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 A

Explanation

Choice A rationale

Risedronate is a type of medication known as a bisphosphonate, which is used to treat and prevent osteoporosis. It works by slowing bone loss to help maintain strong bones and reduce the risk of fractures. It’s important to take risedronate correctly to ensure it works effectively. One key instruction is that it should be taken with a full glass of plain water, at least 30 minutes before any food, beverage, or other medicines. This is because food and beverages can decrease the amount of risedronate absorbed by the body. Therefore, the nurse should instruct the client that it is necessary to take nothing but water with the medication.

Choice B rationale

Withholding the medication until the client’s breakfast tray is available on the unit would not be the best action. This is because risedronate needs to be taken as soon as you get out of bed in the morning and at least 30 minutes before any food, beverage, or other medicines. Waiting for the breakfast tray could delay the administration of the medication and potentially decrease its effectiveness.

Choice C rationale

Consulting with a pharmacist about scheduling the dose one hour after the client eats is not the best action. As mentioned earlier, risedronate should be taken at least 30 minutes before any food, beverage, or other medicines. Taking it after eating could decrease the amount of medication that is absorbed by the body, reducing its effectiveness.

Choice D rationale

Assigning an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk is not the correct action. This is because risedronate should be taken with a full glass of plain water, not milk. In fact, taking risedronate with milk could decrease the amount of medication that is absorbed by the body.

A. The best time to take the tablet is at bedtime. B. Crush the tablets and mix with pudding. C. Wait 2 hours after meals to take the tablet. D. Take the tablet with a daily multivitamin.

Correct Answer is C

Explanation

Choice A rationale

The best time to take ferrous sulfate is not necessarily at bedtime. It’s more important that the medication is taken on an empty stomach.

Choice B rationale

Crushing the tablets is not recommended. Enteric-coated tablets should be swallowed whole.

Choice C rationale

Ferrous sulfate is best absorbed on an empty stomach. The patient should wait for 2 hours after meals before taking the tablet to promote the best absorption of the medication.

Choice D rationale

Taking the tablet with a daily multivitamin is not typically recommended. Some vitamins and minerals can interfere with the absorption of ferrous sulfate.

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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

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Correct Answer is A

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