Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?

Reported history of alcoholism.

Toenails appear thick and yellow.

White blood cells count of 8,500/mm3 or 85 x 109 /L (SI).

Employed as a construction worker.

Answer and Explanation

The Correct Answer is A

Terbinafine HCL is primarily metabolized by the liver, and a history of alcoholism may indicate liver dysfunction or damage, which could aﬀect the metabolism and clearance of the drug. The nurse should assess the client's liver function, including liver enzymes, bilirubin levels, and albumin levels, before administering terbinafine HCL.

While options b, c, and d may be important assessment findings, they are not as crucial as a history of alcoholism when it comes to administering terbinafine HCL.

The thick and yellow toenails (option b) are typical symptoms of a fungal toenail infection, which is the reason for prescribing terbinafine HCL.

The white blood cell count (option c) is within normal range.

Being employed as a construction worker (option d) does not have a direct impact on the use of terbinafine HCL.

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Correct Answer is D

Explanation

The client is experiencing syncope (fainting) due to a drop in blood pressure to 70/40 mm Hg, which is too low. This suggests that the client's blood pressure medications are reducing their blood pressure too much, resulting in hypotension. The rationale for the nurse's decision to hold the client's scheduled antihypertensive medications is to prevent further hypotension and allow the client's blood pressure to stabilize at a safer level.

Option a is incorrect because diuresis (increased urine output) is not a likely cause of the client's hypotension.

Option b is incorrect because the client's symptoms suggest hypotension due to reduced blood pressure, rather than drug toxicity.

Option c is incorrect because the antagonistic interaction among blood pressure medications would result in reduced eﬀectiveness but would not necessarily cause hypotension.

A. Take medication on an empty stomach. B. Avoid the use of iron supplements. C. Administer levothyroxine at bedtime. D. Consume foods that are high in iodine.

Correct Answer is A

Explanation

Levothyroxine is a thyroid hormone replacement medication used to treat hypothyroidism. To ensure proper absorption and eﬀectiveness of the medication, it should be taken on an empty stomach, preferably in the morning, and at least 30 minutes before eating. Therefore, when the client indicates that they understand the need to take the medication on an empty stomach, it indicates that the education was eﬀective.

Option b, "Avoid the use of iron supplements," is also important education for clients taking levothyroxine because iron supplements can interfere with the absorption of the medication. However, it is not the best indicator of eﬀective education because the question asks for the statement that indicates education was eﬀective, and option a is a more direct and specific response to the medication.

Option c, "Administer levothyroxine at bedtime," is not accurate information because the medication should be taken in the morning on an empty stomach.

Option d, "Consume foods that are high in iodine," is not recommended for clients taking levothyroxine because high amounts of iodine can interfere with thyroid function. Therefore, this statement indicates a need for further education.

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Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who receives multiple antihypertensive multiple medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse’s decision to hold the client’s scheduled antihypertensive medications?

Correct Answer is D

Explanation

A client receives a new prescription for levothyroxine. Which statement made by client indicates to the nurse that the education was eﬀective?

Correct Answer is A

Explanation

A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

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The nurse is planning care for a patient with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

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Two months after taking nitrofurantoin for a bacterial infection, a client reports the onset of severe, watery diarrhea to the home care nurse. How should the nurse respond?