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 B

Explanation

Before administering the first dose of any antibiotic, it is essential to obtain a culture and sensitivity test to identify the causative organism and determine the most eﬀective antibiotic to use. Administering a broad- spectrum antibiotic before obtaining a culture and sensitivity test may lead to the development of antibiotic-resistant strains of bacteria, making it more difficult to treat the infection in the future.

Options a, c, and d are not as important as obtaining a culture and sensitivity test. Monitoring for signs of sodium and ﬂuid retention, irrigation and topical antibiotic application to the wound area, and completing blood count and serum electrolytes are important, but obtaining a culture and sensitivity test is the priority.

A. Fingerstick glucose. B. Serum electrolytes and ammonia. C. Stool color and character. D. Serum hepatic enzymes.

Correct Answer is B

Explanation

Lactulose is a medication commonly used in the management of hepatic encephalopathy. It works by reducing the absorption of ammonia in the gut, which is a toxin that can accumulate in the blood in patients with liver dysfunction.

Monitoring serum electrolytes and ammonia levels can help the nurse evaluate the eﬀectiveness of lactulose therapy. Elevated ammonia levels can indicate that the medication is not eﬀectively reducing ammonia absorption and may require adjustment in dose or frequency. Additionally, monitoring electrolyte levels can help detect any imbalances that may occur because of lactulose therapy.

Fingerstick glucose levels (option A) are not relevant to evaluating the therapeutic response of lactulose in hepatic encephalopathy.

Stool color and character (option C) may be monitored to assess the side eﬀects of lactulose, such as diarrhea, but are not the best assessments to evaluate therapeutic response.

Serum hepatic enzymes (option D) may be useful in assessing the severity of liver disease but are not the best assessment to evaluate the therapeutic response of lactulose in hepatic encephalopathy.

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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

On admission, the healthcare provider describes a broad spectrum of antibiotic, ticarcillin for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

Correct Answer is B

Explanation

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the nest information to evaluate the client’s therapeutic response to the drug?

Correct Answer is B

Explanation

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