Patient Data

Exhibits

Which home medication(s) may affect the amount of insulin needed by the client? Select all that apply.

Ibuprofen

Oral contraceptive

Corticosteroids

Epinephrine

St. John's Wort

Fluconazole

Answer and Explanation

Correct Answer : B,C,D,F

A. Ibuprofen: While ibuprofen can affect renal function and has its own risks in diabetes, it does not have a significant or consistent effect on insulin requirements. It is not a primary medication impacting glucose metabolism.

B. Oral contraceptive: Estrogen in oral contraceptives can cause increased insulin resistance, potentially requiring higher doses of insulin to maintain glucose control. Therefore, it can affect the client’s insulin needs.

C. Corticosteroids: Corticosteroids such as prednisone raise blood glucose levels by promoting gluconeogenesis and insulin resistance. Clients taking corticosteroids often require increased insulin dosing.

D. Epinephrine: Epinephrine stimulates glycogen breakdown and raises blood glucose levels as part of the stress response. It can significantly impact blood sugar control and thus influence insulin requirements.

E. St. John's Wort: St. John's Wort can interact with many medications, but its effect on insulin or blood glucose regulation is not strong enough to significantly alter insulin needs. It is more notable for affecting medications through liver enzyme induction.

F. Fluconazole: Fluconazole can inhibit the metabolism of some drugs and may increase insulin sensitivity in certain cases. It can alter glucose control by enhancing insulin action, which may lead to a need for insulin dose adjustments.

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Correct Answer is B

Explanation

A. Start the second course of therapy after an 8-week delay: While a second course of isotretinoin may sometimes be considered after a break if acne persists, this timing is medication management guidance and is less urgent than immediate safety concerns like sun sensitivity.

B. Consider an alternative summer job, other than life guarding: Isotretinoin causes extreme photosensitivity, making prolonged sun exposure dangerous. Adolescents working outdoors, like lifeguards, are at high risk for severe sunburns, so suggesting alternative employment protects their health.

C. Store the medicine in a plastic, tight, light resistant container: Proper medication storage is important but not the most critical concern compared to preventing serious adverse effects like sunburn, teratogenicity, or psychiatric symptoms with isotretinoin use.

D. Discontinue all multivitamins during acne medication therapy: There is generally no need to discontinue all multivitamins while taking isotretinoin unless specifically instructed by the healthcare provider. Some multivitamins contain vitamin A, excessive intake of vitamin A should be avoided. However, discontinuing all multivitamins without guidance could lead to other nutritional deficiencies.

A. History of glaucoma. B. Taking an antiemetic medication. C. Currently pregnant. D. D Allergy to aspirin.

Correct Answer is C

Explanation

A. History of glaucoma: Glaucoma history is relevant for some medications that increase intraocular pressure, but misoprostol primarily affects the gastrointestinal and reproductive systems. It does not typically worsen glaucoma or require caution for that condition.

B. Taking an antiemetic medication: Although gastrointestinal side effects like nausea can occur with misoprostol, concurrent antiemetic use is not a contraindication. This information is less critical before the first dose compared to other more serious concerns.

C. Currently pregnant: Misoprostol is contraindicated during pregnancy because it can stimulate uterine contractions and cause miscarriage. Determining pregnancy status is crucial before administering the drug to prevent serious harm to both the client and fetus.

D. Allergy to aspirin: While clients with certain allergies require careful medication review, misoprostol is not a nonsteroidal anti-inflammatory drug (NSAID) and does not cross-react with aspirin allergies. Confirming pregnancy status is the more immediate priority.

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Patient Data Exhibits Which home medication(s) may affect the amount of insulin needed by the client? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adolescent receives a new prescription for isotretinoin for cystic acne. Which information is most important for the nurse to provide?

Correct Answer is B

Explanation

Prior to administration of the initial dose of the gastrointestinal (GI) agent misoprostol, which information should the nurse obtain from the client?

Correct Answer is C

Explanation

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Patient Data Exhibits Mark whether the assessment finding represents a therapeutic result of the lactulose administered, a nontherapeutic side effect, or an unrelated finding. Each row must have one option selected.

Patient Data

Exhibits

Which home medication(s) may affect the amount of insulin needed by the client? Select all that apply.