A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?
Stop the oral contraceptive immediately.
Take the medications at least 12 hours apart.
Use an additional form of contraception.
Avoid prolonged exposure to direct sunlight.
The Correct Answer is C
Choice A reason: Stopping the oral contraceptive immediately is not necessary and may increase the risk of unintended pregnancy. Erythromycin can reduce the effectiveness of oral contraceptives by interfering with their metabolism, but it does not make them completely ineffective.
Choice B reason: Taking the medications at least 12 hours apart is not sufficient to prevent the interaction between erythromycin and oral contraceptives. The interaction can occur regardless of the timing of the doses.
Choice C reason: Using an additional form of contraception is the best instruction for the client who is taking an oral contraceptive and erythromycin. This can prevent pregnancy in case the oral contraceptive fails due to the interaction with erythromycin. The additional form of contraception should be non-hormonal, such as a barrier method or a copper intrauterine device.
Choice D reason: Avoiding prolonged exposure to direct sunlight is a good advice for anyone taking erythromycin, as it can cause photosensitivity and increase the risk of sunburn. However, this is not related to the interaction with oral contraceptives and does not affect their efficacy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Breast feeding is not recommended while taking this medication, as isotretinoin can pass into breast milk and harm
the nursing infant. However, this information is not as important as choice d, as the client may not be breast feeding or planning to breast feed.
Choice B reason: Baseline liver function results must be obtained during therapy, as isotretinoin can cause liver damage and increase liver enzymes. However, this information is not as important as choice d, as the client may not have liver problems or need liver function tests.
Choice C reason: Do not take multiple vitamins that contain vitamin A while taking this drug, as isotretinoin is a derivative of vitamin A and can cause vitamin A toxicity if taken in excess. However, this information is not as important as choice d, as the client may not take multiple vitamins or have vitamin A toxicity.
Choice D reason: Discontinue this medication one month before attempting to conceive, as isotretinoin can cause severe birth defects and miscarriages if taken during pregnancy. Therefore, this information is most important for the nurse to provide this client, as the client is planning to become pregnant and should avoid isotretinoin exposure.
Correct Answer is C
Explanation
Choice C reason: Acetylcysteine is a mucolytic agent that breaks down mucus and makes it easier to cough up or suction out. This helps to clear the airways and improve oxygenation. The nurse should expect to see increased sputum production after administering acetylcysteine and provide frequent suctioning as needed.
Choice A reason: Bronchodilation and wheezing are not therapeutic responses of acetylcysteine, but rather possible adverse effects. Acetylcysteine can cause bronchospasm or bronchoconstriction in some clients, especially those with asthma or chronic obstructive pulmonary disease (COPD). The nurse should monitor the client's breath sounds and oxygen saturation and report any signs of respiratory distress.
Choice B reason: Unpleasant smell when using the medication is not a therapeutic response of acetylcysteine, but rather a common side effect. Acetylcysteine has a rotten egg odor that can be unpleasant for both the client and the nurse. The nurse can minimize this by using a mouthwash or a flavored lozenge before and after administering acetylcysteine.
Choice D reason: Hypotension is not a therapeutic response of acetylcysteine, but rather a rare but serious adverse effect. Acetylcysteine can cause vasodilation or hypovolemia in some clients, leading to low blood pressure and shock. The nurse should monitor the client's vital signs and report any signs of hypotension.
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