Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
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?
A. Reported history of alcoholism.
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.
B. Toenails appear thick and yellow.
The thick and yellow toenails (option b) are typical symptoms of a fungal toenail infection, which is the reason for prescribing terbinafine HCL.
C. White blood cells count of 8,500/mm3 or 85 x 109 /L (SI).
The white blood cell count (option c) is within normal range.
D. Employed as a construction worker.
Being employed as a construction worker (option d) does not have a direct impact on the use of terbinafine HCL.
This question is an excerpt from Nurse Dive's nursing test bank - HESI Pharmacology Proctored Exam. Take the full exam now
Full Explanation
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.
Similar Questions
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?
A. Fingerstick glucose.
Fingerstick glucose levels (option A) are not relevant to evaluating the therapeutic response of lactulose in hepatic encephalopathy.
B. Serum electrolytes and ammonia.
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.
C. Stool color and character.
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.
D. Serum hepatic enzymes.
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.
Full 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.
The nurse is providing instructions about a client’s new medication. How should the nurse explain the purpose of probenecid, a uricosuric drug?
A. Decreases pain during urination.
B. Increases strength of the urine system.
C. Promotes excretion of uric acid in the urine.
Probenecid is a uricosuric drug that works by inhibiting the reabsorption of uric acid in the kidneys and promotes its excretion in the urine. This drug is used to treat gout and hyperuricemia (high levels of uric acid in the blood). Therefore, the nurse should explain to the client that the purpose of probenecid is to promote the excretion of uric acid in the urine and lower the levels of uric acid in the blood, which can help prevent gout attacks and kidney stones. Options a, b, and d are incorrect as they do not accurately describe the mechanism of action or purpose of probenecid.
D. Prevents formation of kidney stones.
Full Explanation
Probenecid is a uricosuric drug that works by inhibiting the reabsorption of uric acid in the kidneys and promotes its excretion in the urine. This drug is used to treat gout and hyperuricemia (high levels of uric acid in the blood). Therefore, the nurse should explain to the client that the purpose of probenecid is to promote the excretion of uric acid in the urine and lower the levels of uric acid in the blood, which can help prevent gout attacks and kidney stones.
Options a, b, and d are incorrect as they do not accurately describe the mechanism of action or purpose of probenecid.
The nurse administers risedronate to a client with osteoporosis at 07:00. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?
A. Consult a pharmacist about the scheduling of the dose one hour after the client eats.
B. Assign unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk.
C. Withhold the medication until the client’s breakfast tray is available on the unit.
D. Instruct the client that it is necessary to take nothing but water with the medication.
Risedronate should be taken with plain water only. It should be taken on an empty stomach, at least 30 minutes before eating or drinking anything other than plain water. Taking risedronate with milk or other beverages can interfere with its absorption and reduce its effectiveness.
Full Explanation
Risedronate should be taken with plain water only. It should be taken on an empty stomach, at least 30 minutes before eating or drinking anything other than plain water. Taking risedronate with milk or other beverages can interfere with its absorption and reduce its effectiveness.
