Before administering the evening dose of carbamazepine, the nurse notes that the patient’s morning carbamazepine level was 84 mcg/mL. What action should the nurse take?

Notify the healthcare provider of the carbamazepine level.

Administer the carbamazepine as prescribed.

Withhold this dose of the carbamazepine.

Assess the patient for side effects of carbamazepine.

Answer and Explanation

The Correct Answer is A

The correct answer is A:

Choice A reason: Notifying the healthcare provider is crucial because the patient’s carbamazepine level is significantly above the therapeutic range, which is 4-12 mcg/mL. A level of 84 mcg/mL indicates a high risk of toxicity, and the healthcare provider must be informed to take appropriate action, which may include adjusting the dose or discontinuing the medication.

Choice B reason: Administering the carbamazepine as prescribed would not be safe without addressing the elevated drug level. Continuing to administer the medication could increase the risk of severe side effects and toxicity due to the already high serum level.

Choice C reason: Withholding the dose may be a necessary immediate action, but it does not address the need for medical intervention to manage the patient’s elevated drug level. Therefore, while withholding the dose might be part of the response, it should follow notifying the healthcare provider.

Choice D reason: Assessing the patient for side effects is important, but it is not the most immediate action required. The priority is to notify the healthcare provider because of the potential for serious toxicity given the high carbamazepine level.

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Correct Answer is B

Explanation

Choice A rationale

Tetracycline should not be consumed with milk or antacids. These substances contain calcium, which can bind to tetracycline in the stomach and reduce its absorption and effectiveness.

Choice B rationale

Tetracycline can make the skin more sensitive to sunlight, increasing the risk of sunburn. Patients should be advised to protect their skin from sunlight while taking this medication.

Choice C rationale

Taking tetracycline with orange juice is not recommended. Citrus fruits and juices contain calcium, which can bind to tetracycline in the stomach and reduce its absorption and effectiveness.

Choice D rationale

Returning to the clinic weekly for serum drug level checks is not typically necessary for patients taking tetracycline. While regular follow-up appointments may be needed to monitor the patient’s response to treatment, weekly serum drug level checks are not a standard part of tetracycline therapy.

A. The client primes the inhaler with 7 pumps. B. The client stores the medication at room temperature. C. The client rinses their mouth after each use. D. The client attaches a spacer device to the inhaler.

Correct Answer is A

Explanation

Choice A rationale

Ipratropium is a bronchodilator used to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD)3. The inhaler needs to be primed before use to ensure the right amount of medicine is delivered. However, priming the inhaler with 7 pumps is not recommended. Therefore, if the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.

Choice B rationale

Storing the medication at room temperature is the correct way to store ipratropium. Therefore, this action does not indicate that additional teaching is needed.

Choice C rationale

Rinsing the mouth after each use of the inhaler is a recommended practice. This helps to prevent dry mouth and throat irritation caused by the medication. Therefore, this action does not indicate that additional teaching is needed.

Choice D rationale

Attaching a spacer device to the inhaler can help improve the delivery of the medication. Therefore, this action does not indicate that additional teaching is needed.

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Before administering the evening dose of carbamazepine, the nurse notes that the patient’s morning carbamazepine level was 84 mcg/mL. What action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCI. What should the nurse include in the patient’s teaching plan?

Correct Answer is B

Explanation

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

Correct Answer is A

Explanation

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