. Apply a telemetry monitor before administering the dose. D. Withhold the scheduled dose and notify the healthcare provider.

Correct Answer is D

Explanation

Choice A reason: Assessing for orthostatic hypotension before administering the dose is not necessary, as labetalol does not cause orthostatic hypotension. Orthostatic hypotension is a condition where the blood pressure drops significantly when changing positions from lying to sitting or standing. Labetalol is a beta-blocker that lowers blood pressure by reducing the heart rate and cardiac output.

Choice B reason: Administering the dose and monitoring the client's B/P regularly is not appropriate, as labetalol may cause further bradycardia (slow heart rate) in this client. The client's heart rate is already below normal (48 beats/minute), which may indicate that labetalol is overdosed or contraindicated. Bradycardia can lead to decreased perfusion, dizziness, fatigue, and fainting.

Choice C reason: Applying a telemetry monitor before administering the dose is not sufficient, as labetalol may cause serious cardiac arrhythmias (irregular heart rhythms) in this client. The client's heart rate is already below normal (48 beats/minute), which may indicate that labetalol is affecting the electrical conduction system of the heart. Arrhythmias can cause palpitations, chest pain, shortness of breath, and cardiac arrest.

Choice D reason: Withholding the scheduled dose and notifying the healthcare provider is the best action for the nurse to take in this situation. The client's heart rate is already below normal (48 beats/minute), which may indicate that labetalol is causing adverse effects or interactions with other medications. The healthcare provider should be informed of the client's vital signs and medication history, and decide whether to adjust or discontinue labetalol.

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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 the nurse to provide this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care?

Correct Answer is C

Explanation

The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's vital signs are temperature 99°F (37.22°C), heart rate 48 beats/minute, respirations 16 breaths/minute, and blood pressure (B/P) 150/90 mm Hg. Which action should the nurse take?

Correct Answer is D

Explanation

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